Help!

kbrn2002, ADN, RN · Jul 26, 2015

Why the focus on the ability to prescribe meds as a way to "help'? There are many, many ways a provider including a clinical psychologist can help their clientele that don't require the "just take this pill and it'll be better" model of practice.

Horseshoe, BSN, RN · Jul 26, 2015

Have you been in school constantly from childhood to high school to college twice to grad school?!?!?

Wow, that's a lot of education. The armchair psychologist in me wonders how long you are going to remain a professional student and if you are afraid of joining the working world. There is admittedly a certain amount of "safety" in the life of a student.

Whatever you decide, good luck.

SeattleJess · Jul 26, 2015

My knee-jerk reaction to your question was "What is he trying to avoid?"

Those maxed out student loans would be occupying my attention.

Also, by the time you knock off your prerequisites (if not now), you are going to be the much older, out-of-sync member of your nursing school cohort. It would take a much stronger motivation than wanting to write prescriptions, I'm thinking, to put up with the challenges you will inevitably face as a student who does not fit into his cohort.

Check your motives. Really check them, then decide.

Best of luck to you whatever you decide to do.

Awesomocity0 · Jul 26, 2015

I'm pretty much with everyone else when they say, "it's time to get an adult job, buddy." So instead of reiterating that, I'm going to give you my two cents as someone who worked a mental health nurse.

There are different types of units, but on all of the ones on which I've worked (in a mental health hospital, not in the cupcake world of 'easy' and stable inpatients in medical hospitals on a 20 bed mental health floor), patients have an interdisciplinary team. That team, depending on the unit, include RNs, therapists/psychologists, psychiatrists, and social workers separate from the ones that might lead their 1 on 1 therapy.

The nurses (my role in all this) do daily assessments and quick 1 on 1s, pass meds, monitor safety continuously, enforce rules, and support the efforts of the rest of the team members when they are not there. Social workers talk about discharge planning, teaching, resources outside, etc. The psychiatrists, I kid you not, spend all of ten minutes every day coming in and talking to patients, readjusting their meds. That is literally all they do - readjust meds. There is no talk therapy involved with that. And our NPs and PAs did literally the same thing. There is too much of a patient load on them to have talk therapy and med adjustment every single day. For actual therapy, they have their therapists and three time a week, hour long, 1 on 1s.

That last thing - that is your role in this. You CANNOT and should not aspire to 'do it all.' The more you do, the less effective you are at it. Mental health should always be addressed in a multidisciplinary approach for inpatient populations, and I think you should get a reality check if you did not already know this.

Heck, even if you worked with outpatients as a psychologist (and here's a newsflash, psychiatrists have their MDs or DOs, went to med school, and did residencies to have that handy little prescription pad), you would still be doing a service. The majority of these outpatients are fine with a little SSRI, which they can get from their PCPs. And if you really DO want to throw away everything you've done so you can perpetually live in the state of studenthood, then why don't you instead team up with an MD in his/her practice? I see that all over the place. Don't you? Wouldn't that make more sense to you?

Edit: OH, and have you thought about how much you would miss if you continued on a different path? Do you think you are qualified and capable now? Because one of my favorite PhD psychologists with whom I worked, was just in the process of trying a new technique for not integrating the parts for patients with DID but actually making them all live together in harmony, and his therapy sessions (I sat in on a couple) were incredible. He constantly learned new things and tried them. That man is a genius. And if you think merely having a PhD puts you on that level, I'm going to laugh at you. It would take you a lifetime to achieve that level. So why not try for that instead of half-arsing several things?

Also, good to keep in mind that you need to practice at least two years as an RN to apply for NP school. With your track record, I wouldn't be surprised if during those two years you decided you did not work to work as an RN and instead decided that there was a real need in laboratory sciences and wanted to go back to school for microbiology.

elkpark · Jul 27, 2015

There are many, many ways a provider including a clinical psychologist can help their clientele that don't require the "just take this pill and it'll be better" model of practice.

(Yes, there are, but they don't pay nearly as well as pushing pills. That's where the big bucks are, and why everyone and her/his mom suddenly wants to become a PMHNP.)

adsanders1963 · Jul 27, 2015

Thank you for your kind words. Everyone else was rude.

adsanders1963 · Jul 27, 2015

I earned both of my bachelors degrees simultaneously and for free.

adsanders1963 · Jul 27, 2015

I've worked in the working world and gone to school while doing so.

