Long story short, my sister has decided that she wants to become a Psychiatric Nurse Practitioner. She has a master's in psych, and believes this will be an easy thing to achieve, but she just simply doesn't want to clean poop.
I do assist with peri care, sometimes with a tech, and sometimes because the tech is with another patient. It's not the biggest part of my job and it is not the worst part of my job. It gives me a chance to assess skin issues, to change any bandages that may be on the coccyx, and to let the patient know that I'm there no matter what reason they need me.
I tried to explain this to her, and she just doesn't 'get it'. I get this idea that becoming an NP is practically the same as a MD to her, and that worries me. She'll learn, I suppose. I just hope that she will understand that assisting a patient at a time when they can't even go to the bathroom by themselves is not a bad thing. It's not horrible to help someone. It's what we do.
I'm just bothered by it. Thoughts...comments? Ways to make her understand? all appreciated.
I say, good for her! It doesn't make her less important to patient care. It's a different scope of nursing. I don't want to clean poop either. Honestly, who really wants to clean poop?
I'm sorry, but there are few things that irritate me more than RNs who think they're too good to clean up poopy patients. Or puke-y patients. OK, any patients. I guess what it comes down to is, it comes with the territory; get off your high horse and clean it up already.
I thought poop would bother me when I started nursing school, only to find that what really grossed me out was thick, tenacious drool. Ugh.
I'm sorry, but there are few things that irritate me more than RNs who think they're too good to clean up poopy patients. Or puke-y patients. OK, any patients. I guess what it comes down to is, it comes with the territory; get off your high horse and clean it up already.
I thought poop would bother me when I started nursing school, only to find that what really grossed me out was thick, tenacious drool. Ugh.
Unfortunately there are nurses that think because they have an education they don't have to do the "lesser" jobs. Our nursing instructors taught us you can work up to your degree and that your are never, ever "too good" or "too educated" to do ANY jobs, including cleaning poop.
I'm sorry, but there are few things that irritate me more than RNs who think they're too good to clean up poopy patients. Or puke-y patients. OK, any patients. I guess what it comes down to is, it comes with the territory; get off your high horse and clean it up already.
I thought poop would bother me when I started nursing school, only to find that what really grossed me out was thick, tenacious drool. Ugh.
Ew... those are definitely for the CNA to clean up.
I was reading through a lot of these because I myself have a similar background to your sister's. I have a M.S. in cognitive neuroscience and worked as a psychometrist conducting neuropsychological evaluations. Granted, it sounds like your sister is a fully practicing and licensed professional (I wasn't). I went for my master's to work as a psychologist, spending 7 years in school, I've realized that this particular path wasn't a good fit for my goals overall. The Ph.D. program is one of my most selective programs one can ever get into. It's almost easier to apply to medical schools and have a statistically better chance of getting in there than a Ph.D. in counseling or clinical psychology. With that being said, a Ph.D. student will spend 7 years of their lives before they can remotely sit for their licensing exam. Upon getting that license, the average starting pay is $50K.....for a Ph.D. psychologist! This salary evens out at $75-90K after 10+ years or experience. On the flip side, the NP route, takes 2 years (3 years if it's a direct entry program plus the additional year for nursing pre req classes), starting salary in Texas averages $90K and spans upwards to $120K within 5-8 years.
Also, considering your sister has been working with the mentally ill, this isn't going to be all that different. I've been chased around the hospital room, I was backed into a corner, I locked my patient in a bathroom once. Other than fecal matter, a lot of the common psychiatric issues NPs see, are what psychologists and master's level psychotherapists see. The demand for psychologists and master's level therapists is EXTREMELY low compared to RNs and NPs. My decisions are based on career mobility, starting and growing salary, more tools at my disposal to help the mentally ill and a well balanced life style compared to the Ph.D. psychologist route. Having been a grad student and worked with them, I found that spending 70% of my time doing research wasn't what I wanted to do. The Ph.D. programs train you to be a researcher so that this research informs your clinical practice. You are trained on psychometrics, other mental health fields aren't, and if they do, it's nowhere near what psychologists learn (psychometric testing is their bread and butter).
