Published Nov 2, 2001
I finish my nursing degree at the end of the year. My univeristy isn't really very interested in their students being psychiatric nurses instead prefering them to be med/surg nurses after graduation.
So my question is to the psychiatric nurses who have done no med/sug nursing (apart from university training rotations) do you feel that doing psych nursing has 'cut off' your options to get a job as a med/sug nurse if you wish to pursue that path dome years after doing psych nursing?
Well, let me tell you that in my large teaching hospital, we get very complicated psych patients. We rarely have a patient with only one diagnosis. We get OB, ortho, PICC lines, COPD, HIV, AIDS dementia, angina, CVA, post op repair of self inflicted GSW, cutting, MVA, cancer, TB, oh, and everyone seems to be diabetic. We get the complicated cases other psych units won't touch. As for IV's and enemas, we give em. We also have the local burn unit so all those who have set themselves on fire are admitted to our unit after they are stable enough but still require lots of extra care. I still know how to take a pulse and do a physical assessment and neuro checks. The patients with high BP still have to take their meds while on our unit so we are familiar with newer meds. We also get a lot of delirious cases since our unit is locked which have been caused by everything from hepatic encephalopathy to flagyl to steroids. Oh, we also had a case of VRE recently.
All of this is just off the top of my head.
Now if you ask me about art lines and vents, I will have to tell you I don't know about those things. I think I saw them once or twice in clinicals but try not to remember things like that.
I went right into psych right after graduation 10 years ago and since I am the new kid on the block, any new fangled thing that comes along, I get to take care of. So my skills have not gotten too rusty yet but ask me in 10 more years.
Hey thanks for your message Aerozoling! :)
I am new here, read your post this morning, and tried to post a response. but got lost in the process. If you are stll seeking input, feel free to email me at [email protected] I have been in Psych nursing for 12 years.
I agree that we can become "ghettoised" as psych RNs. For example, this morning, when I d/c a patient's IV, the family member exclaimed, "I forgot: you must be a real nurse too!". I also trained in the big city tertiary hospitals (in Toronto, Canada) where MH nursing was discouraged. I worked as a psych orderly at a provincial psychiatric facilty while in nursing school, but after graduating, I did the med-surg gig: a full year in cardiovascular sugery, which I hated. I found that the highly efficient and specialised areas, meant for streamlined service, had a side effect for me of boredom. Ever worked in a unit doing only CABGs and valve jobs? I thought that every patient came in with the same Dx, same Rx, same Tx...I then did some palliative care, a lot of agency work, and finally returned to my true love: psychiatry. Now, I see that every day is different. I am the MHN in a remote hospital, which means that I must assess anybody who comes in the door...not just the "big" Axis I things, but all the AODA stuff, eating disorders, PDs, etc. Each day presents brand new challenges. After more than a decade, I would not do any other type of nursing, unless I were to specialise within psych itself, e.g., forensics, dual dignosis, etc. My own personal opinion is that all of those other med-surg skills are just those: skills. We can teach lay people to administer their own insulin, regulate their PCAs, or whatever. In the same way, the MH nurse can learn to do bloods and the like. My manager recently tried to coerce me into ACLS, which I think was intended to meet his agenda of having a greater pool for the ICU! (Fortunately, I am at graduate schol on the ACLS days!) In sum, I would say to you, not to worry. You will always be able to work in general nursing, concurrently with, or after, your psych days. As a psych RN, you can do both, but you might discover that you don't want to!
There is much to do in psychiatric nursing...other than working a unit...and pick which unit for which speciality of mental illness care. Try education or consultation to hospitals, doctor's offices and the community about mental health. Home health care can use good psych nurses...which you could strike a deal and align yourself with a med/surg nurse for your psych expertise. Any area you specialize in you will lose some of the other skills. Read the literature. Work sometimes in a float position for the med floors or teach in a university for undergraduate basic clinicals.
Psych nurses would make excellent med/surg nurses! 90% of the job in working with med/surg patients IS "psych"!
Thanks all so much for your replies, I have found them very helpful!
Psych. Nursing is really an expanding field. It's good to get some med-surg experience before going into any specialty. Health care is becoming more and more specialized, so if after getting a little experience you want to specialize, go for it. Psych. is a great field. Face it the world is getting crazier every day. There definitely will be a need to take care of people with this type of problem. I spent 10 yrs. doing all the critical care ..med surg., specialty stuff before I went to Psych., which was the last place I thought I would work...Now going on my 22 yr. I have few regrets. Good Luck
I am thinking about changing to Psyc Nursing myself. I have a BA in psychology and will be finishing my BSN in August. I received by AD in nursing 9 years ago and have worked primarily on med-surg units, home health/hospice for those years. However, recently I have decided I want to get a Masters in Education, specializing in Community Counseling and eventually obtain my LPC. Psych has always come very easy to me and the reason I originally chose Psychology as my major was because my older sister was diagnosed with a mental illness. My other sister also struggled with a substance abuse. I wanted to learn why/how this happened to them. After I recently had a health scare, I reassessed my life and came to the conclusion that I am not happy in med-surg. I also think because of my background, I have an insight to the families and those who live with mental illness. But a lot of my friends who are nurses in med-surg think I am a little "crazy" to want to do that. I just know I cannot continue working in a setting (med-surg) which does not hold the interest/passion.
I worked LTC for 3 years, then Med/Surg for 2 1/2 years. I have been on a Psych unit for about 1 month now and loving it. Learning something new everyday. It is different from what I am used to, but still have the HTN, DM and other dx's.
For all the RN's out in the "trenches"-- do not re-invent the wheel. As an RN, you can become an Advance Practice Clinical Specialist in Psych-Mental Health. There are programs that are a result of a MSN. There still might be a few that do the Cetificate training that allows you to sit the exam.
Where I work, an LPC makes less than an RN, Certified in Psych-Mental Health with a BSN.
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