MSN program questions

The problem is that, now that so many states are offering Rx authority to both psych NPs and psych CNSs, all the graduate programs focus on the physical assessment/prescribing part of the equation. I am an "old school" psych CNS who went to grad school long before anyone ever considered the possibility that psych CNSs might someday be eligible for Rx authority, so my graduate program was two intensive, rigorous years of training as a psychotherapist (which is what psych nursing graduate programs used to be). I don't think psych CNS programs like that even exist any more. Psych NP programs have, from the v. beginning, focused on prescribing rather than therapy, and the psych CNS programs are slowly becoming indistinguishable from the psych NP programs.

Some psych nurses used to go outside of nursing for graduate programs to become therapists (getting graduate degrees in psychology, counseling, etc.), but the ANCC has tightened the requirements over the years so that it's no longerpossible to become certified as a psych CNS with a graduate degree in another field -- it has to be an MSN in psych nursing.

I guess, at this point, you can either grit your teeth and do a psych NP/CNS program and then focus on learning to become a good therapist after you complete the degree, or "jump the fence" and move into another field (psychology, social work, counseling).

Have you talked seriously with your current employer about what your professional prospects might be with them, realistically, if it is your intention to stay with them (as you suggested in your post)? Most of the facilities I have been aware of in recent years use social workers or LPCs as therapists because they are much cheaper than psychologists or MSN-prepared RNs. If I were you, I would not just assume that you have a professional future with a particular organization as a psych NP or CNS just because you're working for them now. And your current employer may be only interested in using you for med management, rather than as a therapist -- that is certainly the trend in psychiatric nursing advanced practice these days.

Sorry to sound so gloomy about all this :) -- best wishes!

Rx authority might not be a bad idea I guess if I plan on opening my own office down the road. I would assume we would still need physicians over site right? I can't imagine the powers that be actually having a awakening that a nurse can really manage these things on their own *smile*

That depends entirely on what state you're in. There are quite a few states now that allow advanced practice nurses to practice independently, without any physician oversight at all. In others, the required physician supervision or collaboration might amount to having an agreement with a physician that s/he is available for consultation as needed, or your "supervising" physician reviews a sample of your charts once a month or so ... Many APNs choose to work within a practice with one or more physicians (right there in the building with you at all times) or in a facility/program in an interdisciplinary model. Others own and operate their own practices and hire a physician to provide whatever level of supervision is necessary. There is a lot of variation; but the trend is definitely toward decreasing levels of supervision.