Common Nursing Complaints & Psych NP's - Not As Bad?

TraumaRN21 · Jul 23, 2012

Does anyone know what the job prospects are for mental health NP's in South Florida? Salary and how soon after graduation will you get a job.

Quickowit · Jul 28, 2012

Ellen,

I hope to be starting my DE program next year. I am a public defender who spent 5 years representing clients charged with capital murder and clients already on death row. For the past five years I've represented clients charged with or convicted with federal felonies.

Most of my clients had previously been diagnosed with mental illness and/or cognitive disabilities or were diagnosed by psychiatrists and pyschologists whom I retained. I've worked with clients with thought disorders, mood disorders, personality disorders, dual diagnoses, you name it. I've had incompetent clients and one client found NGRI (delusional disorder) and civilly committed. I've done biopsychosocial interviews for clients and their family members and worked with psychiatrists, psychologists, APNs, LCSWs, forensic pathologists whom I've selected based upon my initial assessment of a client. The ones who are aware of my decision to change careers are all extremely supportive.

Before law school I worked as a program specialist at a homeless shelter and a services coordinator for a Communities in Schools program helping at risk youth.

The direct entry program I hope to enter requires you to work full time as a psych RN while completing your specialty track classes part-time. I love being in the community and want to practice in a community mental health center or as part of an PACT team. I'm looking to keep people out of jail and not just minimize their sentences even though it will entail a significant pay cut.

How much do you think my background will help me? I understand the distinction you make between trust and respect. It's kind of like the way people who have only done criminal defense view criminal defense lawyers who used to be prosecutors. But I'm wondering if you think my cooworkers would have greater respect for me based upon my work history? That's really important when you work on an interdisciplinary team.

Thanks

Annaiya, NP · Aug 3, 2012

How much do you think my background will help me? I understand the distinction you make between trust and respect. It's kind of like the way people who have only done criminal defense view criminal defense lawyers who used to be prosecutors. But I'm wondering if you think my cooworkers would have greater respect for me based upon my work history? That's really important when you work on an interdisciplinary team.

I too was a lawyer before going back for nursing. Although people will be interested/impressed with your legal background, if your nursing skills and knowledge aren't top notch, your background won't help you. I found the transition from law to nursing to be a significant change. Definitely work as a psych RN while in school. It will help with the transition from thinking like a lawyer to thinking like a nurse. I love what I do, and I'm very glad I made the switch. Good luck!

Quickowit · Aug 3, 2012

Thanks for the input.It's nice to hear from people who have made the transition. It's funny, though, because I don't think of myself of a lawyer as much as a social worker. For public defenders, it's almost always about sentencing. I spend an unbelievable amount of time doing social histories and working with families.

mania4real · Dec 6, 2014

Interesting views but I think one does not have to work as an RN in order to be a good NP. As a matter of fact, I know I had to change my physician with an FNP in a VA hospital who never worked as an RN because of what I though was lack of know and care on the part of the physician. Today, I'm happy with my decision - she's so knowledgeable and caring.

xeniah · Oct 16, 2015

HI Baggins1215 ! I saw this post of yours recently. First of all thank you for sharing! I am an RN working FT for past three years on a med-surg and ortho/neuro floor and considering the same path of mental health nurse practitioner and wanted to ask you what is the most fulfilling part of your job? I am interested in the counseling part and I am good at it although my past life coaching experience 2000 -2010 was with people who just wanted to improve their lives an was not with anyone with significant mental illness. My passion is rooted deeply in the mental/emotional causes of disease (mental or physical) and also in preventative medicine through wellness/ educating people on cause and effect, avoiding onset of (avoidable) mental illness through education, outreach and family wellness programs parental support and resources education etc. One of my main interests is in preventing (preventable) mental illness that comes from emotional trauma. I also have some interest in treating PTSD. I have heard that NP's in this field do more prescribing medication than 1 on 1 counseling. Do you find that to be true? I really am not interested in prescribing pharmaceutical medicines to be honest. I am interested in almost every other type of therapy to help mental/emotional illness that does not involve medications. I have 2 young kids and am already working full time so mostly just gathering information right now. My income requirements are 90,000+. I have settled for jobs I loved in the past but was always living hand to mouth and being financially stable and having financial freedom is very important to me especially the older I get. Can you tell me what a typical day in your job looks like? I really appreciate any information you can provide even if it is just brief. I know you must be a busy lady as well! :) Thanks again in advance!

