LMFT considering career change to Psych NP

[tp0613]

Hi Everyone,

I am a licensed marriage and family therapist. I got my bachelors in psych/anthropology, and masters in counseling psych. I do not have a science bachelors, and only took Biology in undergrad. I am considering going back to school to become a Psych NP for more stability, benefits, long term prospects, increased pay, and more dynamic work. I have researched direct entry programs (for people with a non science bachelors), and have found a few programs. I would have to take nutrition, anatomy/phys, pharmacology, and microbiology. There are a few classes that do not require Chem as a prerequisite for micro and other lower div classes.

A few questions
1. how essential would taking Chem be to nursing/NP school? If it isn't required by some of these other prerequisite classes, it makes me nervous if it is essential to later classes in nursing or NP school
2. is having a LMFT background a positive in the Psych NP career? I know it is much different when prescribing/working within the medical model vs doing counseling, but I would assume the therapeutic communication, psychotherapy/talk therapy background would be beneficial.
3. Programs I've been looking at are 3 years. First year taking nursing classes, sitting for NCLEX, and then upon passing continuing on to Masters NP classes while continuing rotations. Since I plan to go straight through school and hopefully work right after, does this seem too rushed to have good experience? My understanding is that Psych NP is very different than other NP specialities, and so not having a lot of clinical experience upon graduation isn't quite the same as a FNP or Acute Care NP (those I have heard having actual nursing experience prior to school is extremely beneficial, if not required).

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[pamac]

1. No. There’s no reason to take any more chemistry than you need to. Just take what is required as a prerequisite for nursing school.
2. Yes, it would be tremendously helpful. You won’t be doing much therapy that you bill for on its own, but you will use it in the course of your med management, as well as your interviews, assessments, and conversations. You can bill for it, but the bulk of your value will be in the med management realm. But helping patients is part of that. So I guess the main point is that you won’t be sitting down much just to talk it out, but you will be talking it out as part of your new role, and can bill for it as part of the encounter. But, I don’t have counseling experience, so maybe you could bring that skill to the table and find a better use for it than what justice I can do describing it.
3. Want to know a secret?.... you don’t have to go to an expensive direct entry program to have the same result by doing an accelerated BSN program, and then immediately going to NP school. You could probably do that much closer to home too. In fact, it’s better than a direct entry because you can work while you go to school, or take a break and do Np school later if something comes up. Think about it.

 

[roastedcapers]

Agree with the above but would add that accelerated NP programs provide clinical placements and not all NP programs do that, so that’s one benefit of going straight through.

 

[pamac]

Agree with the above but would add that accelerated NP programs provide clinical placements and not all NP programs do that, so that’s one benefit of going straight through.

That is true, but it comes at the price of location (you have to relocate to the direct entry program because all the ones I know of are full time and require in person attendance), and they are very expensive. They are also kind of quirky in that they award the degree in ways you might not expect. For instance, when I was looking at those programs, they wouldn’t award you a BSN, only the MSN upon completion of the whole program. You would have obtained the RN certification, but not the degree of you left the program early. That’s a real downer if life gets in the way and you have to drop the program in the NP portion. It’s helpful to have the ASN or BSN in the job search in that case. Just seems a bit onerous in its face.

Clinical placement can be handy to have performed by your program. However, as a licensed and practicing counselor, the OP might have a network of colleagues in place that could easily help them find excellent placements. I cultivated my clinical placements years before I needed them, and they were better than anything a program would have put together for me. The reason why they were better was because they were at places that knew me, and places that I wanted to work at after I graduated. I’ve read one particular poster on a forum criticize “doing clinicals with your buddies”, but that really doesn’t mean anything at its heart. If you are planning on going to work in a high stakes environment, you don’t want your exposure to the job site to be limited to one day of interviews where you showed up while everyone was on their best behavior so that they could sucker you into a job that you wouldn’t take if you knew better. I had responsibility for finding my clinical placements. I picked from among the best people in my region to be precepted by, among the best facilities to work at for a PMHNP. I got job offers to work at places I knew would treat me well. Every place I did my clinicals at made me a great offer, and all of them before I was even done with school. Interviewing was a formality, because they all knew me and had seen me work. Additionally, people who had known me from my clinical time that had moved in to other jobs ended up telling folks at their new locations to recruit me.

All that could be because I’m awesome, but it’s much more likely that it’s merely because of effort and networking.... I’m a believer that hard work builds good fortune. I’m also a believer that my own efforts to secure great placement sites would pay off more than leaving that task to an overburdened placement coordinator at a university. Their goal is simply securing as many sites as possible while dealing with schedules, competition from other programs, scarcity of sites, etc. Setting things up with my sites wasn’t always easy at all. I had some rejection when I was looking for some specific niche training, but a network associate of someone in my network came through for me, and I was in great shape from there.

So my ultimate point is that you have options and opportunities you might not know you have. What one person looked at as a liability was something I looked at as an absolutely critical step in my professional progress. Clinical sites are your absolute best opportunity to land a job that is a good fit. They see you work and they develop trust in you. Even if you don’t want to work there, you can develop relationships and resources that can help you later on. Throughout my different careers in healthcare, I’ve had people reaching out to help me and talk to people about me to their friends. I had one preceptor who went out of their way to help me land a job at a place that I really wanted to work at.

Someone can do well when their program does all the placement, but the job market is changing. You are seeing ads for jobs that say “experienced candidates only, no new grads.” Or even places that say “PA only”, or else “NP only”. Those kinds of places will often compromise when they have seen you in action. I’d never want to come out of school without doing everything I could while I was in school to set the stage for the best start I could have.

Incidentally, one of the good aspects of being on an NP route (that isn’t direct entry) is due to that networking aspect. Had I gone off to a direct entry NP program, or even PA school, I would have basically opted out of doing clinical rotations in familiar territory. Most of the NPs I know around me are walking right into jobs that were set up before they even graduated, and all because they were job candidates that were essentially known and vetted before they even showed up. You see this kind of thing happen with resident physicians. Many or most of them are recruited by the places they did their residencies. Places around me love recruiting residents, and having that pipeline in place is one of the main reasons they host them... because they are hoping to snag them upon the completion of residency. It really helps to have that inside track. If I had gone off to school in a distant locale, I’d becoming back to my region and would be a stranger to the job market. My application wouldn’t have a face behind it, but would go on the pile with the ones from all the other new grads. Meanwhile, the NP applicant who did clinical rotations at that clinic would be who they remembered.... they saw him work, he brought in cupcakes for everyone, and the patients asked asked for him and missed him when he was gone. That is the way you get all of the main things you want out of a job.... you work for them before you even graduate.