An "if you were me"question...

EricJRN, MSN, RN · Aug 6, 2008

Will they let you into the psych NP program without psych RN experience?

llg, PhD, RN · Aug 6, 2008

I was impressed by the way you are thinking this through motorcycle mama. I believe your thinking on what schools will tell you, the FNP role, etc. are right on target.

If you are really sick of taking classes at the moment, I suggest you take a little break between you BSN completion program and grad school. It's like going grocery shopping when you are nauseated -- none of the food looks appealing and it is harder to make a good choice that will please you later. It doesn't have to be a long break, just enough to get over that negative feeling towards taking classes. (and classes are classes whether they are undergraduate or graduate.)

Take a little break and decide what type of job roles appeal to you. Then investigate possible academic programs that will help you reach your career goals. Don't make the mistake of choosing an academic program first and then having to figure out what you are going to with that degree after you graduate. Too many people make that mistake and end up with academic credentials that don't help them advance their careers in the direction they decide they want later. It gets frustrating, tiring, and expensive to discover that you academic degree didn't prepare you for the jobs you really want.

So ... decide on the types of jobs you want first. Then look into academic programs to help you get those jobs.

What types of jobs apeal to you? Are you interested in primary care of adults in an outpatient setting? Are you interested in doing staff development in a hospital setting? Are you interested in teaching in a nursing school? Research? Intensive care? Chronic care? Working with the elderly? Pediatrics? New moms? Is having a Monday-Friday day shift job important to you? Do you want the highest paying jobs? etc. etc. etc. These are the types of questions you should be asking yourself. Figure out what types of career you want, what population you want to work with, etc.. That will help you narrow down your choices.

BBFRN, BSN, PhD · Aug 6, 2008

Most grad programs that I have seen require at least a 3.0 GPA for entry, and sometimes a minimum GRE score (usually combined score of at least 1000 w/at least a 4 on the written part.)

Maybe you could take llg's advice on waiting for a bit, and use that time to get a job at the local VA psych unit? Then, you could study for and take the GRE in the meantime if it is required in your chosen program. If you feel you need to improve your GPA as well, you could also take some more upper level psych courses to bump it up while obtaining more psych ed, too. (This is all assuming you don't have any psych experience.)

Edited to add: Have you also checked out any psych CNS programs?

marachne · Aug 6, 2008

All the above advice is excellent and should be thought about thoroughly before continuing, but a couple of thoughts directly related to your questions:

Many of the PMHNPs that I have talked to have expressed frustration both about the education/training they recieved and the role that PMHNPs often find themselves in because niether emphasize actual counseling and therapy, but rather the prescribing aspect of the role. They c/o not getting much training in providing any kind of talk therapy, more diagnostic and prescribing. I have also heard that, unless you're going into private practice, PMHNPs tend to be hired for their prescribing ability, not their ability to work with clients.
That said, I think there is a large (and rapidly growing!) need for work around PTSD and grief -- if the gov't doesn't just try and ignore and cover up what's happening to people who have been deployed in Iran & Afghanistan. Also, an area I have particular interest in is PTSD at end-of-life, particularly PTSD and dementia at EOL. I've worked at the VA, and I see the Viet Nam era vets are starting to come in more and more with terminal diseases (cancers, COPD, Heart Dx, end stage liver dx) not every VN era vet has PTSD, and PTSD existed before VN, but I think between the convergance of the aging boomer generation and the recent vets, there's going to be a sizable need. And that's just in the military setting. There's plenty of civilian PTSD out there too, that's just now being recognized.
From what I understand, the advantage of the FNP is that it is a "generalist" kind of training. Unless you know you want to work in an acute care setting, it seems you have the most flexibility w/an FNP. There are ways of adding specialized training afterwards if you decide to focus on a specific population (For example, OHSU has a summer intensive for geriatrics). I also believe that for some kinds of billing (specifically Medicare) you need to be an FNP.

But as others have stated, you need to figure out why you want an advanced degree and what you see yourself doing with it before making any decisions.

Jo Dirt · Aug 7, 2008

I don't know if it counts as experience or not, but a large percentage of the patients at the nursing home where I work are psych patients.

I became interested in becoming a therapist when I learned about a profound form of grief therapy called IADC, which was discovered by a psychologist who used EMDR techniques on Vietnam Vets who were suffering with PTSD. I found it so moving it has become a strong interest of mine.

I also know how the cookie crumbles, and "they" want pills. This is why I considered a psych NP a compromise. If I could prescribe antidepressants or treat other mental disorders as well as provide counseling...I don't know if that is a pipe dream, maybe it is not realistic. I would love to run a "healing center" and treat all kinds of people who are suffering mentally. I know firsthand mental illness can be even more painful than a physical affliction, which is why I hold a special place for these people.

As a psych NP, could I also treat infections? I just don't know how limited I am with that...ugh!

marachne · Aug 7, 2008

It sounds like psych is what really calls to you. What you might want to do is interview some schools you would consider attending and ask them, point blank, about their PMHNP program -- what are the courses? what is the focus? Are there opportunities for more coursework (and clinical supervision) in therapy, or do they have a connection to another institution where you can expand your knowledge? Then talk to some students or, better yet, ask if they can give you the names of some grads to talk to.

I looked up EMDR and IADC -- it looks interesting (I had heard about EMDR before), but it also sounds like the kind of thing that if you are interested in it, you'd have to go and get the specialized training to use it. Not a bad thing, but not reasonable to expect you'll get that kind of training in a SoN.

As to the scope of practice, you'd be better off asking specifically some PMHNPs, but also know that it is goverened on a state level. Some states are a lot more liberal than others about what NPs can and can't do