The two areas of specialty: psychiatric (psych) and medical-surgical (med surge) nurses, are both nurses. However, there are a few things that set them apart.
Psych nurses deal with the mental health needs of the patient compared to med surge nurses, who deals with the medical part of nursing. For example, a patient who is suicidal will be cared for by a psych nurse, vs. a patient who was hurt by the act of self-mutilation will be cared for by a medical-surgical nurse.
Woking on the psychiatric floor is not the same as working on the medical-surgical floor. Psych nurses have a different approach when it comes to caring for patients.
Floor Atmosphere
Mental health workers will often walk the unit on the psych floor for safety checks (5, 15, 30, or 60 minutes). This is to ensure that patients are safe and that they are all accounted for. On the med surge floor, there is no safety check accountability. However, if a med surge nurse is caring for a psychiatric patient, he or she may have a 1:1 (one-to-one, aka sitter) like a health worker doing a safety check at the bedside. This individual is to watch the 1:1 patient at all times for safety reasons.
In a psych unit, patients can often walk around the locked unit. They are free to go in and out of the room, able to attend groups in the unit, and able to talk to each other. Think of a unit with a game room, sunroom, activity room, etc. Med surge units traditionally would not have this. Patients normally stay in their room and have most necessities within arm’s reach.
Patient Care
In a psych unit, normally, populations are separated between pediatrics, young adult, adults, and geriatrics. As in med surge, it’s pediatrics if the patient is under 18 and adults if the patient is over 18 years of age.
The medication passes in the psych unit can be different. The patients line up by the medication window (yes, kinda like in the movies). This is normally seen in the young adults and adults unit. This is for the safety of the nurses. It can sometimes be chaotic or dangerous. Some patients can be labile. On the med surge floor, a traditional nurse would be able to bring in her computer on wheels (COW) in each room and can do a medication pass in front of the patient.
Providing patient hygiene can be difficult at times. The psych nurse will have to encourage the patient on “walkie-talkies” (patients that are independent to care for themselves). And, of course, those who can’t be provided care. You can say the same in a med surge, and the nurses must provide patient hygiene to those who cannot.
When it comes to medical care, psych nurses will have to know about the most basic nursing 101. A psych nurse should at least know the normal range of vital signs. Other than airway, breathing, and circulation, psych nurses practice differently. EKGs are not done daily to monitor the patient’s QTC vs. on the medical surgical floor, and the nurse would have to do this every day. Psych nurses sedate more than med surge nurses. Also, psych nurses are highly trained in restraining a patient safely. This is because psych nurses go through training more than often, and it happens regularly in the psych unit compared to the med surge unit.
Conclusion
Remember that both specialty areas are different on each their own. While a psych nurse’s priority is to get the patient to the level of safe mental health capacity, the med surge nurse would want her / his patient to be able to heal his or her wound from an accident. In general, both are hands-on, and both should practice patient-nurse relationships but in different areas.
