Psych RN's, being phased out??? - page 2

I'm going to be graduating in 2007 with my BSN. Psych nursing is one of the three specialties that intrigue me. (I know, I'm going to have to make up my mind pretty soon!) I was talking to a friend... Read More

  1. by   aquarius11
    Halinja,

    I have not heard this but have heard snippets about those in the psychiatric nursing field with a masters degree ( i think some are called clinical specialists) possibly being phased out. This I heard from my psych. nursing instructor. I'm not exactly clear on this but have heard that there is a push for nurses to go straight from BSN to getting their doctorate, skipping a masters degree. This sounds confusing, sorry. Has anyone else heard about this? To answer your question though 2 people in my class (May 2006) have been hired as psych nurses.
  2. by   rn/writer
    Two increasinglly necessary psych specialty areas are child & adolescent psych (I did this for years) and geropsych.

    Kids are entering the psych arena at younger and younger ages. When I started at my old job, we took kids twelve and up with occasional exceptions made for bright 10 or 11 year olds. By the time I left, we were taking kids as young as four or five.

    At the opposite end of the spectrum, people are living longer. Along with the physical problems that can accompany old age, there are psych issues as well. Family members are better educated about things like depression and understand that help is available. Nursing homes sometimes send patients to a geropsych hospital unit if they have become delusion or combative.

    I don't see psych as a nursing specialty fading out any time soon.
    Last edit by rn/writer on Sep 17, '06
  3. by   Halinja
    Quote from aquarius11
    Halinja,

    I have not heard this but have heard snippets about those in the psychiatric nursing field with a masters degree ( i think some are called clinical specialists) possibly being phased out. This I heard from my psych. nursing instructor. I'm not exactly clear on this but have heard that there is a push for nurses to go straight from BSN to getting their doctorate, skipping a masters degree. This sounds confusing, sorry. Has anyone else heard about this? To answer your question though 2 people in my class (May 2006) have been hired as psych nurses.
    I've done some reading on the internet since I originally posted. It sounds as if maybe the clinical specialists are being phased out, but being replaced with a NP. Do I have it right, clinical specialists cannot prescribe, but a Nurse Practitioner can?

    I hadn't hear the 'skip the masters' thing, though. They'd still be nurses, wouldn't they? Even with a doctorate?
  4. by   Halinja
    Quote from Melina
    I know there will always be psych RNs, just like there will always be psych patients. I am more concerned about a lack of interst in the specialty. I was sad to hear that the only Master's program for psych nursing in the state (University of Colorado) has shut down their program due to lack of interest. I know it isn't for everyone. I have gotten some really strange looks from people when I've told them I'm interested in mental health. I might have to go for an online program for my MS.

    ~Mel'
    I've gotten those funny looks too. Or a knowing one from some students, accompanied with a "oh, you'll just get to sit around, riiiiiight, I get it."

    Uh, no, I thought I might actually try and work with the patients...y'know, do nurse stuff? I don't know which of the looks is worse.

    There's a psych masters being offered in Portland Oregon...not the state of colorado, but its the only one I know about right now
  5. by   kimee
    I agree completely with IMustBeCrazy. I have worked ER-Psych, and know how vitally we are appreciated. However, I do understand where the new grad's thinking may come in....They have closed State Hospitals all over this country, believing erronously, that the mentally ill could be better served and cheaper too, in the private sector. This has lead to the increase in the homeless population, as well as our jails and ER's....just check the prison population in last 20 years....if you check the states that first closed their State Psych facilities...you can follow the trail... Sad but true. I know that fellow psych nurses at our State Psych Hospital (which closed in 2001), now work in the jails and prisons, as well as the ever changing "private behavioral health hospitals" that have changed management like some of our Nursing homes! Will there be a continued need for "the psych nurse"? Yes, Definately. But her/his job may not be in a psychiatric facility...but the Nursing home, prison, jail or yes, even your local ER.
  6. by   rajah
    No they are not phasing out Psych RN's. There is a great need as LPN's usually have to be under their supervision. They did phase out many advance practice Nurses. Now it seems many are being hired back!
  7. by   voodoosgirl
    In the state of Maine the latest "model" of care is to have patients see an advanced practice RN (APRN) who can prescribe. The care is all medication management with very little "therapy". Now some psychiatrists are using RN's as "extenders". The RN who has psych experience sees the client, writes the note, and updates the psychiatrist. This way one doctor can see exponentially many more patients by having the RN see them for the session while he/she just signs off on orders and drops in to the session for 5 minutes.

