Psych nursing or nursing home/rehab nursing?

[pezz9413]

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?

[CapeCodMermaid, RN]

Psychotic people frequently have other medical problems and there are more than a few psychotic people in long term care. It all depends on what's best for you and your situation.

[LTCangel, ADN, BSN, LPN]

I recently left a hospital setting after 14 years(Ortho/Joint Replacement/Med-Surg) and am now in LTC, the reasons are too many to go into right now but I will tell you that I have NOT lost any skills! LTC now accepts residents with multiple medical issues and I have done everything from starting IV's, running IV fluids, IV Atibiotics, PICC's, colostomies, wound vacs, complex wound care, respiratory therapy, straight caths, changing foleys or placing new ones, 24 hr urines, G-tubes, CHF pts, brittle diabetics, fresh post-ops who are there for rehab or for good, deaths, discharges, admissions, tranfers to hospitals, psych, of course Alzeimer's and dementia, urostomies, drawing labs, arranging appts and consults, passing meds on 24 to 46 residents, using my assessment and critical thinking skills, and the list goes on and on. The push now seems to be to keep the residents in the facility as much as possible and provide the care they need vs sending them out to the hospital. I began my career as an LPN in LTC 15 years ago and it is much different and more intense now than it was then. Yes you will probably make more money on the Psych ward but I am here to tell ya that you WILL NOT lose your skills in LTC/SNF. You will probably gain many and learn time management skills in which to accomplish all the needs of these residents. 15 years ago almost all of the residents were DNRs, not so much now. They are many times full codes or at least limited interventions. So it really is up to you bit do not worry about losing or not gaining skills in LTC. I was afraid I would get rusty, but on the contrary, I use my Nursing skills each shift I work! Just my humble opinion and experience.:welcome:

[LTCangel, ADN, BSN, LPN]

Oh, by the way I am now an RN,BSN.