LPC2RN

Pretty much what elkpark said. Although you can find some PMHNP programs that have a stronger emphasis on therapy. I know the University of Missouri - Columbia has more therapy requirement hours than other programs. But this program is also DNP only.

AllOfMyWat, So I'm sure your logic applies to other areas as well, right? If you don't like spousal abuse, don't abuse your spouse. If you don't like child abuse, don't abuse your child. Does that work for you?

OllieW, It's interesting to me how your second paragraph totally contradicts your first paragraph. You hate how people "demand to force their beliefs on everyone else" and then follow that up with "It made me sick back then and it makes me sick now to think how others hold their own weak morals over the actual needs of others." So, in other words, everyone should act like you, right? You know, those people with their "weak morals." I think it is interesting that you take the position of "right to die" believing that it is a personal one and is nothing out of the ordinary, whereas history proves you wrong. This position you have on euthanasia has not been accepted by any Judeo-Christian culture or any long-standing society since the forming of these people groups.

Rock Hopper, First of all, I would like to say hello to a fellow former psychology student. I too enjoyed the psychology route and wanted to become a psychologist. It was not until a failed PhD in Clinical Psychology application process, followed by a failed PhD in Counseling Psychology application process that I decided to switch goals as I was not about to spend 150K+ on a PsyD to make roughly 70K a year. I decided to go the RN route but looking back on it, I probably should have chosen the MD route. Yes it is more school and hence more expenses and will take a little longer but when the payout is double what a Psych NP makes (and they are at the top end of the NP salary bracket), it works out over time. Is it too late for you to take that route? To give you more current background on me, I will let you know up front that I am not yet board certified as a PMHNP but should be hopefully next month as I graduate this month. I have spent many hours in clinical experiences in both in-patient and out-patient and in private organizations and government organizations. Your level of autonomy is based mostly on the state in which you practice. I went to school in a very restrictive state and will be moving to a very autonomous state. With that move will come an ability to give additional medications, which would not be possible in the state I currently reside and it will provide me with a larger income. The work itself depends largely on the workplace setting. Do you want to work in community mental health? If so, you will be exposed to a large, diverse patient population, many of whom are lower income. In this type of setting you may feel busy as you may be expected to see 3-4 patients an hour for med management. If you work for the VA, your patients' psychopathology will be pretty predictable (mostly PTSD and depression) but the workload may be lighter (2 per hour for med management). If you are in a private practice, you decide how many patients per hour, how many patients per day. Regarding the "grueling" aspect of the training, yes it is. Where abouts in the training process are you? There are different decisions that will make the process either easier or more challenging. Will you go to school FT or PT? Will you work FT, PT, PRN, or not at all during your training? How long is the program? Is it an MSN or DNP? If you want to do research in the future, you may want to consider going through an MSN route to be able to start working as a provider and then enroll in a PT PhD program (if one exists, I wouldn't know as I have not looked into them) because most research is done in a university setting and most professors who are involved in research have a PhD as you well know. Sorry if these responses are vague. You can PM me if you have more specific questions. Good luck.

Whether they give the scholarships depends on their needs. The only NPs that I am aware of are FNPs and psych. I don't know about them giving the scholarship for FNPs, though. Here is the thing with my app. I started the process and was hoping on getting in on the end of the cycle. Had I made it to the April or maybe it was the May board, I would have had a better shot but because my application did not get completed until the start of the new cycle, I was told that they were only going to take DNPs. The way it was explained was, they had like 5 scholarship positions to fill for that year. By the time the April/May board came around 3 of the spots had been taken in previous boards so two were left. At that point, knowing that the end of the cycle was approaching and they needed to fill those other two spots, they were reportedly more open to taking a MSN student, which is what I was. I am pushing through with the PMHNP, yes. I am in my third semester and plan to be done this December. It is rigorous but if you can get through nursing school, I believe you can get through NP school. What programs are you looking at? And what area of the country are you in?

I graduated in June 2014 and immediately started in an ED internship. Six months later I was on an adult psych unit. When I applied, I had been on the psych unit for about three months, so not much experience.

