Psychiatric Nurse Practitioner

elkpark · Oct 24, 2010

All nurse practitioners (including psych NPs) are required to also be licensed RNs. Direct entry nurse practitioner programs consist of a year or so of basic general nursing education qualifying you to write the NCLEX exam (the same general nursing content, including clinical experience, as any ADN or BSN program), followed by the additional nurse practitioner education.

While you may not have to deal with much "bodily functions, bodily fluids" as a psych NP in private practice, you certainly will in the process of becoming one.

Best wishes for your journey.

williamd · Oct 24, 2010

The clinical practice of a psychiatric nurse practitioner involves the assessment, diagnosis, and treatment of those with a mental illness. Medications are just a part, therapy is also an important element. Nurses have an important, different perspective from the medical profession. We look at the whole person and utilize a holistic aproach. While a PMHNP is not licensed to treat medical problems, you will need to know how the physical body impacts a persons mental health. Don't worry though, you will have plenty of training along the way. First in the undergrad nursing program, then in your NP training, everyone is required to take and advanced health assessment, pathophysiology, and pharmacology courses.

But if you prefer to work in areas of less blood and guts, the psychiatric field is a good place. You will deal somewhat in with those things, but to a lesser extent. The field is fill with nurses who feel the same way you do. And you never know, as you go through training and then work, you may find a different nich that really speaks to you. There is something for most everyone in the field of nursing. The important thing is to have a desire to help you fellow man.

maziemoo22 · Oct 26, 2010

I agree with elkpark. I'm in my 1st year of a direct entry psych np program. I am doing clinicals on surg and medical floors and I have to deal with the "bodily functions and bodily fluids." However, it's only for a year and it's not all that bad...you get used to it. Just keep your ultimate goal in mind...good luck!

luckylady5 · Oct 26, 2010

Thank you for the replies! The school that I am thinking of applying to (applied last year and was waitlisted) is a 3 year program, so the first 2 are devoted to the BSN - not sure I can handle that for 2 years. I would hate to start the program and find that I can't do it. Is it true now that most of the really "dirty work" is given to CNAs or others? Thanks again!

elkpark · Oct 29, 2010

Is it true now that most of the really "dirty work" is given to CNAs or others? Thanks again!

Some facilities and some settings use CNAs quite a lot to do the hands-on, direct physical care (baths, vital signs, etc.), but some do not. Also, while CNAs can do baths, helping people with toileting, etc., there are many procedures and interventions they are not qualified or permitted to do, like dressing changes, enemas, dealing with most tubes, etc. Everything that CNAs do is ultimately the RN's responsibility -- sometimes you are able to delegate some tasks to a CNA (although it's still the RN's responsibility to make sure that it's been done appropriately) and sometimes you aren't.

Nursing students v. rarely get to delegate anything to a CNA -- the point of clinical is to become competent at providing complete nursing care, including the tasks and activities that might be delgated to a CNA in "real life." You can expect to do all (or nearly all) of the direct nursing care of your clients (including the "really 'dirty work'") in clinical while you're in school.

luckylady5 · Oct 29, 2010

Are you saying that as a direct entry student I would have to give a patient an enema? I can say with almost 100% certainty that I would not be able to do that...I don't know where to go from here. I was hoping to get into this particular profession for so many reasons - I am very interested in mental health, enjoy helping people, good salary, flexibility with schedule (I have young children) etc. :confused: Thank you for your reply!

maziemoo22 · Oct 29, 2010

You may very well have to...I almost had to, but it wasn't my day to give meds... however, my classmate had to give one. But, I was very nervous about the medical part of it, once your in the hospital all the dirty work almost becomes 2nd nature to you. I know its hard to fathom, but it's not that bad!

