A polite request for psych nurse info

  1. Hi, I am coat tailing on a previous post from Molly J regarding the limited response by psych nurses to information requests.Psych nurses do not seem to respond to posts like the other specialty nurses do. This is especially troublesome for student nurses (like myself) who are interested in pursuing a career in psych nursing. It is not just on this site either. I have approached quite a few psych nurses to get emloyment information and they have all been very tight lipped. What is the big secret????? I personally just want to know how you like your job, what kind of career opportunities there are for psych nurses, is it better to get an advanced degree as a clinical nurse specialist or as a psychiatric nurse practitioner or is there no benefit to getting an advanced degree? Is there really such a position as a nurse psychotherapist and if so how do you become one ? Can they prescribe meds? Is the pay for psych nursing comparable to other nurse specialties? Is there a high turnover rate for psych nurses? Do you recommend getting some Med -Surg experience first? Some body please break the code of silence . I would REALLY appreciate it.

    Thank you so much!
    Mia
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  2. 15 Comments

  3. by   pattyjo
    Hi Mia, I replied to both you and Molly on her post, so take a look there.
  4. by   Bjo
    Hi, Mia,
    I would love to discuss psychiatric nursing with you. I am a nurse manager in a psychiatric hospital for children and adolescents. I have worked at this hospital for 8 years. Let me know if I can be of any help.
    I love my job. I prefer to work with the kids rather than with adults. Our turnover rate is low but lately we have had trouble getting nurses to work at our facility. I think the problem there is the fast pace. I didn't go in to med surg before I took this job. I had worked as an LPN when I graduated in 1986 and most of my jobs were in long term care facilities for the elderly. My passion was mental health and I got this job when the facility was just newly opened. I went back to school to get my degree as an RN because of the $5 per hour pay difference! In December of last year I sat for the certification test through the ANCC and received my certification. I could go on and on but I'll wait to hear from you!
    Thanks,
    Bobbi Jo
  5. by   kawrn712
    Hello, my name is Kim and I am a nursing student interested in psychiatric nursing with children and adolescents also. Would you mind sharing with me what you do, the education needed, etc? I would really appreciate it. Thank you.
  6. by   morghan
    For Mia:

    In response to your desire for information re: psych nursing...
    this is a great specialty! I have been a nurse for a long time, with a variety of experiences, OB, OR and currently Psych. I graduated, mmm 1968 from a Diploma school; then went back to get my BSN, and now am enrolled in a Master's Program in Wichita, Kansas. Advanced practice is the way to go, for sure.
    I just assumed a new role at my hospital, Attending RN, which means I assume total management for all the psych clients within our unit's practice group (that is all the docs who admit to our 26 bed GeroPsych unit. I do a specialized assessment, contact and interface with the patient and family, make discharge plans, and if the patient is transferred to a medical unit or ICU, I go there too.
    Good Luck with your endeavors.
    PsychRN from Wichita-Morghan
  7. by   Aerolizing
    Hi Mia,
    I love psych nursing (nine years inpatient, one out patient) and I would like to get into teaching psych clinicals. There are so many opportunities in psych nursing. In Ohio, where I work, you can be an staff nurse which I recommend as there is no better training than real life. Let someone else pay for you schooling too. I got into this with ADN. I also sat for my certification although at my hospital, I received no special pay. Other facilities recognize certification and will pay more for nurses with it and our local visiting nurse does not accept anyone into psych without it.
    As for turnover, depends where you are working. I worked for a private facilty where $$$ is always the motivating factor for everything and I was not satisfied. I did not go home with a good feeling after working there. The company wanted more and more from me without paying me more and more. My friend worked in a private psych free standing hospital with children and adolescents and she was beat up on a regular basis. Ask around, teenagers can be moody. Not my cup of tea. Most have issues with mommy and daddy and when you meet them, you see why. I liked adult nursing. Fewer wrestling matches.
    At the public hospital where I worked at for nine years, staff rarely left. Seems they all came to retire. Many staff had been there for over 10 years. They really knew how long they had til retirement. Good sign I think. No room to move up the ladder there but, staffing was good, work place environment was safe, rate of pay was competitive. Psych is not really considered a specialty so no extra pay for me.
    When I started looking for a job in nursing, I did some home care and got to go into different psych units around for private duty patients back when that happened. There was a nursing shortage too back then so I felt I was in the driver's seat. If I had not been to an area psych unit for a clinical, I called and asked to take a tour. Seems so bold but it worked. I had a medical director take me on a tour of our local state facility. When I interviewed, I already knew what I did not like about the psych unit where I worked as a nurse tech so I asked a whole pile of questions like.... how many iv's, gero, medically compromised etc. I also asked what happened on their last patient outburst. Turns out when I asked that, there had just been a rather unusual violent outburst from a patient. These things you need to know before you get stuck in a job where you want to get out right away. A little homework goes a long way. Oh, don't forget to ask the staff the best and worst parts of their jobs. You are interviewing them too.
    Good luck,
    Diane
    ps If I did not answer any questions, feel free to ask me.
  8. by   victoreia
    I have been in psych nursing for three years now and I love it. I have worked with adults and I worked on a MICA unit which is mental illness and addiction problems. Now I work with adolescents and enjoy that. Always be on alert because you never know when a psychiatric client might go off. I have a very good rapport with all 64 clients but I still watch my back. I love working with kids and love my job. The pay is competative and I make more then some medsurg nurses I know. In any profession the more education you have the better off you are. Pay may not always accompany an advanced nursing degree but it does wonders for your self esteem and looks very good on a resume. Pay basically depends on where you live and work I think. BSN's here do not really make more then ASN's. That is not the case in other areas. Before you accept a job check out pay scales for your area. If you work with children be ready to be nice to sexual offenders, parents or clients themselves. Be prepared to be nice to parents who have abused and neglected their kids. I have heard and seen horrible things that have happened to the clients I work with. Do not try to save them and think you can take them under your wing and change their lives. Be a nurse and advocate for them. Do not be a parent figure for them.
  9. by   MHN
    To Mia, Here in Australia its seems to be a bit easier and less

