Psychiatric nurses focus on mental health. This includes the prevention of mental illness and the maintenance of good mental health, as well as the diagnosis and treatment of mental disorders. They care for pediatric, teenage, adult, and elderly patients who may have a broad spectrum of mentally and emotionally related medical needs. In addition to providing individualized nursing care, psychiatric nurses serve as consultants, conduct research, and work in management and administrative positions in institutions and corporations. The American Psychiatric Nurses Association (APNA) has approximately 4,900 members.
Psychiatric Nurse Career History
Although some mentally ill people were treated as early as the 15th century in institutions like the Hospital of Saint Mary of Bethlehem in London, the practice of institutionalizing people with mental disorders did not become common until the 17th century.
During the 17th, 18th, and even into the 19th centuries, treatment of mentally ill patients was quite crude and often simply barbarous. This state of affairs started to change as medical practitioners began to see mental illness as a medical problem. During the late 18th and early 19th centuries, hospitals began increasingly concentrating on keeping patients clean and comfortable, building their self-respect, and treating them with friendliness and encouragement. This method of treating mental illness resulted in the establishment of specially designed institutions for the care of mental patients.
Linda Richards is considered to be the first psychiatric nurse in the United States. In 1882, she opened the Boston City Hospital Training School for Nurses to educate nurses in the care of psychiatric patients. But it wasn’t until more than 30 years later that the first psychiatric nursing program of study within the curriculum of a nursing school was established. Such training was gradually added to nursing school programs throughout the United States and Canada.
The National Mental Health Act of 1946 created a strong interest in mental health issues and the educational preparation for psychiatric nurses and other professionals in the field. In 1954, the first graduate program in psychiatric nursing was started at Rutgers University.
The American Psychiatric Nurses Association has emerged as the leading voice of psychiatric nurses in the United States. It has approximately 4,500 members involved in inpatient and outpatient levels of care.
The Job of Psychiatric Nurses
According to the APNA, psychiatric nursing occurs at two levels—basic and advanced. Basic psychiatric nurses are registered nurses who work primarily with patients needing mental health or psychiatric care.
Advanced practice psychiatric nurses are also registered nurses but they have earned certification as certified nurse specialists (CNSs) or have taken graduate courses to become clinical specialists/nurse practitioners (CNS/NPs), or psychiatric nurse practitioners (PNPs). Some of these specialists may work in supervisory or administrative positions and may, depending on their state’s laws, be able to provide psychotherapy services and prescribe medications. Psychiatric nurses in this second, more advanced group may sub-specialize in areas such as child-adolescent mental health nursing, geropsychiatric nursing, forensics, or substance abuse.
Psychiatric nurses perform a wide range of direct-care nursing duties for the mentally ill, emotionally disturbed, and developmentally handicapped. They may work with individuals, groups, families, and communities. They care for all people, including children, teens, adults, and the elderly.
In addition to direct patient care, some psychiatric nurses may use their training in the community as community health nurses or educators. They may also work for insurance or managed-care companies, or in health care institutions or government facilities in an administrative, supervisory, or research position. Other nurses may be self-employed on a consulting or contract basis.
Psychiatric nursing is a very intense nursing specialty. Patients require constant attention, mental and physical care, and monitoring.
Psychiatric Nurse Career Requirements
Psychiatric nurses must first be registered nurses. To prepare for this career, you should take high school mathematics and science courses, including biology, chemistry, and physics. Health courses will also be helpful. English and speech courses should not be neglected because you must be able to communicate well with patients.
There are three basic kinds of training programs that you may choose from to become a registered nurse: associate’s degree, diploma, and bachelor’s degree. Your choice of the three training programs to choose should depend on your career goals. A bachelor’s degree in nursing is required for most supervisory or administrative positions, for jobs in public health agencies, and for admission to graduate nursing programs. A master’s degree is usually necessary to prepare for a nursing specialty or to teach. For some specialties, such as nursing research, a Ph.D. is essential.
Entry-level requirements to become a psychiatric nurse depend on the state, the institution, its size, whom it serves, and the availability of nurses in that specialty and geographical region. Usually nurses must have some nursing experience before entering the psychiatric nursing field. Some institutions may require certification as a psychiatric nurse. Psychiatric nurses who wish to advance their education may take graduate level courses and become nurse specialists or nurse practitioners.
Certification or Licensing
Psychiatric nurses who are advanced practice nurses and have post-master’s degree supervised clinical practice can become certified as specialists in adult or in child and adolescent psychiatric-mental health nursing. Certification is available through the American Nurses Credentialing Center.
All states and the District of Columbia require a license to practice nursing. To obtain a license, graduates of approved nursing schools must pass a national examination. Nurses may be licensed by more than one state. In some states, continuing education is a condition for license renewal. Different titles require different education and training levels.
