Becoming a Psychiatric Nurse
A mental illness is as devastating as many bodily illnesses, but not nearly as well understood by the public to be a true medical condition. Psychiatric nurses use their expertise in mental health, crisis intervention, therapy and medications to help patients master mental illness and the stigma that surrounds it so that they can live fulfilling and productive lives.
Psychiatric nurses begin their work by interviewing and assessing new patients to learn their history, symptoms, patterns of illness and daily living habits. They care for people with:
- Anxiety disorders (including phobias, panic disorder)
- Mood disorders (including depression, bipolar disorder)
- Psychotic disorders (including schizophrenia)
- Addictions and substance abuse
- Alzheimer’s disease and related dementias
Together with a treatment team, psychiatric nurses develop detailed plans to provide the comprehensive care patients need to live their best lives. During the treatment phase, psychiatric nurses provide supportive counseling that helps patients and their families to better understand the illness. These professionals also help patients tackle everyday tasks like dressing, grooming and managing their medications.
A career in psychiatric nursing provides an opportunity for compassionate people to make a significant difference in the lives of those who suffer from mental illness. The care that these professionals provide helps patients ward off disability, poverty, social isolation and other complications associated with these conditions. In many cases, psychiatric nurses see their patients recover enough to return to their homes, jobs, families and the comforts of their everyday lives.
Psychiatric nurses work in many settings, including:
- General and psychiatric hospitals
- Addiction and substance abuse treatment centers
- Home health care agencies
- Community mental health programs
- Correctional institutes
- Outpatient mental health clinics
- Schools (especially those serving people with emotional and cognitive impairments)
Psychiatric nurses generally work in clean, well-lit environments, though some travel to patients’ homes. In some settings, they spend long periods on their feet and frequently stoop, bend and lift as they care for patients.
Psychiatric nurses spend most of the workday talking with patients, families and other members of the treatment team. Depending on the activity, they work with individuals, families or small groups of patients. They are sometimes called upon to help with patients who are very upset or behaving in dangerous or destructive ways.
In inpatient facilities, psychiatric nurses work in shifts that provide patient coverage 24 hours per day, seven days per week—including holidays. In outpatient and community settings, they generally work regular business hours and are on call some evenings and weekends.
Many kinds of nurses work in the mental health field, including certified nursing assistants (CNAs), licensed practical nurses (LPNs), registered nurses (RNs) and advanced practice psychiatric nurses. While all play an important role in helping patients, only RNs and advanced practice nurses are trained to assess, treat and counsel patients.
To become an RN, candidates must earn an associate’s or bachelor’s degree in nursing. Training takes two to four years and includes hands-on work in many areas of nursing. Some schools offer bridge programs for working nurses who wish to earn a bachelor’s degree and accelerated programs for students who hold a bachelor’s degree in another field.
To become nurse practitioners, RNs must complete two to five years of additional study to earn a master’s degree or doctorate in nursing.
When enrolling a nursing school, it’s important to choose an accredited program. Both the National League for Nursing Accrediting Commission and the American Association of Colleges of Nursing offer searchable program directories on their websites.
Accredited nursing education programs include extensive hands-on experience in clinical settings. Newly certified RNs can complete an optional one-year residency to enhance their clinical skills. All nurses are required to take a certain number of continuing medical education (CME) credits each year.
Licensing and/or Certification
Nurses must be certified before practicing in all 50 states and the District of Columbia. This requires completion of a state-approved training program and a passing score on the National Council Licensure Examination (NCLEX).
An experienced psychiatric RN can pursue voluntary certification as a Psychiatric Mental Health Nurse (PMHN) through the American Nurses Credentialing Center (ANCC). Candidates must pass an examination and demonstrate both work experience and continuing education in the psychiatric nursing field.
Necessary Skills and Qualities
Above all, aspiring psychiatric nurses should feel compassion and empathy for people who are living with mental illness. Nurses need a good dose of emotional maturity in order to support their patients without feeling overwhelmed by their problems.
Psychiatric nurses need to be “people people” who enjoy lots of interaction. They must have excellent communication skills in order to convey concepts and give clear instructions. Because they work within a team of healthcare professionals, they should be natural collaborators who enjoy supporting the work of others.
Problem solving is another essential skill. When an emergency arises, psychiatric nurses must be able to think on their feet and react quickly.
Psychiatric nurses need to be detail-oriented, particularly when working with medications.
Opportunities for Advancements
Experienced psychiatric nurses may be promoted to manage inpatient-nursing units or serve as head nurses or directors of nursing. These administrative positions require leadership, solid judgment and excellent negotiation and communication skills. In choosing nurse leaders, most employers favor experienced candidates and those with advanced degrees.
Some psychiatric RNs pursue certification as advanced practice psychiatric nurses. This allows them to serve as primary mental health providers, open their own practices and (where permitted by law) prescribe medications.
Salaries of psychiatric nurses range from $32,500 (for first-year nurses) to $118,359 (for those with five to nine years of experience). Median annual wages are around $66,000. Salary tends to increase with education level and experience.
Employment of registered nurses is expected to grow by 26% between 2010 and 2020, which is considered much faster than the average for all occupations. Much of this growth will be due to the aging of the baby boomer generation and their increasing need for healthcare services. The number of people living with the effects of stroke, Alzheimer’s disease and related dementias is on the rise and creating a demand for psychiatric nurses.
Turnover among psychiatric nurses tends to be high. Many hospitals offer incentives to qualified candidates, including signing bonuses, flexible work schedules and tuition reimbursement. Employers strongly prefer experienced candidates with bachelor’s degrees.