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- Jan 1 by myelinQuote from harmonizerThis has not been the case at all in the states I've looked at, nor does it reflect the experience of the psych NPs I know in practice. Not only does the need for psych NPs seem to be much higher than the need for FNPs, but the salaries are much higher as well. This has been the case for the NPs in the region that I have discussed this with (mostly the pacific northwest and the southwest). Also, employers seem to be favoring psych NPs because they don't command the salary of a psychiatrist. Psych NPs and psychiatrists were used interchangeably in the state that I just moved from, as well. FNPs do not get hired to practice psych around here, either.Not true. In general, there are obviously much more opening for FNPs than Psych NP. See indeed.com, you can search for tons of job for FNPs, but very few psych NP positions in most states.
- Jan 1 by harmonizerIf you choose pysch NP route, then be ready to relocate few areas of the country where myelin and Ellen NP mentioned for the jobs and "fair" pay. And honestly, not all of those cities are desirable for living (many of them are too cold/too hot/too rural/too conservative etc). I gave up more desirable living conditions and moved across the country to be in an independent practice state. No, psych NP and psychiatrist are not used interchangeably all the time at least here. Even in this independent practice state, there are a few procedures that psych NP can't do eg. (involuntary commitments for treatments & leading ACT team). So in many of those settings, they still need psychiatrists for those procedures. Remember, independent "prescriptive" authority does not mean independent "practice." Starting salary is higher than some states but not by that much, considering the initial relocation cost, also the starting salary is still not worth it given the increased responsibility and liability of being more independent. I would recommend doing FNP. You will be more in demand (in general- nationwide), have wider scope of practice, may not need to relocate, and may not face similar problems.
- Jan 1 by zenmanI was in an independent practice state working in a hospital. I did involuntary commitments for up to 7 days all the time (ED admits) without consulting anybody. After that the psychiatrists had to sign the papers for commitments to the state hospital if we thought the patient was still a danger to themselves or others, otherwise they would be discharged within that 7 day period. And I was usually the one writing up the commitment papers for the psychiatrist to sign. Fortunately, the psychiatrist had to go to court. Not something I wanted to do. Another thing you need to consider is that you may be more valuable in an independent practice state. Many of the physicians were hacked off at my medical director because they had to sign off on all the orders made by PAs. My med director didn't have to do a thing with my work...and she loved it. And I was hired over another psychiatrist.
Now I'm in a state where NPs have to have a collaborating physician. I'm working for the military so that's a moot point but I've made up my mind to head straight back to an independent practice state as soon as this gig is over. It's just so much less hassle.
- Jan 1 by harmonizerPlease note that the laws about involuntary commitments & forced treatments differ from states to states, even among independent practice states. Zenman, I think you talked about emergency involuntary commitment only. There is another procedure called "court-ordered treatment" for chronically mentally ill people in outpatient settings/non-emergency purpose. The step must be renewed and initiated by a psychiatrist only.
I don't like that almost all independent practice states are either freezing cold in the winter or covered by deserts.
When will the good ol'southern states & California with excellent and hospital weather turn into independent practice states for NPs, hopefully by next decade?Last edit by harmonizer on Jan 1
- Jan 1 by nurse*sunshineharmonizer,
There is a reason you will see more jobs listed for FNPs than PMHNPs. A greater portion of the US population is treated for chronic medical conditions than chronic mental health conditions. Greatest demand is not determined by the amount of practice opportunities.
I have found job listings all over the US with very good salaries for both FNPs and PMHNPs. I researched your claim about salaries and found several sources that listed the average salary for PMHNPs as higher than FNPs but nothing to support your claim.
- Jan 1 by Miss PsychNPI agree nurse*sunshine. I have worked in Ohio, Missouri, Arkansas, Oregon, New Mexico, West Virginia, Tennessee and now Maryland as a Psych NP and made a very good living. I am now certified as a FNP and the offers were quite low...like by 20k less than what I make now. One company offered more only after they realized I was an adult psych turned family psych add fnp. Then and only then they offer more money....but it was still less than what I make now working only as a Psych NP. My advise to the person having second thoughts is to do what you love. I love working in psych and it wasnt the money that attracted me into the field...but it certainly hasnt hurt either!
- Jan 2 by myelinWow, this thread is full of really interesting comments and info. Miss PsychNP, what prompted you to earn the FNP cert on top of psych? Did you get sick of psych or was is that you wanted to address both the physical and mental health circumstances of your patients? I'm curious because I think I might eventually want to add FNP on as well (I'm on the FPMHNP track now). Do you find maintaining both licensures difficult? Thanks!
- Jan 2 by Miss PsychNPMyelin,
I initially wanted to obtained both certifications but went ahead with the adult psych, then earned the family psych to finish with the fnp. I have always loved integrated treatment (medicine) and found out of necessity that I had to learn how medications prescribed for physical health conditions can affect psychotropic medications.
No...I would never get 'sick' of psych. It is really my calling. I think you need to have a strong understanding of either even if you choose to work in only one field. As a Psych NP, I have encountered a patients in my appts with medical crises that could easily go unchecked like a child diagnosed with ADHD and Disruptive Disorder of which she had neither, but instead suffered from convergence insufficiency resulting in her inability to read (no even the pcp picked that one up) so I referred her to an opthamologist.
No it is not difficult to maintain both certifications. I work 3 days as a psych np and 1 day as a fnp. Once I finish developing an integrated clinic, I will split two days to provide patients an opportunity to have primary care services. In Maryland, I cant work as both at the same time and must specify how I split the time (weird).
Adding FNP is not for everyone...I choose to work with undeserve populations so having two certifications to provide primary physical health and mental health allow me provide services to those with limited access to care.
Good luck with your studies!
- Jan 3 by ReInventorI'm not even a nurse yet, but I work for a psychiatrist and when I mentioned that I was interested in becoming a psych NP, they actually already said they would hire me if I become one, because the demand is so great! The waiting lists for psychiatric treatment stretch out for months, and I'm not even in an 'underserved' area.
- Jan 3 by myelinThank you Miss PsychNP for the reply. What you're doing sounds exactly like what I'd hope to achieve at some point in my career, though I plan on working as a psych NP only for several years (pay down my loans, etc.) before going back to become a FNP as well.
Hey ReInventor, I'm curious. What part of the country are you in (or if you're willing to share, what state)?