Lastly, the medical school route. She would need to spend 2 years for pre-req classes at a minimum, 4 years in med school (assuming she gets in on her first try), 4 years in residency for psychiatry. I am 27 now, If I did this, I would be 38. For many people, being in school until you are 38 and having a family might not be feasible. If everyone could do medical school, more people would be doing it. My husband wanted to do it, he's a pharmacist from Brazil, I consider him much smarter than myself, he still ended up with a 25 on the MCAT which wasn't all that great. So, he decided to go the Pharm.D. route instead. It was a better fit overall for his personal and professional goals.
I have a M.S. in cognitive neuroscience and worked as a psychometrist conducting neuropsychological evaluations. Granted, it sounds like your sister is a fully practicing and licensed professional (I wasn't). I went for my master's to work as a psychologist, spending 7 years in school, I've realized that this particular path wasn't a good fit for my goals overall. The Ph.D. program is one of my most selective programs one can ever get into. It's almost easier to apply to medical schools and have a statistically better chance of getting in there than a Ph.D. in counseling or clinical psychology. With that being said, a Ph.D. student will spend 7 years of their lives before they can remotely sit for their licensing exam. Upon getting that license, the average starting pay is $50K.....for a Ph.D. psychologist! This salary evens out at $75-90K after 10+ years or experience.
I'm glad you said this. I think people may not realize how incredibly selective PhD programs can be. When I was applying to clinical psychology programs, in another life, my rejection letter from the University of Washington said they got 900 applications and made 5 offers (a 0.56% acceptance rate). All of the people they accepted had not only published in leading journals already, but had published within the area of research of their future doctoral supervisors. Which is a staggering number of pieces that would have to come together in order for a person to be accepted to UW.
In my area there's a significant demand for master's level therapists, but they work predominantly in community mental health clinics and make around $40k/year. You have to really enjoy the work to go that route.
I have been published in some top tier journals such as the National Academy of Neuropsychology. I've been an ad-hoc peer reviewer in journals of sports, clinical and forensic neuropsychology. I've presented conference abstracts at the National Academy of Neuropsychology and International Neuropsychological Society. Despite working at a top 20 medical university in both the Department of Neuropsychology as well as the Department of Neurology, I still couldn't beat out others. The variables at play are great. You could have an amazing GPA, a mediocre GRE score, some research experience and get in, some people attend top universities and do great, get a great GRE, have no research experience and still get in. At the end of the day, you see programs boast that while the Ph.D. program is there to train future psychologists, you as the student must have a research interest that aligns well with the mentor whom will vouch for you to take you in. If a department has 15 full time faculty members and only 8 of them are accepting new students in their respective "labs" you could be SOL despite having amazing credentials. People really have no idea what it means to get into a Ph.D. program. They think it's like medical school admissions or other professional schools where you submit an application, letters of recommendation, etc. and they make a decision based on those variables. The same holds true for the Ph.D. option but much much more. You are being select to be trained and to research at the expense of the university who will pay you to go to school for the next 5 years. Even applying to crappy programs still yield very very competitive admissions processes.
The reason for this involves issues like an internship imbalance for APA-accredited internship sites, thus forcing programs that are APA approved to cap their admissions. You also have a vast majority that cap it due to the traditional training model that they want to educate researchers first and foremost who will use their skills in research to inform their clinical practice. This model has slowly shifted due to the advent of the Psy.D. programs. This brings up another point...say you want to circumvent this whole Ph.D. application process, you'd still be fighting an uphill battle, but for more available seats because they will admit according to a clinical model similar to that of medical schools, etc. The catch is that you will spend 5 years in school and come out $200-250K in debt...all so you can spend 2 more years gaining supervised hours to sit for your licensing exam and to make $50K (this is a liberal estimate). That salary will fluctuate for the next 8 years and if you are lucky, you will hit $70-85K before your 10th year in practice. Then there is the slight issue of market demand. As unfortunate sounding as it is, Americans don't want to spend 1 workday and $100 a session to talk about their feelings and do this for 4 months to start remotely feeling a therapeutic effect. Additionally, there is the feasibility of insurance companies reimbursing for services provided by a psychologist in which master's level practitioners have taken over the market and can charge about 90% of what a psychologist would charge. More notably, you have these practitioners trying to double dip in providing psychometric testing, in some states, it's mandated that insurance companies will only reimburse PSYCHIATRISTS to give these tests. Psychiatrists are not trained to implement these tests nor equipped to infer their results. That's why they, as well as psychiatric NPs and psychiatric PAs stick to the "clinical observation" method in diagnosing a mental illness vs. a more quantitative approach psychologists use in conjunction with the DSM or ICD-10.
