Psych nursing or nursing home/rehab nursing?

sutelibunn · Aug 21, 2011

I've nothing to add to your questions, as I'm still a student, but as someone interested in possibly going into the psychiatric nursing field I'm curious about what answers you'll get pertaining to how working as a psych nurse would affect changing fields down the road.

ImThatGuy, BSN, RN · Aug 21, 2011

I'd go with the psych job. Assessment skills, like any other, can be honed once again if they become dull. You won't "lose" them. I think it's silly when people bring that point up on here.

Why would I go with the psych job? Less sick people, better money.

Guest717236 · Aug 21, 2011

Having a psych background is a plus. For many outpatient jobs,

employers like a blend of medical and psych experience. You will not lose your skills,psych patients have medical issues too.

SunSurfRN · Aug 21, 2011

I'd go with the psych job. Assessment skills, like any other, can be honed once again if they become dull. You won't "lose" them. I think it's silly when people bring that point up on here.
Why would I go with the psych job? Less sick people, better money.

I am playing devils advocate here...you will be exposed to more in the Rehab/SNF arena in terms of hands on Med/Surg type of work, and once in Psyche you aren't doing Med Surg type of work like wound care. At least in the Rehab job you will feel more comfortable in the transition to Med Surg whereas in Psyche it could be a bit of a shock to the system.

redge03 · Aug 21, 2011

A little different view. I would go psych... You will still use your skills and that is good experience for future jobs. A new grad in LTC, you will feel like you don't have any skills! Sadly you don't have the time as much as you would like and it is a fast paced environment. I went to LTC from school, it took a year to learn how to manage everything including the aides and feel comfortable in my skills. It doesn't stop at nursing skills in the real world. You become maintainence, housekeeping, cable/telephone "guy", referee, secratary and the person the grumpy doc's take their frustration out on. You will also get the psych patients with all of the regular patients added in. I would do psych, but I dearly love LTC. If I were you, I would follow what your intuition is telling you to do.

Good luck and let us know what you did!

P.S. I also agree with thatguy, you don't loose skills, you may need a refresher on certain ones but you haven't been able to really build them yet! I still have to refresh myself and I have worked sub-acute/LTC 8 years.

bananimal · Aug 22, 2011

I'm a new grad too and I am starting a in a locked psych unit in a hospital in september. I am one of only a handful of my graduating classmates that got a job in a hospital-- if i were you, I'd take it! Once you're in that hospital, you can always transfer to medsurg or something else that interests you down the line. From what I hear from my friends who are working in SNFs and LTC.. you really don't utilize much skill at all, mainly passing meds and dealing with less than ideal conditions and workers. Use your new pysch background as an advantage when interviewing.. you will know all your psych conditions and meds (which MANY patients in other areas will have psych issues!), you may have a sharper sense for something about to go wrong, you will be focused on safety (which is important in any setting), and your interview skills will be through the roof and you will be better equipped to calm down an agitated patient. Thats the way I see it anyways. And if nothing else... more money? Take it. :) Good luck!

Flo., BSN, RN · Aug 22, 2011

psych all the way!

tempest · Aug 22, 2011

I went right into psych from nursing school 2.5 yrs ago. Believe me you DO lose your skills. Unless you love psych and want to stay there, go with the rehab.

MrChicagoRN, RN · Aug 22, 2011

I'd go with the psych job. Assessment skills, like any other, can be honed once again if they become dull. You won't "lose" them. I think it's silly when people bring that point up on here.
Why would I go with the psych job? Less sick people, better money.

Less sick people? Your kidding right?

To the OP:

Psych is a challenging field dealing with suffering people trying to make sense of their lives; experiencing an illness that can't be diagnosed or easily monitored with a CT or a blood test. It is a challenge as it requires you to utilize the art of nursing and healing, and less reliance on pure science. It all depends on your strengths, your personality. It's a very personally rewarding field, but not for everyone. But you will develop therapeutic skills that will serve you well no matter where you go in the future.

IdrilRN, BSN, RN · Aug 22, 2011

I work part time psych and per diem in LTC. I love them both too much to go one way or the other. In psych I use a much different skill set then I do at the LTC. I was an LPN for 12 years before getting my RN and did most of my time in LTC. As for LTC~ you will not lose your skills. If anything you will learn time managment more then anything. I've always thought of SNF/sub acute rehab as a mini hospital. You have many more patients then in a hospital, they are not quite as sick BUT you must do assesments. If you have someone in for Pneumonia and needed a bit of rehab to get their strengh back, you will be asses lungs sounds and to make sure that Pneumonia gets better. You will be charting on it. Orthopedic surgery, we get them often three days post op! You are checking healing, CMST's, lungs to make sure they don't develope pneumnoia. You will get that ortho patient with a psych issue and diebetes, you will teach, you will asses pain, you will do a lot. Infected hardware, peeps there to get IV antibiotic and strenthing before they can have a revision.

I've recently had a man with bladder cancer, no bladder, and two urostomies. In pain, having insomnia and watching to make sure he doesn't get an infection. He was also on IV antibiotics via his picc (In VT only RN's allowed to do. Often I am running three IV's on nights)

For some reason in our area we've had a rash of lower extremity cellulitus. three peeps at once. So with that goes, IV's via piccs, assesing, assesing, assesing every shift sometimes twice. And guess what, their mobility in and out of bed, how they eat, and drink. Mental status etc...

And if they seem like they are getting worse, they go to the ER for further eval often they stay sometimes they come back.

I didn't even mention the CHFers. You will take care of people who are dying. :sniff: and you will have your share of psych patients.

I will agree they are not at the level of when they were in the hospital but they are elderly and can go south very quickly. Although some people are young and need skilled care.

Oh, how could I forget?!?!?!? :nuke:

Making sure everyones had a bowel movement at least every three days!!! :yeah:

Once you become obsessed with their bowels as much as they are then you can truly call yourself a LTC nurse. :anpom::w00t:

But it really depends on what you want to do. Working in psych has really put my life in perspective.

Good luck in your future endeavors.

nursemichelle80, BSN, RN · Aug 22, 2011

Hi-
I am a new grad who has been looking for a job for almost 5 months. I have been offered 2 very different jobs. One is a nurse on a locked psych unit in a hospital the other is working in a nursing home/rehab on a subacute unit. I am struggling to choose between jobs they are both the 3-11 shift one is 32hrs/wk the other 40hrs/wk. The psych pays more and has much better benefits but do you lose your assessment skills by being a psych nurse and if in a year or so you want to change jobs how does it affect that? I know the unit does have chronically ill patients but not like a med surg floor the subacute has more of a med surge feel to it. Can anyone shed some light?

As a psych nurse (in a men's prison) I can tell you that you won't lose your assessment skills. You will learn many other assessment skills that you might never have used in a hospital. I did NOT want to go into psych. I fought it. I got thrown into it when I was a traveler and found that I was "good" at it. It's a great area to have experience in! Good luck!