xeniah · Oct 16, 2015

HI Baggins1215 ! I saw this post of yours recently. First of all thank you for sharing! I am an RN working FT for past three years on a med-surg and ortho/neuro floor and considering the same path of mental health nurse practitioner and wanted to ask you what is the most fulfilling part of your job? I am interested in the counseling part and I am good at it although my past life coaching experience 2000 -2010 was with people who just wanted to improve their lives an was not with anyone with significant mental illness. My passion is rooted deeply in the mental/emotional causes of disease (mental or physical) and also in preventative medicine through wellness/ educating people on cause and effect, avoiding onset of (avoidable) mental illness through education, outreach and family wellness programs parental support and resources education etc. One of my main interests is in preventing (preventable) mental illness that comes from emotional trauma. I also have some interest in treating PTSD. I have heard that NP's in this field do more prescribing medication than 1 on 1 counseling. Do you find that to be true? I really am not interested in prescribing pharmaceutical medicines to be honest. I am interested in almost every other type of therapy to help mental/emotional illness that does not involve medications. I have 2 young kids and am already working full time so mostly just gathering information right now. My income requirements are 90,000+. I have settled for jobs I loved in the past but was always living hand to mouth and being financially stable and having financial freedom is very important to me especially the older I get. Can you tell me what a typical day in your job looks like? I really appreciate any information you can provide even if it is just brief. I know you must be a busy lady as well! :) Thanks again in advance!

elkpark · Oct 16, 2015

HI Baggins1215 ! I saw this post of yours recently. First of all thank you for sharing! I am an RN working FT for past three years on a med-surg and ortho/neuro floor and considering the same path of mental health nurse practitioner and wanted to ask you what is the most fulfilling part of your job? I am interested in the counseling part and I am good at it although my past life coaching experience 2000 -2010 was with people who just wanted to improve their lives an was not with anyone with significant mental illness. My passion is rooted deeply in the mental/emotional causes of disease (mental or physical) and also in preventative medicine through wellness/ educating people on cause and effect, avoiding onset of (avoidable) mental illness through education, outreach and family wellness programs parental support and resources education etc. One of my main interests is in preventing (preventable) mental illness that comes from emotional trauma. I also have some interest in treating PTSD. I have heard that NP's in this field do more prescribing medication than 1 on 1 counseling. Do you find that to be true? I really am not interested in prescribing pharmaceutical medicines to be honest. I am interested in almost every other type of therapy to help mental/emotional illness that does not involve medications. I have 2 young kids and am already working full time so mostly just gathering information right now. My income requirements are 90,000+. I have settled for jobs I loved in the past but was always living hand to mouth and being financially stable and having financial freedom is very important to me especially the older I get. Can you tell me what a typical day in your job looks like? I really appreciate any information you can provide even if it is just brief. I know you must be a busy lady as well! :) Thanks again in advance!

Psych NP education and practice is focusing on prescribing and medication management. There is little training in therapy, and limited opportunity to practice it. It's not cost effective to have someone who has rx authority talking to people about their feelings and problems for significant periods of time. Most therapy is done by therapists from other mental health disciplines who get paid a fraction of what psych NPs do. You are going to have a v. hard time either a) being a psych NP who does therapy or b) being a therapist who makes $90k a year.

(Also, there is a huge difference between "coaching" basically health people and doing psychotherapy (effectively, that is -- there are plenty of lousy "therapists" out there) with people with significant mental illness.)

PG2018 · Oct 17, 2015

You'll make more than 90k.

You won't do therapy.

You'll have an awkward relationship with therapists.

You could very well be a psychiatrist's lapdog so be selective.

You'll do the same work, if not more than MDs, but make less.

Your ability to control your schedule could yield income greater than primary care MDs so be selective.

You'll eventually lose the allure of wellness and life coaching.

You will study often and demonstrate efficacy or be like "the other half" or incompetents that give us a bad rap.

You'll wonder why people stop taking meds that work, ignore your instructions to take meds for at least a month before stopping, why people prescribe meds that don't work, wonder why they can show up a month later not having had time to go to the pharmacy and pick up their prescription, and become replulsed by any hint of wanting Xanax or Klonopin.

You'll enjoy your job, your autonomy, responsibility, and liberty never experienced as a RN.

Psychcns · Oct 17, 2015

Agree with previous two posters. I do Locums tenens inpatient and outpatient

My typical day outpatient

800 review labs mail

830-12 see patients. New eval 90 min

med follow up 30 minutes. Type note as I interview and listen

12-1 unpaid lunch

1-430 same as morning

430-5. Review labs etc

Make phone calls and collaborate when your patients are no shows

Did not attend staff meetings at this job

Inpatient schedule

8-83O morning report

830-10. Team. More indepth review of treatment

10-5. Meetings with patients, writing notes, putting in orders, talking with pharmacy, family meetings, admissions, discharges, dictating, collaboration, restraints, emergency meds

1 hour unpaid lunch

Both roles had a steady pace.

No formal therapy but having a therapy background helps

xeniah · Nov 17, 2015

elkpark, psychguy, and psychcns thank you so much for your feedback! It really helps to have feedback from people who know more about this field than I do!!!! There are limited opportunities these days to find out what a career is really like from the inside before starting school and committing a ton of time and money first and to be honest, of course the money sounds so appealing but I have absolutely no interest in prescribing medications. :/

xeniah · Dec 2, 2015

Anyone reading this know of online psychiatric nurse practitioner programs heavy on psych classes?