Want to specialize - Should RN become substance abuse counselor?

Whispera, MSN, RN · Feb 19, 2011

Can you even get certified as a CARN without experience in an addictions-specific unit?

tuttle13 · Feb 21, 2011

Can you even get certified as a CARN without experience in an addictions-specific unit?

NO - That is why I said I want to "eventually" get my CARN. Can't get certified without working for at least 2 years in additions unit, yet can't get hired without experience. It is the same old catch 22. That is why I don't know if going for the counselor cert classes will help me get hired as an RN in addictions because at least I will also be able to run therapy sessions. Still will have no experience but additional education that may help to get foot in the door. Anyone else try this approach? How did you get your first job in addictions?

Whispera, MSN, RN · Feb 21, 2011

I worked in addictions as a generic RN. We had two CARNs there, but they didn't do anything different than the rest of us did. I ran some groups, and so did the others. Most of our groups were run, though, by people who came in from outside the hospital.

I got the job in a hospital that was full-range of services. My job was specifically on the psych unit, but I often worked the addictions side, and my addictions knowledge, after awhile was very helpful with my psych patients, since there's often dual diagnosis with them.

Simba&NalasMom, LPN · Feb 22, 2011

Interesting thread. I started thinking the other day that I may look into addictions counseling myself. I am an LPN living in Portland and I really don't want to move anywhere; thing is, I'm feeling discouraged about pursuing an RN degree in this area b/c of the time it takes to get into programs, cost, prereq's, etc. on top of the job market being not very friendly to new grad RNs, even in better economic times.

I'm interested to see what feedback others will post here.

mentalhealthRN · Feb 23, 2011

I would say to see if you can get into a psych unit--an acute locked unit in an acute hospital setting. It may be easier to get into that then directly into addictions. Then after a couple of years there you could try to move into addictions.Or if at a hospital that has one, work the MICA unit. This will get you the psych and the CD experience. Granted not detox per say but...... If you get that inpatient acute psych experience you could also then try a psych ER if you have one in your area. Not sure if you are interested in more the acute detox part of CD or outpatient or inpatient. As far as the CARN. I worked in Detox and thought about it but decided not to go that way as I prefer more of the psych side--straight psych and dual diagnosis MICA. So I am planning to get my LMHC masters instead. But I would say overall if you can't get into CD directly try going via psych. They like that experience as it is all intertwined. Good luck to you. The other option then the CARN is to get your CASAC--you would likely have to choose to work as an RN or a CASAC not both, but that is an option too if you like the counseling side of it.

tuttle13 · Feb 25, 2011

I would love to work on a psych unit in a hospital, but there are no jobs at this time. I have been trying to get into a hospital to work for two years, but none of them in my area are hiring any new nurses. Any openings are for "internal staff only". That is why I have been looking into private rehab facilities. So I guess I will have to wait it out until the economy recovers enough so that hiring freezes are lifted. Can you believe that it is still so difficult for qualified RNs to get a job? Anyway, thanks to everyone who responded so far.

Zen APRN · Mar 5, 2011

Don't waste your time becoming a substance abuse counselor. The pay is horrible and you would be working below your license. In addition, you really have to have a lot of clinical hours to be a CADC or any other type of cert in the field.

The best thing to do is like another poster suggested and step into a psych job. I work on an acute psych unit and I would say that 80% if not higher of the patients we see are poly sub. It's a nice way to get into the field. Personally I prefer the psych unit than the substance abuse unit because you get a more diverse experience. I worked at a treatment facility before and it was really a lot of just doing meds, admissions, and discharges. As a psych nurse I do all of that but I have more hands on care with my patients. I run groups and can choose the topics so I can do a substance abuse group when I need to depending on the population on the unit.

Have you tried looking for government jobs? The Veterans Administration has behavioral health positions at a lot of their facilities. They are also really big on education so once you have your time in with them they will pay for you to advance your education which can include obtaining your CARN. To get your CARN you need 3 years direct addictions nursing. You can get that experience on a psych unit. I will be sitting for my CARN soon and I just obtained my psych mental health board cert and I qualify for both of them from my experience on an acute psych unit.

Don't give up - you just need to knock on the right door! Where are you located?

Raidernurse · Mar 8, 2011

Can you even get certified as a CARN without experience in an addictions-specific unit?

There are a few ways. Sometimes if work in a community clinic and work a lot with substance abusers, your supervisor can write a letter summarizing how many hours of your time you have spent treating that population.

I am in recovery, and believe that a lot of nurses who have gone through programs for being impaired could do well to seek Addictions nursing as an alternative. Sometimes it helps to be "one of them." And as we have all heard it said, "It takes one to know one." Which isn't necessarily true mind you. I have met plenty of gread D&A counselors who were not addicts.

tuttle13 · Mar 10, 2011

Thanks to everyone who responded. I am in Connecticut BTW to the poster who asked. My issue is that there are not that many hospitals or clinics within an acceptable commute. I will just keep applying to psych units and hope that someone will give me a chance.

shrinkyrn · May 11, 2011

It took me a LONG time, worked psych, dual diagnosis, got certified as CARN, I now work in an Addictions private office as the Addictions nurse...I wear many hats, do some counseling, I ran a Suboxone program for a while, am working on a Dual Disorders program right now, we are working on a program for clients who need medication enhanced treatment i.e. Vivitrol, Campral, Suboxone....etc.. It is rewarding and utilizes my Certification and my skills....but the pay is NOT what you'd make in a hospital by any means....that's not what I'm in it for....more money would be nice but.....

gnursjr2 · May 14, 2011

When I graduated from RN school in December 2008, no one would hire me. After 8 months of searching I had to move out of state to a private psych hospital. I had to leave everything behind, it was really hard. Anyway, I stayed there for about a year. Worked Acute adult, adolescent, and chemical dependency unit. Got some great experience, and was recruited for another job, which turned out to be a nightmare. I am now currently traveling, but want to go back to a perm job. The job market is still very tough out there for psych, too many nurses for too few jobs. Also, now the hospitals want even more experience. Good luck to you.