Is the psych field under-staffed?

Specialties Psychiatric

Published

Hi all,

I am applying to school in one month so I know I have PLENTY of time to figure out where I want to be, but I'm already feeling an affinity for Psych. I'm 40 and in college I wanted to be a psychiatrist...until a very intimidating professor basically scared me away from it. In '99 I started pre-reqs to get my master's in psychology and then I got pregnant and stopped. During that time I really became disillusioned with the mental health field as a stood by my good friend as she dealt and continues to deal with her own mental health issues. She has bi-polar disorder and I feel it does such a disservice to the patient to have one practitioner give meds and another do counseling. I feel a holistic approach would serve the person better for many reasons, but the main one being monetary. Most people have an insurance plan that limits the number of mental health visits you can have in a year, and when you have to use two of those visits to get meds and counseling it really screws the patient. She was put into a position of having to choose between counseling or med adjustment, and believe me, her med adjustment was nuts (at least from my perspective). Because of those limits she wasn't going to counseling regularly and wasn't moving forward with many of her emotional trigger issues. Many times she would ask my advice and I would tell her my opinion, predicated with, "you should ask your counselor, but I think..." Many times she would tell me that the counselor had told her the same thing I said or one of the conclusions I had drawn about her behavior was very on point. Anyway, I sort of turned away from psych because I felt the whole set-up was not serving her well and THEN I found out about Psych NP's who can counsel AND prescribe meds! So that has gotten me really curious about this specialty. I live near Charlotte, NC and have a VA in my home town so within 45 minutes of me I have 4 inpatient facilities - 2 in Charlotte, 1 in Concord, and 1 at the VA. Is Psych nursing under-staffed? Can you find a job reasonably easily? What is the best way to REALLY know if you are cut out to be in the psych field? Should you be a psych RN before entering a Psych NP program? The nearest program to me is UNC-Chapel Hill. Does anyone know how good their program is? What is your advice for someone considering this field? Thank you all!

Specializes in Psych (25 years), Medical (15 years).
Is Psych nursing under-staffed? Can you find a job reasonably easily? What is the best way to REALLY know if you are cut out to be in the psych field? Should you be a psych RN before entering a Psych NP program? What is your advice for someone considering this field?

Psych Nurse Staffing: It's anybody's call. A matter of a subjective perspective. Two competent Satff members can get done what five incompetents can't. But, generally speaking, from my subjective viewpoint: No.

Job Availabilty: Relatively available, here in the St. Louis area.

Cut out to be in the psych field: You are. I can feel it. RevolutioN2013, you have a passion for it. Without being a savior. I sense a realistic attitude coming from you.

RN before NP: Sure. Why not? The more experience, the better.

Advice: Know this: Mental Illness is an illness like a Physical Illness. Do not expect the affected organ (the brain) to function normally during an exacerbation of symptoms or if its chemistry is not stabilized. Expect the unexpected, as the seat of all emotional and cognitive processes occur within this affected organ.

I enjoyed answering your questions. I hope you equally enjoy the answers.

The best to you, RevolutioN2013.

Dave

Thank you for your reply, Dave, and thanks also for the vote of confidence :). I've never heard this stated...just thinking here so I may be off base...but it seems that the brain chemicals being out of balance (is there a correct medical term for this?) would result in an inability to meet Safety & Security needs. Once the medication stabilizes the physical problems you can begin using psychotherapy to deal with Love/Belonging, Self Esteem, and Self-Actualization issues which would, I would think, vary by patient. This concept sort of gelled in my mind from seeing what my friend with bi-polar has gone through. Each time she would go through depression, anxiety, or mania, she needed the medications to get back to a stable mind-set and THEN she was more receptive to counseling & therapy. I do think that I can be pretty perceptive about who people are underneath their social veneer, but I have never been around people who have BPD, Schizophrenia, or are socio- or psychopaths and I would imagine that those disorders are a pretty different kettle of fish! I guess overall when I think about psychiatric patients immediately all sorts of questions spring to mind...like "Is med Px really hit or miss or is there a more scientific approach to Px and adjusting meds?" and "What is EMDR and how has it helped people?" and "What percentage of the homeless are suffering from a debilitating mental disorder and how do those people get treatment?" I have endless questions but when I think about the actual medical field it's just...crickets OR active aversion like what I feel when I consider the NICU. God bless the folks who work there but I would absolutely FREAK working in that environment. I do NOT want to work with the tiny humans LOL! (Sorry Grey's Anatomy reference). When one goes through the AMH-NP training is there a lot of learning about the different types of therapies or is the NP role more tailored to med Px? The reason I ask this is that after Googling "Psych NP" and reading some of the material the impression I get is that the main focus of the job is the latter and I really want to do therapy and be able to Px as an adjunct. Listen to me...I'm talking as if my decision is made and I haven't even been accepted to NS yet. :lol2:

I have been a psych nurse now for 5 years and absolutely love it! At the hospital I work my manager just told me he had around 15 to 20 nurses applying for the same position. So currently where I live in Iowa I wouldn't say there is a shortage, but that doesn't mean there arn't in other areas. I would deffinitely recommend working as a psych RN first before applying for a NP psych program. I cannot stress enough how I think psych is a great field to work in! :)

Specializes in Psych.

Just wanted to add that it is against federal law now for insurance plans to limit the number of mental health visits to a lesser number provided for medical visits:

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays, deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits.

Specializes in Psych (25 years), Medical (15 years).

Well there, RevolutioN2013, one has to realize that a Nurse considering the effects of acetylcholinase inhibitors on the long term memory potential still has to wipe the butts of incotinent Alzheimer's patients.

In other words, theory is worth considering and can be an entertaining head trip, but what is it you really want to do?

Therein lay your answers.

Dave

Wax on, wax off. :D

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