MSW to NP?

Specialties Psychiatric

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I am currently pursuing a Master of Social Work, concentrating in clinical practice in mental health. I love the field, but have recently been thinking about a three year NP Program with a concentration in mental health, following my graduation from the MSW program. I find psychiatry intellectually stimulating and clinical work challenging (in a good way!) and enjoyable. I feel as though getting nursing training would be an excellent compliment to my social work skills, and allow me to take a more comprehensive approach to patient care. I could be completely off-base here, so I am very interested in hearing what real professionals in the field have to say about this notion. Thanks!

I feel your confusion about the issue and here is what I know. There are some programs out there right now (UNC) that will allow a dual track of CNS and NP at the same time. Some of the course differences are that a NP will have to take advanced pharmacology and Physical assessment. CNS's route will be a little more academic in that their roles can be more in the psych or specialty educator role. NP's are more geared toward direct practitioner and medication prescription role, the physical aspect of the role.

Depending upon the state and company, each role can do the basic same job descriptions, but there are those states that are very specific on scope of practice. Many states will allow you to do the CNS program and then take an additional three classes to sit for the NP exam also.

Many professionals believe that the CNS role is being phased out or will be obsolete, but their role is as valuable as any and definitely contributes to the value of nursing and in the private sector.

When pertaining to private practice, there are many independate, completely NP organized practices out there. I can think of two right now in Cincinnati and in Lexington KY. For some it is just easier to become part of a psychiatric group and have the collaberating psychiatrist there at the office. Plus there are still states that really don't give NP's and CNS's much support or are not recognized as highly as in other states.

I would disagree a little with Psychrich (only) about the "more academic" comment about CNS programs -- Psych CNSs are trained as (clinical) diagnosticians and psychotherapists; there is no pharmacology or physical assessment content in the programs, because that is not part of the psych CNS role, but it is all about providing direct client care in clinical settings. The MSN in psych nursing has been around for many decades, and was, in fact, the original, first advanced practice role developed in nursing (we led the way for everyone else ... :) ). The Psych NP role has only been around the last few years; it supposedly combines the psych focus of the psych CNS with the pharmacology/physical assessment training of the nurse practitioner.

My concern about psych NPs is this: Psych CNS programs are two year programs (in most schools). Traditional (non-psych) NP programs are two year programs (in most schools). Psych NP programs are two year programs (in most schools) -- so, doesn't that basically mean that the students are getting (the equivalent of ) half a CNS program and half an NP program?? If so, are they really prepared to be competent at either?

I've never had any interest in prescribing meds for people (if I did, I would have gone to med school instead of nursing school ...). My observation over the years has been that there are far too many people doing a poor job of Rxing psych meds for people; I don't see any need for me to add to that problem ... I've always found the medication issues so boring that it's perfectly fine with me to leave that to the docs, and I appreciate them taking care of the scutwork for me. :chuckle

Most of the psych CNSs I've known over the years have had private, outpatient practices in psychotherapy (that's traditionally been the interest and motivation in becoming a psych CS). I've always been considered an oddball within the psych CNS community because I prefer inpatient settings. There's no reason why psych NPs can't have their own private practices, or be part of larger, existing practices, depending on the specific requirements of individual states (as I said in my earlier post, my only personal experience with psych NPs has been in inpatient settings -- I didn't mean to imply that they only work in inpatient settings). Certainly, psych NPs with their own practices would have more flexibility in determining how much of their time they want to spend doing therapy as opposed to med management (although, again, I have to wonder how well prepared they are as psychotherapists ...) But, once you have prescriptive authority, the reality of the marketplace is that your time is much more valuable writing Rxs than it is doing anything else ...

I'm sure that there are lots of psych NPs out there who have created their dream jobs and are loving what they're doing. More power to them. There's something for everyone in nursing.

Thanks to you both for the valuable information. In addition to what I've read on this thread and some other research I have done, I think I may be best suited for the CNS role. My top priority would be to be to be as good a psychotherapist as possible and since medication management would be secondary for me, it would be a smart shift to go with the CNS route. It also seems that there is also the potential to take some pharmacology classes later and take the NP test if I wanted (in some places anyhow - I think Colorado allows this?).

