My psychiatric patient has began to have medical issues that I and my hospital are not equipped to deal with, so I call report to the receiving medical hospital and to ambulance services to get my patient transferred. "Are they breathing?" I get asked almost every time. The sarcastic part of me wants to say "Nah, I just thought I'd leave that out so you'll have a good surprise when you get here. [Insert expletive]" but the professional nurse in my says, "Yes. As I said in their vital signs their oxygen level is xx% and their respiratory rate is xx." Why would I get asked such a ridiculous question that would never be asked to a nurse at a medical hospital? Because I'm psych. For some reason, we're looked down upon. I've heard other nurses say we're not "real nurses." When I ran into a classmate I graduated with, she was proud to tell me she worked in an ER. I told her where I worked, her whole demeanor changed. Needless to say, that conversation didn't last long.  It's truly sad how many look down at us for doing our jobs. No, I do not remember all parts of medical nursing because I don't use them on a daily basis. But most medical nurses I know would not know how to react to a patient with paranoid schizophrenia who is certain there are gang members out to get him and he pulls a shank out. While this is a worst case scenario (and yes I've had it happen to me), it is the truth. We know we may face these dangers going to work. But we go because we know how to react and handle certain situations. We know when we call a doctor for an emergency prn medication, that if she/ he asks us what we think they need... we know what to say. We know what medicines work best to help in certain situations. We know how to proceed with verbal deescalation.  While sitting in the ER one night with a family member, I heard a patient nearby become violent. He was throwing things and cursing and yelling. It was obvious the staff did not know how to handle that situation. They called in every security personnel they had (over the intercom). It took them over an hour to figure out what to do.  I'm not saying all this to say mental health nursing is superior or whatever. I'm just saying this bias against us because we don't know medical nursing is ridiculous. During nursing school in the psych rotation, I remember hearing majority of classmates talk badly about psych.  In every nurse's career, they are going to encounter a psych patient at some point. Then they may realize that we are REAL nurses; we just play a completely different ballgame.