still a good idea to get med/surg experience first?

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Hi,

I'm a pre-nursing student with a strong interest in psych nursing. I eventually want to become a PMHNP or psych CNS. So, for a long time the standard motto for new RN grads was to do med/surg first, then get a job in their speciality of choosing. But, I'm wandering if this recession has changed the rules a bit. In this economy some people have commented on here how once you're in a med/surg (or whatever field you're currently in) you can be somewhat pigeon-holed to that area b/c employers are only considering applicants with experience in that area. Do you follow me? In other words, if you're a med/surg nurse now, you might have some luck finding another med/surg job, but it will be harder to switch fields. So, my question is: what would you tell someone who is determined to eventually work in psych; still get a med/surg job first, or go right ahead into psych?

You get it :)

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I was told the same thing too mainly because I was told that it would make me more marketable and help me hold onto my "nursing skills" which I would promptly lose once I went into psych nursing (supposedly). I already knew that I would never want to be any kind of nurse but a psych nurse so it did not matter to me if I ever had a med surg job or any other kind of nursing job. If for some reason I was forced to take some other kind of nursing job and it had been some time since I used those particular skills I would just take a refresher nursing skills course and go from there but it would be the absolute last resort. Sometimes you just know. I just knew. Psych nursing is something of a different animal but I have still had to draw bood, take various samples of body fluids, tube feed, catheterize, deliver injections, give meds along with several other crucial nursing skills that I would supposedly not use in psych nursing. I love psych nursing so much that I just transfered out of my Family Nurse Practitioner program into a Doctor of Nursing Practice program in child and family psychiatry...everyone said do the FNP then get your psych cert...but when you know what you want, you just know what you want. Follow your heart that way you can enjoy the journey just as much as the destination :)

butterfly :redpinkhe

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Specializes in Psychiatric, Detox/Rehab, Geriatrics.

I ALWAYS knew I wanted to be a psych nurse, and when I graduated nursing school, there were no psych jobs available, so I did medical nursing for 6 months, which now that I did that, Im glad that i have that experience to draw upon. Good luck to you!

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.

I went straight from nursing school into mental health. Five years later I found myself out of work and unable to get a job because my employer closed my facility and there were almost no mental health jobs available in my area. I went from making $20 per hour to living on less than $300 per week on an unemployment check. Get the med-surg experience. It will broaden your base and make you more employable should the unthinkable happen.

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Specializes in ED.

i currently work in Med Surg right now full time and planning to take a part time job in Psych. I loved Psych clinical back and in school, and somehow i loved the action when something was going on in the unit. I loved talking to psych clients and create that therapeutic bond between them.

With my Med Surg background i hope itll be an easier transition.

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I loved the Psych clinicals in school, too, and knew that would be where I'd have the most fulfillment. It took me awhile to get a job and it's in med/surg. I've been there full time going on seven months....I like it most days, but don't think i could do it for years down the road. BUT, I now also have a PRN position at a local hospital for teens and await to work my first shift. I say try for where your heart is but don't pass up something that comes your way with the job market as it is now.

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Oops! Meant to say "PRN position for psych nurse in a unit for teens"...I can't wait to get started.

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Specializes in Psychiatric.

I got such mixed reviews when I was comtemplating the same thing. My psych instructors however told me go into Psych. If that is what you want and you know it is your area don't reconsider based on the old idea that you need med-surg. Ultimately I went straight into Psych with a small stint in home health and I haven't regretted it one bit. I, like you, plan on going on for further degrees and plan on staying in Psych. I don't mind picking up experience in other areas for flexibility and employability but in all honesty I want to do exactly what I'm doing and I haven't regretted my decision to stay focused on my own specialty. It's not a necessity, its simply an option. Look at it that way. Do you want more options or do you want more emphasis and experience in your specialty? Answer that and you will know what direction to move in. Essentially it may be harder to change if you change your mind later, but it's not impossible!

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Specializes in Pediatric Hem/Onc.

I'm split between psych and peds. I'm actually thinking of doing pediatric psych. I've spoken to enough nurses that I'm not convinced the whole "must do med surg as a new grad!" mantra is the rule. I think the job market in your area has a lot to do with your decision, too. The facility for our psych rotation flat out told us they love hiring new grads regardless of degree. They start at $28/hr with full benefits.

When I mentioned the med-surg "rule" and worry about losing my skills, the nurse educator smiled and said "This is why PRN positions are a beautiful thing. I had the exact same worry when I graduated."

It certainly gave me something to think about! It would be awesome to do both.

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Specializes in Adolescent Psych, PICU.

I do not think you have to have med/surg experience before psych. You will learn what you need to learn on the job and over time. Experience is what counts.

I had a year of ICU before going to psych, I am NO better nurse than anyone else in my unit. We have a LOT of nurses who wanted to do psych and that is where they started fresh out of school, they are excellent nurses and when medical issues arise they are perfectly capable to handle them. I honestly dont feel I have any real advantage.

So if you want to do psych, do psych!

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ITA. You can't go wrong with a year or two of solid med-surg experience to start your career -- you can go anywhere in nursing you want from there. If you go directly into psych and decide a few, or several, years later that you want to (or need to) look for a job in another area, you'll have a v. hard time getting anyone in a non-psych area to take you seriously.

It's working in psych that will "pigeonhole" you, not working in med-surg!

psych in particular because we aren't real nurses:yawn:

but really, like you allude to, even if you could look into a crystal ball and discover that you retire a psych nurse after 40 years of being a psych nurse, getting a minute or 2 of some form of m/s will make you far far more marketable because you have fresh skills that some psych nurses have done anything remotely close, such as starting an IV, in 2 decades.

but if you absolutely want to start immediately in psych, keep your mind open to med/psych where the medical condition has to be acute and the primary admitting Dx; the psych is 2ndary; or probably even some gero-psych facilities might get you some experience building m/s skills

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I strongly suggest that you get some type of med/surg, ER, or ICU experience as a new grad before going in to psych nursing, even if it's only for a few months. I started out in the ICU before going in to psych, which helped tremendously with my physical assessment skills. Psych pts have medical problems, too, especially the geriatric psych population. A nurse needs to be able to physically assess a patient to help decide whether or not they need to be sent out to the ER for an eval.

I don't think u need years of medical experience, though. Six months to a year should be good enough to develop a reasonable level of physical assessment and medication administration experience. All inpatient psych pts get medically cleared when they're admitted to the unit; however, a lot can happen within that inpatient stay, and it would be beneficial for u to be able to identify any non-psych (medical) issues.

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