MSW to PMHNP/FNP (dangerous ideas!)

[NuggetsHuman]

Egad!

I think after four or five years of stewing on this, I have decided to start down the path of nursing education, leading toward a PMHNP (family). I have a BA in psych, an MS in social justice studies, and an MSW in direct human service work. My prior work history includes running a DV shelter, working in boys' residential treatment and therapeutic foster care, ER social work (which I loved, loved, loved!), and now providing youth and family mental health crisis response.

I see really clearly how having additional training on psychopharm and prescriptive authority would be really helpful. Plus, child and adolescent mental health has rather picked me as a specialty. I never intended to be "that annoying lady who tells you how to parent your kid but doesn't have any of her own."

In addition, I FINALLY completed my WFR (wilderness first responder) 10 day training. It's been on my to-do list since 2004. It was some of the best training I've ever had in ANYthing. It helped me to realize exactly how excited I get learning medical stuff. Given my interest in emergency medicine, I wonder if I wouldn't be better off doing an FNP (focusing on acute care), or stopping after by RN to get some ER nursing experience.

I took one biology and one Chemistry class when I was an undergrad music major 20 years ago (EGAD INDEED!) now. So I will obviously have my hands full with prerequisites for a while. I've decided to start with the nutrition class to see how it goes.

So I'm looking at at least 6 prerequisite courses-- 2 Chemistry, Microbiology, 2 anatomy and physiology, plus the nutrition. I have the statistics and developmental psych, as long as they aren't required to be in the last 10 years.

Then *hopefully* an accelerated BSN program, and then into a DNP program for three years.

I am working full time in the crisis response program, and it doesn't leave me with lot of extra energy for volunteering because of the level of self-care required to do my job well. Do you think this will count as "hands-on" health care experience because I'm in and out of emergency rooms and IPU (inpatient psych units) all day long?

I want to make my application really competitive, and assume I will probably get mostly As with maybe a B for my science classes.

Any words of advice or encouragement as I start exploring down this path?

Oh, also, editing to add that I am *really* committed to working with under-served populations. Anyone have experience with loan forgiveness programs for PMHNP work?

[NuggetsHuman, BSN, RN]

Well, it happened. Pending successful completion of Microbiology starting January.

I opted for the 2 year evening/weekend program for the BSN because financially my spouse and I can't really take the hit of me not working at least some.

[NuggetsHuman, BSN, RN]

Ahahaha.... Yeah.

So.

I really just couldn't afford Drexel, and after talking with people who know more about the programs in the Philly area, I've applied to and been accepted to LaSalle's ACHIEVE program. It's a three year (instead of two) BSN.

Ordered my clinical uniform and, yes, even white shoes.

Aaaaahhhhhhh!!! It's happening!!!

Friday at work I was in a room with two MDs and two NPs who all broke out in giant grins and so much excitement when I told them I'm starting at the end of August.

[umbdude, MSN, APRN]

NuggetsHuman said:

Ahahaha.... Yeah.

So.

I really just couldn't afford Drexel, and after talking with people who know more about the programs in the Philly area, I've applied to and been accepted to LaSalle's ACHIEVE program. It's a three year (instead of two) BSN.

Ordered my clinical uniform and, yes, even white shoes.

Aaaaahhhhhhh! It's happening!

Friday at work I was in a room with two MDs and two NPs who all broke out in giant grins and so much excitement when I told them I'm starting at the end of August.

WOW!, original post in 2012. Nice to see that you're following through and congratulations!

[NuggetsHuman, BSN, RN]

Thanks, umbdude.

I'm nothing if not persistent!

I hesitated about whether I was really going for it because I just received a promotion at work. I work in an FQHC and was hired as a behavioral health consultant to work with our brand new medication assisted treatment program at two different clinic sites. The promotion was really just an acknowledgement of the program development role I've been doing this whole time, as well as increasing the capacity of our department to take on more staff. We will find out in September if we will be awarded both a multi-year HRSA grant and a multi-year SAMHSA grant that will grow our MAT program to a minimum of 10 clinic sessions per week for at least 4 clinic sites around the city.

I'm a little annoyed that the Nurse Corps scholarship program prioritizes full time students because this year there's a set aside of I forget exactly what percent for behavioral health, and a chunk of THAT set aside to fund... *drum roll* addiction medicine focusing on opioid use. I get that it's a workforce development program, but it sucks that I'd have to quit my full time job in the field and gamble on getting a competitive scholarship.

[NuggetsHuman, BSN, RN]

Finishing up the first semester of the BSN! WHOOP!

Here's what's left:

One very short presentation with a 1 page reflection paper

1 regular patho exam

intro to nursing final

patho final

In terms of academic performance, I'm doing just fine. Solid cusp between B+/A- territory without actually killing myself with stress.

