11-7 "No-Skills" Argument, Psych/Detox Nursing


  • Specializes in Sub-Acute/Psychiatric/Detox. Has 2 years experience.

I am an LPN. I have been at my job for almost a year at a inpatient drug detox. I love what I do it just clicks with me. I am tired of hearing I will lose all of my nursing assessment skills from older nurses saying I should do Med-Surg. Sadly LPNs in my area do not work on the floors at hospitals in the capacity of a nurse.

I don't buy the argument that if I stay as a detox nurse for a few years that I will lose all my skills so bad I won't be able to find a job at an LTC or other similar setting...I learn quickly and can multi-task with min. assistance with skills learned from my past life as a pharmacy tech. It would be one thing if I wanted to work in an ICU, ER (I buy the the "losing skills argument" in those scenarios). I would be okay if I had to find a job in a non-psych setting.

I have no intentions of ever working on a med-surg floor. I am smart and could do it. But it isn't my cup of tea.

My main interest is Psych/Detox nursing. I work 11-7 full time. I plan on going to Excelsior and getting my RN..then my BSN online at a local State College. Then someday...my MSN for a Psychiatric Mental Health Nurse Practitioner.

I respect all Nurses...especially Acute Care Hospital Nurses.

Anybody in a similar situation or have experiences of being in a specialty for years and switching over to say Nursing home or hospital?

I plan on staying where I am at right now... its like what is was 20 years ago other nurses are telling me... a total job war.. I thank god everyday that I am able to have that SMALL chance to have a life changing impact on my patients.

Chin up

694 Posts

Specializes in Med surg, LTC, Administration. Has 26 years experience.

Brava!! Nice to hear, you are a breath of fresh air!

MedicalLPN, LPN

241 Posts

Specializes in Onco, palliative care, PCU, HH, hospice.

Congrats to you for finding your passion in nursing!! I think too many people don't realize that psychiatric nursing comes with its own valuable set of skills.

eriksoln, BSN, RN

2 Articles; 2,636 Posts

Specializes in M/S, Travel Nursing, Pulmonary. Has 15 years experience.

I wonder about the "loss of skills" thing myself a lot actually. I believe I'd like to go to the OR, but something that has held me back is the perceived "loss of skills". What if I hate it and its true?

I have reasons to believe it does happen, and other reasons to believe it doesn't. Not going to list it all out here. Sometimes I wonder though, does the "loss of skills" train of thought come from the same group that pushes the idea that the only real nursing is hospital nursing?

For the most part, if someone held a gun to my head and said I had to take one side or the other I'd say: Its neither really, neither group (loss of skills believers vs. non-believers) is completely right. I'm willing to bet some people do, others don't and that it has more to do with the person than the field they are in.

:p Guess I'd end up shot with that answer since I didn't pick a side, but you get the drift.

Whispera, MSN, RN

3,458 Posts

Specializes in psych, addictions, hospice, education.

After graduation from nursing school I worked on a psych/CD unit for 5 years. Then, the general hospital in which the unit rested was closed. In order to stay employed at that hospital I had to work med/surg.

I had lost my med/surg skills. I got them back quickly. You can too, if you need to.

What I DID have when I had to make the change to med/surg was an ability to see past the mask people wear, and get to the heart of their concerns. I could also make great assessments and recommendations to the doctors about the people in detox, planned or unexpected. You'll be able to do those things too.

Don't let anyone tell you that your skills will be lost. They'll just be hidden a bit, for awhile, until they're needed again.


81 Posts

Which skills? Where one set of skills is lost, another is gained. You enjoy what you do-why worry about losing skills you'll never use? I don't think psych/detox is going to go away soon.

heron, ASN, RN

3,646 Posts

Specializes in Hospice. Has 51 years experience.

Who sez detox doesn't involve skills??? Detoxing is not a benign process physically, especially if there are additional medical dx's present. Couple that with the behaviors that go along with drug addiction, seems to me you really have to be on your toes. Feh ... you go for it!

Specializes in chemical dependency detox/psych.

Oh, you use plenty of skills, so no worries. We still have to do a head to toe assessment q shift on our patients, and we deal w/many medical conditions that are exacerbated by alcoholism and drug use.

Just an FYI, though: You won't be able to get an MSN for a NP down the road...you'll need a DNP. (New requirements from AACN effective in 2015.)


253 Posts

Specializes in Sub-Acute/Psychiatric/Detox. Has 2 years experience.

Yes the whole DNP thing kind of turns me off... But I am in my late 20s right now and I can't even think about being an NP without my RN first.

This DNP thing is like the whole PharmD. Vs. Registered Pharmacist Thing.

Or Diploma RN vs. ADN vs. BSN. vs. MSN.

What can you do anyway? The people who hire and colleges want the DNP can't fight city hall.

Thank you for all of the replies.


24 Posts

I was a charge nurse for three years at an inpatient psych unit based in a regional hospital. We had pt's with medical/surgical issues all of the time, along with their medical problems, we were dealing with psych issues such as detox, psychosis, etc. That does take lots of critical thinking...lol. I did IV's, recovery from procedures, etc., along with keeping an eye out for sign/symptoms of withdrawal, contraband... I may not have done cardiac drips, or tons of medical procedures, but it keeps you on your toes.

I now work in a labor and delivery department of the same hospital. I've been there for about a month. Didn't actually hit the floor until the middle of March. I have used tons of my psych training, along with learning all sorts of new procedures. I LOVE it :) Best of both worlds.

I was a little concerned about the whole psych to floor nurse transition, but if someone has the ability and desire to learn, it can be picked up fairly quickly. I juggle one labor pt, as opposed to 25 psych patients, but that one takes every bit of my concentration. It's nice to be able to do so much bedside nursing. I spend the majority of my time in the pt's room, which I think is very therapeutic (sorry about spelling...it's not yet 5 a.m. and my brain is still foggy). One of my pt's family member asked if I was a doctor (we have to wear white coats). It was so funny because the pt said "If she was a doctor, she wouldn't be in the room all of the time. I've only seen him twice." l


444 Posts

Specializes in Psych.

You make career moves based upon where it is you ultimately want to go, and based on the path you've outlined, working in LTC sounds like it would amount to a detour. Trust your own instincts and don't concern yourself with others' notions of what you 'ought' to do. Invest your energy in preparing for what you WANT.

Whispera, MSN, RN

3,458 Posts

Specializes in psych, addictions, hospice, education.

While they say a DNP will be required for being a NP, they also said a BSN would be required to be a nurse. How will they provide enough people to do the work if they have such restrictive requirements that only some can reach them. I'd bet a nickel the DNP requirement falls through...