At the end of the day, you see programs boast that while the Ph.D. program is there to train future psychologists, you as the student must have a research interest that aligns well with the mentor whom will vouch for you to take you in. If a department has 15 full time faculty members and only 8 of them are accepting new students in their respective "labs" you could be SOL despite having amazing credentials.
... and you have to identify faculty who share your interest, who are accepting students, at an institution with a reputation that will secure you a job offer. When I was applying I'd identified a dozen schools/faculty that met those criteria, but half of them weren't accepting new grad students. It's not like you can wait around for an opening, either. Once you graduate your degree starts getting stale fast. I worked in a research lab on campus for three years after I graduated, led on by the promise that the next morificecript would be mine to write, or the next experiment mine to design. 25-year-old me didn't realize I'd been shafted until the faculty member in the next lab over told me if I'd been in her lab I'd have published two or three papers already. I got a couple of offers, mainly because I'd spent so much time at conferences that some faculty at other schools recalled me, but by then I'd decided that even though I loved research I kind of hate academia. The prospect of getting a job at Generic State University and then watching the obituaries for a job opening had zero appeal to me.
Whoops, a little reminiscent there.
This model has slowly shifted due to the advent of the Psy.D. programs. This brings up another point...say you want to circumvent this whole Ph.D. application process, you'd still be fighting an uphill battle, but for more available seats because they will admit according to a clinical model similar to that of medical schools, etc. The catch is that you will spend 5 years in school and come out $200-250K in debt...all so you can spend 2 more years gaining supervised hours to sit for your licensing exam and to make $50K (this is a liberal estimate).
And be looked down upon by PhDs. My university had one PsyD faculty, and whenever she made a mistake someone would say, "Well, she is a PsyD." Clinical doctorates were for people who weren't serious or smart enough to get into PhD programs, and clinical practice outside of a research context is so frowned upon you can't even mention it as an interest in a grad school interview at a good school (Columbia potentially excepted).
Then there is the slight issue of market demand. As unfortunate sounding as it is, Americans don't want to spend 1 workday and $100 a session to talk about their feelings and do this for 4 months to start remotely feeling a therapeutic effect. ... Psychiatrists are not trained to implement these tests nor equipped to infer their results. That's why they, as well as psychiatric NPs and psychiatric PAs stick to the "clinical observation" method in diagnosing a mental illness vs. a more quantitative approach psychologists use in conjunction with the DSM or ICD-10.
I am, or will soon be, one of these double dipping psych nurse practitioners. The sad thing about it is that I'm actually trained to do therapy, but my clinic loses (or will lose) money if it makes up a substantial portion of my practice. So we employ MSWs and MAs in counseling to do all of the therapy, I manage meds (which insurance reimburses at more than twice the rate of therapy), and we refer patients to psychologists only for testing (I'm not spending all day doing ADHD testing on a wound up 6-year-old, even if I did know what the hell I was doing). So the only person working within the full scope of their license is the therapist.
Thanks for the reminder how I ended up where I am. Sometimes I long for the days of analyzing research data and reading a stack of articles for a lit review, but only until I remind myself why I didn't pursue it.
justmovingon
21 Posts
I say, good for her! It doesn't make her less important to patient care. It's a different scope of nursing. I don't want to clean poop either. Honestly, who really wants to clean poop?