Gilversplace, You can find a healthcare recruiter by going to the AF website. I applied for an HPSP position last year. This was my experience: You call them and let them know you are interested. They send you a ton of documents to complete on-line and send back. You have to send them transcripts, citizenship documents, marriage licenses, copies of children's birth certificates, copies of your birth certificates, driver's license, certifications, letters of recommendation, letter of acceptance from the PMHNP program, (probably forgetting some things because there was a lot). After they get all of that paperwork, you are scheduled to interview with a nurse officer. I interviewed with a Lt. Col (not a PMHNP) at a base about 3 1/2-4 hours drive away. She was pretty cool. The interview lasted all of about 20 minutes. Then I was scheduled for a telephone interview with the head PMHNP in the AF. He was also a Lt. Col. That interview lasted about 15 minutes. I was cleared by both of them. Unfortunately, my package was nixed at the last moment before going to the board because I have a medical condition. An asymptomatic condition but one in which they feel would have been a problem. When they told me "No", they gave me a couple of reasons why, the main thing being my disease. But they also said that they prefer DNP students. The program I was accepted into is an MSN program, so if you want to get accepted into the scholarship program, get into a DNP program. I made first contact with the recruiter in March and missed the next board, which happened in April, only because I was waiting on medical paperwork from the VA. I waited until the next board, which was August, and called the recruiter in early Sep. who told me that he meant to call me back in July to tell me that I was medically disqualified. I guess when I filled out the medical questionnaire back in March, the MEPS medical officers wanted more information (a medical note stating I was diagnosed), when they finally got that in July, they said "no". It was a lot of time, effort, and money spent for nothing. So, in theory, the process should have lasted about 4-8 weeks to create an application and about another 3-4 weeks to be accepted by the board, then schedule the MEPS visit then another couple of weeks before the check comes in (from what I was told). I knew what I was getting into trying to get into the AF. I served over 7 years active duty in the AF. I loved parts of it (camaraderie, sense of purpose, pride in country, travel, benefits) and hated other parts of it (you are property so if they want you to work 15 12-hour days in a row you will, having to put up with incompetent leaders and not being able to quit, not liking where you get stationed). I would recommend it. If you have any other specific questions about the AF or the application process, feel free to shoot me a PM. Good luck.

Hey Aspiring, Where to begin? Well first off, if $80K is your goal, then any and every organization will hire you. The VA appears to be at about that level, maybe a little less but their pay scale goes up from there. Anywhere else, such as private practice, it is not unheard of to see new grads starting at $100K. In my area, they can start at about $115K. I have seen other areas, such as Arizona, starting at $120K. If you are ambitious enough, I have heard of independent PMHNPs with a few years experience making >$150K. Why you may ask would someone with a MSN make more than a psychologist? Because there is more money in medicine. In regards to the nursing profession. Beware that the medical bug might bite. I too was a counselor and wanted to go into nursing strictly to work mental health. However, as you study and learn about the human body, you may find other systems to be fascinating. You may find that you would enjoy the work flow of a different setting or you may enjoy the skills used in one setting over another. I went into the ER after I graduated and I loved it. I did not want to do med-surg and have to see the same patients every day. I liked getting them in, drawing labs, running tests, giving them drugs, and getting them out. When I went back to nursing school, I thought it would be easy as I compared it to my previous educational experience but it was much more difficult. If you decide you want to do it, be prepared for a lot of hard work and long days. You may have to put in 60-70 hours a week, especially if you plan on working at all during your education. With that being said, I do not regret my decision one bit. If I had to do it over again though, I would have probably gone the PA route instead of NP. I could have taken another year of pre-reqs and gone straight into a 2-year PA program instead of having to get my ASN, BSN, and now MSN. My 6-year course could have only taken 3-4 years. Not only that but going through a PA program gives you flexibility. You can work psych and make the same as an NP or you could work in the ED or in surgery because you are trained as a generalist and your supervising doc trains you in the specific area. You say it sounds too good to be true. If you are saying that, then it is only because you are seriously underestimating how hard it is to get that degree. Trust me, by the time you complete the training, you will realize that you will have a skill set that not many have. You will look back and say, "anybody really could be a therapist and that is why they only make $35K a year." You will know that you have earned that six figure income. I think you will like the fit, being a counselor and going into psych. When it comes to psych specific courses, you will have an advantage over your classmates, especially if you used the DSM as part of your counseling practice. Good luck. I think you will enjoy the ride.