I just want to throw some thoughts out there on med management and see what some opinions are. I know this can be a controversial issue and my motive is just to get some honest opinions from nurses in the field. Alot of what you say elkpark, really resonates with me. We have had a couple of psychiatrists who are very competent prescribers and we have also had even more who are really lame. I know I am largely speaking out of ignorance here as I do not have my master's degree and I have not gone to medical school, but honest to god, psych med prescription seems to me more of a crap shoot than anything. A large part of my issue with the docs who are poor prescribers is that they overprescribe. We have a number of borderline patients who are on the most amazing cocktail of meds - I think it is almost criminal. Granted, these are very difficult patients and sometimes it just seems easier to throw a med at them and quiet them, but it just seems wrong and actually contraindicated. So I hear what you are saying about wanting to stay out of meds and for the most part I would agree.... but there are times at work when I think I could do a better job prescribing than some of these docs .... and , believe me, I am not an arrogant person. I realize that there are lots of considerations in prescribing but it does seem that the choices of psych meds are relatively limited (as compared to medical meds). I will tell you what would keep me out of the prescribing role is the young, first break schizophrenic who is not responding at all ( we have this 20yo gentleman on our unit right now). This kid who was seemingly fine 3 mos ago is now gone and the meds have had absolutely no effect and so now it is looking like a Clozaril trial. These are cases were I say "thank god I am not the psychiatrist". I guess no real "point" to all this rambling and ranting just wanted to get some other viewpoints on this issue.

So, again, thanks for the great information and the lively discussion! Am certainly open to more.

Christine

This is very interesting to me. I think you should definitely do it. I was wondering if you could post or PM me and let me know what school you are thinking of going to. I am an RN who was a school nurse and an elementary school teacher. I want to be a psychiatric nurse practitioner, and I am trying to decide how to go about it. I graduated from nursing school many many years ago with a BS in Nursing. I then got an MA in education. I took a refresher course and did very well. When I tried to get a psych. job, nobody would hire me because of lack of med surg experience. I do not want to work med surg. So I am trying to decide if I should redo my nursing skills education by taking a direct entry master's program where nobody has nursing skills. I found out that I could do this and would not have to take the boards as I am currently licensed. Your school sounds interesting to me, as you said you could take a concentration in mental health. My other choice is to go directly into a psychiatric nurse practitioner's program without redoing my nursing skills. I would appreiciate everyone's opinion. My three choices are

1- direct entry master's program with specialty in psych nursing

2- take a second refresher course in med surg (as the last one I took was two years ago) and then take a regular psychiatric nurse practitioner's program

3-just go directly to a psychiatric nurse practitioner's program.

I have been worrying that it may not be wise to become a psychiatric nurse practitioner with never being a psychiatric nurse. But if you guys think it is a good idea for an MSW to do it, would it be ok for me too? Thanks for any advice Krisssy

I brought this up again. Any advice for me??? Please! thanks Krisssy

This is very interesting to me. I think you should definitely do it. I was wondering if you could post or PM me and let me know what school you are thinking of going to. I am an RN who was a school nurse and an elementary school teacher. I want to be a psychiatric nurse practitioner, and I am trying to decide how to go about it. I graduated from nursing school many many years ago with a BS in Nursing. I then got an MA in education. I took a refresher course and did very well. When I tried to get a psych. job, nobody would hire me because of lack of med surg experience. I do not want to work med surg. So I am trying to decide if I should redo my nursing skills education by taking a direct entry master's program where nobody has nursing skills. I found out that I could do this and would not have to take the boards as I am currently licensed. Your school sounds interesting to me, as you said you could take a concentration in mental health. My other choice is to go directly into a psychiatric nurse practitioner's program without redoing my nursing skills. I would appreiciate

everyone's opinion. My three choices are

1- direct entry master's program with specialty in psych nursing

2- take a second refresher course in med surg (as the last one I took was two years ago) and then take a regular psychiatric nurse practitioner's program

3-just go directly to a psychiatric nurse practitioner's program.

I have been worrying that it may not be wise to become a psychiatric nurse practitioner with never being a psychiatric nurse. But if you guys think it is a good idea for an MSW to do it, would it be ok for me too? Thanks for any advice Krisssy

Krissy-

How many years did you practice in the role of a nurse and how long has it been since being involved in nursing?

