New Grad - Please Help :)

[ellienurse3]

Hi all!

I am a new graduate nurse from an accelerated BSN program and recently got offered a position in an inpatient psych unit for a residency program. I also was looking into inpatient rehabilitation and the like. I really like seeing patients over the course of their treatment and building relationships with them. However, I've always liked the psych aspect of nursing and not so much the med-surg aspects (though I believe it is just as important to understand the physical as well as psychological aspects of a patient and their diagnoses). I was just looking for some advice as to what job would be better for a new grad. I am afraid if I take a job in another area it will put me behind in psych as I am thinking of becoming an NP someday and would need experience...but have been told I should get medical experience first before psych. As well as this, my family seems nervous for me to go into psych (but that's the stigma of mental illness that needs to be overcome!)

Thanks in advance!

[Meriwhen, ASN, BSN, MSN, RN]

Getting medical experience first can't hurt, but if your heart is set on psych, then go straight into psych. Lots of nurses have had successful careers starting out in psych. And you will have to deal with patients' physical conditions anyway--it's not as though they have you as their psych nurse while another nurse simultaneously serves as their medical nurse.

If you want the best of both worlds, look for a psych-medical unit. These are units that have psych patients with higher medical acuity: they're too medically unstable for placement on a psych unit, but they're too psychiatrically unstable to go to a med/surg unit. You're not going to get the very complex or critical condition patients though--they're going on an ICU/PCU no matter what's going on mentally. But you will get the sicker-than-usual patients, and working on this type of unit will give you both psych and medical experience.

[BettyDear]

First of all congrats on graduating and welcome to the world of nursing. I don't believe any job will really hold you back if psych is your area of interest because as my psych professor used to say, "it's all psych!" Just about all experience as a nurse can be worthwhile if you enter into it with an open mind and the idea that you are there to learn in order to strengthen your general clinical skills. I have been working community psych for 10+ years. My first job out of nursing school was in a rehab hosp. where I picked up some good basic clinical skills; assessment, wound care; trach, IV's, time management and so on. It was also a great experience as at the time insurance allowed patients to actually stay inpatient for a good period of time and you really got to establish a relationship with them as they went through the recovery process. From there I did a stint in long-term care. Then it was out into the community working with clients living in residential programs and ultimately with a PACT team (Program of Assertive Community Treatment) serving individuals with chronic mental health issues. I think I always knew I was destined to be a psych nurse just took a bit of an indirect route but got there anyway. It hasn't ever been "easy" but it's all been worthwhile in regards to my career. My thought is that there is no absolute right or wrong here so try not to put that pressure on yourself. I agree with Meriwhen that if your heart is set on psych then go for it. I graduated with plenty of nurses that went straight into certain speciality areas without getting med/surg. first and they have done just fine. The clients my team works with are a fantastic group of individuals that happen to have a psychiatric diagnosis and need compassionate, skilled nursing care just like anyone else. I understand your families concerns fueled at least in part by the stigma associated with mental illness. Guess I would just add that there are risks inherent with being a nurse irregardless of the type of nursing and any nurse can get hurt on the job. As part of any psych job you should receive specific training regarding preventing and de-escalating highly charged situations and maintaining safety for yourself and others. Follow your heart, trust your instincts, practice good self-care, keep learning...you will be just fine. All the best.