So it is barbaric to use manual restraints on a person but not to have three people enter the patient's room and physically restrain them? What is the difference? How long do you restrain them for? Just long enough to give them a B-52 (or whatever) or do you wait until it takes effect? What if the chemical restraint does not work (which happens often in those on high doses of sedatives, drug abusers, or poor responders)? When we use manual restraints, the person is placed on a 1:1 where they have a sitter watching them constantly and charting on them every 15 minutes until they come out of restraints. A specially trained nurse also comes in to check on the patient every two hours (if the patient is in restraints that long) to ensure pulses are still palpable distal to all restraint points and performs a focused assessment. Once the patient appears to have calmed down, one point is released every 15 minutes, for a minimum time in restraint of one hour. The order for restraint has to be renewed by a doctor every 8 hours (this need to renew a restraint order rarely occurs).

Megan, I am interested in your progress. It has been a couple of years since you created this post? Have you accepted a position? Was the compensation favorable? Thanks.

For those of you who have taken the ANCC, could you please tell me what study methods or study aids you used that you felt were helpful? Due to my specialty, I will have to take the ANCC. Thanks.

Congratulations!

I was a new grad hired into the ED so the questions I was asked will likely be different than the ones you, being an experienced RN, might receive. I was presented with a scenario of patient is given a foley and you see the tech break sterile field. What do you do? Most nursing students would say start again but in an emergent situation the right answer is get it in there and notify the doc who can add antibiotics if necessary. Another question they asked was meant to examine my ability to think quickly and analyze a situation. They asked, if you could be any ingredient in any pie you wanted, what ingredient in what pie and why? Most people said something about being pecans in a pecan pie because they were nutty. I went with lemon from a lemon meringue pie because I can be sweet or sour. I am warm and love the summer. You get the idea. And of course there are all of the typical interview questions: Why this ED? Why are you better than the other candidates? Tell me about a time you noticed a change that needed to be made on your unit/in your work place, how did you go about effecting a change? What would you do if you noticed a fellow nurse sneaking a controlled med or asked you to waste drugs with them but you saw them pocket the drugs? Good luck. If you like fast pace, excitement and learning, I think you will enjoy it. I did.

I am wondering if maybe it is your work place. In my work as an RN with psychologists, I have found that they are generally respected on the unit, although there is not a whole lot of working together. They come onto the unit for a couple of group therapy sessions, an individual session or two and occasionally family therapy, listen to nurses give report about patients during staff meetings, and they are gone.

We use a 5-point restraint system with padded straps on the wrists, ankles, and one across the waist. What do you do for patients that are intent on harming themselves? Are your seclusion rooms completely padded? Most states do not have unions in nursing. I know California does but that is the only one I know of. Most of our hospitals are privately run. The U.S. went to mostly privately run hospitals starting in the middle of last century when we started deinstitutionalization (I believe, but if someone can correct me on this, please do). There are pros and cons to both socialized medicine and private medicine. Personally, I enjoy the higher pay for medical professionals and being able to get services in a reasonable time as opposed to having to wait, sometimes for months, for an MRI that one may find in a socialized system. It costs money, but I prefer to be able to decide my future. If this is healthcare in countries with socialized medicine, then I will pay a little more... Hard-up hospital orders staff: Don't wash sheets - turn them over | Daily Mail Online

In this case, the techs' account of the story would be interesting but not necessary as the security footage showed them standing just feet away, doing nothing, while other staff members are seen running down the hall to my aid.

Thank you to many of you for your support. Recent comments by Marigoldey, TCASII, and Chevyv are spot on. It seems it is common to have this issue in psych. For those of you worried that I may be in need of EAP, fear not. In fact, I administered meds to this same patient the following day without any fears or concerns but prepared for aggression just in case. Thankfully, PTSD is not a guarantee after every trauma. I also agree with those who have said that regardless of policy for those on safety checks, those performing the check should try something. Since the incident I was able to observe the response (or lack there of) to the incident by other personnel on the unit. The camera records the hallway and although the incident, which occurred off camera, was not observed, I was able to see who responded and when. Although it felt like about 30 seconds to a minute, the whole incident lasted all of about 12 seconds. During that time on the camera, I saw a nurse and tech from another unit rushing to my defense while two techs who were a couple of feet from the room I was in stood there motionless. The management, who I appreciate dearly for their support, did not appear interested in viewing the footage to see how the response could have been improved (or at least not that they made me aware of). They also have not reported to me that they want to correct the inaction of the techs. I will likely choose to not work as many PRN shifts and will refuse to work on the same wing as those techs who failed to respond.