I would not go for option #1. The direct entry programs are mainly for people with bachelor degrees in other disciplines. These programs are very high paced and it would be redundant with your original nursing school training. If it were me, I would consider option #3. The role of the NP is very different from that of the RN. I know that this is controversial, but schools are encouraging students to go straight into specialty areas or onto grad school and the one-year of med-surg is not required. I have looked into many of these programs and experience as a psych nurse is also not required. Of course it would probably be helpful, particularly when you graduate and are looking for a job. Perhaps you could obtain a part-time position in a psych area while you attend school. I encourage you to speak with an academic advisor or the student affairs office of the schools you are considering. They will be able to offer great advice.

Good luck!

Katy

Krissy-

How many years did you practice in the role of a nurse and how long has it been since being involved in nursing?

I would not go for option #1. The direct entry programs are mainly for people with bachelor degrees in other disciplines. These programs are very high paced and it would be redundant with your original nursing school training. If it were me, I would consider option #3. The role of the NP is very different from that of the RN. I know that this is controversial, but schools are encouraging students to go straight into specialty areas or onto grad school and the one-year of med-surg is not required. I have looked into many of these programs and experience as a psych nurse is also not required. Of course it would probably be helpful, particularly when you graduate and are looking for a job. Perhaps you could obtain a part-time position in a psych area while you attend school. I encourage you to speak with an academic advisor or the student affairs office of the schools you are considering. They will be able to offer great advice.

Good luck!

Katy

Katyosu Thank you so much for your reply. I practiced as a school nurse teacher as soon as I got my RN and BS degree. I practiced for two years from 1969-1971. Then I was a classroom elementary school teacher for 25 years. Two years ago I took a med surg refresher for 6 weeks with clinicals.

I had emailed a few direct entry master's programs, and the deans agreed with what you are saying. They, too, thought it would be ridiculous to repeat everything. They said a refresher course was enough. Your advise is very helpful, as at your age you are more familiar with these programs and what they are like. I do have an appt. with an advisor from a state school which offers an online psychiatric nurse practitioner program. I will let everyone know what she says. Thanks again for your advice. Are you going to go directly to a psychiatric nurse practitioner program when you graduate from nursing school? Or are you going to work first and if so in what field? Krisssy

Katyosu Thank you so much for your reply. I practiced as a school nurse teacher as soon as I got my RN and BS degree. I practiced for two years from 1969-1971. Then I was a classroom elementary school teacher for 25 years. Two years ago I took a med surg refresher for 6 weeks with clinicals.

I had emailed a few direct entry master's programs, and the deans agreed with what you are saying. They, too, thought it would be ridiculous to repeat everything. They said a refresher course was enough. Your advise is very helpful, as at your age you are more familiar with these programs and what they are like. I do have an appt. with an advisor from a state school which offers an online psychiatric nurse practitioner program. I will let everyone know what she says. Thanks again for your advice. Are you going to go directly to a psychiatric nurse practitioner program when you graduate from nursing school? Or are you going to work first and if so in what field? Krisssy

Krissy,

I am planning going directly into grad school. I was planning on doing a psych NP program, but now I am more interested in psych CNS. I worry that the jobs may not be available for psych CNS, although I believe that this would be a better fit for me. I am planning on applying for an accelerated PhD program that will allow me to obtain a MS, sit for the CNS licensing exam, and continue on to get a PhD. I am planning on working part-time, hopefully as a psych nurse, until I become a CNS.

Good luck in your program!

~Katy

At this point, I have decided to apply to a NY state psychiatric nurse program, although I have heard some things that are making me a little tentative about going there. I am also applying to MU Sinclair in Missouri where they have an online program in a psychiatric nursing. I have to go online, because I will be living in NY in the summer. and in Fla. in the winter. If I can't get into a psychiatric nurse practitioner online program, I would consider the University of Iowa's school nursing master's. I am happy to see that the young people of today are going straight into their specialty, because that is what I want to do. I know I will need a graduate statistics class, and if they want me to take another nursing med surg refresher couse I will. Can anyone recommend any other online psychiatric nurse practitioner programs that they have heard good things about? I am starting my applications now for the spring term. Do you speak to an advisor before applying? Thanks for all your help everyone Krisssy

ok...so Psych CNS can provide psychotherapy...i'm in massachusetts...is the role the same in every state?

also..i noticed that these postings are several years old...what did you decide to do??

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