RNsRWe, ASN, RN · Jul 27, 2015

Hello all,
I am a 35 yo male who will be finishing his PhD in clinical psychology this year. I am thinking about going back to school to become a FNP or Psychiatric NP. During my clinical internship I had a lot of conversations with patients and psychiatrists about the lack of behavioral healthcare, especially in prescribing medicine. There are only a few states that allow for psychologists to prescribe and as of now I can't committ to living that far away from my parents due to them aging. I am also interested in working with the LGBT community at the basic medical but also psychiatric level. I have great skills in psychotherapy but I would like to be able to assist them further. With all this being said...
What are your thoughts about someone with a PhD re-entering into another healthcare field?
What challenges do you think I face?
Also, I have 2 bachelor's degrees (Biology and Psychology). I would have to start over with courses that would allow me to even apply to nursing school. What are your thoughts on getting my RN and then pursuing a BSN-MSN program?
Additionally, I have maxed out my loans so as for now I would have to either pay out of pocket or work to pay for school. Has anyone worked and gotten their ASN and then continued on in school while working?
I know I have a lot of questions but I have been contemplating this a lot lately.

Weeellll.....there's a lot of questions there, but I'll offer my thoughts, since you asked.

What challenges would you face? I'd expect that getting through a nursing program might be a big one, since your your post doesn't scream "dedicated to becoming an RN" at me. I appreciate that you believe that there is a need for prescribing medication to mental health patients, I wonder if you appreciate what it is going to take for you to get there.

You will need to complete pre-requisite coursework, naturally....and that takes time and money. Ok. Let's say it's not too much time, not too much money....you can expect then either two years of standard-pace nursing coursework (which is a decent pace already) or a very intense, fast-paced accelerated program. You won't be doing anything whatsoever that has anything to do with your end goal....you will be learning how to become an entry-to-practice RN.

You will be studying a ton of material in subjects that you will consider irrelevant (because your main goal is to be a prescribing provider in mental health, not a practicing bedside RN). You will focus a significant amount of your time on medical-surgical studies, respiratory, maternity...etc etc... I wonder how dedicated you would remain to getting through all of that, since NURSING isn't really your goal?

Continuing the think-through....you would be expected to be a working RN for a while in order to be the best candidate for an FNP program; will you really do this? Since you are unlikely to want to work in a field you have little to no interest in, what is the likelihood of success?

Finally, there ARE direct-entry MSN, NP programs out there, with varying levels of quality and reputation. You would certainly be a reasonable candidate given your educational background. Some swear they are 100% equivalent to the more traditional route (that includes clinical experience) and some who swear they are not. I have no opinion on that, I'm merely presenting that there is a recognized controversy......your future employer might have no problem with such a path to becoming an NP, or they might refuse you because of it. Just worth considering is all.

After all that....maybe I can just offer my observation on what I see as an additional potential problem for you? Given your history, I would expect you would not "stick with" this course of education; I'd expect you'd find a reason to withdraw from the program (likely for the reasons I mentioned) and then you'd be FURTHER in debt, without any employment prospects.

Food for thought. Good luck with your decision!

Jensmom7, BSN, RN · Jul 27, 2015

Thank you for your kind words. Everyone else was rude.

"Kind" is probably what has kept you from advancing past being a student your entire life so far.

You had to have realized that not everyone was going to pat you on the head and tell you that all knowledge is important, and you'll find what you really want to do in time.

Because you may not. Saying it's time to push yourself out of the nest and join the workforce while you ponder your future isn't being rude. It just isn't what you want to hear.

elkpark · Jul 27, 2015

Also, good to keep in mind that you need to practice at least two years as an RN to apply for NP school.

This isn't true. There are scads of the so-called "direct entry" MSN programs that take people with a BA/BS in some other discipline and no nursing licensure or experience, and turn them into advanced practice nurses. They are basically a mash-up of an accelerated BSN program and a graduate program in nursing, and the OP would qualify for those programs. These programs have been around for decades now, and I'm always kinda surprised to find there are still nurses who aren't aware of them.

No licensure, no nursing experience, required.

Jensmom7, BSN, RN · Jul 28, 2015

This isn't true. There are scads of the so-called "direct entry" MSN programs that take people with a BA/BS in some other discipline and no nursing licensure or experience, and turn them into advanced practice nurses. They are basically a mash-up of an accelerated BSN program and a graduate program in nursing, and the OP would qualify for those programs. These programs have been around for decades now, and I'm always kinda surprised to find there are still nurses who aren't aware of them.
No licensure, no nursing experience, required.

You know that saying, "When ignorance is bliss, 'tis folly to be wise"?

It applies here, in spades. What if physicians could do the same? I don't see the AMA ever condoning something like that.

I truly fear for the future of Nursing. That's not hyperbole; what in the world are we middle aged/almost seniors going to do when we need nursing care? And God help future generations.

Help!

Should I pursue a career in nursing?