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This is a discussion on Prospects for a FNP with a Psych secondary certification in Clinical Nurse Specialists (CNS), part of Advanced Practice Nursing ... hello all, i am in a fnp+pmhnp+mhcns program (custom curriculum)and am looking for advice. the...by t2krookie Jul 20, '10hello all,
i am in a fnp+pmhnp+mhcns program (custom curriculum)and am looking for advice.
the psych portion is referred to as a “blended” program that prepares us for taking both the pmhnp and psych cns certification exam. i added the fnp portion to allow flexibility in options and with the goal of being a one stop shop for the mentally ill. i’m sure i don’t need to tell this forum that there is lots of co-morbidities in the older psych population).
any who, most in my program are only interested in doing the pmhnp certification and the few cns minded folks are not interested in the pmhnp certification. i’m still a year and a half away from graduation, but i’m trying to look ahead to my options/possibilities. does anyone here know a dual certified psychnp/psychcns nurse?
if not, speculation about the following questions would still be welcome. my specific questions are:
1 what are the common roles for a cns with psych np cert ?
2 what advantages might testing for my cns afford ?
3 what disadvantages might exist to dual certification (not fnp but the dual mhnp/cns) ?
4 what question should i be asking that i have not ?
your responses would be most welcome. if it helps, i have 10+ years of psych experience and about the same in critical care(ed, icu, telemetry, ltac), and own/operate an assisted living home for mentally ill.
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- Jul 25, '10 by talknwThere's no advantage of having the Psych CNS if your desire is to be a Psych NP. There's an overlap of education, and as an NP you're doing more such as prescribing and managing patients. Sounds like an interesting program, what school is this that allows you to customize your program with an FNP add-on?
- Jul 25, '10 by zenmanI agree. You're just creating extra work for yourself by working on CNS. Will you be working in a setting where you can use both FNP and PMHNP?
- Jul 25, '10 by t2krookiehi guys and thanks for responding. i was beginning to think no one could give feedback. as for the university, it is case western reserve. they are very expensive but also have an impeccable pass rate 99+%. as for the fnp add-on, i won't be able to use it in my initial setting (mhmr = pure out-pt psych) but i will be taking some part-time work to build skills and confidence as an fnp. eventually (2 years likely) i will progress towards a mobile care model, doing on site psych and medical management for patients in group living situations. i am already plugged into several such facilities and own one myself so i'm confident the fnp will pay off (not sure i will be able to see my own guys though. need to research the legality).
as for the cns portion, is there no additional billable procedures to be taken advantage of as a cns v. a mhnp? is there nothing a cns can /does do that a mhnp canít do and bill for?
i'm not looking to line my pockets, but i still have a family and a big big school bill to pay off. as i said, trying to see all the angles to this twisted system of ours. even if the cns shows no financial advantage, i am always glad for more diverse training even if i do not seek the certification.
- Jul 27, '10 by sdempsHi! You must really like school! I practice in Virginia as an Adult Psych MH CNS. Here, a board certified CNS in private practice can bill insurance for certain procedure codes. I can do psychotherapy and receive reimbursement. As far as my colleagues who are PsychNPs, they are working for community mental health centers or private sector outpatient facilities. From what I see and what they tell me, the employers mainly want them to be prescribers. They don't do therapy, although their interactions are therapeutic. At the MH center I work in part time, we are trying to get funding to bring a NP to do primary care for our SMI clients who lack affordable health care. In the mean time, we do screening and education for metabolic syndrome as a nursing initiative.
The disappearing tax base has stripped the community mental health system to the bone. I work with such dedicated and awesome providers, and I wish more nurses would explore psychiatric nursing. I love my mix of 1/2 time private practice in treating trauma and addiction, and 1/2 time at the mental health center. A bonus is that I get benefits from my county job. I love both venues.
You have high aspirations, so pace yourself and all will become clear in time.
- Jul 28, '10 by t2krookieActually I love school which is ironic given my early years. Never took it as seriously as I do now and didn't appreciate the environment like I do now. Guess we all have to grow up a little some time. Pressure is on given my age as well. Early 40s is gonna give me a good 20 years in practice. I ought to be a ble to change a few lives in that time I hope.
- Jul 30, '10 by juschillinI have a pmhnp degree and don't see a need for the dual degree. I don't understand what it would do for you to have the cns if you have the np...BUT I highly support the dual fnp/pmhnp to open up your future career options because where I live (Charleston SC) there are next to NO pmhnp jobs and I can't relocate. A couple of my classmates did the dual degree (fnp+pmhnp) and they were SMART. I feel that I was mislead by my school to only do pmhnp. That program doesn't even exist anymore at that school. I am interested in your home for mentally ill. Can you tell me more? I am out of work and desperately am seeking some way to use my degree...I can't get hired anywhere...over qualified.
- Jul 30, '10 by t2krookieQuote from julia1964wow julia,i have a pmhnp degree and don't see a need for the dual degree. i don't understand what it would do for you to have the cns if you have the np...but i highly support the dual fnp/pmhnp to open up your future career options because where i live (charleston sc) there are next to no pmhnp jobs and i can't relocate. a couple of my classmates did the dual degree (fnp+pmhnp) and they were smart. i feel that i was mislead by my school to only do pmhnp. that program doesn't even exist anymore at that school. i am interested in your home for mentally ill. can you tell me more? i am out of work and desperately am seeking some way to use my degree...i can't get hired anywhere...over qualified.
i just read your post and scooted on over to this web site and found 4 jobs advertising for psych nps in north carolina. and thatís just one recruiters site. maybe one of them is close enough to your area in next sc?
as for my assisted living, a fellow nurse and i worked together for a long time and became disgusted with the revolving door of the psych acute floor. most would come back due to horrible living conditions (rat infested slums) thieving mates (the acrogenous type, not the marital type ) , lost meds, non-caring boarding home operators, ect... so we opened up our own psychiatric pt only boarding home. well to make a long story longer, my friend backed out after the first month and i took over completely and transitioned to assisted living. it's not technically a "not for profit", but i lose money every few months so i should file as one(repair, equipment, turnover). i don't place the cost out of the range of the indigent (high premium on top of state money provided) like most places. if ya wanna do this as a business to stay employed, you have some darn good selling points(your education) and could go after the higher paying clients. there is no monopoly on crazy regardless of income. matter of fact, i find the silver spoon psychotics harder to bear than the indigents. in my case however, this place is more like a cathartic for my humanity. i just hope i can find a way to keep it going after i'm practicing full time.
- Aug 4, '10 by panmanI was a psych nurse for over 20 years then dropped out for a decade and have been looking into PNP as a result.
In speaking with a director at UND, sdemp has ditto'd her response. I got an MSW in the 90's cause LCSW's had their act together and PNP's are still finding their way. It flows that prescriptive powers would be in demand but I wouldn't want to be excluded from doing therapy. NP role varies from state to state and I wouldn't want to be restricted from practice any more than necessary nor have mobility limited any more than necessary. UND offers a dual program with like an extra 5 credit hours to pull it off since the curriculum's are so similar there anyway. In what job searching I've done to date, PNP's are significantly more demand that CNS's - probably because of prescriptive power. Lots of disciplines can do the therapy so that would thin demand.
Don't think I've ran across a program combining FNP and PNP, interesting.
- Aug 4, '10 by t2krookieOne thing I forgot to mention that is an advantage in the blended Psych CNS/PMHNP program is that I can do clinicals with both NP/Psychiatrists as well as therapists. It definately widened my clinical site options without increasing the hours. The psych portion is 720 hours and the FNP portion is 680. I find it a bit ironic the FNP being less hours but there ya go.