Why do one year Med surg nursing before going into Psychiatry Nursing

Specialties Psychiatric

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I want to go into psychiatry as a nurse but my coworkers a re telling me to go into medsurg for one year before going into psych. they explained about going straight into psych would not be as profitable for me and some organizations require the nurse to do a least one year med surg. Is that true? and Why?;)

Specializes in Med-Surg, Geriatric, Behavioral Health.

Becoming a "well rounded" nurse is the key.....

...be it a psych nurse who is ALSO competent enough in assessing and intervening upon non psych health issues (diabetes, HTN, asthma, wound ulcers, etc)

as well as....

a non psych nurse who is ALSO competent enough in assessing and intervening upon psych health issues (depression, anxiety, stress, psychosis, personality disorders, etc)

Rarely, does a patient come in with just ONE presenting health problem/issue...usually there is more than one...with each issue significantly impacting the other.

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I have a son with schizophrenia, and he does have other health issues, but I have had no luck getting regular MDs to help him. It is almost impossible to get him to go to a doctor, unless there is an acute problem. When he does go in, the doctors and nurses seem afraid to talk with him about his general health. I asked one to do a physical, and he refused. He did tell my son he should get a job. That made me angry, because "getting a job" isn't going to help with high blood sugar, cholesterol, or heaven knows what else that is going on with him. I think a psych nurse, or doctor for that matter, should be able to improve the physical health of their patients as well as their mental health. Often they are the only medical personnel that take a mentally ill person seriously.

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Specializes in Med./Surg., Diabetes, Med. ICU, home hea.

Well, I'll throw my 2 cents in... and vote for at LEAST one year in med/surg before doing psych nursing. Psych nursing is my latest nursing incarnation and I can tell you that I use my nursing process MORE for the patients' medical problems on many days than I do for their mental health/spiritual health problems.

Let's see... on the average adult floor of 18, I've had up to 5 diabetics at a time (don't need my statistics class for that one), seven (or more) hypertensives, 3 wound cares, 3 who have a seizure disorder, 2 or more asthmatics/and/or COPD'ers, God knows how many with CAD... but at least 3 with prn SL nitro orders... and the list goes on.

Assessment skills are a plus as admissions have to go FAST before the next crisis... either medical or psychiatric. In the middle of the night, with a patient complaining about chest and/or abd pain, you have GOT to have the assessment done, have the patient's chart, MAR and history ready for when the physican calls you back.

Can you make it without med/surg experience? Of course, but is investment well made. I can't tell you how many times I've had to assist other RN's with assessment and interventions during a potential medical crisis... RN's who aren't flustered with most psychiatric emergencies.

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Specializes in Neuro/Med-Surg/Oncology.

Can you make it without med/surg experience? Of course, but is investment well made.

I think this sums it up in a nutshell. No education or experience is ever wasted. You never know when you will need it.

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The notion of doing a year of med-surg before psych is a fallacy to get more nurses to work in med-surg, where the crux of the shortage exists. In reality, your med-surg experiences from school will still put you years ahead of the nurses who have been doing psych for 20 years and have long since forgotten their med-surg skills. I went straight into psych as a new grad and have never regretted it. We take new grads into the ICU, ED, and L&D - they don't have to do a year of med-surg first! Go to the area of nursing where your heart lies.

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On a psych unit the nurse is often the person watching and managing the patient's physical health. There is a whole team of folks focused on the psychosocial aspects of the case. You may be the only one who is aware the patient's low grade fever and chronic cough. If you miss its significance, it gets missed.

This is so true -- I have seen very scary things happen on psych units over the years (including near-deaths) because everyone was focused on the psychosocial aspects of the client's condition and no one (including the RNs) paid appropriate attention to physical sxs/complaints.

If the nurses don't pick up on a physical problem and insist that it be appropriately evaluated/treated, no one else is going to.

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Specializes in Med/Surg <1; Epic Certified <1.
plus, my parents really aren't keen on me having a MH career, so a few more years might give me time to convince them I'm not going to get shanked in the temple.

Hey, thanks for the laugh at the end of a clinical day, lol!!! Too, too funny!!

I was told this week that hospitals in this area require a year of med/surg before hiring in to psych. I can see the pluses, especially if pts haver other med problems as well. And the hospitals locally can probably afford to require this as a prereq since we have a limited # of beds in this area for psych pts.

Interesting thread!!

