Psychiatric nursing... do you really lose all your nursing skills?

[lilmoongoddess]

Hello!

I'm a new grad and I have accepted a position on the inpatient unit in mental health. I'm excited to start my career in this field, but I have a question for those who have or already work there. I keep hearing rumours that nurses in mental health lose their nursing skills and thus the chances of receiving a job in acute care are limited. My long-term goal is to become an ER nurse, so I'm wondering if there's anything I should do to ensure that I can do to achieve this goal in the future?

[Callisonanne]

It completely depends on what type of psych unit you work in. We have patients going through ECT so we do picc lines and IVs. Patients come in with wounds, catheters, and ports. We draw labs and use feeding tubes. We also have patients with ng tubes and feeding tubes due to not eating in 2 weeks from psychosis. We have hypertensive crises and patients on dialysis. My biggest advice is volunteer for everything and get all the education you can. I can learn a skill in 1 week (just as nursing school taught me). In 4 years I can talk down the 300 lb psychotic patient who wants to throw a chair and bash my face in. In psych you can't do a physical hold without documenting it. The police come to our unit and ask us what to do not the other way around.

Watch a psych nurse pick up NMS or a severe dystonic reaction in no time and treat it. Experience is always valuable.

[ER-BSN]

Psych nursing is a different game than ER. You will use skills specific to that field of nursing and it will not easily transition to ER. Depending on the type of unit your are assigned to, such as: does your unit take all psych patients or only patients that have been medically cleared prior to entering your unit. That is the huge difference in some of the "skills" you will "lose". Many Behavioral Health Services (aka psych) only accept patients who have been medically cleared, meaning all medical issues are resolved before they can be admitted to the psych unit. This means no hypertensive pts, no hyper/hypo glycemic patients, no respiratory distress, no dysrhythmic patients...ect. You WILL lose those critical thinking avenues when not used daily. You will lose the ability to know medications and lab values pertinent to really sick patients, but this is true in any area of nursing when you don't have "sick" patients routinely or if you have a dedicated area of illness, such as orthopedics, urology, cardiology, etc.. You will focus on the area you are in and be very good at it!! ER is a grab bag of everything so you have to be prepared for all aspects of illness, with no background information on a pt many times.

If you ultimately want to become an ER nurse, I would recommend as many have stated already, to take a part time or PRN position in an acute care setting to stay familiar with common physiological illness. This way you can stay abreast of common lab values, signs and symptoms of various diseases, as well as common medications used. Good luck!

[dopeynat25]

I have been a psych nurse for 7 years and currently work as an ED nurse for over a year. I agree that having experience in acute care will prepare you with getting a job in the ED and succeeding. There are common nursing skills that are done daily such as iv starts, ngt insertion, foley catheter insertion, wound care, defibrillation, cardiovert, pacing, hanging iv meds/drips, etc.

I’ve always had more than one job- one in psych and another in acute care, to learn and/or keep my skills. I did an ED internship class at my hospital while I was working as a psychiatric emergency nurse. I had previous experience in med surg/tele and a medical psychiatric floor (med surg pts with psych issues). My ED has a lot of psych and chemical dependency patients so my psych experience definitely was useful.

Most EDs won't consider you without X number of years of experience in acute care, critical care, or prior ED experience.