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Although new RN grads are traditionally given the advice that in order to be “real nurses” they must do a year on a medical/surgical floor, these jobs are not always readily available. Additionally, for a new grad who is very specifically interested in psych mental health nursing and not interested in other areas of specialization, a year on the medical/surgical floor might well lead to burn-out and even drop out.
There are ways new grads can develop assessment skill and hone their clinical skills while still working in an area where they build and hone their psych specific skills.
Many of the patients on a psych gerontology floor arrive with multiple co-morbidities. Some are even transferred from long term care facilities when their behavior has become a danger to themselves, other patients or staff. New grads working on a psych gerontology floor may well get a great deal of experience with IVs (especially for rehydration), catheters, feeding tubes as well as multiple med interactions.
Emergency Room Nursing
Since many people come into the emergency room after (or in the middle of) traumatic experiences, fights or domestic violence, conflict deescalation is a highly prized skill in an emergency room nurse. In addition, you’ll have chances to counsel patients about self destructive behaviors and engage in supportive therapeutic interactions with family members.
Jerry Tracer, who currently works in a psychiatric emergency room, got his start in nursing with a position in a men’s state prison. “It was very very challenging for a new grad, but I learned a lot,” he said, “and I gained some very valuable experience when helping to assess prisoners after fights or take down situations. I also got lots of pre-hospital first aid experience, more like a first responder might do since I was the first responder. It’s hard to get that kind of experience anywhere else in nursing.”
Seize the Day
If you’re offered a job on a general psych floor and psych mental health nursing is your passion, there are actions you can take to keep your medical clinical skills sharp.
For example, if you’re on a psych unit in a general hospital, you can be the first to volunteer to float to the medical floors, and you can always offer to take care of the more medically fragile patients. If your hospital doesn’t require medical clearance, it’s possible that you may be able to work with patients who require IV therapy, multiple ongoing assessments or have non-healing wounds.
Keep in mind that many psychopharmocological drugs can cause serious side effects, so you’ll be tasked with assessing these side effects no matter where in the psych mental health arena you work. In addition, psych mental health units that are staffed with proactive nurse educators will have ongoing skill training available for nurses.
If None Of The Above Applies
If you’re unable to keep your clinical skills current using the above suggestions, remember you can always take a break from psych nursing to spend a year on a med surg floor. If jobs aren’t plentiful where you are, there are almost always refresher courses available, either through continuing nurse education or a local community college or four year school of nursing.
Remember, as one nurse with three decades of psych experience said, “All nursing, if done right, is psych nursing. Illness always affects the emotional well being of our patients, not just their physical bodies.”