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Specializes in Psych.

I went into psych nursing right after I graduated and in the 24 years I have worked in psych not going into med-surg first has never negatively impacted my career.

At a regular hospital as a psych rn you get the same pay as an rn who works on med/surg.

I have to disagree with this poster. I have worked in hospitals were psych nursing make more than med-surg nurses because they get extra pay for working in a specialty.

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Specializes in Psychiatric.

I have been working as a charge nurse on a long term psych unit for over 2 years. I came right out of school. I did not have any med surg experience other than what I received in clinicals. You need to be focused on the whole picture in psych just like any other area including the physical medical aspects not just the mental aspect. 9/10 times the patient is going to have underlying medical issues as well as their mental issues. If you keep that in mind you will do just fine. I ask you to take a close look at yourself and how you deal with people in certain situations when their mental illness presents itself in all its glory. Not everyone can do Psych, just like not everyone is cut out for OB. I have seen and currently work with those who should not be working on a Psych unit b/c they make behaviors worse by looking at their own reactions to the behavior. If you are someone who scares easily, then this is not the area for you. Be sure of your convictions and remember everyone has their own strengths and you'll do fine. Good Luck.

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The argument can be made for either side I believe-if you know what you want to do then go for it-I did. But gaining medical experience can also be very beneficial to be able to more completely take care of one's patient..

For myself, I have recently started at a facility that has a large detox unit, adolescent chemical dependency unit. I would love to work there but without the traditional Med-Surg experience I feel a little trepidation about my ability to do so and I'm not planning to anytime soon. It would probably just take me more time to figure things out but I feel that the nurses who do have Med-Surg might think I'm a fool.

I did try to do Med-Surg a few months ago and though I learned a lot for the short time (and gained some confidence!) I was there I must admit it wasn't for me :uhoh3:. Hate to say that you get comfortable in a certain place, but at my current stage in life I need that comfort level to be able to function. Going to Med-Surg was like going back to school again..

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Specializes in med-surg, post-partum, ER, psychiatric.

Great posts with some great answers for sure. First and foremost, it is an individual choice. I don't think there's truly a right or wrong answer in this. It's just the same I was told when I was trying to break in an ER environment. I have been a medic for several years; however, it essentially counted for naught becuase I didn't have the 6 mos to 1-year NURSING experience in Med-Surg, or ICU/CCU, et al........forget the fact of having to use critical thinking skills in the "street" and such............and having patients at the "rawest" before getting to the ER. At any rate, sometimes there is antiquated thinking within the nursing field in that one must "pay their dues" before venturing out into a specific specialty area. I think that is one reason why we lose newly licensed RNs so early in their careers. They are made to be in a career area that they truly do not want to be in nor would be good in doing. It not only affects the RN but also the patients. Happy nurses equal happy patients. But those are just my thoughts and opinions.

I "paid my dues" by doing Med-Surg, and I really didn't enjoy doing it. I am first and foremost an EMS "adrenaline junky type" with a love, as well, for psych. However, on the flip side, I cannot say I totally regretted having to do Med-Surg either, in that it sure has helped me when dealing with Med-Surg issues even though I am a psychiatric RN in a state hospital. As one individual posted, a lot of the times patients will truly have some underlying medical conditions along with their psychological conditions. Another BIG factor is that a lot of the psych meds also cause medical conditions, such as diabetes. Having good skills in Med-Surg can help out in recognizing underlying issues in a psych patient. A lot of things you really don't see and get taught in nursing school. Additionally, we do have geriatric psych patients as well, and believe-you-me, they come with a TON of medical conditions. I know of psych nurses who do not like working on the geriatric unit just for that reason. I know for me, I have benefitted by having that med-surg/trauma experience (I don't work geriatrics, though, but do work primarily children and then get pulled from time to time to adult civil units and forensic units........................deal with injuries, medical conditions, you name it....................along with psych issues).

At any rate, it is truly an individual choice, first and foremost. Go with your heart and not with what somebody tells you you MUST do. Your patients will greatly appreciate it, and you will be a happier RN if you are doing what you truly do want to do.

Good luck to you in YOUR decision! :lol2:

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I have to say I have yet to hear a nurse who did take the straight to psych route express any regret about the decision

It seems everyone supports whichever decision it is that they made - those with med surg experience say that is the best way, but those without it feel it was unnecessary

any psych nurses here who wish they did have that med surg behind them?

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