I'm an RN with licenses in Hawaii and Arizona. I never worked med/surg and was hired into hospice when I graduated many years ago. Due to some burnout issues, I went on nurse hiatus but was reinstated in 2011. Without any recent clinical experience, I was hired into a case management job and I enjoyed certain aspects of it, mostly the autonomy and working from home. I did medical and then later worked strictly with the behavioral health population. I love everything about psych nursing, I've never worked in a hospital in psych but was familiar with a lot of it because case managers were directly involved with admissions, medication management (which I loved) and discharge/follow up. The main challenge of course being that our population was not compliant with treatment so I felt like I was more a clerical personal assistant than a nurse. I have thought about applying to the psych hospitals in Hawaii where I have lived for 10 years, but it's hard to get a foot in the door, and also because I had a gap in employment, and am a A.A.S. nurse (no BSN), I'm up against a lot of obstacles.
I've often considered studying for my master's and working as a psy NP . I seem to have a knack for the medications and anything psy related, and had a decent insight into community nursing as a case manager.
Being 44 years old, with no savings, an 8 year old in Hawaii, I feel like my choices are a bit limited. Of course I wonder if I'm too old to pursue a master's and would that be tough for my 8 year old. His father and I are not together and while his father is helpful with child raising, he is based in Hawaii and he has never really taken my nurse work seriously, in other words I've always tried to find nurse work that works around his schedule. I feel life passing by and have decided that if this is something I really want to pursue, that I need to do it soon.
What I lack on resume experience, again I make up for with an intuitive knowledge for psy disorders and management. I've often felt like I have not worked up to my potential academically and professionally, but then again with a young son, priorities in life change.
I've considered getting licensed in other states and to attempt travel psych nursing (inpatient) but I know that may require me to leave the state. My other family lives in Arizona and there are a lot of psychiatric hospitals , and even with my lack of experience inpatient, some of the recruiters have acknowledged that case management would be considered an asset. Potentially, I could build up experience in Arizona then look into travel assignments.
I want to remain flexible with options to accommodate my son.
But the voice in me from my 20's keeps saying that if I wanted to be a psy NP, then go for it. Financially I cannot afford it so I would have to apply for loans. I imagine it would take three years of academic work and then I would be a newb NP . I don't know where I'd go to school (Hawaii does not have a psy NP program, only general NP). And I don't know where I would work after I graduated. It is very hard to consider leaving the island because it is just as important as any career.
Are the online NP programs reputable, would it be possible to remain here and complete an online program?
Or should I focus on gaining more "resume" experience by working as a psy RN inpatient (although I really felt I learned a LOT with case management because we were in the field alone ). I'm not new to crisis intervention or deescalating patients. I understand milieu in hospitals, I know what a COWS assessment is, how to score for suicide/harm to self to direct a one on one, I have done med passes as an LPN in nursing homes, as I mentioned as a case manager I spent a lot of time in psych hospitals here so I'm not new to it, unfortunately hospital staff often views case managers as the go to when stable housing cannot be found or a pt is noncompliant with treatment. I've seen both sides and I understand the insurance side as well , having working in medical case management/ UM.
Personality wise, I'm confident in what I know but I respect the experience of others. I felt frustration when I didn't agree with a treatment plan or a doctor's change in medications. I work very well by myself and have always enjoyed the creative problem solving "overall" planning for pts. I quickly pick up on the gaps and barriers in healthcare and prefer working towards long term solutions . Although I spent time as an LPN in LTC, and I know how to task, "clinical" skills have never been my favorite part. I enjoy pt contact but am seeking a role that is more comprehensive, more autonomous, and possibly more authority (hate that word) . It's not so much that I want to write scripts as that I enjoy the entire management of care that can be customized for each person . A lower patient case load with more intense long term care is my ideal.
And I like to write :)
Wow, that's a lot, and I certainly don't anticipate an easy answer. I know the obstacles with where I live and being a mom, yet I'm not sure working to be a psy NP is the best choice. I've often heard psy RN's state that they enjoyed being an RN but they LOVED being a NP. I know it also comes down to a matter of deciding what is most important, and that's the tough part. I want the best life for my son but I don't want to pass by what may be something very satisfying.
Because of where I live (and love it) and lack of savings, I think the part that concerns me the most is, what if I earn the master's and don't enjoy the work? For many many years I felt that way as an RN, it was before I worked in psych and I never felt a pull towards ICU or ER . Hospice nursing was something I enjoyed because I agreed with the mission, but psy has been the only area that I've felt I was in the right place. I don't want to go into debt and find out psy NP is not how I imagined it would be (again just like when I became an RN) , then again I don't know if I would feel challenged enough working as a psy hospital RN (and that is in no way meant as if to sound that psy RN's are not as smart or important).
I've spent quite a lot of time looking into the role of the psy NP but I guess you just don't know if it's a fit until you are in the shoes.
Thank you, any input or words from the experienced are welcome. I know what I want in theory, but is it reality?