tineann

Hello, I am contemplating a position in Army Reserve as a Psych NP. If anyone out there is currently (or recently been) in this role, could you share your experience? I talked to a recruiter today and she is going to seek an age waiver for me (I'm 49.) She gave me some information, but I need to find a way to connect with someone who has actually done this. What are the drills like? Do you get to use your psych skills? Do you prescribe? What is the pay like? Thanks in advance..

I am scheduled to take my exam next week. My masters was from University of Rhode Island. I don't know about on-line programs. I do know, that at URI, the Adult Mental Health CNS program will be discontinued after this next year. While I don't agree with it, I think this is the trend. You may need to go with Psych NP...

I purchased the mometrix study guide for the Adult Mental Health CNS exam - which I will be taking this upcoming week. In my opinion, a complete waste of money. Very poorly organized and written with factual errors (I only spent about an hour looking it over, before I trashcanned it). I am using the Adult Psych NP study guide written by the ANCC (they don't produce one for adult psych CNS) and the ANCC book for general psych nursing certification. I also bought the 150 questions for the CNS exam and used the NP questions that a colleague bought. I hope I pass... never know. Anyway, that is just my experience with the mometrix book.

Hi, PMH stands for Psychiatric-Mental Health. Yeah, I know, all the abbreviations are a bit much. Thanks - I've heard of Mometrix - I'll check it out!

I am graduating next month and will be eligible to sit for the Adult CNS PMH exam. It is my understanding that this test was changed and/or updated this past April. The only official study materials that the ANCC provides for this exam are the 150 practice questions that can be purchased for 90-ish dollars. There are no review courses or study manuals. Before I digress into my irritation and frustration over this, let me ask my question: Has anyone taken this exam since April who could provide me with some study guidance? Now, to *****. Why are there not study materials??? I purchased the questions and made my way through the first half of them - questions are lifespan - both adults and kids. So, I paid for some questions about an age group that I won't be tested on. Really, how hard would it be to offer each age group 150 appropriate questions? I understand that this particular CNS test will not be offered after 2014, but, for now, it still is. I am very irritated by the lack of support that the ANCC is providing for folks taking this test.

Hi, I am sure this information could be gleaned somewhere from this site, but I have not been able to find it. Could someone direct me to the actual link/language to the ANCC which states that NP's would be 'grandfathered' under the proposed DNP "shift", but CNS's would not. I do believe that I have read this statement, but for the life of me, can't locate it. Thanks! Christine

Hi, I had 3 review books - Barrons, Kaplan and then one other that I can't recall (I dumped them all after the test - sort of therapeutic!). I think the combination was helpful - that aside, I think Kaplan was probably most helpful to me. I purchased the one with the most practice tests and was glad that I did. Amazing to me how much I was able to improve with just repeated testing. Practicing vocab was very helpful as well. When do you take the test?

Hi, I took the GRE's last December and I recall them being fairly close to my actual score - I think within 30 points or so on both Math and Verbal? Without a doubt, the best prep for me (after initial reviews and vocab drills) was taking many timed tests. Good Luck!

Hi Lauren, I will be starting the Graduate Program at URI this fall. I will be in the Psych - Adult CNS program. I graduated from their undergrad program in 1994 - felt I got a very good education. It is very difficult to know how the program "stacks up" against others (at least for me). Anecdotally, I hear good things. I also applied and was accepted to Yale's program (I live in Westerly,RI) - agonizing decision. I was giving Yale more of a "chance" in that I had gone up there twice and talked with the profs - no doubt, they have a great program. Went up to URI 3 days ago to meet with the head of the grad psych dept (who I knew from my undergrad days) and left with no doubt that URI was a better fit for me. I feel very good about the psych program at this point. Can't speak to the other specialities but I would guess that they are respectable at the very least. Cost - about $335 a credit for instate.. not too bad. I will be going part time as I have to continue to work 4 days/wk and so it will take me 3 1/2 years to finish. Tuition reimbursement at my hospital is $2200 a year - will cover a good deal of the cost (not all). Hope this has been helpful - any more questions, just ask! Good Luck! Christine

Thank you for your response. You raise some really good points and outline a viable option for the future. Appreciate the constructive advice.

This isn't a petty issue to me or I would not have taken the time to place a posting.Safety is not petty to me. As I have said and implied in previous postings I have been very fortunate that I have been forced to work some nights only recently - however, I have become aware that for MANY nurses this is an ongoing issue. Lets just for the sake of argument take my experience out of it. What I had hoped to do was start a dialogue about this practice (night rotation) in general and maybe brainstorm some ideas/solutions. Lets focus on ALL of the nurses who are impacted by this practice all of the time and keep in mind that for some nurses this practice is more difficult for others and can even feel unsafe. By the way, I am not inflexible and I frequently step out of my comfort zone..... I just have a really hard time working nights.

