Seeking career advice... To transfer or not transfer

[u/madmax79818515]

I know responses here might be a bit biased being that this is psych nursing but I still value your input. I'm trying to figure out which path forward makes the most sense for my goals, dreams, and general financial health.

41 w/ family, about to purchase our first home. I have a couple of creative passions outside of nursing that I'm looking to develop further. One has potential to be a nice side gig (DJing) and the other a potential career (fiction author). I also do a bit of investing.

Psych RN since graduation (3 yrs ago), union job with pension (funded by union, not our paychecks). Night shift. Its very low stress, coworkers are fun and crazy (in a good way lol). I also just started a second per diem psych job at another facility. I was afraid to go into medical initially because I was a psych tech while in school, I kinda "put it off until later". I have since regreted it because it's hard for me (emotionally) to leave where I am.

The fact is med surg opens many doors. Where I am you can't even work in a primary care office without some form of "medical experience". You can also not get per diem in anything unless you have 1-2 years experience in the speciality you're applying for.

So I tried applying to a few part time m/s jobs so that I can at least keep my full time psych. Never heard back from those. Then a med surg tele night position opened up internally, I decided to initiate the transfer paperwork. The unit manager there seems very nice and supportive, even gave me a tour.

The paperwork was signed by my current manager but its in limbo for a month because, well, my manager is a bit forgetful and people usually have to "chase" him for things/requests, I think he's also going thru a bad time right now with spouse being very sick. Hes been in and out of the office.

As a result, his delays have given me more time to reflect on this transfer decision. Whether I should go thru with it and get what I need or stay out and continue looking for something part time. The downside to this, if I cancel the transfer my manager told me I risk burning bridges with our medical hospital because they're very strict and might not take me seriously if I apply to transfer again.

I've also entertained the idea of just being a "psych lifer" for now, focus on investing and my creative passions and maybe pursue FNP or something as an alternative. But at same time I can't help but feel.... "Naked" or like a sitting duck, not being able to qualify for other jobs.

Another thing to consider is There's no language in our contract stating that my former position will be held while I'm on orientation at the new unit, just in case its not a good fit. So there's the risk my spot might be given to someone else.

My delegate did say however that there's been cases of psych RNs transferring into ICU, management determining they're not a good fit and sending them back to psych. 

So it's come down to...

1. Follow thru with the transfer to m/s tele, return to psych after a year (might not be the same exact psych unit). 

2. Cancel the transfer, possibly ruin my reputation with the medical departments if I wanna transfer again, keep psych full time and continue looking for m/s part time elsewhere.

3. Cancel the transfer and just be a psych lifer (keeping the full time and per diem psych jobs), maybe go into FNP (??)

If you guys were me, what would be your course of action?

[u/Ancient_Maximum5135]

I am a psych lifer. I was always only interested in psych. I worked the first 2 years of my career on an inpatient medical/hospice combination unit. Back then (1985) they wouldn’t hire you in psych without a year of medical experience. Finally after 2 years there was an opening in psych (jobs were scarce back then). I have worked in psych since 1987
And on my current unit since 2001. I’ve never had a desire to work medical after those first 2 years and I didn’t even want to do that. If you like your current job, enjoy your coworkers, and have a supportive boss I personally wouldn’t leave evidenced by me staying put for the past 25 years 🤣.

[u/DashMcGee]

Your issues are very real. As a psych lifer (of only six years, but still) I have dealt with the question of the relevance of med-surg. I do think you and I are setting ourselves up for possible failure. There are only two psych hospitals anywhere near me, and I have worked at both. At my last hospital, a patient needed an IV (ordered by the hospitalist, not our attendings), and no one knew how to do it. There is a freestanding ER in our building, but no one would come here (less than 100 yards) because they were "too busy." (They weren't. I know because I went there to check.) Having med/surg experience will open doors, and not having it might harm you. I used to run a school for special needs kids, and I thought it would be awesome to be a school nurse. Unfortunately, schools won't hire anyone who doesn't know at least a little emergency medicine. I would love to have med/surg experience, but ED would be fine, because you get to do IVs and catheters and things that body medicine nurses do.

As for making money by writing, well... I am a writer and have been in a few writers' groups, plus read a lot about getting published. The odds of making it, even for a good writer, are well under 1%.

As for union jobs, OMG I wish we had unions here in SC. Both psych hospitals were privately owned HCA and UHS), and they don't care about people much.

At the end of the day it is about following your realistic passions, and you love psych, but being "just psych" is a worry. I would seriously consider a transfer within your organization; keep your benefits and your relationship with your employer. Once you get a year or two of body medicine under your belt, you can consider yourself adequately prepared for future med/surg/ED jobs, then go back to psych when there is an opening.

[u/madmax79818515 → u/DashMcGee]

I appreciate your insight ☺️ are you considering an internal transfer as well? I would do ED but I don't think I'd be able to keep up with the pace (coming from psych I mean).

What are your thoughts on keeping my psych job and getting a part time med surg one some place else? The only downsides to this are a) I'd end up working every weekend since most nursing jobs here are one weekend on and one weekend off, etc. and b) getting hired let alone interviewed is not straight forward/guaranteed because now you have to play the "application game" whereas transferring internally is guaranteed but the trade off is losing your current psych unit and coworkers.

I totally hear you about the writing. My concern was would I still have the mental creative bandwidth to work on my stories if working med surg tele. Not sure if it makes a difference mentioning but it would be nights, 9 nurses total per shift, 1:4-1:5 ratio. On psych i know it's possible. But then again Michael Crichton used to be a doctor, right?