Observations about new nurses and the field

P3G · Jan 5

I think a big problem is that nursing schools tend to promote traditional "medical" types of nursing: med-surg, ER, ICU, etc. Yes, most programs these days have a psych rotation in their curriculum, but a lot of professors and older nurses push the idea that you need to start off in a med-surg or telemetry unit after you graduate. A lot of nurses even discourage going into psych altogether, claiming that once you work psych you'll be pigeon-holed into that specialty forever because hospitals would rather hire nurses with bedside experience. Another valid concern is that nurses feel they'll lose their "hard" skills if they work in psych--skills like IV starts, head to toe assessments, urinary catheter insertions, etc. I'm sure there are other reasons why the overall interest in psych may be declining, but these are just a few I could think of off the top of my head.

I don't work in psych currently, but it was one of my favorite rotations in nursing school and am still interested in the specialty. I'm a new grad so I've got lots of time to explore different specialties down the line--psych may very well be one of them.

B52, ADN, BSN, MSN, RN · Jan 5

I agree with PG3, During nursing school, I was drawn to psych, yet I received no encouragement. I just ignored everyone and jumped right into psych, and I don't regret it. I have no inntentions of becoming a nurse practitioner. My master's is in nursing admin, and my next goal is psych educator.

MoLo · Jan 5

This is exciting to hear! I agree, psych is not stressed in school, I wonder what people's level of comfort with it is. And I go back and forth on the "do your time in med-surg first," there are things you will see less frequently in psych that are still medical emergencies, but if you are working as a team, the team will respond appropriately and you learn.

subee, MSN, CRNA · Jan 6

MoLo said:

This is exciting to hear! I agree, psych is not stressed in school, I wonder what people's level of comfort with it is. And I go back and forth on the "do your time in med-surg first," there are things you will see less frequently in psych that are still medical emergencies, but if you are working as a team, the team will respond appropriately and you learn.

I am old school - first degree in nursing was a BSN. Our psych rotation was a full semester and mostly inpatient. Are students not getting this kind of exposure anymore?

toomuchbaloney · Jan 6

subee said:

I am old school - first degree in nursing was a BSN. Our psych rotation was a full semester and mostly inpatient. Are students not getting this kind of exposure anymore?

I interpreted it to mean that although we received a good exposure to the field in training, students aren't regularly directed to employment in psych.

subee, MSN, CRNA · Jan 7

toomuchbaloney said:

I interpreted it to mean that although we received a good exposure to the field in training, students aren't regularly directed to employment in psych.

Maybe psych needs better PR, like it's own TV show:)

MoLo · Jan 7

I think students get the exposure, but I wonder how much it is encouraged? And how do other nurses feel about psych, and what kind of beliefs are shared? Periodically nursing students in rotation on my unit would approach me about their interest in the specialty, and I got the feeling they did not have many people to talk to about this. Many nurses express fear of psych. I personally am terrified of maternity nursing!

MoLo · Jan 7

I think there was a psych tv show, but it was short-lived. I think people did not believe it. We thought it was tame!

Red Shirt 6, CNA · Jan 11

subee said:

Maybe psych needs better PR, like it's own TV show:)

subee makes an interesting point the PR and the limited exposure on TV.

Psychiatric Nurse TV Series.

Wakefield (2021)
Ratched (2020)
Durdom (2006)

TV Series with the focus on the Doctor

The Eleventh Hour (1962-1964)
The Psychiatrist (1971)
The Bob Newhart Show (1972-1978)
Frasier (1993-2004)
Wire In The Blood (2002-2008)
Mental (2009)
Anger Management (2012-2014)
The Alienist (2018-2020)

This is the results of a quick search so and does not include ensemble series like Chaicago Med.

Snowranger19, MSN, APRN · Feb 28

Way back when I became an RN, my school highly encouraged everyone to get at-least 1 year of medical experience before going into psych. I don't think this is completely neccesarily, but I can think of many times it served me well through my psych RN career. Even in psych, you will have medical issues to deal with (emergencies, wound care, detox, IVs) and I worked with many psych-only nurses that were VERY uncomfortable.

Psych is also a hard specialty that gets underappreciated. We don't have all the medical procedures and tasks that other RNs do... but we typically have higher patient loads and they can be very draining.

In my ED days, I could have 4 patients needing constant monitoring and IV changes, wound care and I would be running back and forth. Psych you may have 10 patients; one psychotic, one on suicide watch, one needing detox/CIWA checks every hour, etc. Psych documentation also is a lot heavier and narrative/conversation focused (if done correctly).

I have also seen an increase in acuity in psych patients/inpatient over the past few years. Addictions also typically falls under psych, which is very hard.

Also, as a PMHNP that takes NP students, most of the PMHNP students are get are actually from other specialties wanting to be a Psych NP for various reasons. I'd love to have an experienced Psych RN as a PMHNP student!

subee, MSN, CRNA · Feb 29

Snowranger19 said:

Way back when I became an RN, my school highly encouraged everyone to get at-least 1 year of medical experience before going into psych. I don't think this is completely neccesarily, but I can think of many times it served me well through my psych RN career. Even in psych, you will have medical issues to deal with (emergencies, wound care, detox, IVs) and I worked with many psych-only nurses that were VERY uncomfortable.

Psych is also a hard specialty that gets underappreciated. We don't have all the medical procedures and tasks that other RNs do... but we typically have higher patient loads and they can be very draining.

In my ED days, I could have 4 patients needing constant monitoring and IV changes, wound care and I would be running back and forth. Psych you may have 10 patients; one psychotic, one on suicide watch, one needing detox/CIWA checks every hour, etc. Psych documentation also is a lot heavier and narrative/conversation focused (if done correctly).

I have also seen an increase in acuity in psych patients/inpatient over the past few years. Addictions also typically falls under psych, which is very hard.

Also, as a PMHNP that takes NP students, most of the PMHNP students are get are actually from other specialties wanting to be a Psych NP for various reasons. I'd love to have an experienced Psych RN as a PMHNP student!

What a concept: An experienced psych nurse decides to become an NP:)