What was your path to NP?

Trauma Columnist · May 10, 2016

Good question - I would have done it sooner and chosen a different path - a more direct one - lol

MomAndSonInMD · May 10, 2016

Good question - I would have done it sooner and chosen a different path - a more direct one - lol

How so? Cut out the lower level certs, perhaps?

Trauma Columnist · May 10, 2016

Nope - I did the LPN, ADN, BSN, MSN, then 2 post MSN certs - what an idiot I was! Lots of time, effort and money.

If I could go back and do it again, I would have done an ADN to MSN program, gotten and acute care adult cert and acute care peds cert and worked in the ER.

MomAndSonInMD · May 10, 2016

Nope - I did the LPN, ADN, BSN, MSN, then 2 post MSN certs - what an idiot I was! Lots of time, effort and money.
If I could go back and do it again, I would have done an ADN to MSN program, gotten and acute care adult cert and acute care peds cert and worked in the ER.

There's an ADN to MSN program?! My end goal is MSN since I already have a bachelor's in an unrelated field. I didn't see that as an option at the schools I was reviewing, but I'll have to do a double check. That might be a great option for me.

That's also an interesting point about the certs. too. I am going to remember that tip. My interests are varied from acute care to pediatrics. It's good to know that I can get certs. to support those interests. The academic advisors I've spoken to have been little help, and at almost 40 and way too much college (two bachelors in unrelated fields at different times), I know the right questions to ask. Who knows how the young kids get the information that are seeking from these "advisors". It's great to hear it from someone that has actually done it. Thank you.

PG2018 · May 10, 2016

I worked in a governmental field before healthcare. My first undergrad was unrelated although electively science rich.

At one point, circa 2002, I became a paramedic. That's rather easy to do, and I did it in conjunction to the rest of my life at the time. I never really worked as a paramedic. Over a period of four years, the time I maintained the certification, I may have spent five or six months doing some occasional weekend or holiday ambulance work.

So now we have a biology rich background, some paramedical training and healthcare exposure, and eventually a lot of time interacting with the public as well as interviewing people.

I began to entertain a medical career. By that point, I felt too vested in my other life commitments to apply to med school. I feel like I would've been a great applicant and a doctor if I had pursued that path. Other options were PA, a difficult and somewhat new path in my state, and pharmacy. I am SO happy I didn't choose pharmacy although being a clinical, consulting pharmacist would be interesting. I very much despise talking on the phone and retail pharmacists always seem to have a phone glued to their ear. I use

Back tracking a bit, I directly observed a serious need for mental health care in America. As I have admitted, I am not inherently emotionally intelligent, but along the way I learned something about body language, communication, interviewing, hidden meanings, etc. I independently developed interests in psychology, e.g. personality theory, social psychology, cognitive science, neuroscience, psychopathology, behavioral analysis so I explored this by online venues, Amazon books, training, pop psychology blogs, a few textbooks that I purchased and read. (My wife joking refers to me as autistic because I can develop some seriously circumscribed interests.)

So moving back to becoming a NP, I first gave thought to going through FNP training because I naively thought generalist training was better than focused training although I perceived mental health as a finer interest for me. I became increasingly aware of Psychiatry NPs during my first semester of RN'dom, and as I began to study that and talk with people I became more aware of the demand for Psych NPs as well as the then present supply. For that reason, it seemed like the right practice arrangement could also be a cash cow so in addition to doing work that matters and being intellectually rewarded there could also be financial rewards. After two years of undergrad work, I was awarded the BSN and started working in capacities that would accomodate graduate school which I immediately enrolled in. My NP training was conducted in community health (psychotherapy), private practice (C&A), and the VA (adult, geriatric, detox, inpatient, and C&L). I really enjoyed the VA and was quite good at establishing rapport with both the veterans and the staff. The community health organization offered me a position which I rejected. The VA continues to be an open door for me. I love those guys there. I ended up working in a corporate-type of environment although we're actually organized as a nonprofit, and yes it's the cash cow of mental health. It makes no sense until you examine our innter business model that I won't reveal here.

So now I do something I find interesting, provide a needed service, by all accounts seem to work with a great deal of efficacy, I'm solo and autonomous, and I make 225% more than the community mental health job would've paid not counting productivity bonuses that I wouldn't have made anyone else.

