What is a Psychiatric Nurse?
A psychiatric nurse is a medical professional who works specifically within the realm of mental health. Psychiatric nurses are registered nurses (RNs) who care for patients and their families by aiding psychiatrists to assess and treat various mental ailments such as schizophrenia, anorexia, bulimia, substance abuse and addiction, bipolar disorder, depression, suicide risk, and Alzheimer’s disease.
What Does a Psychiatric Nurse Do?
A psychiatric nurse provides all of the same types of medical care as a traditional RN, including but not limited to: assisting physicians and psychiatrists, administering medications, maintaining medical records, checking vitals, watching over patients during treatment and recovery, and consulting with patients and their families. However, a psychiatric nurse specializes in caring for patients who suffer from mental illness, which makes them responsible for also monitoring the specific symptoms and behaviors associated with those illnesses.
Psychiatric nurses assist psychiatrists in patient evaluations, diagnoses, and identifying the best long-term courses of treatment—as most mental illnesses are usually chronic conditions. For example, when a new patient suffering from depression and/or thoughts of suicide first enters a mental health clinic or psychiatrist’s office, a psychiatric nurse conducts the initial interview to assess the patient and his or her medical and mental health history, symptoms, and everyday lifestyle.
Where RNs work under the supervision of a physician, psychiatric nurses usually work under the supervision of a mental health specialist such as behavioral therapists, psychiatrics, and neurologists. Psychiatric nurses consult with patients and their family members to ensure that the specifics of a patient’s treatment plan are carried out effectively at home. They work one-on-one with patients to assist them in setting and achieving mental health goals for both the long-term and on a day-to-day basis.
Additionally, psychiatric nurses educate patients of any available community services, resources, and programs that may help them to stay on track between professional visits. For example, psychiatric nurses who work with patients struggling with substance abuse and addiction provide patients with detailed lists for the times and locations of group meetings such as Alcoholics Anonymous or Narcotics Anonymous.
Where Does a Psychiatric Nurse Work?
A psychiatric nurse works in any healthcare environment where mental health and psychiatric services are provided. The most typical of these settings are traditional and psychiatric hospitals, outpatient clinics, private practice offices, communal health organizations, nursing homes and other elderly care services, correctional facilities such as jails and prisons, and schools that have a large number of students with behavioral issues. Some psychiatric nurses even make visits to the private homes of patients who are immobile, disabled, or unable to commute to an onsite facility for other any number of reasons.
What are the Requirements to Become a Psychiatric Nurse?
To become a psychiatric nurse, there are three different educational routes candidates can take. They can either earn an associate’s degree in nursing through a two-year program, a diploma in nursing through a three-year program, or a four-year bachelor’s degree in nursing. Psychiatric nurses take the same educational courses as a regular RN, such as biology and microbiology, anatomy, nutrition, physiology, and pharmacology. However, psychiatric nurses usually elect for additional classes in substance abuse, counseling and behavioral therapy, and psychopathology.
The types of classes each psychiatric nurse will take depends upon the specific realm of mental illness in which they plan to specialize. For example, psychiatric nurses who plan to work with elderly patients may complete courses concentrating on various types of dementia and Alzheimer’s disease. Psychiatric nurses who plan to work with patients who struggle with substance abuse may concentrate on the different types of recreational drugs, prescription drug abuse, and addiction.
After graduating from a state-recognized school, psychiatric nurses are just like traditional RNs in that they must pass the National Council Licensure Examination or NCLEX in order to gain licensure.
While regular RNs may accept their first nursing job once they pass the NCLEX, most employers may not hire psychiatric nurses unless they have pursued further education and acquired additional certification. In order to do so, psychiatric nurses are first required to hold an active RN license and to have worked full-time for two years as a practicing RN.
Next, candidates are expected to become a certified Psychiatric Mental Health Nurse or a PMHN through programs offered by the American Nurses Credentialing Center or ANCC. This certification is only valid for five years and requirements for certification vary from state to state. Typically, however, psychiatric nurses must fulfill at least 2,000 clinical hours in psych nursing, and complete 30 hours of additional education specializing in the assessment and treatment of mental illness.
