Psych nursing skill set

**NickiLaughs, ADN, BSN, RN** · May 15, 2006

It is a fact that you will lose a lot of nursing skills in psychiatric nursing, but like you said, many other skills that you were not taught in school are used. I just got offered a job on a psych floor and the DON already warned me that I would lose my skills, I said "that's OK, a lot of them I've never used anyway" As long as psych nursing is what you love, those other skills will be useless to you anyway. Follow your heart!

I do believe there is a lot of nurses who don't like psych, and can't understand why anyone would want to work in the field. Whenever I tell other nurses my goal of working in psych they wrinkle their nose and look at me like I belong in a ward myself. Don't worry you're not alone. Good luck!

rn/writer, RN · May 16, 2006

as a rather fresh nurse, i have changed my speciality to psych nursing. i've been in the field now for just over a year, and i can not count the number of times that nurses have come up to me and told me i have made the 'wrong decision' in that i will 'lose my skills'. i feel that psych nursing is a total different set of skills, many of which we did not learn in nursing school. a lot have told me that i will get lax and forget many of the things that i did learn, skill wise. i feel that psych nursing entails a complete different set of skills that many nurses working in the 'general' hospital would not know how to use. i love psych and wish that other's would not look at it as not using my 'nursing skills'. there is far more place for advancement and i feel that i am using my degree to the highest i can where i am working currently. i am wondering if anyone else has come across similar comments from collagues and how that has made you feel. i love the skills that i am using and getting to lear and i think it's wonderful that there are so many avenuse to presue in nursing.

i went into psych with only six months of the sacred med/surg nursing under my belt. stayed there a long time and, yes, some of my medical skills did atrophy. on the plus side, i was also an emt so my assessment skills stayed pretty sharp. on the minus side, i missed much of the developing technology and new protocols, not to mention i lost my familiarity with many of the "old" equipment and practices.

i liked psych and, as you said, picked up all kinds of interesting abilities that i wouldn't have acquired in a regular medical setting.

eventually, it became time for a change. i was more than a little overwhelmed at the thought of returning to acute care and started looking at the available options. i ended up taking an 8-wk rn refresher course at a local community college. the course included two weeks of classroom and lab (sterile technique, ivs, suctioning, and a whole lot more), and a six-week clinical in a hospital setting. i ended up on an ortho-neuro floor which showed me that was not where i want eventual employment, but the experience got me back up to speed on the basics and restored my confidence as a medically oriented nurse.

i am coming up on one year working in a busy urban postpartum unit. my job is a very good fit and i'm thrilled to have it. and i find myself using my psych background all the time.

if psych is what you love, go for it, understanding that your lack of med/surg experience may raise some hurdles later on. that lack may even cause you some problems now in that you may have difficulty recognizing/addressing medical issues in a patient population that can be a handful when it comes to effective communication. some may withhold information. others may not be able to process or tell you what they're feeling physically. determination on your part to educate yourself and take advantage of training your employer offers can offset your limited med/surg background.

as for the future, who knows? you may spend your entire career in psych. if you want to look elsewhere, there are opportunities that would require miminal brush up. there are others where you would benefit from taking a refresher course. that's why such courses exist. just know that it can be done. one of my classmates was returning to nursing with one year of floor experience and 15 years at home. she did very well.

i'd encourage any nurse in any field to keep learning. seek after the things that apply to your specialty, but also be open to information and ideas outside your area. this keeps the brain nimble, the spirit humble, and the imagination alive and kicking.

i wish you well.

Thunderwolf, MSN, RN · May 18, 2006

I echo rn/writer.

Wolfie

Previous 10 year psych nurse who now has been working med surg for 3 years.

CharlieRN · May 23, 2006

I'm of the opinion that basic nursing skills are like riding a bicycle. It comes right back to you.

Your psych skills will overlay your other nursing skills though, so that you will need to consciously work past them.

When I challenged a physical assessment course for the ski patrol I almost flunked, because, after three years as a male nurse on a unit devoted to the care of women who had been profoundly abused in childhood, I had serious inhibitions about touching a female patient. The ski patrol wanted a rapid, hands on, head to toe, trauma assessment. (reach under heavy clothing to feel all body surfaces for blood, swelling, displaced bones, pressing firmly enough that pain response will be happen if injury is present.):uhoh21: It caught me by surprise but I got over it.

Whispera, MSN, RN · May 23, 2006

I think any skills are good to have. It saddens me that some think psych nursing skills are less valuable than med-surg skills. I've never heard anyone say to a psych nurse who's switching to med-surg....whoa, be careful or you'll lose your psych skills! Also, I think that any skills, once learned, if lost, are never totally lost. Each learning makes them easier to re-learn. I say go for the nursing you want and learn everything it throws your way!

GalRN · May 27, 2006

I have been a nurse for 8 yrs and doing strictly psych for abour 5 yrs. I have found that the skills that I was most comfortable with come back right away. The stuff I wasn't good at before I still stink at. I had the opportunity to test that belief last month when I went to work w/ my mom, who's an RN on an acute neuro unit. Just as before, I'm great w/ trachs and resp care, and I still am terrible at cathing females. You don't forget your old skills when you go into psych, you just pay more attn to the different ones that you are using more often.

StuPer · May 30, 2006

I have heard this arguement so many times, and I find it quite distressing and annoying. While I acknowledge that over time lack of experience will degrade unused skills, but please also remember it goes both ways... the skill set you pick up in psych is equally prone to atrophy if unused.

The number of nurses who decide to make psych their specialty is increasingly rare, and we need all the help we can get. Telling potential psych nurses they will be at a disadvantage if they go psych, for future career changes assumes

a) that they are making a mistake and that when they realise this they will find it hard to get back into 'mainstream nursing'. and;

b) That if you do the 'right thing' and start in med/surg you'll feel just fine and dandy about returning to an acute psych environment after 1-2yrs and just pick up where you left off.

I think both assumptions are presumtious and if someone wants to do psych should be encouraged unreservedly. If at a later date they do, for whatever reason change their mind, re-training in generalist nursing, I would suggest is easier to come by than retraining into the 'psych' environment.

regards StuPer

MissNursieNurse · Jun 14, 2006

I work in a psych hospital for the criminally insane. I feel that I HAVE to defend myself on a day-to-day basis because I am choosing psych. I started this thread to see if anyone had the same encounter as I did. I chose psych because I find it fasicinating. I have thought about applying to med school eventually, not to be an MD but to be a psychiatrist. People are finding it hard to believe that I enjoy what I'm doing. A lot of the 'old school boys' where I work were forced to get their RN just to keep their job (back in the 70's and early 80's) so a lot of these guys went into psych because they had to and do not enjoy what they do, but the pay check. Just today I was talking with an RPN about how I want to make a difference and help these people; his response was "Have you seen it work yet?" I said..." Well it doesn't hurt to try". These patients may have done horrendous things in the past, but they ARE mentally ill and they are humans. I think that we must have that mentality or we will lose what we went into nursing for. I guess being a new grad I feel that I have to defend why I went into psych because everyone is finding it hard to believe that someone would actually like it.

Any input on how to deal with this constant criticism every day???

It can be so frustrating at times!!!!!!!!