JustKeepDriving · May 11, 2016

I did my first BA in Psychology and volunteered as a house supervisor at a homeless shelter and did internship hours at a hospital that involved shadowing and direct patient care work. Because I'm possibly some kind of work masochist and start to decomp when I have too much free time - I did research assistant work in a white collar crime lab with the department of criminology and did internship hours that culminated in an independent undergraduate research project in the field of alternative sentencing (A hybrid between corrections, Addictions and Psych) that was nominated for an award and presented at my University's research symposium. At that time I was a full time university student and also enrolled doing community college classes doing nursing prerequisites (it was my back up plan in the event I didn't get accepted to graduate school for social work).

After graduation I applied for multiple graduate schools for social work and one ABSN program. I got accepted into most of the MSW programs and the ABSN program. I decided to pursue the ABSN because it seemed like the better option (I didn't want to do the 2 year MSW degree and 2 years supervision in order to sit for the Social Work Licencing exam).

Upon completing my ABSN I went into Forensic Psychiatry and worked in maximum security behavioral stabilization. I had almost all the autonomy in the world working there, pulled 60 hour work weeks, and after about 6 months I started working as charge and doing the code team. Then I was witness to an assault that left one of my staff members brain damaged - I was using my weight to hold one patient's door closed (he swung at one of my staff, missed an I talked him back in the room and was waiting for the code equipment to arrive so I could take him to our seclusion room) and another patient busted out of a room about 10 feet away from me and started assaulting one of the 2:1's and the other 2:1 ran - leaving that staff to get hit about 30 times in the head. All I could do was watch and scream for more staff - if I left my post, that first guy would bust out and then we'd have an even bigger problem. I took a hiatus in the OR after that because I knew I would have a hard time being therapeutic unless I worked through that experience.

The OR for me lasted not so long - I really, really hated it. I am not a medical nurse and definitely not an OR nurse; but it was much less stressful and gave me the ability work through my stuff - which is what I needed the most at the time. I returned to Forensic psych on contract - hoping to do medium security or transition while I figured out where I wanted to go with my career (I was thinking management or education). It didn't really work out like that as they kept pulling me off orientation to float me to max - like they hadn't even reinstated my computer access and the staffing office and education office had some big fight about it (I did finally get my orientation days figured out).

The psychiatrists I worked with encouraged me to go for PMHNP so I applied to a graduate program out of state and was accepted. The nurse manager of behavioral stabilization snatched me off the float pool for full time capacity as charge nurse - knowing full well that I was leaving for grad school - to basically do floor training/education for new grad nurses and run the code team. Which was a great experience because I love training/teaching people and I want to get new grads passionate about psych nursing.

I'm 1/2 done with my PMHNP program and hope to graduate with intent to return to forensics. I still work as a Psych RN in acute care (which compared to forensics is really relaxed). I go offered a great internship position for clinical, doing 20 hours a week of community outpatient that works in conjunction with a major academic teaching hospital/medical school and get to rotate through and attend lectures and journal club with the M3/M4 and PGY1's. I also have mandatory rotations in inpatient, psych ER, CL, geriatrics and peds on top of the 20 h base outpatient rotations and a bunch of elective rotations (Eating disorders, Corrections, Maternal Psych ect) that are available. I can take call with my attending if I want to. Plus I get to be part of a focus group on Psych NP education - I mean I couldn't say better thing about the clinical portion of my training. It's hard and in combinations with work + class (on-campus program) I have very little free time but I'm getting my money's worth and will have close to 2000 hrs worth of clinical time by graduation.

What would I have done differently? Nothing really. I'm really happy with how my career came together. I would have liked to have spent some time working as an ER nurse because it seems like a great job with a lot of autonomy and you get a mix of medical and psych patients (I do think my med skills are not as strong as they should be and I spend a lot of time trying to supplement that knowledge with theory/self motivated education - but theory will never be as good as practice).

Barnstormin' PMHNP · May 11, 2016

JustKeepDriving, fascinating path to psych!

