Pros vs. Cons: Starting Career in Psych?

Jules A, MSN · Jul 25, 2008

Hi,

I started in Psych as a LPN and didn't even consider doing a year of med surge once I got my RN. I fully agree that there are pros to having the extra skills however it would have made me miserable and they are mostly skills you will never use in psych. The good news is that on my unit anything more than basic first aid and I'm on the phone calling 911 no med surge skills needed for that. Just my opinion but I think many of the hardcore "you must have a year of med-surge or you will be the most incompetent nurse in the world and your clients will croak under your care" folks were pressured into doing it and now are passing it on.

FWIW I also know a 20 year Psych nurse with no other experience that switched to ED 8 years ago...yes in a competitve market you can get hired and trained in a different speciality with only psych experience! She does great and is no spring chicken. As RNs we are fortunate now that in most areas the demand far exceeds the supply and our opportunities are nearly endless. Good luck with whatever you decide and know that psych definitly needs great male nurses!

medsurgrnco, BSN, RN · Jul 26, 2008

I had prior work experience with psych patients, and worked as an RN in med/surg before becoming a psych nurse. I think nurses who work in psych could benefit from working in med/surg first. Psych patients do sometimes have medical issues or develop them, and a nurse with a background in med/surg is more prepared to address those issues and recognize issues that need more intensive treatment. Many nurses who work in psych do not have that background, and my current employer is very glad I had med/surg experience. Also a nurse may decide they don't like psych (and many do not like working with psych patients), and then not be able to get the more extended orientation in a hospital that new grads typically get. Your post didn't give me the impression that you thought psych was your niche, and IMHO someone would be better off starting off in med/surg if there is no strong pull toward a specialty.

Thunderwolf, MSN, RN · Jul 26, 2008

Psych patients are NOT without physical ailments/diseases. The better prepared you are to wear BOTH hats (psych and non-psych) actually serves you and the psych patient best.

IMHO

wonderbee, BSN, RN · Jul 27, 2008

There are both schools of thought on this. I think a lot depends on what kind of unit you're on. For instance, a geri psych unit will necessarily have more med-surg issues than a general adolescent unit. Some psych hospitals are direct feeds from associated medical facilities. Others have looser associations and don't get so many transfers.

I have worked with nurses who went straight into psych. We get a good share of medical transfers. My unit had only one med surg RN. That would be me. I have to report that if left to their own devices, the patient care for those having med surg issues is woefully deficient. I know of a nurse who would have a nerveous breakdown if she had to program an IV pump and yeah, we do have to run fluids and even TPN sometimes. I'm amazed at the inability of our nurses to know how to assess for dehydration. But It's not the nurses who have the problem. They muddle along regardless. It's the patients who could get better care.

A nurse will do fine either way. It's the patient who stands to gain the most from the more experienced nurse.

JerseyGuy2 · Jul 27, 2008

Thanks so much to all of you who replied.....your input is much appreciated. At this point (just finished BSN, but haven't yet sat for boards), I don't know where I want to start out with certainty. All of you gave me alot to think about....and it was nice of you folks to share your thoughts with me. :yeah:

JD1106 · Jul 27, 2008

If you know that you would like to do psych and are worried about getting med-surg experience, then you may want to consider starting in geri-psych. I am a new RN as well and chose geri-psych b/c I knew that I would be dealing with medical issues in that population. My orientation involves much of the same classes as the med-surg nurse - I have a skills lab working with IV pumps, EKGs, and feeding tubes and we had a med-surg competency exam that we were required to take. I will also be taking a course my third week of orientation to practice starting IVs and drawing blood, etc. Another new psych RN-orientee working with children is NOT doing all of the med-surg classes, such as the IV class, that I am.

Good luck in whatever path you choose!

inthesky · Jul 28, 2008

I went straight from nursing school to psych. My psych patients have an enormous amount of medical problems and it has been a big challenge for me. The medical learning curve is high because I have not done med-surg, but I am getting through it by asking a ton of questions of those who do know, learning by experience, and doing research. Also, while I have not honed certain nursing skills, I have retained most of the physiology I learned in school. I don't regret going straight into psych because i KNOW that i want to be here and I would have been miserable in med surg (miserable to the point of endangering my own mental health). If you are not extremely sure about psych, then med surg experience is probably a good idea. Going straight into psych does seem to box you into a hole in nursing and the medical learning curve is steep.

=)

batgirl23 · Jul 29, 2008

i have been a psych nurse for over 22 years with absolutely no regrets. i went into psych straight out of school. in fact i finished my senior preceptorship on thursday and started full-time on that unit the following tuesday. :)

in nursing as in anything, if you can find something you are passionate in you should do it. life is way too short to do something because other people tell you you should.

i personally found med-surg nursing very frustrating. i wanted to talk to patients, to spend time with them. there just wasn't the time in med-surg to nurse the way i wanted to. in psych, i found my niche. there is enough physical-medical things to appeal to the side of me that wanted the "task-y" stuff, but i also had time - if fact it is my job - to talk to people! :smokin:

i started on geri psych and neuro-psych units where the basic physical nursing was there. i got to hone my assessment skills and practice good basic physical care. at the same time i was starting to develop my psych nursing skills - communication techniques, crisis intervention skills, therapeutic use of self, etc.

over the years i have changed specialty areas frequently (always in psych, though). i have worked in forensics, gerieatrics, mood disorders, schizophrenia, inpatients and outpatients. i also worked as a study co-ordinator for drug study research (also a very good area for honing assessment and triage skills). i currently work as an nurse educator doing staff development. (teaching is my other passion, so i am incredibly lucky! :redpinkhe )

i have said this before on other threads: if you feel drawn to a career in psych - mental health, then go for it!! my faculty advisor (who was not a psych nurse btw) told me in my final year that the technical skills / technology can be learned or re-learned at any time - the skills you learn in psych nursing are invaluable and will always be relevant wherever you go in nursing or in life. i have never forgotten that and i have found it to be true. :nurse:

best of luck to you!

househome · Jul 29, 2008

I started out doing med-surg. I think it's a good idea, because you do learn the basics and have a good foundation for anything else that you do. I did one year of med-surg because in the early 70's everyone had to. But I was glad that I did. I went to ob/gyn after that, then OR then psych. I know a lot of younger nurses start out at psych, and I think they do themselves a disservice.

Hope this helped.

Caratzas66 · Jul 29, 2008

JD1106, you make a very good point about geri-psych. I'm in the same boat as JerseyGuy2 (we were classmates) and I also am wondering where to start. Your explanation of how you keep a hand in both areas makes geri-psych an intriguing possibility. THanks.

beeenieweeenie, RN · Jul 29, 2008

I was just going to start a thread on this very subject. I know that Psych is my niche. I like med surg, but my heart is in most definitely in psych.

I am seriously considering going straight into psych because I want to be a nurse practioner, and the school I want to go to requires a year of nursing experience in your desired specialty area.