Will starting in psych put me at a disadvantage in the future?

subee, MSN, CRNA · Jun 28, 2012

I'm in an accelerated BSN program, due to graduate in December. I'm very interested in psych nursing and have an MS in addictions counseling. Whenever I tell classmates/teachers/other RNs about my interest in pscyh, I get a very negative reaction. The reaction that concerns me the most is when folks tell me I should not get a job in psych right off the bat b/c I wil l lose my "basic nursing skills" and look less desireable to recruiters if I choose to change specialties down the road (I'm also interested in the ED). Any reaction to this? I've been told that getting my feet wet on a med/surg floor is the smartest idea as it will prepare me for whatever eventual direction I want to take my career, but this simply doesn't interest me. Advice needed! Will starting at psych put me at a disadvantage with future, more medicine-based nursing jobs? Thank you :)

Why bother becoming a nurse if you're "not interested" in the only job offer that may come you're way.

SoundRN7 · Jun 28, 2012

Don't let others' negative reaction get to you. I have a strong interest in psych nursing too and in RN school it was not highly regarded. One clinical instructor even told me that because I had an interest in psych nursing I wasn't really interested in nursing at all, and that she was wasting her time teaching me anything. Yea, she was a real gem and I had a horrible quarter with her! Psych nursing is indeed nursing, just another type of nursing.

backtowork · Jun 28, 2012

I say..go psych nurse go..too many good nurses have taken the "med surg first" advice only to burn right out and quit nursing. I love the NP idea. I have never worked in a setting yet where a psych nurses skills were not highly valued and sought after in 30 some odd years..this includes everything from corrections to managed care to hospice and ICU. Do what you love...you will always be a winner.

backtowork · Jun 28, 2012

..and I totally agree with modgoth1..lots of nurses on this site who totally prefer wearing their negative knickers instead of their positive panties while they build their monuments of nothing for no one. Stay positive, stay strong, stay focused.

Camisa · Jun 28, 2012

Hello,

I have heard this say advise given to lots of new nurses. What I hear you say however, is that you already have some "psych" experience in you background and you want to move into another section of this same speciality. If you already know what you are comfortable with--then you could combine both your specialities. Another thing that is happening in the field now are those specialities merging into psychiatric emergency rooms. You could find a hospital that offers this opportunity.

I must admit that I spent many years avoiding psychiatry but once I moved into that area I have discovered that no matter which speciality I was practicing--it was all psychiatric nursing. I have recently celebrated 20+ years working in an acute psychiatric setting.

spdaydream · Jun 28, 2012

Thanks for the advice, everyone! Becoming a Psych NP is my long term goal, but I was just concerned about "shooting myself in the foot" by specializing in something like psych too soon. I appreciate all the kind words, too.

pattyjo, MSN, RN · Jun 30, 2012

I have a "Do what you love" philosophy on this, so if psych nursing is calling your name, go for it. I've worked in different areas through my career, usually briefly, but always end up back in psych.

Now, having said that, I need to respectfully disagree with those who say med surg and psych are totally different and you don't need med surg skills if you are going into psych. You will have patients who have bipolar disorder and type 2 diabetes; major depression and high blood pressure; and yes, schizophrenia and pregnancy. Not only that, the newer medications are effective in helping to manage symptoms, but they also carry a risk of metabolic d/o, seizures, thyroid and cardiac dysfunction. Some increase the risk for various other disorders, like agranulocytosis. If you are going to work with persons who have substance abuse issues, you most certainly will run into co-occurring liver disease, neuropathies, GI problems. You are a nurse: your role will be to assess, advocate, educate, keep your patient safe, help them return to a higher level of functioning. If you are concerned about losing your skills (I'm guessing you mean the tasks like starting IVs, dropping NG tubes etc) then maybe consider a casual position on a med surg unit. Or take a refresher course if the situation dictates.

It sounds like you are thinking this through, and that is a good thing! Good wishes to you as you continue on, and make the decision that makes the most sense to you.

12flrn · Jul 2, 2012

I think this depends on where you work. I had 6 mos experience of med/surg before going into psych. 15 years later and I still haven't looked back. I've had past co workers who were psych nurses and in between worked in all sorts of other settings keeping all of those medical skills. For myself, even though I worked all psych, I still used my medical skills because the one hospital admitted some seriously medically complex people (high risk pregnancy, 3rd degree burns...not to mention heart disease and diabetes and renal failure). If this is the route you want to take, I say go for it. Good luck. We can use more good nurses