CNS in Psych???

mtsteelhorse · Aug 6, 2011

I'm pleased to see this thread has expanded...I'm learning a lot! I have been looking into a counseling degree but the $$$ is a factor for me. I can't go backwards for heavens sake. Keep me posted and all input on here is helpful!

Simply Complicated · Aug 7, 2011

I'm pleased to see this thread has expanded...I'm learning a lot! I have been looking into a counseling degree but the $$$ is a factor for me. I can't go backwards for heavens sake. Keep me posted and all input on here is helpful!

Sounds like you and I are in very similiar situations. I will be sure to keep this in my topics, and let you know whenever I learn anything new.

mtsteelhorse · Aug 7, 2011

I'll do the same...you are much younger so you have years on your side!

Simply Complicated · Aug 7, 2011

I'll do the same...you are much younger so you have years on your side!

Haha. I have a few years, but not really enough to want to do a doctorate program. I'll be close to 36 by the time I even finish my BSN as I will be 34 in a few weeks. I'm not sure what to do. I've been reading through the boards here for the advanced practice and the CNS doesn't sound like it's anything that is very marketable atleast not in psych. :eek:

Whispera, MSN, RN · Aug 7, 2011

I worked as a psych nurse for awhile before I got my CNS. I worked in on a psych floor in a general hospital for 5 years. It had a CD unit, and adult unit that included eating disorders, and a psych ICU. After that I worked in a psych hospital that had a CD unit, an adult unit, a psych ICU, a geriatric psych unit, and a unit for psychiatrically challenged people who had developmental disorders. On all those units I ran groups. I didn't do therapy groups but I did medication education, goal setting, wrap up, nutrition, and any other topic I chose that fit the patients. I also spent time with patients in one to one conversation. This was in addition to the meds and paperwork which was considerable. When I wasn't tied up with that, I was out with the patients. Look around you where you work. Does the staff tend to stay in the nursing station or are they out with the patients. You need to be out with the patients--that's where you make the biggest impact. Don't let role models of being behind the window lead you to believe that's ok. SimplyComplicated...can you be the one who makes the difference? Can you do groups even if others don't? I did. I'm not tooting my own horn. I did it because it was the right thing to do and itt was so much more fun than the paperwork! It's what kept me feeling good about the job--that and the learning about the patients and feeling what I did made a difference. I loved seeing patients get better!

Whispera, when you are talking about the general psych nursing and doing groups and such, was this something you encountered in inpatient facilities? I am currently a psych RN in a hospital. We have 4 units as well as an ER. I'm a float, so I go between the units. Although we do not do any groups. We have counselors on staff that do our groups. I actually posted a thread earlier today, asking about the difference between units and how the roles vary. My job is close to what you described, meds and paperwork.

mtsteelhorse · Aug 7, 2011

I'll be close to 36 by the time I even finish my BSN as I will be 34 in a few weeks.

I was 36 when I went to nursing school! I agree...the CNS sounds like a waste. I don't live near any hospitals with psych units so I guess the jail is the next best thing! :lol2:

mtsteelhorse · Aug 7, 2011

"I'll be close to 36 by the time I even finish my BSN as I will be 34 in a few weeks."
I was 36 when I went to nursing school! I agree...the CNS sounds like a waste. I don't live near any hospitals with psych units so I guess the jail is the next best thing!

Whispera, MSN, RN · Aug 7, 2011

I was 42 when I finished my BSN and 50 when I finished my CNS. I would have been 42 and 50 anyway....

mtsteelhorse · Aug 7, 2011

AMEN TO THAT! :yeah:

Simply Complicated · Aug 7, 2011

I worked as a psych nurse for awhile before I got my CNS. I worked in on a psych floor in a general hospital for 5 years. It had a CD unit, and adult unit that included eating disorders, and a psych ICU. After that I worked in a psych hospital that had a CD unit, an adult unit, a psych ICU, a geriatric psych unit, and a unit for psychiatrically challenged people who had developmental disorders. On all those units I ran groups. I didn't do therapy groups but I did medication education, goal setting, wrap up, nutrition, and any other topic I chose that fit the patients. I also spent time with patients in one to one conversation. This was in addition to the meds and paperwork which was considerable. When I wasn't tied up with that, I was out with the patients. Look around you where you work. Does the staff tend to stay in the nursing station or are they out with the patients. You need to be out with the patients--that's where you make the biggest impact. Don't let role models of being behind the window lead you to believe that's ok. SimplyComplicated...can you be the one who makes the difference? Can you do groups even if others don't? I did. I'm not tooting my own horn. I did it because it was the right thing to do and itt was so much more fun than the paperwork! It's what kept me feeling good about the job--that and the learning about the patients and feeling what I did made a difference. I loved seeing patients get better!
Whispera, when you are talking about the general psych nursing and doing groups and such, was this something you encountered in inpatient facilities? I am currently a psych RN in a hospital. We have 4 units as well as an ER. I'm a float, so I go between the units. Although we do not do any groups. We have counselors on staff that do our groups. I actually posted a thread earlier today, asking about the difference between units and how the roles vary. My job is close to what you described, meds and paperwork.
There is really not anyway for any of our nurses to run groups honestly. The way our unit is set up, and our responsibilities just don't really allow for it. I do go out and talk to patients and all that though. I guess I will just see how my next job plays out and get a little more experience first. I need to do my BSN anyways, and will see where to go from there.

