Psychiatric Nursing or Social Work?

January 19, 2009 9:30 PM

I'd like a flexible career involving meaningful interactions with people while I help them sort out their issues. Given the economy, psychic is definitely out (kidding, kidding). Help me figure out whether I should pursue a MSW or a degree in Psychiatric Nursing! (please?)

I have a VERY hard time picking a career. I'm an INFJ. We do that, apparently.
I've noticed a few patterns though, and one thing that I always come back to psychology. I really do love psyc (everything from the big picture theoretical perspective to the micro, abnormal psyc/pathology perspective.) I have been doing research for a while now and have come to the point where I absolutely hate it. I do want to do therapy, however, but don't even want to deal with PIs, funding, research projects, etc. So, clinical phd programs are out. I've considered Counseling PhD, Ed psyc doctorates, and PsyDs, but none of them resonate. I'm finishing a master's in public health and have started looking into MSW programs or Psychiatric Nursing as two possible career paths.

Here are my career needs: flexibility, job security (both of which nursing has in spades, it seems), decent salary (again, definitely with the nursing, but not so much with the MSW), autonomy (it seems like nurses have the edge here as well)

It seems like the odds are in favor of nursing, but here are my concerns:
-totally squicked out by bodily emissions
-get bored/disheartened/depressed quickly when I'm doing something I hate (which I could forsee if I get stuck doing bedpans or paperwork for long stretches)
-I'm not sure how much therapy I'll actually be doing
-I'm into mindfulness and acceptance based therapies and integrative (mind/body/spirit) medicine, which I don't see a lot of in nursing (please please correct me if I'm wrong because this is a BIG concern of mine)

I get the impression that MSWs do a lot more actual therapy. But when I started reading about psyc. nursing, I honestly felt like I discovered some secret that no one else was in on. I mean, I'd get to do therapy, prescribe meds if I want, PLUS I'd get a really good salary and incredible flexibility? And while the Nurse Ratched references WOULD get tiring, what am I missing? Why isn't everyone else who likes psychology doing this?

I'm totally baffled and irked that I can't make a decision so I'd appreciate any anecdotes and/or insight into this or any of my concerns above. Thanks!

posted by Eudaimonia to Work & Money (7 answers total)

I don't know where you are schooling, but reading the intro sentence to your post made me think immediately of a friend who works as an adviser for Co-op Education - she has a degree in Media and Communications. Basically she does career advising, but gets to work in academia (which I understand to be her cuppa), but similar jobs are also available in a social-workish type of setting and might not require a SWK degree. Maybe talk to whatever the equivalent of Human Resources is in the US? Health and Human Services?
posted by tamarack at 9:49 PM on January 19, 2009

Not to make your life more complicate, have you considered an MFT? It stands for marriage and family therapy but most work is mainly with individuals. Similar to MSW, MFTs usually spend the majority of their time doing counseling with room for a wide variety different styles. They also work with clients over a period of weeks or months (sometimes years) giving you a chance to build a relationship and see the results of your work over time. Meets all of your concerns about nursing. High autonomy. Not so flexible in the hours since clients rely on you personally to be there. Pay varies widely, most combine self-employment with a salaried part-time position.
posted by metahawk at 10:03 PM on January 19, 2009 [1 favorite]

Have you ever visited the inside of a mental institution/psych emergency ward? Probably a good idea before you make up your mind. If the "NF" implies you're really sensitive, I don't know how much of a fit that's going to be.

And if you haven't seen it, Titicut Follies is one of the most powerful, memorable documentaries ever made. It raises a lot of vital questions, I'll never forget it.

"TITICUT FOLLIES is a documentary film that tells you more than you could possibly want to know — but no more than you should know — about life behind the walls of one of those institutions where we file and forget the criminal insane… A society’s treatment of the least of its citizens — and surely these are the least of ours — is perhaps the best measure of its civilization. The repulsive reality revealed in TITICUT FOLLIES forces us to contemplate our capacity for callousness.
...

"The only American film banned from release for reasons other than obscenity or national security, Titicut Follies was filmed inside the Massachusetts Correctional Institution at Bridgewater, a prison hospital for the criminally insane. After the Commonwealth of Massachusetts sued the filmmakers, the Massachusetts Supreme Judicial Court ruled that the film constituted was an invasion of inmate privacy and ordered the withdrawal of the film from circulation."
posted by aquafortis at 10:12 PM on January 19, 2009 [1 favorite]

I can't testify to this myself, but I did hear a huge rant from someone nearing the end of their schooling and mentally filed "MSW" under "educational path never to pursue." Don't make a decision on my commentary alone, but before going down the MSW path, I'd look into the extensiveness of the schooling and training (lengthy), against the pay (surprisingly low), against the availability of work with populations you'd like to work with (easy to find work with challenging populations, but harder to hard work with groups stable enough that my friend felt he'd actually be helping). YMMV, this is a second-hand report of one person's opinion.
posted by salvia at 10:39 PM on January 19, 2009

I've interacted with psychiatric nurses in both hospital and private non profit mental health settings and the psychiatric nurses I've worked with did very little therapeutic interacting with clients and an awful lot of dispensing medications.
posted by The Straightener at 6:20 AM on January 20, 2009 [2 favorites]

Like salvia, I don't have personal experience, but have come to the same conclusion about the MSW being a less valuable credential. The individuals I know with that degree are typically social workers, make pretty low wages, work for agencies that are under-staffed (and thus do not have flexible schedules) and have a very high burn-out rate. I am sure there are some people with an MSW that have jobs you would like, but there are also a lot of people with that degree in jobs you might not.
posted by mjcon at 6:53 AM on January 20, 2009

I just discovered this post, a year old, and I'm wondering if you ever figured things out. I'm in pretty much the exact same position that you are now, loving therapy and psychology, wanting good pay, and not loving research, and trying to figure out what to do with my life. PM me!
posted by whalebreath at 11:53 AM on January 19, 2010