New Grad Struggles Want Psych Nursing

deza, MSN, NP · Feb 12, 2018

I went into psych partly because the medical stuff I find terrifying. Even on simple things I will over think and worry about the little things that really don't matter. I have learned through experience not to worry about some of those things. Like giving medication in a different muscle than the usual spot. When I first started I would worry about giving blood pressure medications especially with those borderline blood pressures 100/60 and 90/60. If I am unsure I usually ask another nurse or 2, maybe call the doctor.

Maybe you could talk to a manger or preceptor about what you are going through.

I would probably switch though if in your situation.

By the way it's nice to see someone used the correct form of the word advice.

KenyakeoniRN · Feb 13, 2018

I want to but i am scared they will be upset with me and fire me or something crazy. I feel like I look weak. I am so depressed with this job.

oceanblue52 · Feb 14, 2018

If you are trying to transfer within your hospital, you will likely need 6 months experience before they approve a transfer. A word of warning, it can sometimes be difficult to transition back into acute care after working in Psych; managers tend to think you've "lost your skills." Dumb because those soft skills you gain in Psych are needed in any setting. But I digress.

If you are truly miserable, and not just having new grad anxiety, I don't see why you can't apply for jobs more to your liking. Think carefully about what you liked about your Psych rotation. I worked 5 months home health as a new grad and then transitioned to a new one. If you apply and get offers, vet them carefully. If you leave this job early you'll want to stick around the second one at least a year, ideally 2 or 3 to show stability.

KenyakeoniRN · Feb 14, 2018

Its a year here, but they will transfer you if the unit is too much for you. I just need time to bill up the nerve to say something

Heylove, BSN, RN, EMT-B · Feb 14, 2018

The only thing that concerns me is if you think psych nursing will be easier or less acute. Psych nurses deal with different acute issues, and not "easier" by any means. Trust me, I knew that I did not want to work med/surg or ICU, and I knew that all the way through nursing school. I think the anxiety you're having is normal for new grads in your position. Do you still work with a preceptor or someone you can talk to? The skills you acquire on your unit will be valuable throughout your career, stick with it!

Yoga RN · Feb 14, 2018

Request to schedule a face-to-face meeting with your nursing manager. They will be able to offer advice on how to better adjust to your unit, as well as if it is possible to transfer to psych. It never hurts to ask, and it is important to honestly communicate about how you are feeling in your new position.

It seems to me if you love working with the patients and completing assessments, then psych would be a great fit for you.

missannabelle · Feb 14, 2018

I started as a psych RN right out of nursing school, and after 1.5 years there, I went to Med-Surg. My psych skills were very valuable there, and the things I learned working in Med-Surg for the 6 months I stayed were very valuable after I returned to psych. I think that there are some people who just are better suited to one or the other, and I think knowing that about yourself is key. But, if you've only been in your current position for a couple of weeks, you are still in the learning curve. I would give yourself at least a few months, but ideally 6 months to a year, before deciding to change. Not only does hopping around make you look flaky (I'm not saying you are, just saying that it can look that way to employers), but you never know - you may find that you love Med-Surg once you are more comfortable. Odds are that after only two weeks in psych, you would be equally overwhelmed and frustrated. Being a psych RN is different than being a student in clinical on a psych floor. Our students are not able to do very much of the work the RNs actually do. Also, psych patients aren't immune from medical issues, and we manage IVs, feeding tubes, Foleys, wound care, mobility, incontinence, isolation precautions, etc. on our psych unit with many of our patients. Add to that the detoxing patients with CIWAs, OWLs, etc., the management of medications with very small therapeutic ranges (Lithium, Depakote) and serious side effects (agranulocytosis, neuroleptic malignant syndrome, extrapyramidal syndrome, etc.) and there is a lot of "medical" stuff involved in psych nursing. Although I do not believe you *have to* have Med-Surg experience to be a good psych RN, I do believe that the experience makes you valuable to employers and a leader with your peers when medical issues come up. I guess what I'm saying is, stick it out for a bit if you can. If you still hate it in six months, you can move (possibly even within your current hospital, without burning bridges), and what you learn in Med-Surg will be valuable to you for the rest of your career. If you jump ship now, you run the risk of burning bridges at your current employer, gaining a reputation as unreliable in the community (nursing is a small world, and you never know if the next hospital's manager will be friends with your current manager, etc...) and (most importantly, IMO) never getting to know for sure that you could be a competent Med-Surg nurse. You will do yourself a huge favor if you stick it out and leave with the confidence that comes from knowing you *can* do the job, and realizing you just don't want to, instead of leaving after only a few weeks without proving to yourself that you could do it.