morecoffeepls, BSN, RN · Aug 7, 2011

I'm really glad this thread took off. Sounds like a few of us are in the same boat. Also sounds like we got into that boat a little later than we would've preferred (I just turned 38, have been a registered nurse for about 2 1/2 years, and will get my BSN at the end of the year). As behind as I feel, I was grateful to have found my calling in psychiatric nursing, and became board certified as soon as I was eligible. But now what? Although I bet Whispera is a great CNS and an invaluable interdisciplinary team member, that sounds like a hard road & I need to know that my advanced degree will be, as another poster put it, marketable. (I just performed a quick search & can't find any Psych CNS programs in my state, and I don't recall seeing any job postings for the same when browsing.)

It's probably more rhetorical than anything, and my own response will be the same no doubt, but a question: what about the conversion from APRN to DNP is throwing you off this track entirely? Also, if CNS were an option, would the salary be comparable? What else? Oh yeah, when I first started dealing with my stress over the DNP thing, someone almost talked me into considering the Psych PA option, which I still dismiss on principle, but maybe that's something someone else in my position might want to consider. I like the principles of nursing, and I especially enjoy this population, but to make a "real" living doing both seems impossible unless I am pushing pills or in an office somewhere. Before someone gives me the speech, my priorities are geared toward providing for my family, and if I have to give up the dream of making a difference on the frontlines I will. Also, if a Psych APRN were to come across this thread I'm sure they would set us straight about my/our descriptions of their role.

I keep saying, "I can't see past December", when asked about my plans. That's when I finish this stupid BSN program. But it's right around the corner. I don't want to change the direction of this thread, and most of the time people's advice is more grating than helpful (no offense, bad advice givers - it's me, not you), but at some point I'd like to provide some insight into my situation and get some feedback. I'll start a thread, perhaps. Don't know why I brought it up, and now it's too late to delete this part ...

Whispera, MSN, RN · Aug 7, 2011

Depending on where you work the roles of psych NP and psych CNS can be pretty much the same. Both roles are considered to be APRN roles. ANCC recommends all advanced practice nurses of Masters level education use the designation of APRN. So, I'm not Whispera, CNS. I'm Whispera, APRN. Where I've worked there were no PSYCH NPs, only generic NPs. I believe if the facilities could have found psych NPs they would have hired them, if there had been openings (there weren't)but there weren't any in my area, at least none that were known. I think they considered psych CNSs to be somewhat equivalent to psych NPs. I also get a feeling psych NPs at those particular facilities would have been required to do physicals and monitor/treat the medical needs of their patients, so the psychiatrists wouldn't have to. The generic NPs were on call 24/7 for their patients. Schools are eliminating psych CNS programs. My school eliminated the psych CNS program the year after I finished it, due to "lack of interest." My school is a biggie in nursing education.

When I went to get certified as an APRN, I had the choice of being certified as a psych NP or a psych CNS. I chose the CNS route because, at the time I felt I'd end up doing lots of physicals for patients if I was a psych NP. Since then I've learned that isn't necessarily the case, but sometimes it's the case. I didn't want to do physicals. I wanted to do psychiatric assessment, diagnosis, prescription of treatment, and therapy. Sometimes you have to invent yourself and keep on keeping on until you get to do what you want to do.

The DNP track is years and money added onto the MSN role. I think these days, and hopefully not forever, getting that degree will limit a person's ability to find a job, unless he or she works totally autonomously. I also don't know that a collaborative agreement with a doctor wouldn't still be required to prescribe and/or bill for any services rendered. In psych I don't know that the DNP would be helpful to marketability at all. Facilities are resistant to hiring psych CNSs and psych NPs already, if there are even jobs available in their advanced practice role. Imagine their resistance to paying someone who would deserve more as a DNP.

morecoffeepls, I'd never say a thing against someone who went into nursing to provide for his or her family. It's not a calling to everyone. It wasn't a calling for me. I did it because I couldn't get a job in my first chosen role as elementary education teacher. I didn't want to be a bag lady if something happened to my husband. There was a nearby nursing school and there were jobs in nursing. As luck would have it, I found I love what I'm doing in spite of the sometimes-huge bumps in the road.

Sometimes when a door closes, a window opens that leads to a brighter, more colorful garden than the door led to...