MSN program questions

Specialties Psychiatric

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Specializes in Mental Health and Substance Abuse.

I am completing my BSN this December and am looking at MSN courses at this time with a goal of starting one next spring.

My desire is to be a therapist where I can eventually have my own office. Right now I work in a psychiatric hospital as a nurse manager and plan to grow into the therapy path through this facility.

The question is - what is the best step to take education wise to achieve this goal? I am getting a lot of feedback regarding MSN in adult psychiatric mental health NP but when I review the programs for that it seems to be more of the role of med management vs therapy.

Any nurses out there work as therapist? If so what route did you take to get there?

Thank you!

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The problem is that, now that so many states are offering Rx authority to both psych NPs and psych CNSs, all the graduate programs focus on the physical assessment/prescribing part of the equation. I am an "old school" psych CNS who went to grad school long before anyone ever considered the possibility that psych CNSs might someday be eligible for Rx authority, so my graduate program was two intensive, rigorous years of training as a psychotherapist (which is what psych nursing graduate programs used to be). I don't think psych CNS programs like that even exist any more. Psych NP programs have, from the v. beginning, focused on prescribing rather than therapy, and the psych CNS programs are slowly becoming indistinguishable from the psych NP programs.

Some psych nurses used to go outside of nursing for graduate programs to become therapists (getting graduate degrees in psychology, counseling, etc.), but the ANCC has tightened the requirements over the years so that it's no longerpossible to become certified as a psych CNS with a graduate degree in another field -- it has to be an MSN in psych nursing.

I guess, at this point, you can either grit your teeth and do a psych NP/CNS program and then focus on learning to become a good therapist after you complete the degree, or "jump the fence" and move into another field (psychology, social work, counseling).

Have you talked seriously with your current employer about what your professional prospects might be with them, realistically, if it is your intention to stay with them (as you suggested in your post)? Most of the facilities I have been aware of in recent years use social workers or LPCs as therapists because they are much cheaper than psychologists or MSN-prepared RNs. If I were you, I would not just assume that you have a professional future with a particular organization as a psych NP or CNS just because you're working for them now. And your current employer may be only interested in using you for med management, rather than as a therapist -- that is certainly the trend in psychiatric nursing advanced practice these days.

Sorry to sound so gloomy about all this :) -- best wishes!

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Specializes in Mental Health and Substance Abuse.

Didn't sound gloomy at all, it's reality. While I would like to think that I have a future where I work I never count on that. Especially in this economy! That's why I am trying to set up my future best I can so I can go into my own business. I thought about going the PsyD route but I will have to look into what you are saying about the ANCC.

Rx authority might not be a bad idea I guess if I plan on opening my own office down the road. I would assume we would still need physicians over site right? I can't imagine the powers that be actually having a awakening that a nurse can really manage these things on their own *smile*

Seriously though, my goal has always been therapy so that is the way I will go. Just need to see what road is going to get me there. Your posting gave me some things to think about. I am guess I am leaning towards the MSN then getting the therapy training I will need.

Hopefully some others will post about this and I can get some other great feedback. Are there any schools you would recommend over others? I am in need of a mostly online program for sure.

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Rx authority might not be a bad idea I guess if I plan on opening my own office down the road. I would assume we would still need physicians over site right? I can't imagine the powers that be actually having a awakening that a nurse can really manage these things on their own *smile*

That depends entirely on what state you're in. There are quite a few states now that allow advanced practice nurses to practice independently, without any physician oversight at all. In others, the required physician supervision or collaboration might amount to having an agreement with a physician that s/he is available for consultation as needed, or your "supervising" physician reviews a sample of your charts once a month or so ... Many APNs choose to work within a practice with one or more physicians (right there in the building with you at all times) or in a facility/program in an interdisciplinary model. Others own and operate their own practices and hire a physician to provide whatever level of supervision is necessary. There is a lot of variation; but the trend is definitely toward decreasing levels of supervision.

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Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.

I am curious as to what information you will find. I am a long ways from any of this, as I am just starting my bachelor's degree. I originally planned to do psychology or social work, but nursing runs in my family. So that was the path I went. I have looked into things as well, but like you said the NP route seems so med focused.

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