LCSW seeking to become a psychiatric nurse

[nateprentice]

Hello folks.

I am an LCSW with 20+years of experience in mental health/addictions social work who is interested in switching careers now that I am in my mid 40's. I have a BSW, an MSW from an Ivy League school, and am currently one semester away from finishing a Certificate of Advanced Studies in Pastoral Counseling. In addition, I am a couple of pay cycles away from completing my Certificate in Clinical Hypnosis from the American Society of Clinical Hypnosis. While I am not Certified in EMDR, I completed my training in the early 1990's.

Reasons for leaving? Simple. Social Work is great for a psychosocial perspective and being able to look at more than the medical model. However, it is weak on the bio-psychosocial perspective. So, I think having that added perspective will make things easier in my work. The big reason, to be honest, is that supporting a family on $35K per year is just not possible.

So, here I am looking at efficient but quality-full ways of getting a solid education in nursing. I am not married to psych nursing as an idea, but I think it is a logical progression from my previous practice.

I envision doing the following when my education is done: continuing to do psychotherapy, possibly prescribing medication. I could see doing inpatient psych nursing, but I've worked with psych nurses on floors before, and they didn't seem to do a lot of therapy--mostly medication management. My passion is therapy.

So, here are my questions:

1. Money does not grow on trees. Therefore, what can one do with an LCSW, CAS-PC, and a BSN? What can't one do?

2. In 2015, I understand nurses will not be able to prescribe with an MSN. They will need a DNP (or Ph.D.?) What will happen to MSNs at that point who are not grandfathered? The reason I ask is because if I want to become a Psychiatric Nurse Practitioner (I.e. one who can prescribe), I need to consider whether or not I should be thinking of an MSN or skipping the MSN and going straight for the DNP. At my age, this is a relevant question. If a DNP is not in the cards, what will happen to non-grandfathered MSNs in terms of clinical privilege and pay?

3. At this point, I'm looking for quick, but well-balanced programs to ease into the BSN level. The MSN/DNP decision will be made later. The second-career BSN programs seem to range between 1-2 years in my area (I live in the Philadelphia, PA area). Any tips, especially from the hiring perspective? Any good programs in the Philly area? Any to avoid? What about online programs in terms of cost, time and reputation?

4. If you are an MSW with a BSN, what do you do in your daily work? How does a BSN enhance your practice and pay as a joint-degree person?

5. How is the turf war between Psychiatric Nurse Practitioners and Psychiatrists going?

I want to thank you for reading this, and considering my multitude of questions. I can be reached at [email protected] if you want to talk with me privately. For further information on my current practice, you can look at http://nateprenticetherapy.com.

Thanks.

Nate

[sstokes1202]

I believe the DNP requirement will happen. I am towards the end of my 34 year career but I still plan to complete a DNP program in order to stay clinically relevant. I have heard there will be grandfathering but I cannot find any documentation about how this will be handled . Get the prerequisite courses that you may need to get accepted . Apply and get in to the program that accepts you. I live in California and the second career professionals need to take the core sciences that they may not have taken in their original specialty. In California nursing programs have waiting list so students typically apply to all then enter any program that accepts them. They are regulated by the board of registered nurses so you should get a fine education. If I were you I would take the 2nd career option because upon completion you have your NP. Also there is consideration for your advanced education. Good luck. I am new to the community. Looking forward to hearing from others on this topic.

[delerben]

Your story is my story almost to the "t". I have an MA in Psych but have been practicing Social Work for 15 years. Just have the BSN and thinking about going on for the Psych NP. I figure, one step a a time. I will be able to double my social work salary in a few years as a BSN so money is not the drive but I would love to prescribe psychotropics, etc.. Let me know if I can help you in any way and best of luck

[koi310]

Hi Nate:

1. IMO, psychiatric nursing with a BSN is mostly about millieu, passing meds, therapeutic communication, the occasional takedown, suicide/razor precautions, etc. You are also responsible for nursing care such as IV therapy (you see it in inpatient psych wards) and wound care, as well as basic nursing care such as ADLs (bathing, grooming, etc) if the patient isn't independent. There are psychiatric aides who the ADLs, but you'll have to do it if they are busy because their care is ultimately the nurse's responsibility. In short, most psychiatric nursing is not directly related to psychotherapy. I don't know of any BSN psychiatric nurses that are trained in psychotherapy and I am not aware of any ADN/BSN nursing curriculum including such training in their curriculum.

Given that, I am not sure how useful your experience in SW or psychotherapy will be in securing a job as a BSN psychiatric nurse. Your experience with MH/addiction patients is something in your favor, but your inexperience as a nurse is not. If you get hired as a psych nurse, you will be the lowest member on the totem pole in terms of experience and seniority, meaning you will probably be the one working nights, weekends, and holidays.

2. Regarding the psychiatric DNP and prescription privileges: scope of practice and prescription privileges depend on your state's Practice Act. You'll have to research that. The only comment I will make regarding prescription privileges is that you have full responsibility but usually limited precription rights. You might be able to prescribe some psychotrophics, but you also have to monitor their side effects as well as any potential drug interactions. It's your choice if you want to take on that sort of responsiblity. I know a psychiatric BSN-RN who is also a PMHCNS-BC with prescription privileges who works part-time as a therapist, and she will not prescribe because she is too afraid of the potential liability.

Regarding the MSN/DNP: I think a lot of schools are already moving toward the DNP. There are direct entry programs that will allow you to get an accelerated BSN (1 year) while pursuing your DNP, but those programs are not cheap. I inquired about a direct entry program in my home state and was quoted $30K/year, and this was from the state (public) university in 2009. In all, my total loan debt might be approximately $100K, but the counselors assured me that I could easily make it back, because I would be making that much per year, *cough**cough*. Making $100k/year is not guaranteed, however, and a lot of NPs work as regular floor nurses making the BSN wage. Buyer beware.

I'd advise you to make friends with some psychiatric nurses in your area and pick their brains about their jobs. See if you can shadow them on a shift. That's the best way to decide if you want to go the medical route.