Thanks for all the replies! I would like to state that I certainly am not looking for sympathy in regards to my situation.... I realize that many other nurses have and have had it much worse. I also realize that this is currently part of my contract and I will continue to work my share of nights. I do intend to persue this topic when our contract is renegotiated as I do feel it is a huge safety issue. whether I get anywhere or not, remains to be seen. I can't help but wonder if this has been a practice for so long that it just becomes part of the background and is never questioned. Kind of like manadatory overtime....Perhaps if a little presssure were collectively applied, management would find ways to decrease this practice. Worth a try anyway! I am curious if there are nurses who work in hospitals that don't require night rotation?

Chris, I appreciate your response and would agree that when the tragic event occurs, a precedent will be set and management will then need to get more creative (ie probably pay more money for a person who can safely fill in while they wait for a qualified applicant). Suzanne, I hear what you are saying and I am really not one that automatically vilifies management. I do believe, though, that they are looking out for their best interests (as am I). If they can piece it together for 2 mos until the traveler comes rather than hire a very expensive pool nurse then they will do it - especially if the contract allows them to do that. However, if they can, in 10 days, bring in 60 out of state nurses to cover for a potential strike (which they just did at my hospital).. why can't they cover nights until a suitable replacement is found? Especially if the health and welfare of the patients and staff are at risk? My issue as I have already stated is that I believe there are serious safety issues involved here. I do believe if a patient death (god forbid) and ensuing lawsuit was attributed to a sleep deprived nurse being forced to work nights then the hospital might rethink it's policy. But why does it have to come to this? Nurses work hard and I think that there are not alot of people in society who could do what nurses do - but I do not think that means we need to be martyrs as well. What really blew me away when this happened on our unit 5 mos ago (I work inpatient psych) was that I found out that the neuro floor had been on night rotation for a year! Does this mean they are just exceptionally dedicated nurses (which I am sure they are) or could it be that they are really being taken advantage of? I mean,come on, this is outrageous. Why would management change a thing if these nurses just quietly continued to rotate? Thanks all for the thoughts/opinions and different angles.... it is helping me to process this issue.

Thanks for the responses. A couple of other pieces of info. Our union just settled with the hospital last night at the 11th hour. We were close to striking- not over this issue...however, all the strike nurses were in town and were being oriented to Pyxis etc. Obviously nights would have been covered by the strike nurses. Necessity is the mother of of invention. If they were forced to find nurses that felt comfortable and safe working nights I can't help but think they would find them. Might mean paying large sums of money - but what is the price for safety? I sometimes feel that nurses don't force issues enough and that we are then left in compromising positions.

I work the day shift in a smallish community hospital (nonprofit). We are unionized. Our contract does have language that allows for days to rotate to nights in the event of a night shortage. I have worked here for 10 years and have never been in this situation and so have thought nothing of it. About 5 mos ago we lost our night nurse. We have had a traveler for part of that time and another one is coming in Jan. We have been filling in - each of us usually picks up 1-2 nights/wk to minimize the stress for one another. This is extremely hard on me and many of my co-workers. My body clock is such that I can only sleep between the hours of 8pm - 5 am. I am incredibly sleep deprived when I have to work nights (patient safety?) and the half hour commute home in the morning is downright scary for me. Here is my question - do we have a good chance of ending this practice if management is put on notice that we are doing this under diress and that, regardless of what the contract says, we cannot ensure safe patient care in our sleep deprived state and that, further, we are not safe to drive home. If everyone affected by this signed a statement to this effect would they not legally have to stop this practice if only to protect themselves? Any lawyers or nurses out there with any opinions or experience on this matters? Thanks!

I tend to agree with Thunderwolf. I had 2 1/2 years of med/surg prior to transfering to psych 8 years ago and I am really glad I have that experience under my belt. I am finding that our patients very often have medical issues that need to be addressed and it is so helpful to have some clinical experience with these medical issues. However, my closest collegue went right into psych from school and I don't think she regrets her decision. I will say that I usually end up dealing with the more medically compromised patients though - partly because I have more of a background and largely because I feel more confidant in this area. Confidance is a biggy - it is nice to feel able to deal with a variety of different situations with some level of competance.