How Long Does It Take to Become a Psychiatric Nurse?
The amount of time it takes to become a psychiatric nurse depends upon the type of RN education he or she decides to pursue. For a two-year associate’s degree, it takes approximately seven years to become a psychiatric nurse. For a three-year diploma, it takes eight years. And finally, if a psychiatric nurse begins with a four-year bachelor’s degree, it will take nine years in total before they can fully practice within the field.
What Do You Learn in a Psychiatric Nurse Practitioner Program?
- Theories and Systems of Mental Health and Illnesses – Psychiatric nurse practitioner candidates learn about the theories used to explain what constitutes mental illness and the factors believed to attribute to mental illnesses. The most common theory uses models based on the works of Sigmund Freud, Carl Rogers, and B.F. Skinner to explain how mental illnesses develop as a kind of consequential coping mechanism to unhealthy environments and social pressures patients experienced during their cognitive development. Psychiatric nurse practitioners will also learn about more recent theories which attribute the state of one’s mental health and/or illness to biological and neurophysiological processes.
- Assessment and Diagnosis in Psychiatric Mental Health for Adults – Psychiatric nurse practitioners will learn about the field’s accepted and trusted methods for assessing mental health in adults and accurately diagnosing mental illnesses.
- Assessment and Diagnosis in Psychiatric Mental Health for Children and Adolescents – In addition to assessing the mental health of adults, a psychiatric nurse practitioner program teaches its students how to assess and diagnose mental disorders in children and adolescents. The brains of children and adolescents are not completely developed, and so the criteria by which to measure their mental and cognitive health is much different.
- Principles and Concepts of Neuroscience – As neuroscience and technological advances continue to expand understandings of the human brain and its functions and roles in mental health, psychiatric nurse practitioners must learn the foundations of this field and how it will affect and continue to change the way in which psychiatric professionals assess, diagnose, and treat their patients.
- Psychiatric Pharmacology for Adults – As psychiatric nurse practitioners are qualified to prescribe medications for their patients, it is essential that they possess a profound understanding of psychiatric pharmacology.
- Psychiatric Pharmacology for Children and Adolescents – Treating mental illnesses in children and adolescents is far more complicated than treating adults because medications can affect how their brains ultimately develop.
- Common Mental Health Problems of the Elderly – Treating psychiatric illnesses in elderly patients is a unique and specialized area in mental health. The elderly brain is prone to physiological deterioration, which commonly manifests as Alzheimer’s disorder and other types of dementia.
- Therapeutic Interventions for Children and Families – As psychiatric nurse practitioners will face mental health issues that affect entire families, they must learn how to intervene in a way that addresses the needs of family members who are in their elderly years, middle aged, adolescence, and early childhood.
What is an Online Psychiatric Nurse Practitioner Program?
Nurses who already hold a Bachelor’s of Science in Nursing and have one to two years of clinical psychiatric nursing experience may be able to work as a psychiatric nurse practitioner by earning their degree on online. An online psychiatric nurse practitioner program is extremely convenient for nurses who wish to continue working as they earn their degree because they can complete the program in their off-hours in the comfort of their own home. This program teaches degree candidates how to evaluate patients’ mental health, diagnose psychiatric illnesses, assist patients by using behavioral and talk therapy, and prescribe the appropriate medications for patients who may require them.
What Skills are Required for a Psychiatric Nurse?
- Observational skills – Psychiatric nurses must possess exceptional observational skills. People who suffer from mental illness are experts in deception and concealing their symptoms. A psychiatric nurse must be able to identify even the subtlest of signs because missing them could mean life or death—especially for patients who struggle with suicidal thoughts. Paying attention and knowing the meaning of small physical details and behaviors is crucial because they may often conflict with what a patient is explicitly saying. The faintest signs that an average person would miss completely, a psychiatric nurse must be able to detect.