Lovely_RN, MSN · Oct 29, 2010

It might not be an enema but it's going to be something. It could have to do with toileting or cleaning up an incontinent patient. It could be sputum...blood...dressing a smelly open wound...giving a bed bath to someone who hasn't had a bath in eons because their incapable of taking care of themselves. Enemas are actually very easy to give and not as messy as you think. You insert a tube into the rectum and instill the solution (a bit more to it then that but that's pretty much it). If the person can ambulate they will go on their own or they will go on a bed pan or an incontinence brief.

Are you sure you can't overcome your aversion? Seems odd to me to give up a career that may last many years because you have to handle an organic material, that we all produce, for a year while you're in school. You will get to wear gloves and the hardest part is the smell and overcoming your mind.

Are you saying that as a direct entry student I would have to give a patient an enema? I can say with almost 100% certainty that I would not be able to do that...I don't know where to go from here. I was hoping to get into this particular profession for so many reasons - I am very interested in mental health, enjoy helping people, good salary, flexibility with schedule (I have young children) etc. Thank you for your reply!

luckylady5 · Oct 29, 2010

Thanks for the replies! I don't know if I can get over this aversion - I have children and I could change their diapers all day long, but I literally gag if it's anyone else, including my own nephew. I can only imagine that it would be even worse for me if it were an adult. I'm afraid that I would get physically sick. Blood doesn't bother me so much, I think I could handle that, but cleaning up a mess or bathing someone will be very, very hard for me. Can I be the only one who feels this way?

elkpark · Oct 29, 2010

Are you saying that as a direct entry student I would have to give a patient an enema? I can say with almost 100% certainty that I would not be able to do that...I don't know where to go from here. I was hoping to get into this particular profession for so many reasons - I am very interested in mental health, enjoy helping people, good salary, flexibility with schedule (I have young children) etc. Thank you for your reply!

"As a direct entry student," you will have to do all the same things that all other nursing students do, pass the same licensure exam, and be legally responsible for the same knowledge and skills as all other RNs. An RN license is an RN license is an RN license. You will just have additional education and responsibilities that come with the graduate education part of the program and NP role and certification.

You would not necessarily ever have to do anything like that again, once you're out of school, but part of a direct-entry psych NP program is education and licensure as a registered nurse, same as all the other, "regular" RNs. The profession you're trying to get into is NURSING.

You're certainly not the only person looking at direct entry programs who feels that way. I went through grad school (as a traditional, experienced-RN student) in a program that included a direct entry program, and I used to get v. annoyed with my direct entry classmates who could hardly bring themselves to say the word "nurse," and clearly had real issues with the idea of being one. (However, they had all already survived the year of "basic" nursing education and were now in the specialty part of the program.) They made it v. clear that they had no intention whatsoever of ever working a single day as a "nurse" -- they were going to be clinicians, and dirt and illness and bodily fluids were for someone else to deal with.

If this is a deal-breaker for you, there are other mental health disciplines that don't involve any physical/personal care -- psychology, social work, counseling. Nursing is certainly not for everyone, and there's nothing wrong with not wanting to pursue it.

thekellyone · Dec 6, 2010

I am a psychiatric RN in a inner city hospital. In the state I work in there are actually very few psych units in many county hospitals. Since so many are in the city you really deal with a array of psych problems along with a TON of medical problems. Many mentally ill patients can often neglect their medical needs due to illness or lack of funds. So I can honestly say that I do as much medical care along with mental health care.

When I was in nursing school we were made to do EVERYTHING!!! I personally dont have any problems of being squimish but with nursing comes some squimish parts. I cannot think of any days at my job that I havent done something medical. We have patients who are "medical"

floors transferred to us all the time. I have had patients go into labor, have seizures, go into arrest, have DTs all on my floor...so just because its psych doesnt mean that you get out of any of the squimish parts....also in regards to CNAs or techs...every hospital is different but our techs are usually doing oberservations on high risk patients...and they can't do it all...so at the end of the day it is on the nurse...hope this helps if you have any questions let me know! I am doing psych NP also soon...