Which path do I take?

windsurfer8, BSN, RN · Oct 5

I am not sure looking for the "fastest" should be the priority. Being a psych NP is no joke. The responsibility is immense. If a patient discharges and commits suicide or even often an attempt your charting and orders will be scrutinized top to bottom. I have seen psych NPs lose their careers over decisions like discharging patients early or mistakes in charting. So I would take your time with making sure you have a good idea what you are actually doing. To get your RN license you have to graduate with either an ADN or BSN. Then pass NCLEX. It might be worth getting your RN license and working in psych before committing tons of money and time into a psych NP career.

mariav, BSN, RN · Oct 5

I would highly recommend making an appointment to speak directly with an advisor at a university that offers a DNP program in mental health. I'm a BSN, RN but my first bachelor's was in Psychology. I worked ten years as a clinician in inpatient psych before pursuing the BSN. There are a lot of prerequisites you must take before you are even eligible to apply for a BSN program. It took me a couple of years to complete them all.

The next step is getting accepted into a program. If you still need to work, then a regular track BSN or ADN with a bridge program to BSN is best and will take around four years to complete. However, if you are able to take a year off from working, you can apply for an Accelerated BSN program which is for students with a non-nursing Bachelor's and is condensed into one year. That's the route I took but be warned, it will be the most brutal year of your life. Not only will you be in class eight hours a day, 4-5 days per week but you will also have clinicals on many of the days you are not in class. For most of mine I was expected to arrive at 0500 or 0600 to meet with my preceptor for an hour and discuss the patients I was assigned to that day. Work 12 hours then meet again for an hour afterwards to discuss the shift. Once you are home you will spend 3-4 hours researching your patients' diagnoses, labs, comorbidities, and medications. I averaged around 2-3 hours of sleep per night during clinicals. Your grades cannot fall below 77% (I think. I graduated in 2013 so that may have changed) or you will fail the class. Most people don't know how hard a BSN is to earn and how much work you put into it. You really have to want it.

I'm only now looking into BSN to DNP programs and it looks like I have another four years of debt and brutality to look forward to. Are you sure this is the right path for you? This is why I suggest speaking with an advisor. They can review your transcripts and give you a good picture of your path to a DNP. Hope I didn't scare you off. Nursing is the hardest job you will ever love.

barcode120x, RN, NP · Oct 7

You can consider looking into MSN-entry level programs. These programs are for those that hold a non-nursing bachelors degree that are interested in getting their RN. The time frame is similar to that of an ADN or BSN, 2 years but are being taught at the master's level. Once you finish, you will hold a masters degree in nursing, be able to sit for your boards, and then if you have interest in going for NP or PMHNP, you should be able to transfer/transition into those programs for an additional year. I can only attest to the transition to the NP Program at my university. We had students that finished the MSN-E program joined us for the 1-year post graduate FNP part. I am not sure if PMHNP follows a similar route, but check with the university.

Fast and cheap do not come hand in hand when it comes nursing degrees. I'd argue it's the complete opposite. You can go to for profit schools, get a huge loan, and get in and get out and finish at like the BSN level. Or, you go the cheap route, or traditional route like I did years ago. Get your ADN (2 years) at a community college, then transfer and get your BSN online (1 to 2 years depending on your pace), then your masters (2 years) and/or DNP. I guess you just have to figure out what's more worth, time or money. Time is probably most important and you will eventually pay off your loans as a nurse.

When it comes to online programs, I'm totally for it for a BSN IF you already hold your ADN/RN (with some sort of work experience). I don't know what the curriculum nowadays is for full online ADN/RN programs, but I would stay clear of that. You are not doing yourself or the patient population a favor by doing online. You need to get in the class, mingle with your teachers and classmates about anything and everything related to nursing, and discuss topics and clinical experiences among each other.

FullGlass, BSN, MSN, NP · Oct 8

Your post is a great example of why the nurse practitioner profession is coming under increasing fire. Not once do you mention gettng a QUALITY education. Coming from the business world, you should know that you can get at max 2 out of 3 of the following: price, quality, or schedule (speed).

Furthermore, you can't get a DNP with only on-line education from a reputable school. You must have in person training in order to learn physical exam skills (and yes, you need to learn this even for a PMHNP), as well as various labs and simulations. And of course, you must complete clinicals in person.

Frankly, you do not seem like someone who should be an NP. I suggest you get some hands on experience with patient care first by earning a certificate to be a Certified Nursing Assistant (or "tech"). There are weekend programs for this. If you complete this and still decide you want to become a nurse, then there are some different options to earn an RN. And none of these are going to be 100% online.

Bonesandall29 · Nov 7

FullGlass said:

Your post is a great example of why the nurse practitioner profession is coming under increasing fire. Not once do you mention gettng a QUALITY education. Coming from the business world, you should know that you can get at max 2 out of 3 of the following: price, quality, or schedule (speed).

