didn't think i wanted med-surg, now i'm not so sure

April, RN, BSN, RN · Nov 11, 2009

I think the switch to neuro/med-surg would be great. You will learn a lot in med-surg, and I think you are right in that your psych background and your interest in the brain will only help you. You might find that the longer you work in psych, the harder it will be to switch into a different specialty. And, as you said yourself, sometimes getting the same patients over and over again in a specific specialty gets boring and you start to feel unchallenged. The experience you will get in neuro/med-surg can only benefit you... and will look good on your resume.

Blackheartednurse · Nov 11, 2009

Med-surg is my dream job right for right now (but I also like OB and ER),as a novice nurse I would like to be exposed to as much experience as I can get so I went ahead and applied to medical telemetry/observational unit..very paced unit,ration on evening nights (they only had an opening evening/night rotation is 1:7,1:8) however most stable patients..more of med-surg population,some pt with mild chest pain but not your typical cardiac pt...I interviewed on monday with the HR and a nurse manager..I assume interview went so-so,I was able to answer all the behavioral questions right away however they have several other people applying for this position so they will let me know by friday...

My advice to you is to try out med-surg,it is great learning opportunity that will become priceless in your further career,let us know,good luck!

RhiaRN75, RN · Nov 11, 2009

I think it's a great idea, myself. I've worked neuro when I floated, it was one of my favorite floors. Now, NICU is some intense stuff- and I wouldn't want to to to that straight from a psych floor. (I didn't do primary nursing on NICU.... the rare times I floated there I was strictly 'CNA' status.)

I can see where someone might say 'you don't have the clinical skills, stay in psych'. I don't think that's entirely fair. You should have an orientation phase anyhow- which gives you the opportunity to brush up on and develop med-surg clinical skills. Really.... what do you need? Not much changes in regards to foley care and assessment, for example. Lung sounds are lung sounds. Even nurses w/ med-surg background would probably not know how to take care of an epidural drain, ICP moniter, etc..... and a hospital with a neuro floor is probably large enough to have an IV team. There is more Med-Surg to neuro then one may think- decubes happen, people need rehab/PT/OT, if someone has TBI they may also have ostomys from other injuries sustained in the accident, a lot will have central lines left over from NICU, feeding tubes..... the works. If you have a good orientation and brush up on those skills, though, you should be fine!

What I suggest you do is strongly emphasize you psych skills. Conflict resolution, de-escalation, appropriate setting of limits, helping one to develop coping skills, preventing outbursts.... all necessary on neuro. (Dealing w/ some neurosurgeons needs a fair amount of these skills as well, lol.) I think that would be a huge asset on a neuro floor!!! I have seen TBI and post-brain surgery pts have some definite cognitive and personality problems.... from temporary deficits that eventually resolved to life-long disability and personality change.

Your psych background would be sooooo valuable.... clinical skills are one thing, but having good psych skills is something many people can never master. Think of all the intervention..... not just with the pts, but with families as well.

The more I think about, the better I like it. Were I the manager of a neuro unit- I'd love to hire a good psych nurse!!!

pinkiepie_RN · Nov 11, 2009

I think it's a great idea, myself. I've worked neuro when I floated, it was one of my favorite floors. Now, NICU is some intense stuff- and I wouldn't want to to to that straight from a psych floor. (I didn't do primary nursing on NICU.... the rare times I floated there I was strictly 'CNA' status.)
I can see where someone might say 'you don't have the clinical skills, stay in psych'. I don't think that's entirely fair. You should have an orientation phase anyhow- which gives you the opportunity to brush up on and develop med-surg clinical skills. Really.... what do you need? Not much changes in regards to foley care and assessment, for example. Lung sounds are lung sounds. Even nurses w/ med-surg background would probably not know how to take care of an epidural drain, ICP moniter, etc..... and a hospital with a neuro floor is probably large enough to have an IV team. There is more Med-Surg to neuro then one may think- decubes happen, people need rehab/PT/OT, if someone has TBI they may also have ostomys from other injuries sustained in the accident, a lot will have central lines left over from NICU, feeding tubes..... the works. If you have a good orientation and brush up on those skills, though, you should be fine!
What I suggest you do is strongly emphasize you psych skills. Conflict resolution, de-escalation, appropriate setting of limits, helping one to develop coping skills, preventing outbursts.... all necessary on neuro. (Dealing w/ some neurosurgeons needs a fair amount of these skills as well, lol.) I think that would be a huge asset on a neuro floor!!! I have seen TBI and post-brain surgery pts have some definite cognitive and personality problems.... from temporary deficits that eventually resolved to life-long disability and personality change.
Your psych background would be sooooo valuable.... clinical skills are one thing, but having good psych skills is something many people can never master. Think of all the intervention..... not just with the pts, but with families as well.
The more I think about, the better I like it. Were I the manager of a neuro unit- I'd love to hire a good psych nurse!!!

Thanks for your support. I'm thinking I might call the recruiter back and emphasize those skills you spoke of!

April, RN, BSN, RN · Nov 11, 2009

Thanks for your support. I'm thinking I might call the recruiter back and emphasize those skills you spoke of!

Good for you! Be proactive and sell yourself! :)

diane227, LPN, RN · Nov 14, 2009

Psych is a wonderful profession and it takes a certain set of skills that a lot of people do not have but it is very limiting. You will usually not use most of the skills that you learn in nursing school and you will not see a variety of other disease processes. You do not have to make med surg your final career choice but med surg can be very helpful to you. It teaches you to get very organized and you will use your skills and will be exposed to all types of diseases. In addition, you can still use your psych skills. I started out in med surg before I went to the ICU and then to the ED where I spent most of my career. I am back on med surg now and it is completely different now. The patients we take care of on the floor now would have been in the ICU 30 years ago. So go out and get your experience. You can always go back to psych later on if you find that psych is what you really want to do.