As a perfectionist, I'm getting a LOT of practice reminding myself that there is no functional difference between getting an 86% and a 96% on an exam, and the 86% gives me more time to deal with the rest of my life including my very full full time job. We not only got awarded both the SAMHSA and HRSA grants, but also two other grants for program expansion and evaluation. And both my department head and I are doing two peoples' jobs until we get the behavioral health consultant positions we were in filled.

(I saw 53 patients last week. My productivity expectation is 32. And if my manager gives me any more **** about not having my notes done on time, I'm going to poke her in the eyes until she gives me a chunk of her admin time because I have no admin time that is not tied up in meetings.)

I feel really fortunate to the academic stuff pretty easily and that I learn well in a traditional educational environment. Do I wish I could have the luxury of going to school full time? Sure, sometimes. But truthfully, I feel like I'm learning more and more at work just by thinking a little more like a nurse in addition to a social worker. Full time school is book learning, which is good. But full time work and part time school is applied learning and critical thinking, which in the long run serves me better.

For example, in clinic last week one of the nurse care managers pulled me in to help out with a patient in crisis. Thanks to the intro class, I was fascinated doing this kind of meta-observation about how nursing therapeutic communication is different from therapist therapeutic communication.

Plus I get to see all kinds of fascinating things in clinic like cellulitis and abscesses aplenty, and a gazillion chronic health conditions exacerbated by homelessness, addiction, poverty, and trauma. I mean, I would see all these things in clinic at work anyway. But I notice that I'm thinking about them in a more complex way... in a more medical and more nursing way already.

As long as I remember school is my full time hobby right now, I do alright. But once finals are over I'm going to knit myself a very ugly Christmas sweater for our work Ugly Sweater Day.

[umbdude, MSN, APRN]

NuggetsHuman said:

Finishing up the first semester of the BSN! WHOOP!

Plus I get to see all kinds of fascinating things in clinic like cellulitis and abscesses aplenty, and a gazillion chronic health conditions exacerbated by homelessness, addiction, poverty, and trauma. I mean, I would see all these things in clinic at work anyway. But I notice that I'm thinking about them in a more complex way... in a more medical and more nursing way already.

As long as I remember school is my full time hobby right now, I do alright. But once finals are over I'm going to knit myself a very ugly Christmas sweater for our work Ugly Sweater Day.

Adult health (or med-surg) will be a tough one. Make sure to put more time aside to study! Good luck!

[NuggetsHuman, BSN, RN]

Thanks for the pro-tip and continuing encouragement.

I'm making some adjustments to life to minimize and condense my remaining private practice clients and not taking any new people. Hopefully eventually everyone will feel like they have enough support to just check in periodically.

Spring semester is health assessment and pharmacology. Clinicals are every other Saturday in the lab for health assessment.

Summer term is foundations and then next fall I think is when we get into adult health.

Eating the elephant one bite at a time!

[NuggetsHuman, BSN, RN]

Ahahahahahahah....

Pharmacology. is. kicking. my. ass.

It will be fine. I'm just having some challenges with how to organize the information. Rote memorization is definitely not my strong suit, but writing things over and over and over and over again with the same color coding seems be helping.

[NuggetsHuman, BSN, RN]

Pharmacology kicked my ***, but I kicked back!

It's really interesting to me that I catch myself at work thinking about information in different ways than I have in the past. For example, I look at a patient's problem and med lists and find myself thinking through implications of not just emotional health, but also physical health.

We have Fundamentals of Nursing this Summer, which includes one classroom evening and one lab evening (in addition to clinical weekends).

Since I go right from work to school and my job doesn't object, I wore my clinical uniform, white shoes and all, to work this week. The doc I've worked most closely with over the last 2.5 years asked me to help her with a procedure (I&D facial/neck abscess... yummy).

We both cracked up about how the only thing that changed was my clothes, but now she looks at me and things, "Hey, you're a nurse. Can you come help me with this?" (instead of just looking at me as a social worker who can help with emotional/behavioral stuff)

[NuggetsHuman, BSN, RN]

Oh--I also wanted to add that as I look back on my original post, I have a lot of thoughts and feelings. Among them are:

-GRATITUDE for the encouragement of you all, and critical thinking encouraged about which path (PMHNP/FNP, NP/PA). I feel really solid in my choices. The plan is PMHNP, by the way. I've made good friends with the psych NP at the health center where I work who had lots of good things to say about working in integrated primary care, which is what I'm already doing and my heart loves so hard.

-KIND HUMOR toward my naivety and just not knowing what I didn't know. I'm sure this will continue to happen, and I'm glad that I have some light hearted chuckles about my younger self.

It's nutty to me that I've been having this conversation since 2012, and here I am seven years and a move ALL the way across the country and a few attend and delays. I'M DOING THE THING! Yay!

[NuggetsHuman, BSN, RN]

(also my typos are appalling!!!)

[LouiA1s]

I am also a clinical social worker! I obtained by LCSW a few months ago and I am interested in pursuing studies in nursing education. My long term goal is PMHNP. It is a little overwhelming to think about changing careers, however it has been very helpful to read about your journey :)