Psychiatric nurses should like working in a fast-paced environment that requires life-long learning. Research into human behavior and the brain is constantly resulting in new information and treatment methods regarding patient care, drug therapy, and treatments.
In many cases, psychiatric nurses are confronted with situations that may require them to act immediately, independently, and confidently, so they must have good decision- making skills. They must also be good team players and able to get along with people from all walks of life. They must work with patients and families as well as other medical, administrative, and institutional personnel.
Psychiatric nurses must be able to deal with people in a troubling time of their lives. They must be able to communicate with the families and friends of persons with mental problems who may find the illness difficult to understand. Nurses need to display patience, understanding, and composure during these emotional times.
Many facilities require nurses to work 10-to 12-hour shifts, which can be very exhausting. In addition, nurses are often on call.
Exploring Psychiatric Nurse Career
To explore the field of nursing further, read up on the field as much as possible. The Internet and your local library are great resources for additional information. Talk to your school’s guidance counselor about your possible interest in health care. He or she may be able to suggest different nursing programs to research or, better yet, give you names of previous students to talk to who have gone on to these medical programs. Volunteering at local hospitals or health care clinics can give you experience working with patients.
Specific to psychiatric nursing, do some research on topics such as drug and alcohol dependence, depression, and other concerns of the field to learn more about this specialized area of nursing.
The American Psychiatric Nurses Association (APNA) has approximately 4,900 members. Approximately 35 percent of its members are basic psychiatric nurses, 59 percent are advanced practice psychiatric nurses, and between 5 and 6 percent have doctorates. Psychiatric nurses are employed in hospitals, psychiatric and mental health facilities, in doctors’ offices, in correctional institutions, in nursing homes, in shelters, and in group homes.
Psychiatric nurses must usually work as registered nurses before they can specialize in psychiatric nursing. To become a registered nurse, they must complete one of the three kinds of educational programs and pass the licensing examination. Registered nurses may apply for employment directly to hospitals, nursing homes, and companies and government agencies that hire nurses. Jobs can also be obtained through school placement offices, by signing up with employment agencies specializing in placement of nursing personnel, or through the state employment office. Other sources of jobs include nurses’ associations, professional journals, and newspaper want ads.
Administrative and supervisory positions in the nursing field go to nurses who have earned at least a bachelor of science degree in nursing. Nurses with many years of experience who are graduates of the diploma program may achieve supervisory positions, but requirements for such promotions have become more difficult in recent years and in many cases require at least a bachelor of science in nursing degree.
According to the American Psychiatric Nurses Association, basic psychiatric nurses earn starting salaries that range from $35,000 to $40,000 annually. Advanced practice psychiatric nurses earn salaries that range from $60,000 to more than $80,000 a year. Nurse executives can make from $100,000 or more. The salaries of nurse-faculty members average about $65,000 annually.
Salary is determined by many factors, including nursing specialty, education, place of employment, shift worked, geographical location, and work experience. Flexible schedules and part-time employment opportunities are available for most nurses. Employers usually provide health and life insurance, and some offer educational reimbursements and year-end bonuses to their full-time staff.
Government institutions, corporations, businesses, nursing homes, correctional institutions, research facilities, and hospitals may employ psychiatric nurses. Most hospital and institutional environments are clean and well lighted. Inner-city facilities and hospitals may be located in relatively unsafe areas. Generally, psychiatric nurses who wish to advance in their careers will find themselves working in larger facilities in major cities.
All nursing careers have some health and disease risks; however, adherence to health and safety guidelines greatly minimizes the chance of contracting infectious diseases such as hepatitis and AIDS. Medical knowledge and good safety measures are also needed to limit the nurse’s exposure to toxic chemicals, radiation, and other hazards. In addition, psychiatric nurses may be exposed to violent and unpredictable behavior, which may increase their risk of injury.
Nurses usually spend much of the day on their feet, either walking or standing. Many hospital nurses work 10- or 12-hour shifts, which can be tiring. Long hours and intense nursing demands can create burnout for some nurses, meaning that they often become dissatisfied with their jobs. Fortunately, there are many areas in which nurses can use their skills, so sometimes trying a different type of nursing may be the answer.
Psychiatric Nurse Career Outlook
Mental illness is a leading cause of disability in the United States and mental disorders affect one in five Americans, including children, adolescents, adults, and the elderly. The need for psychiatric and other nursing specialties will be in great demand in the future. The U.S. Department of Labor projects that employment for all registered nurses will grow much faster than the average for all occupations through 2014. The U.S. Department of Labor projects that registered nurses as a general profession will be second largest number of all new jobs in the United States.
The unemployment rate for all nursing professions according to the American Association of Colleges of Nursing is less than 2 percent.