psych outside of psych

[zoidberg, BSN, RN]

hi all,

im a student now, and will graduate with my bsn next year. i am in the process of figuring out where to start. I have always been drawn to psych, but i know i do not want to work in an inpatient psych floor for very long. I also am planning on becoming an APRN. i guess my point is what is the best place to begin? I am thinking ER. I would get to see everything, and get some psych cases in there of course. However, would a PMHNP program accept a RN who has such little actual psych experience? My ideal job would be working in the ER as a PMHNP managing emergency psych cases. Is this realistic? (do hospitals use NP's this way?). I hate to be one of those students rambling for advice, but i would appreciate some insight from the wise ones. Fire away.

ps this is in psych not pre-NP because i would like to hear from psych nurses :)

[phattass, BSN, RN]

IMHO psych ER is advanced practice. I've seen people start in ER and get faced with losing their licenses fairly quickly (usually having to do with someone suiciding after ER assessment). For what it's worth, I would recommend at least a year minimum (two to three would be great) on an acute psych unit before venturing into psych ER. New grads have done it and survived, but ultimately I think it's a huge risk...unless you would be working in an ER along with another seasoned nurse all the time. Most psych ER's I've encountered only have the one nurse at any given time.

[Psychcns]

A psych floor is a contained environment. You learn about keeping patients safe, the course of treatment for different illnesses, managing aggression, assessment, working with a multidisciplinary team, etc. This gives you a good foundation for psych ER.

[zoidberg, BSN, RN]

thanks for the input.

would working in the ER in a non-psych capacity as well as on a psych floor both part time be a good idea? Or should i just jump in full time psych then go back to ER when i go advance practice?

[Psychcns]

I did med surg, then psych inpatient, then advanced practice. I know someone who went from ER to psych ER and advanced practice and did fine. Another friend did ICU and acute inpt psych concurrently- then got aprn.. I think you want to first get a foundation in nursing or psych nursing. And then see whats next...

[zoidberg, BSN, RN]

yeah. i think im going to try to get part time acute psych and part time something else to get a broad base for advanced practice, be that icu, er, or med/surg. I would like to have that exposure before taking on the responsibility of an APRN.

[elkpark]

There are at least some psych NP programs out there that will take you with no psych experience whatsoever (I precepted a PMHNP student last summer who had only worked in ICU prior to this, but had now decided that she wanted to go into psych, and there have been posts on this site in the past from others following a similar route). I'm not saying I think that's a good idea, just that there are schools that will do it.

[zoidberg, BSN, RN]

thanks. i dont think that i would do a psych np program with no psych rn time though. thanks for letting me know anyhow.

[phattass, BSN, RN]

I think you are at your best if you consolidate your skills in the first year in one place, BUT....I like your plan to do some acute psych and medical ER. :) Best of luck!

[zoidberg, BSN, RN]

yeah, i feel like one place would be best to start so i can get comfortable in one area to some degree. i will just see what doors open and im sure i will find a good position to be in to pursue advanced practice.

thanks again for the input!