Furthermore, you can't get a DNP with only on-line education from a reputable school. You must have in person training in order to learn physical exam skills (and yes, you need to learn this even for a PMHNP), as well as various labs and simulations. And of course, you must complete clinicals in person.

Frankly, you do not seem like someone who should be an NP. I suggest you get some hands on experience with patient care first by earning a certificate to be a Certified Nursing Assistant (or "tech"). There are weekend programs for this. If you complete this and still decide you want to become a nurse, then there are some different options to earn an RN. And none of these are going to be 100% online.

Ouch! I respect your comment.

Shan, RN · Nov 16

I'm afraid I have to agree with FullGlass. I'm always wary of people who want to skip actual nursing and get right to the "provider" part. I'm not an NP, but I would assume that NP school builds on the foundation of existing nursing experience, and fast-track programs have always felt dangerously superficial to me. As a patient, I would not seek care from a nurse practitioner who had never actually practiced as a nurse. As a healthcare worker, I would not feel comfortable performing the duties of a provider without a wealth of knowledge and experience. I know this isn't what you want to hear but proceed with caution. What I can tell you with certainty is that there is no way to safely complete that sort of education cheaply and to do it online would be robbing yourself further of invaluable hands-on experience, which you would already lack.

FullGlass, BSN, MSN, NP · Nov 16

Shan said:

I'm afraid I have to agree with FullGlass. I'm always wary of people who want to skip actual nursing and get right to the "provider" part. I'm not an NP, but I would assume that NP school builds on the foundation of existing nursing experience

Respectfully, you are incorrect. RN work experience is not required to be a good NP. I have written about this and have even posted a mini evidence review on this topic on this site. NPs that go straight from their BSN into an NP Program do just as well. In fact, one study found that MDs evaluated the physical exam skills of such NPs as higher than those with RN experience. I went straight from my ABSN to my MSN and became an NP. I've always received excellent performance reviews from my supervisors and my patients.

RN experience is very different from NP experience. The vast majority of RNs work in hospitals, while the vast majority of NPs work in outpatient settings. The majority of NPs work in primary care. However, most reputable NPs schools require RN experience for acute care NPs, which makes sense, as that is directly relevant experience.

Personally, now that I have been an NP for 8 years, I have not found NPs with RN experience to be any better, in fact, some of the worst NPs I have worked with worked as RNs.

Shan, RN · Nov 18

FullGlass said:

However, most reputable NPs schools require RN experience for acute care NPs, which makes sense, as that is directly relevant experience.

Personally, now that I have been an NP for 8 years, I have not found NPs with RN experience to be any better, in fact, some of the worst NPs I have worked with worked as RNs.

That's really interesting - I'd love to read your evidence review. I understand that most NPs work in primary care but the OP was specifying a specialty, and I have a hard time believing that RN experience in that specialty doesn't make someone more prepared than going straight to NP school. I work in outpatient oncology, quite closely with several NPs and PAs, and the new hires always come to shadow in the infusion room as part of their orientation. The ones without oncology experience are always very intimidated by their lack of that experience, and they tend to stay on orientation longer. But the NPs with previous RN experience in oncology - they're a veritable treasure trove of information and wisdom about their practice and my practice. It was the same when I worked in acute care, as you alluded to.

However, I understand that I was perhaps too general in my original reply - thanks for your perspective. I can absolutely see how RN experience could be a detriment to some people, who perhaps find it more difficult to change their lens from that of RN to provider, or alter some preexisting habits in thinking.

windsurfer8, BSN, RN · Nov 18

Shan said:

Personally, now that I have been an NP for 8 years, I have not found NPs with RN experience to be any better, in fact, some of the worst NPs I have worked with worked as RNs.

I always enjoy when people describe others as "the worst". I wonder what they would say about the person posting this. Also curious how this is quantified or qualified. What does "the worst" mean? I would avoid any NP who used general terms to describe coworkers.

FullGlass, BSN, MSN, NP · Nov 18

windsurfer8 said:

I always enjoy when people describe others as "the worst". I wonder what they would say about the person posting this. Also curious how this is quantified or qualified. What does "the worst" mean? I would avoid any NP who used general terms to describe coworkers.

Why are you challenging my PERSONAL experience? Do you know me? I stand that quote, which is based on my PERSONAL experience. Others may have different experiences.

FullGlass, BSN, MSN, NP · Nov 18

Shan said:

However, I understand that I was perhaps too general in my original reply - thanks for your perspective. I can absolutely see how RN experience could be a detriment to some people, who perhaps find it more difficult to change their lens from that of RN to provider, or alter some preexisting habits in thinking.

Thank you. You can search for my post on that subject. Yes, I agree that directly relevant experience can be helpful for an NP, especially for acute care roles in a hospital. But that is not true of the majority of RNs looking to become NPs - most do not have directly relevant experience for most NP specialties.