    I found this arrangement too envelope pushing for me, but many RN's enjoy it. The need for psychiatric care is huge and at least here, the bulk of the responsibilites for care is falling with nurses. RN's, APRN's and FNP's. I would suspect psych nursing will be a growing need.
  8. by   CaseManager1947
    The whole issue, I believe, stems from several changes 1) de-instutionalization of the chronically mentally ill into the community, which caused a greater need for community based care (hence , ARNP's seeing and doing med checks), and 2) ip psych care being primarily a symptom based focus, stabilize and out the door to OP care settings for continued management. IP units will still need RN's for assessments, care plan development. revision, etc., but more and more LPN and LMHT will be doing the majority. Just some food for thought.
  9. by   voodoosgirl
    Casemanager1947 has oriented me back to reality. Truth is, the NEED for psych nurses is growing, but the USE of psych nurses may be limited. I see it in my setting, more and more "unlicensed assistive personnel" are doing what use to be done by CNA's and to some extent nurses. In my state, non-private assisted living and psych assisted living are using UAP's to do catheter care, give injections, colostomy care, etc. All tasks that use to be done by certified or licensed people.

    The need for psych nurses may not be supported by the facilities willingness to pay for them.
  10. by   scaredofshots
    What? The RN runs the place how could they ever care for these people without the RN??? Who would do the job a bunch of Doctors?? I think not.
  11. by   saphira
    Quote from aquarius11
    Halinja,

    I have not heard this but have heard snippets about those in the psychiatric nursing field with a masters degree ( i think some are called clinical specialists) possibly being phased out. This I heard from my psych. nursing instructor. I'm not exactly clear on this but have heard that there is a push for nurses to go straight from BSN to getting their doctorate, skipping a masters degree. This sounds confusing, sorry. Has anyone else heard about this? To answer your question though 2 people in my class (May 2006) have been hired as psych nurses.
    That's true--there's a push to phase out advanced practice nurses to have them get DNPs or Doctorates in Nursing Practice. This would be for new advanced practice nurses. Any nurse graduating before the DNP becomes the standard would be grandfathered in. The DNPs will have patient care and treatment as their focus and will be NPs, Nurse Educators, etc. That's different from Nurse PhDs who are supposed to be more focused on research. I enrolled in SUNY Stony Brook's online BSN completion program and they talked about it at orientation. They are moving to a DNP in a few years as the terminal degree toward the NP. You'd pick up the MSN along the way.

    As for people not having psych problems and psych nurses being phased out---right. Sure. And people all over will all suddenly be mentally healthy.
    Last edit by saphira on Oct 7, '06
  12. by   cherrymary
    You know, to me this sounds like something we talked about in a class I'm taking on the history of psychiatry, the idea that 50 years from now there will be no psychiatrists, only neurologists!! Just look at the trend: 70 years ago, mental health was about behavioral science and psychotherapy; now the approach is more biological, based on psychopharmacology. This goes along with the associated belief that most MH diseases have some kind of neurological basis that will be established in the future, even if we don't know what it is yet. Remember all the diseases that were once the domain of psychiatrists that were then found to have a physiological basis and began to be treated accordingly - syphilis is the big one, but also pellagra and, increasingly, Alzheimer's. So psych nurses might not be "phased out" necessarily, but their role is probably changing as our conceptions of mental health change. Do those of you who have been practicing for many years see this happen in your work?

    I'm curious (because I'm really interested in psych nursing) - how much of your practice is devoted to psychotherapy and social/behavioral aspects of MH, and how much is pharmacology? Or does it depend on where you get your training?
  13. by   sampaul1966
    substance misuse services in the UK are generally staffed by mental health nurses & thats an area that certainly isn't diminishing in need.

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