    confusing .I am an RN and Midwife and have just completed my

    Post Graduate Diploma in Community Mental Health it only took

    1Yr full time plus 24hrs clinical placement a week for which I was

    paid .I had 31yrs total experience in General and MIdwifery

    when I changed accross to Mental health and I love it. MHN.
  10. by   JudeVC
    Hi Mia:

    I can't speak (write ?) for all Psych nurses but I can for myself. I tend to listen a lot and I believe that helps someone in Psych Nursing so maybe I also tend to lurk instead of speaking out.

    I've worked in Psych Nursing for 17 years as an RN and before that as a Tech/ Nsg Assistant. Initially I graduated from a Diploma program, got my BSN and then my Masters in Psych Nsg. I've worked with children, adolescents and adults of all ages. The patients I see seem to be sicker so a Med Surg background can only help. However the basic skills you learn in school are the ones you'll use and build on throughout your career.

    I am cheap so I agree with letting your employer pay for education. That might be a benefit you look for when evaluating job offers.

    And yes, there really is such a thing as a Nurse Psychotherapist. For years Psych Nurse CNS did this. Now many Psych nurses are becoming Nurse Practioneers and in many states they can RX medications. However they still use the basic and advanced Nursing and Psychiatric skills while treating patients.

    Hope you continue your intrest in Psych Nsg and this reply answered some of your questions. If you have other questions please send me a message.

    Judy
  11. by   Eva Bell
    Hi Mia

    Just to let you know, I too found that nurses functioning as CNS are difficult to get information out of, providing you can find them. Hopefully, this cycle will abate soon. I, for one, will be happy to share what I have learned, or direct to sources I have found useful in my personal plight. Information is available, but sometimes it must be collected in bits and pieces, sometimes challenged, and always shared for the benefit of the patients, families and communities we serve. Sometimes, I toss around the idea I should write a book or something so information is available. If nurses run into these obstacles and can't define what we do or why, how can we expect anyone to?

    I have done psych nursing for over 10 years. Started as ADN, then BSN, the MSN and have also completed a post-master's program. I have worked in Psychiatry almost since I became a nurse. I believe that the knowledge gained during work at the inpatient level (in addition to med-surg) provided me with some excellent opportunities for learning. I have worked inpatient, outpatient, partial programs and home health, and now as nurse practitioner. I am certified as Family NP and Psych Mental Health NP. The new role of PMH NP vs. CNS is confusing and overlapping. However, either can be psychotherapist, both can obtain prescriptive authority. For futher differentiation, you can read several position papers via the internet, some at the ANCC website. I am excited as I expand my role from FNP to PMHNP - essentially adding psychotherapy - as I have been working with a psychiatric practice providing care within the scope of the FNP.

    If you need information or just some support, let me know. Like I said, I would be happy to share.
  12. by   Mary2383
    For Eva, hi! I am currently attending nursing school and I think I would love Psych nursing. Although I have a question about insurance issues. Can a mental health nurse practioner give long term psychotherapy? And if so, will most insurance companies pay for this or will they only pay for a few visits? I have read that a lot of insuranc companies will only pay for about 20 visits, this is why I ask. I appreciate any help you can give me
  13. by   vonbucher
    Eva Bell,
    Thank you for your information. I am an FNP with primarily psych experience. I have applied to two pmhnp programs but they are currently full for this year. I am being "courted" by a psychiatrist who wants me to work with him. What types of things did you do to stay within your FNP scope of practice while working in this setting? I know therapy is a no no.
    Any info would be helpful.
  14. by   CharlieRN
    I'm not an advance practice RN. So I can't give you much info on that. I'm a diploma grad with a BA in an unrelated field. I have about 20 yrs fulltime experience in various inpatient psych units. At this time I am the night supervisor and admissions nurse for a free standing psych hospital.

    In the inpatient psych unit setting, I am strongly in favor of nurses having medsurg or emergency department experience. I think even psych specializing advance practice RN's would do well to have this because with your expanded role goes the assumption that you are a general resource person for nursing issues. The reality is that as you devote more time and effort to becoming a specialist, you will have less general nursing experience, unless you take steps to get it. At the very least it gives you "street cred" with the nurses whom you supervise.

    As to doing "therapy", that depends on just what you propose to do and how you expect to be paid for it. Any RN can sell their services directly to the patient. The "Private duty" role is bedrock. Listening to patients, observing and recording their symptoms, teaching them how to live more healthy lives, performing comfort measures, these are all legitimate nursing functions. You can do a whole lot of therapy within those limits. Just steer clear of diagnosis and prescribing meds. Now once you go looking for 3rd party payment, that's another matter. As long as you are stricly private duty your qualifications as a therapist are pretty much between you and your customer. Once you seek insurance payment they will want to see credentials. You need to check your local laws too, the meaning of "therapist" "counselor" etc may be legally defined.

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