When to make the move

[exit96]

So I am a med surg RN. Have been on the floor for 9 months. I like it. I have wanted to be a nurse for 25ish yrs and finally went to school and graduated in Dec 2011. I was an LPN for 8 months before that, and a CNA for 3-4 yrs prior to that. In the next 5 yrs I want to be able to relocate, 2 hours closer to Chicago and my daughter (and maybe grand children by that time). I have some training in the E.R. as well, done time in LTC with geriatric patients. So my goal is to get as much experience in different specialties over the next 4-5 yrs that will be on my resume when I am ready to make my move. I work 7p-7a, absolutely love the graveyard shift, but physically I hate it...my body just can't hardly handle it. So, I never thought of Psych when doing my clinical rotation, and perhaps some of that was because I was at a prison and it was flat out boring. Recently I have ben offered a position in Adult/Gero Psych. It is appealing because it is day shift 7a-15:30, 5 days a week. I may actually like psych nursing and have an open mind despite the boring prison rotation. I feel really apprehensive to take the job just yet and leave my hospital. The facility I work at is a small community 22 in patient bed facility, but a very nice one at that. Thing is, I am not sure how much more I will learn at this facility, meaning; the more acute patients are shipped to the Main Facility, so I will not see the more acute patients here to gain that experience. I certainly am not saying i have nothing to learn, I learn something everyday. This facility has been a great place to refine my time management/prioritization skills, which are huge for a new grad.

So I guess I am just thinking out loud and looking for comments to help me think through this.

1) I feel as though I am being dis-loyal to the manager that "waited for me" to take my NCLEX to get me hired

2) I feel as though I should get more med surg experience (maybe not though)

3) I feel as though I should just go for the psych opening, I am not getting any younger

4) and they can always hire someone to take my position, there are alot of nurses out there looking for a job

I am 48, I want to experience ICU, ER (am doing some of this at present facility), cardiac etc...so no sense delaying the inevitable???

Thanks, exit96

[Meriwhen, ASN, BSN, MSN, RN]

1. That you may not know until you have a talk with your manager. Perhaps he/she would understand the reasons why you'd want to take another position.

2. One year of m/s experience--two would be better--would enable you to transfer specialties more easily. If your goal is the ICU and ED, you should look up job listings to see exactly how much m/s experience is required, so you can aim for that number. If your goal is to see the nursing world and try out lots of different ones, 1 should suffice.

3. If you think psych, particularly geropsych, is something you should take because you feel you're "not getting any younger," I have to warn you that you'd be in for a rude awakening. But psych is not just giving out meds and babysitting patients...far from it. You may not be fiddling with tubes and foleys, and there will be busy and slow times, but you will be working hard. There is also the potential for physical violence. Geropsych is its own beast because of all the comorbidities older adults often have.

Unfortunately 6 hours of time in lower acuity settings doesn't really convey much, because psych isn't like m/s where you administer the medication/perform the intervention and you often see results fast. Plus wait until nighttime: sundowners kicks in in the seniors, and a lot of psychosis often comes alive at night.

It is daytime though, which may be the answer to your woes regarding not handling graveyard as well anymore.

As far as what you will learn, it'll be less medical and more therapeutic communication, medication administration, and dealing with psychiatric illnesses...and patients with psychiatric illness are found everywhere--they're not just confined to psych. There are also medical conditions to treat and manage, though they are not as acute as what you're used to seeing.

4. That's true. Employers are definitely not lacking for applicants.

It sounds like your interests are truly medical nursing, and there's no shame in that! If that is what you truly want to do, you'd be better off staying at your current job for the year or two to get more m/s experience to transfer to other specialties.

Another option is to see if they'd accept you as a per-diem at the psych job--that way you can keep your first job and gain m/s experience, while also trying out psych to see if you'd really like it (and picking up some psych experience in the process).

Best of luck whatever you decide.

[PRNketamine7, BSN, RN]

I wouldn't leave your current job for psych unless that is definitely the kind of nursing you want to do. It sounds like your current facility is giving you good experience letting you do ER and med surg.

Personally I think you should stay leaving before a year may look strange to future hiring managers. I don't know what the rest of your resume looks like but you definitely don't want to look like a job hopper.

Just my opinion.