JMO. Psych nursing is wonderful, and it's a calling, and I highly recommend it to anyone who feels that call. That said, you have your entire career ahead of you. Start out with a success where you're at, and move forward with the confidence gained from that success underneath you. Good luck to you!

KenyakeoniRN · Feb 14, 2018

You should reread me comment. Nothing about nursing is easy and I know that. I have had 3 semesters of clinicals on psych . I know its not easy. I do know however there are less cardiac issues on psych. Please don't manipulate my words into what you want them to be. Thank you for the advice.

KenyakeoniRN · Feb 14, 2018

Thank you so much Missannabelle.

GeminiNurse29 · Feb 15, 2018

Depends what kind of psych unit you wanna get into. I worked acute inpatient forensic psych as well as geriatric psych. Very, very challenging. Old, aggressive, demented, is downing patients were more likely to hit and kick and fight than other units. Think of the worse nursing homes you know of and imagine it on steroids. That's what we got in inpatient psych. I didn't think I'd last long at that job, just took it for the money, but the experience is priceless. I figure if I could make it there, I'd make it anywhere. Sometimes, it takes awhile to find your niche and comfort level. And there will always be a learning curve no matter what. Also, psych patients have health issues too...it's even more of a challenge trying to dissect them and figure out what's real and what are just attention seeking behaviors. Just like some people find a calling in peds or OBGYN, others find a calling in psych. Good luck.

LisaNICUrn, BSN · Feb 17, 2018

Well I for one knew I didn't want any traditional bedside nursing. I started out in psych and went to NICU for 3 years, and now I'm going back to psych. I missed it tremendously. I did travel nursing for a year and had to float to mother/baby at one location. I absolutely hated dealing with the mom. I was clueless and had no desire to be their nurse. I was a NICU nurse, precisely because I didn't want to nurse adults. I knew that from day one, and now I'm going back to psych because it's my passion. Yes, they have a little medical, I'm going into adolescent psych. I could never do cardiac, med-surg, oncology, heck, I could never do any adult, so I understand hating where you are at.

If you know it's not just new graduate jitters, then if it was for me, I wouldn't stay. The thing is though, units spend a ton of money to put you through orientation and train you, so think very hard before you accept a position. Ask to shadow maybe. Also, make sure you talk to your unit manager. You don't want to get on their bad side and be put down as a no rehire, especially being so new in nursing. Most of the time they are going to tell you to stick it out at least 3 month, 6 months or a year. Most hospitals wont let you transfer so soon, you'd have to switch hospitals and let the hiring manager know why you might not get the best review from that hospital. Let them know how much you are interested in psych from previous clinicals.

You seem to really dislike cardiac, but is there other things? Cardiac isn't the only thing that's going to bring codes and what not, is it just that you don't want to work with adults, maybe look at peds, or maybe you just want psych, which is completely normal. Some people know what they want, and that's it. Be prepared to tell them you didn't apply before or wait for that position.

I'm only saying all this because if you decide to leave a position so soon, it will follow you. You'll just have to explain it. People understand that all specialties aren't for everyone. Trust me, I did hospice for 3 weeks, and dialysis for 2 months and left both because I knew it was not for me at all, I wasn't going to stay somewhere I dreaded every single day. Thankfully I still had my old prn job.

So good luck to you and follow your heart, your dream. I recommend keeping your cardiac manager in the loop though because they will probably have to replace them. Offer to stay until your replacement is found, that's a great idea too.