- Interpersonal skills – Because the concepts and topics that psychiatric nurses discuss with their patients are abstract, such as thoughts, emotions, and sensations, they must be able to listen attentively and communicate as articulately as possible. This interpersonal skill-set also means that psychiatric nurses must learn to essentially speak each individual patient’s own personal emotion-language.
- De-escalation skills – Oftentimes, psychiatric nurses are faced with patients who struggle with intense emotions. Anger, rage, sadness, and suicidal thoughts require psychiatric nurses be skilled at de-escalating situations, tensions, and emotions. Furthermore, psychiatric nurses must sometimes intervene in familial disputes, and in these situations, de-escalation is essential to ensure that communication remains open and amicable so that an appropriate solution may be reached.
- Decision making – Psychiatric nurses must be skilled at making difficult decisions and sticking to the conclusions they make. As they will often encounter patients who are persuasive, obstinate, or indecisive, it is crucial that these health care professionals become comfortable with being a voice of authority and reason.
- Persuasive – It is not uncommon for patients to become difficult, resistant, or even outright refuse to take medications or adjust their behaviors according to their outlined plan of treatment. Psychiatric nurses must be skilled debaters who are convincing enough to persuade patients that following their psychiatrist’s recommendations are in their best interest.
- Critical thinking – Psychiatric nurses must be able to take in a wide variety of signs and symptoms (which are sometimes contradictory) and think critically to arrive at accurate patient assessments and assist psychiatrists in their patient diagnoses.
What are the Advantages and Disadvantages of Being a Psychiatric Nurse?
- Helping others – Perhaps the most cited advantage of being a psychiatric nurse is the feeling these healthcare professionals get from helping others. People suffering from mental illness are often the most misunderstood, overlooked, and outright neglected of those who need medical care.
- Getting to know people – Psychiatric nurses love their jobs because they get to know people from the inside out. Their patients tell them things they have never told even their closest loved ones, and it is through these intimate interactions that psychiatric nurses come to know people more deeply and profoundly than most people ever get the chance.
- Job security – There is a massive shortage of professionals within the field of mental health. As the law of supply and demand determines, psychiatric nurses will never find themselves out of a job due to lack of available opportunities.
- Life lessons – The second most common advantage that psychiatric nurses attribute to their profession is the number of life lessons they learn on a daily basis. Psychiatric nurses say they never fully understood just how fragile life itself is and how vulnerable and delicate people are until they began their careers.
- Variety – From hospitals to private practices, prisons to public schools, psychiatric nurses have the option of working in a wide variety of settings. Furthermore, because there is currently such a shortage amongst mental health professionals, psychiatric nurses have the option to switch almost effortlessly between work environments if they so choose.
- Emotional difficulties – One commonly referenced disadvantage to being a psychiatric nurse is the difficulty that comes with having to be compassionate and understanding while treating some of society’s most abhorred offenders. These types of patients commonly include pedophiles and convicted child molesters, rapists, murderers, psychopaths, and sociopaths.
- Risky – As psychiatric nurses must care for some of society’s most dangerous criminals, the territory comes with its own obvious risks. Whether their work setting is a prison, school, private practice, or psychiatric hospital, psychiatric nurses work with people who are mentally unstable on a day to day basis. At any given moment, these patients can go from nearly catatonic to dangerously violent, making the profession one of the most dangerous within all of healthcare.
- Lack of gratitude – Whether it is grief, attempted suicide, or an absolute breakdown of overall mental health, psychiatric nurses care for patients through some of the most difficult times of their lives, and yet, once patients have recovered and moved on, psychiatric nurses very rarely receive any type of gratitude or appreciation for their compassion and hard work.
How Much Does a Psychiatric Nurse Make?
As of 2018, the median annual salary for a psychiatric staff nurse is $71,663. On the other hand, the median annual salary for a regular staff RN is $84,387. This contrast is especially interesting considering the fact most states require their psychiatric nurses receive additional training and that there is an overall shortage in mental health care workers.