Yet another psychology graduate seeking advice!

Specialties Psychiatric

Published

Hi everyone!

I know this topic gets beaten to death so I apologize...

I graduated with a BA in psych in 2012 and began working as a case manager with the SPMI population in residential settings, which got me headed down the road of clinical psychology.

In the last few years I've moved to the UK, where I've been working as an Assistant Clinical Psychologist on an acute inpatient psych ward for about 2 ish years. I'm not sure of a US-equivalent (I'd never heard of it before) but basically I'm working under the supervision of a Clinical Psych - I run therapy groups on the ward, deliver/score assessments (Becks inventories, SCID, etc), and do 1:1 therapy. Our ward is short admission and the usual mix of clients are borderline/antisocial PD, psychotic illnesses and mood disorders. I also work as a mental health tech on the weekends on the same ward, because it's very understaffed.

I try to make sure I'm working closely not only with the psych department but with the nurses and techs. In addition to doing the therapy work I've been able to sit in on ward rounds, learn how to take vital signs (pathetic I know, but I was excited ;)) and unfortunately have had the experience of restraining patients, putting them into seclusion, etc.

Anyway, this has gotten me thinking that I might be interested in psych nursing instead, but I'm not sure if I have illusions of the job because I'm feeling a little let down by my role in psychology. Doing 1:1 therapy on an acute ward means you see very little progress in such a short space of time, and to be honest although I enjoy it, I don't find it as fulfilling as I imagined. When I think about doing outpatient therapy and having patients come once per week to my office for sessions, I don't quite feel excited about that either.

I like more hands on patient interaction, the idea of writing care plans, meeting with them daily, developing that rapport...I know that nursing on our ward seems to involve a hell of a lot of documentation and reports, and the nurses often complain they don't get much patient time but I'm not sure if that's specific to our (understaffed) ward or not.

The drawbacks I'm envisioning so far is the general nursing side of things (weak stomach, would have to get over that) and that I may not have a hand in the group therapies like the psychs do.

Basically I'm moving back to the US next year and trying to figure out my options and where my passion lies. I have a lot of research to do but it looks as though I could maybe apply for accelerated BS programs in nursing? After that, do you need to go through a separate program to qualify for psychiatric nursing or is that more of a "learn through experience" discipline?

Any advice is really appreciated as I'm just beginning to think about this path. I'm going to speak with some of the nurses on our ward about their roles as well.

Thank you!

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I do know that nursing on our ward seems to involve a hell of a lot of documentation, report writing and the like, and the nurses often complain they don't get much patient time but I'm not sure if that's specific to our (understaffed) ward or not.

The drawbacks I'm envisioning so far is the general nursing side of things (weak stomach, would have to get over that) and that I may not have a hand in the group therapies like the psychs do.

That's not specific to your unit, it's pretty typical, and the "drawbacks (you're) envisioning" are also legitimate.

Welcome to allnurses, and best wishes for your journey!

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That's not specific to your unit, it's pretty typical, and the "drawbacks (you're) envisioning" are also legitimate.

Welcome to allnurses, and best wishes for your journey!

Ah, I had a feeling that was the case! As far as the drawbacks go, I would definitely like to still run therapy groups...we have a nurse running a DBT group but she's been trained for it and I get the feeling it's not typical?

I'm a bit nervous about the physical stuff - OK with blood, maybe urine, not so much anything else. I'd really need to toughen up somehow I think.

Don't mind me BTW, just thinking aloud. Thank you for taking the time to reply!

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Howdy there,

I, like you, was a BS in psych grad in 2011, then ultimately entered nursing through a second degree BSN program. I currently work in inpatient psych, most often in a geriatric psychiatry ward as I adore the geriatric population. When it comes to nursing, you will enter a program, complete the program, sit for the NCLEX, pass the NCLEX, and then ultimately enter into nursing. I chose to go right into psych. When you ask about additional training to enter this particular specialty, you do not have to have additional training, except for training mandated by your hospital, unit, managers, etc. Once you are a nurse, you are a nurse that can go onto most units. Granted, the longer you practice with a particular population, the more adept you should become. Your current experience would, honestly, put you light-years ahead of many new BSN or ADN grads entering psych. If you would like to know more, I would be happy to help. I can tell you about the program I did, the NCLEX, etc.

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I work an inpatient psych setting with majority forensics patients. I also float to the geriatric psych unit which is civil. Let me give you my perspective and maybe it'll help.

