Psych nurses & therapy groups

KatzchenLSW · Dec 16, 2008

Well, many on this board will advise you to go the psychiatirc/ mental health NP route. I debated about the best path to become a psychotherapist myself and ended up deciding to pursue an Master of Social Work for the reasons below.

In my area, most PMHNP are only used for med checks, I have yet to meet one that provides actual therapy. The hospitals, clinics and private practices I called all stated that they would not hire a PMHNP as a therapist because they are too expensive in comparison to other masters level practitioners, and that the NPs on their staff are used exclusively as physician extenders.

The local PMHNP program reflects this reality and students receive very little course work and clinical experience in psychotherapy. If you do decide that PMHNP is the route for you please make sure that your program provides instruction in psychotherapy!

The local MSW program on the other hand has a clinical track available (in addition to the administrative track) where over half of the courses concern different areas of therapy (i.e. marriage and family, individuals, groups, crisis intervention) and a 800 hour practicum in therapy.

I ended up opting for the lower paying career and going for my MSW because I have not interest in prescribing meds...I want to provide therapy, do groups etc.

Other careers that you might want to consider in addition to PMHNP and Clinical Social Worker are Professional Counselor (Requires an MA or MeD in Counseling,) Marriage and Family Therapist (MA in Marriage and Family Therapy,) Psychologist (Doctorate in Psychology) and Psychiatrist (MD)

I would look at the programs available to you, call the places that you would like to work (as it is not realistic or advisable to go into private practice straight out of school) and see which path will work the best for you.

Good luck!

IamRN08 · Dec 16, 2008

Thank you for such a in depth answer. You provided a lot of information that I needed to say the very least :up: .

Originally I had planned on becoming a LCSW but after working with so many of them and hearing the reality of the low paycheck I opted for the nursing route after being advised that it would give me a more direct route to the field. However, when I am working I just cringe with the thought that a med nurse won't show up and I am going to have to push those pills. I ran groups for a long time as a case manager or similar and I was very fullfilled with that type of work.

I am going to have to do some soul searching on this for sure. I can't see myself pushing pills for the rest of my career.

Jules A, MSN · Dec 17, 2008

I think it also depends on where you work. At my facility and the one where a friend of mine works both have a lot of patient contact. We do a group each morning and evening and I'm out on the floor mostly trying to "put out fires" for a large portion of my shift. The patients are why I love what I do.

Whispera, MSN, RN · Dec 17, 2008

The Psych CNS route might get you where you want to go, depending on the policy of the facility and the state practice act where you work. I've run groups both as an RN and as a CNS. In fact, I've worked in two facilities and there was always a "nursing" group, which could be anything the nurse on-duty that day wanted it to be...community meeting to information to socialization to cooking lunch to emotion sharing. That's day shift. Then on pm shift there's wrap up group and maybe another "nursing" group. I'd say the sky could be the limit!

medsurgrnco, BSN, RN · Dec 18, 2008

Even if you're not giving meds, much of your time as a psych RN could be spent doing admissions and discharges with extensive time spent on paperwork and/or the computer. It all depends on the staffing, patient turnover, and what tasks LPNs are allowed to do at each facility.

Suggest you seriously think about what population you want to work with. Counseling, psychology, and social work programs that focus more on psychotherapy don't tend to focus on therapy with psychiatric patients.

KatzchenLSW · Dec 18, 2008

Suggest you seriously think about what population you want to work with. Counseling, psychology, and social work programs that focus more on psychotherapy don't tend to focus on therapy with psychiatric patients.

I think that depends on area and the program. My program does assumes that we will be providing psychotherapy in a variety of settings, including inpatient psychiatric. Many of our clinical field placements are at inpatient psychiatric facilities. The professor that teaches our DSM-IV/ psychopathology class currently works at one of the state run inpatient mental health centers, so all of his classes are taught from that perspective.

Here in (central and southeastern) Ohio many LISWs and LPCCs work with inpatient psychiatric populations, so the schools educate us accordingly. Two of the major hospital systems in Columbus hire both counselors and clinical social workers as their in house therapist, as do the state mental health hospitals. Anywhere outside of the major cities you are very likely to see a social worker for a "psych consult" in the ER as well.

aloevera · Dec 22, 2008

all facilities vary....in mine the RN's lead groups, talk one on one with each pt, and have much contact with the pts....LPN's pass the meds....

when many admissions and discharges the contact is more brief, but many days are spent with pts. the majority of the shift....

IamRN08 · Dec 22, 2008

You all have given such great insight to my question big thanks to each of you! Last week we were told about a new nursing model rolling out which will actually give me more opportunities to work with patients on various aspects so I am excited about that. In addition, the job I have now is giving me a great chance to work with a broad spectrum of patients so I am getting the opportunity to see which population I will want to focus on in the years to come. Thank you to all of you and I hope you are having a wonderful holiday season.