I don't see a 1:7 option. That's what I have.

I may have jumped the gun in my assumption that my colleagues, at least one of them, did nothing. One of the two on the unit with me was on safety checks and per policy, is not allowed to engage in any activity besides watching patients on the unit. But you're right. That person could have tried to distract the person or something.

There is no policy, or at least none that I am aware of, that states specifically what each person's role is. It is kind of a judgement issue. If someone is calling for help and you are the closest person to help, based on their placement and the size of the unit one could easily alert someone (who could then call a code) within earshot or within sight and then respond to the call. Again, 10 seconds is plenty of time do both (alert someone then run to the other end of the wing). Even still, with two techs on the unit, one person could have called for help while the other responded. That should have taken the response time down to about 5-7 seconds.

My management has actually been very helpful and supportive. I love my workplace. As far as what others here have said, many are correct. It is a multifaceted problem with understaffing (made worse by the holidays), lack of adequate training, poor occupational fit for those without a brave spirit, poor office design, poor placement of the office on the unit, etc. Someone mentioned how people knew to come. We have an intercom system where anyone near a phone is able to call a code that sends out a message to the other units to send staff members to respond. Again, due to the holidays and low staffing, the response was smaller than usual but I have no problem with their response as I believed they responded as well as could be expected. The techs on my unit could have shouted or made eye contact to pass a message to start the code process and have been in the office in under 10 seconds.

Having worked both, I prefer the fast pace and excitement of the psych ER. If you enjoyed getting to know your patients as a med-surg nurse, you would probably like IP psych as the patients are there longer. As a psych ER nurse you are probably going to be doing quick assessments, getting labs, preparing and giving haldol or B-52 IMs, getting them out of clothes and be focused on getting them in and getting them out. An IP psych unit would be more like your med-surg experience. You would get report, get assessments, pass meds, chart, pass more meds, chart, get PRNs, chart, go to patient staffings, meds, chart, etc. Regarding becoming an NP, either one would be useful as you are getting exposed to psych assessments, crisis intervention, etc. You would probably get more experience and comfort with psych meds as an IP psych nurse though as the psych ER would be more focused on sedatives (benzos, zyprexa, haldol, thorazine, etc.) What NP programs are you considering?

My thoughts exactly. I was half-tempted to tell them at that moment that they should consider a new line of work.

Okay...so maybe gutless is a strong word but I am having a difficult time finding another term to describe some of my colleagues after the most recent assault I was involved in. The nurses station is isolated and poorly designed to where the patient is between the door and the desk where patients come in and sit down for assessments or just to chat. Some time into my shift a patient enters the office and is focused on some persecutory delusion. I perform some active/reflective listening. He seems okay but just flips instantaneously, screams, jumps up from his chair, slams the door, turns to me and just charges me. I am not easily frightened, but this patient outweighs me by a decent amount and you can tell by the look in his eyes that he wanted to make me pay for...whatever. As I am slammed against the wall, I am pushing back, trying to escape using the bi-yearly, substandard escape maneuvers we are taught during orientation, I am repeatedly shouting for help only to see one or maybe two of the techs open the door, watching the patient attempting to rip my face off, only to see them close the door. I am able to work my way around the patient take two steps to the door to try a futile escape before he grabs my back and closes the door. A couple of seconds later the door opens again and I see a nurse and a tech from a different wing on my unit enter the room. He lunges at me again but I am able to side step him and guide him to the floor. As I feel the other nurse grab him, I get out of the room to collect myself and catch my breath. I was honestly glad to be alive. When something like that happens, which has never happened to me, I felt like I was going to die. Personnel arrived seconds later from other units to assist. After the adrenaline slows down, I assess the damage. Mostly a few scratches and bruises. As a few days have now gone by, I am beginning to feel anger, not over what the patient did (obviously it comes with the job) but by the complete cowardice of the two techs on my wing who just stood by and did nothing to help, despite me shouting at the top of my lungs for help. I must have shouted it at least 15 times. Several of those times were when the techs were looking at us like a deer in headlights and several more after watching them withdraw. Am I alone? Am I wrong to feel pissed off at them? Thanks.