Hi- I currently live in RI but grew up in Bozeman and most of my family is still there. It is absolutely gorgeous!! Down sides (at least for me). Pay is low and real estate (in the Bozeman area) has gotten very, very high. Being a sole wage earner, I really can't even consider moving back - unless I want to live with my parents, which I don't! Everyone's situation is different though and if you can make it work - go for it! You may want to get on http://www.realtor.com and check out the real estate in the area. Good Luck!

Thank you very much for taking the time to respond! The info you provided is helpful

Hi- Your post was interesting to me - I am a psych nurse in Connecticut and am looking at going to Australia for a year to work. I work on an inpatient, locked (we take both voluntary and involuntary patients) unit at a medium size community hospital. Total hospital beds around 250... are capacity on the psych unit is 16. I can only speak for my region, but I can tell you that you could find either an inpatient job or a community based job relatively easy. The community is always in need of psych nurses. The truth is that we actually need more longterm psych hospitals for the most chronically mentally ill. It has really become a revolving door around here and we often discharge patients in less that ideal circumstances simply because what they need is to be cared for on inpatient setting for longer that 1-2 weeks. My feeling is that we are at a crisis, at least in the state of Conn regarding mental health. But, jobs there are! Pay and benefits. I think my hospital is pretty good in this regard. Pay range for RN's is $21-38 dollars/hour depending mostly on years of service (Pay raise each year). They have a strange way of figuring out vacation - amounts to about 3- 4 wks/year , but that also includes holidays. Health and Dental are good plans but the employee copay has risen drastically over the last few years as it has for everyone in the states. Specific psych training over here is a little lacking for general RNs. I think 4 yr degrees have a little more of a psych component than a 2 yr but it is still, in my view, minimal. Alot of on the job training. I think that, in general, in order to be a good psych nurse one has to be passionate about it and so I think that helps bridge the "educational gap" somewhat... most of my collegues are involved in furthering their education one way or another. Duties. What can I say - we manage the unit. Morning report, meds, breakfast trays. Community meeting, Group therapy (MSN prepared nurse runs this), Medication groups. Team meeting each morning with all the disciplines. Admissions, Care plans, care plan updates. Discharges. Managing the mileu... handling difficult patients, setting limits, reassuring, teaching. It is kind of hard to describe because each day is different.. Hope this is helpful. Feel free to ask more questions or pm if you would like! Christine

Thanks Neelia! Useful info....I will be curious to hear about how you like school. I assume you are going to go to UCHSC? I think renting initially would be the best option for me so that I could get a feel for were I would want to settle. What degree are you working toward? Feel free to pm me. I am off to bed after a long day but will probably pm you with some more questions on the area, if that is okay. Thanks again for the response. Christine

I believe Columbia is in NYC. I live in RI. If it is Yale - well, you know, excellent reputation. If you can swing it, go for it! Obviously, go with your gut!

Hi- I've done a bit of reading and this is what I have so far, along with some questions. Correct me where I am wrong. To come to AUS from US to work (psych RN with BSN and 8 yrs experience) I would #1 Figure out which state I want to work and apply to that nursing registration board. Takes 6 ish weeks to obtain registration. #2 With above registration can apply directly for job at hospital. #3 Once job offer is obtained apply for work visa. Is this right? Not planning to move for at least 18 mos - tops, 2 years. How long before I plan to leave should I start the process? In looking at the individual state boards, I read something about sponorship... what is this and is it advised? Can you recommend some reputable psych hospitals? Lastly, my plan was to stay and work in Aus for a year and then return to the states and obtain my masters degree (probably psych CSN but maybe psych NP). Then, I started wondering about getting this degree in AUS. Does anyone know how comparable the education would be and would I be able to translate a psych CSN (if it is even called that) in Australia to the US equivalent when I return? Recommend a school? Thanks in advance! Christine

Hi- I am an RN and work on an inpatient psych unit in CT. Initially when I started here (8 years ago) we had no LPN's. My nurse manager has recently hired a couple. They came from outpatient rehab centers and so came with some substance abuse experience. Because they are LPN's, their role is more limited than the RN's (ie can't do initial admissions, write or revise care plans, sign off MD orders) but there is still plenty for them to do. I think it may be the exception that my nurse manager decided to hire them - not sure if LPN's commonly work on psych units. I know that as an RN, at least on my unit, they prefer that you have a BSN to work psych. Again, not sure if that is standard. I am sure there are other opportunities but this is all that I can speak to. Good luck in school!!

Sounds fabulous!! The more I read about australia the more excited I get.

Thanks for the tip - I will file it away!