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Career Story: Psychiatric Clinical Nurse

Psychiatric Clinical Nurse

Job Title: Psychiatric Clinical Nurse Specialist

Type of Company: An outpatient psychiatric service at a hospital.

Education: BS, Psychology, Smith College •• MSN, Psychiatric Nursing, Yale University

Previous Experience: While I was in nursing school, I worked part-time as a patient care tech on an inpatient unit at a mental health center.

Job Tasks: I work as a psychotherapist in a hospital-based outpatient psychiatric service. The outpatient service provides individual and group therapy. We have an intensive outpatient program for clients needing intensive care, who come to groups three mornings a week. We also have a substance abuse program which offers intensive treatment (meeting three mornings or evenings a week), relapse prevention groups and substance abuse education groups that meet once a week for an hour. My job is to provide therapy to individuals and groups. My clients range from those with chronic mental illnesses, like depression, bipolar illness and anxiety disorders, and psychotic illnesses like schizophrenia, to people who generally function well in their lives, but periodically have crises or developmental issues that they seek counseling for -- relationship problems, like marital conflicts or parent-child conflicts, for example, or grief over the loss of a family member.

On a typical day I see 6-8 clients for individual therapy. Once a week I lead an older adult supportive therapy group. In this group older adults have an opportunity to connect with others, and to give and receive support with the issues of aging, for example, loss of loved ones, physical infirmity, isolation, decreased independence. Many of my clients are taking psychiatric medications that are typically prescribed by psychiatrists, nurse practitioners and primary care doctors. I work collaboratively with the client's prescriber to insure optimal care. I also meet with family members of clients when the client and I determine that this would be beneficial. Some clients I meet with weekly for only a few weeks. Others I see on an ongoing basis to help them maintain their stability.

Best and Worst Parts of the Job: The best part of my job is the opportunity it provides me with to listen to the stories of others, to help others resolve problems and function at the highest level possible. It's very rewarding to witness clients making positive changes in their lives.

The worst part of the job is that it can be very stressful when clients are potentially suicidal. Often there's a fine line between a client's feeling that his or her life isn't worth living and their needing to be hospitalized to protect them from hurting themselves.

Job Tips: I would recommend for anyone thinking of pursuing a job in psychotherapy to work in a mental health setting or volunteer for a crisis hotline. Talk with someone who does the kind of work that you are interested in. Read books about mental health care and memoirs of those who lived with a major mental illness.

Additional Thoughts: Psychotherapy can be a roller coaster. It's extremely rewarding when clients are actively engaged in resolving problems. It can be very frustrating when clients are passive and expect the therapist to fix them. For me the satisfaction of the work far outweighs the stresses and frustrations. It helps to talk with colleagues in peer supervision to help keep the work in perspective.

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