PG2018 · May 12, 2016

I did my first BA in Psychology and volunteered as a house supervisor at a homeless shelter and did internship hours at a hospital that involved shadowing and direct patient care work. Because I'm possibly some kind of work masochist and start to decomp when I have too much free time - I did research assistant work in a white collar crime lab with the department of criminology and did internship hours that culminated in an independent undergraduate research project in the field of alternative sentencing (A hybrid between corrections, Addictions and Psych) that was nominated for an award and presented at my University's research symposium. At that time I was a full time university student and also enrolled doing community college classes doing nursing prerequisites (it was my back up plan in the event I didn't get accepted to graduate school for social work).
After graduation I applied for multiple graduate schools for social work and one ABSN program. I got accepted into most of the MSW programs and the ABSN program. I decided to pursue the ABSN because it seemed like the better option (I didn't want to do the 2 year MSW degree and 2 years supervision in order to sit for the Social Work Licencing exam).
Upon completing my ABSN I went into Forensic Psychiatry and worked in maximum security behavioral stabilization. I had almost all the autonomy in the world working there, pulled 60 hour work weeks, and after about 6 months I started working as charge and doing the code team. Then I was witness to an assault that left one of my staff members brain damaged - I was using my weight to hold one patient's door closed (he swung at one of my staff, missed an I talked him back in the room and was waiting for the code equipment to arrive so I could take him to our seclusion room) and another patient busted out of a room about 10 feet away from me and started assaulting one of the 2:1's and the other 2:1 ran - leaving that staff to get hit about 30 times in the head. All I could do was watch and scream for more staff - if I left my post, that first guy would bust out and then we'd have an even bigger problem. I took a hiatus in the OR after that because I knew I would have a hard time being therapeutic unless I worked through that experience.
The OR for me lasted not so long - I really, really hated it. I am not a medical nurse and definitely not an OR nurse; but it was much less stressful and gave me the ability work through my stuff - which is what I needed the most at the time. I returned to Forensic psych on contract - hoping to do medium security or transition while I figured out where I wanted to go with my career (I was thinking management or education). It didn't really work out like that as they kept pulling me off orientation to float me to max - like they hadn't even reinstated my computer access and the staffing office and education office had some big fight about it (I did finally get my orientation days figured out).
The psychiatrists I worked with encouraged me to go for PMHNP so I applied to a graduate program out of state and was accepted. The nurse manager of behavioral stabilization snatched me off the float pool for full time capacity as charge nurse - knowing full well that I was leaving for grad school - to basically do floor training/education for new grad nurses and run the code team. Which was a great experience because I love training/teaching people and I want to get new grads passionate about psych nursing.
I'm 1/2 done with my PMHNP program and hope to graduate with intent to return to forensics. I still work as a Psych RN in acute care (which compared to forensics is really relaxed). I go offered a great internship position for clinical, doing 20 hours a week of community outpatient that works in conjunction with a major academic teaching hospital/medical school and get to rotate through and attend lectures and journal club with the M3/M4 and PGY1's. I also have mandatory rotations in inpatient, psych ER, CL, geriatrics and peds on top of the 20 h base outpatient rotations and a bunch of elective rotations (Eating disorders, Corrections, Maternal Psych ect) that are available. I can take call with my attending if I want to. Plus I get to be part of a focus group on Psych NP education - I mean I couldn't say better thing about the clinical portion of my training. It's hard and in combinations with work + class (on-campus program) I have very little free time but I'm getting my money's worth and will have close to 2000 hrs worth of clinical time by graduation.
What would I have done differently? Nothing really. I'm really happy with how my career came together. I would have liked to have spent some time working as an ER nurse because it seems like a great job with a lot of autonomy and you get a mix of medical and psych patients (I do think my med skills are not as strong as they should be and I spend a lot of time trying to supplement that knowledge with theory/self motivated education - but theory will never be as good as practice).

Awesome grad program. Kudos on finding it. Big accolades from PsychGuy.

Trauma Columnist · May 12, 2016

Wow - you psych folks are so interesting. I did my RN psych rotation at a state hospital where I saw all I wanted to and thought nope not for me.

Now ER is where its at for me and if I could have my dream job that would be it.

However, to pay the bills and hopefully retire before I'm dead, I'm in nephrology private practice....keep your BP and DM under control guys unless you wanna be MY pt! lol

DFutureNP25 · May 22, 2016

I started out as a CNA, then LPN then ADN then BSN. Starting NP school this fall. I wish I did the RN to MSN program.

rninme · May 24, 2016

Started out as a CNA, then became a Respiratory Therapist for 17 years. I'd always wanted to be a nurse but didn't have the means or opportunity right out of high school, so when I'd had it with management, I applied to RN-Diploma school. Worked for several years in critical care and ED before completing a BSN online and decided why stop now? Just graduated MSN-FNP a couple of weeks ago. What would I change? Nothing!