We have clinical psychologists with PhD but I'm not 100% positive what they do. As a nurse, it's a lot of med management, developing "treatment" plans (care plans), and dealing with pharmacy, lab, and doctors. I've also seen and heard of many disturbing things that will haunt you--the ill patient who gauges out an eyeball, the suicidal patient who tries to hang himself, the inserters who stick anything and everything they can in any orifice, the guy who yanked out a cath, the one who makes art with his feces. On the acute units, there's a lot of hands on/seclusions. On the lower security units, guys are more stable but can decompensate anytime and get sent to max. Or something is coming up--anniversary of a crime, court date, etc and they freak out and do something bad. At my work, we also don't actually touch patients much unless we are doing vitals, giving a shot, or forcing a lab draw or injection. So it can be very startling at first since nursing is so hands on.

You also have to check your judgment and emotions at the door. All of these guys have committed heinous crimes from brutal assault to homicide to crimes against children and vulnerable populations. But you still have to treat them the same. Ask yourself if you are able to do that?

Toss in the usual patients that curse, manipulate, and are abusive verbally *and* physically, and also ask if you can tolerate that or how much you can tolerate? Staff across all disciplines have gotten hurt by patients, from techs to nurses to rehab and even psychiatry. You have to be constantly vigilant and observe. There are also repeat offenders that have been here multiple times. So if you expect to see the rehab-treatment-discharge and never see them again, you'll be mistaken.

Some days, it's great. No two days are ever the same. Other days, it's glorified babysitting.

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Howdy there,

I, like you, was a BS in psych grad in 2011, then ultimately entered nursing through a second degree BSN program. I currently work in inpatient psych, most often in a geriatric psychiatry ward as I adore the geriatric population. When it comes to nursing, you will enter a program, complete the program, sit for the NCLEX, pass the NCLEX, and then ultimately enter into nursing. I chose to go right into psych. When you ask about additional training to enter this particular specialty, you do not have to have additional training, except for training mandated by your hospital, unit, managers, etc. Once you are a nurse, you are a nurse that can go onto most units. Granted, the longer you practice with a particular population, the more adept you should become. Your current experience would, honestly, put you light-years ahead of many new BSN or ADN grads entering psych. If you would like to know more, I would be happy to help. I can tell you about the program I did, the NCLEX, etc.

Hi! Thank you so much for your reply. Did you find it difficult to be accepted into a BSN program with a psych degree? I'm a little curious as to how my credits might transfer as I did very little that I think would be useful for a nursing degree (I think I did one biology course in my first year and to be honest I don't remember doing very well!) I'm assuming that there are certain pre-reqs I would need to complete prior to entering a nursing course so I'm caught up to speed with people who went for a BS in nursing straight off the bat?

Sorry to be an idiot but what's the difference between a BSN and ADN?

I'm hoping my experience on a ward will help but I'm currently trying to finagle my way into some of the free training courses they offer at my hospital that are more medical-focused, hopefully that will do something!

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I work an inpatient psych setting with majority forensics patients. I also float to the geriatric psych unit which is civil. Let me give you my perspective and maybe it'll help....

Some days, it's great. No two days are ever the same. Other days, it's glorified babysitting.

Hi, thank you for sharing! Your job sounds so interesting - I'd never considered nursing in a forensic setting. I've had some experience working with clients who have Antisocial PD diagnoses and I find them fascinating although I'm not sure how I'd handle working with so many of them at once! I definitely don't expect rehab-treatment-discharge because sadly in our hospital we tend to see a lot of the same patients over and over, like a revolving door...it's a bit disheartening on one hand but I suppose you become more and more familiar with them each admission and learn new things.

Overall would you say you enjoy your job?

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Specializes in Cardiac (adult), CC, Peds, MH/Substance.

With a prior degree, you'll probably find an ABSN program is about the same length as an ADN. In my case, it was faster than an ADN. You'll need to take prereqs of you don't have them, generally chemistry, A and P, etc. There are a lot of ABSN programs in the US. I had multiple people with psych degrees in my ABSN. Some schools call them second degree BSN. Where are you thinking of moving?

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Thanks for the info! Currently I'm thinking New York (possibly Long Island or Queens/Manhattan) but I'd venture into New Jersey as well I think.

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Specializes in Cardiac (adult), CC, Peds, MH/Substance.

Expensive places to live. The Texas board of nursing has a list of approved programs on their website. I'd imagine NY and NJ do as well. I found the list helpful in my search.

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Expensive places to live. The Texas board of nursing has a list of approved programs on their website. I'd imagine NY and NJ do as well. I found the list helpful in my search.

Ha yep unfortunately - that's where I'm from so I'd like to just go home really. I'll check out the board of nursing, thanks!

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Specializes in Cardiac (adult), CC, Peds, MH/Substance.

While you're wasting money on living in NYC, you can go to one of my alma maters and waste more money at NYU. They have an ABSN/2nd degree program ;) Probably cheaper somewhere else though.

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