Psychiatric Nurse Practitioner...please help

Specialties NP

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Hi, I am returning to school this year...and I am torn between psychology and nursing. Currently, I'm a psych nurse, LPN, for the VA hospital Miami. I am stationed on PTSD...and I find my job very rewarding. After nearly 5 years of working on my floor, I'm determined to work permanently in psych. I've considered going back to school to become a psychologist, but I don't want to be in school for the next 10 years or more. :no:

Which leads me to this question....As a Psychiatric Nurse Practitioner...would I be required to work on a medical surgical floor for a while before working in my specialty?:nailbiting:

Specializes in Psychiatry.

I would say Psych NP unless you are very interested in psychometric testing. The reason for this is that the reimbursement rates for psychologists through insurance are either significantly less or even not reimbursable. When I was making this decision, I consulted with my Uncle, who is a clinical psychologist. He said that because things for the foreseeable future will be a medical model, it helps to be able to prescribe, and insurance is reimbursing more and more for NPs. Unless you can get into a practice where you don't accept insurance and can just bill as you please, NP makes more sense from that perspective.

there definitely are diploma mill NP programs that accept pretty much anyone/everyone. However, my only point is that the market for psychology is extremely tight right now, because the market is flooded. This is probably because most people who are interested in mental health tend to shy away from the healthcare route and instead go for the therapy (MSW, LFMT, etc.) or psychology (PsyD, PhD) route. This means that there is currently a paucity of psych specialist prescribers, whereas there are way, way too many therapists out there. It's true that psychologists do more than therapy (assessment, testing, etc.) but the reimbursement is dwindling, and there are still far more psychologists than the market can bear. Look into the current psychology internship crisis and post-doc situation for more info.

Specializes in family nurse practitioner.

Myelin, are you a pych NP or FNP?

The reason for this is that the reimbursement rates for psychologists through insurance are either significantly less or even not reimbursable..

What reimbursement are you talking about.. The insurance reimburse psychologists much more for psychotherapy.. and as you know psych NP are not allowed to do psychometric testing.. I would say depending on your interest. Both have goods and bads. And as a psychologist, you have more opportunity for private practice for counseling and psych testing and a cool "PhD" title. Psych NP is still tied with physicians in most states, which prevents them from being independent.

Specializes in Psych, ICU,clinic supervis case manager,.

Hate to keep beating this drum...but b/c I'm a FNP, who is interested in going to a post-master MHNP program...in my intensive search I've not found programs that are willing to accept anyone or anybody...you have to have a MSN from an accredited college...and to become board certified you have to graduate from an accredited college in order to test. Diploma mills are just that do some courses mail them back and that's it...there are to many safe guards to allow a diploma mill in this advance nurse specialty area. So I say again where are they and name one, just one...lol

Tinabeanrn,

I'm a student in the fpmhnp specialty. I know a lot about clinical psychology because that was my original career plan and I worked in the field for several years. I think pmhnp is a superior choice for multiple reasons (saturation of the psychologist market, dwindling reimbursements, internship/postdoc crisis, adjuncts and the lack of tenure tracks for those who want to teach or do research, the huge need for people who can prescribe, strength of nursing lobby, etc.), unless one is only interested in the psychology approach to mental health. If you really love psychology specifically, then go for it. It's not that it's a bad field, it's just that there are more opportunities in nursing/medicine (in my opinion!). Do be aware that the median salary for a clinical psychologist is ~60k.

It's s not that it's a bad field, it's just that there are more opportunities in nursing/medicine (in my opinion!). Do be aware that the median salary for a clinical psychologist is ~60k.

the median salary for a clinical psychologist is 85K according to Salary.com

http://swz.salary.com/SalaryWizard/Psychologist-Salary-Details.aspx

I tend to prefer the US government for this kind of data. According to BLS.gov, it's 68k (note, this is not a starting salary but the median, starting is more like 60k). Anyway, the point is that this field is very saturated (which is why the internship crisis is such a huge, growing problem), but there are definitely ways to make it work if it's what you want (ie: attend a fully funded program, know what your gameplan is from the get go so you can position yourself to be competitive when you graduate, only accept an APA-accredited site for internship, etc.).

OP - I suggest talking to some practicing psychologists, and try and talk to some who work in a variety of settings (pp, medical, research, neuro, community clinics, etc.) Salaries definitely vary by setting. If you can get to the top of the field (neuropsych, working in a medical school or in a medical setting, working for the VA), then clinical psychologists can make a great living. Unfortunately, this is becoming the exception, and many are getting by in CMHCs, pp, etc. I suggest checking out the clin psych forum on sdn, where there are discussions about the future of the field, realities of practice, etc. Tons of info about the field from people currently in it is available over there.

Psychologists : Occupational Outlook Handbook : U.S. Bureau of Labor Statistics

I tend to prefer the US government for this kind of data. According to BLS.gov, it's 68k (note, this is not a starting salary but the median, starting is more like 60k). Anyway, the point is that this field is very saturated (which is why the internship crisis is such a huge, growing problem), but there are definitely ways to make it work if it's what you want (ie: attend a fully funded program, know what your gameplan is from the get go so you can position yourself to be competitive when you graduate, only accept an APA-accredited site for internship, etc.).

OP - I suggest talking to some practicing psychologists, and try and talk to some who work in a variety of settings (pp, medical, research, neuro, community clinics, etc.) Salaries definitely vary by setting. If you can get to the top of the field (neuropsych, working in a medical school or in a medical setting, working for the VA), then clinical psychologists can make a great living. Unfortunately, this is becoming the exception, and many are getting by in CMHCs, pp, etc. I suggest checking out the clin psych forum on sdn, where there are discussions about the future of the field, realities of practice, etc. Tons of info about the field from people currently in it is available over there.

Psychologists : Occupational Outlook Handbook : U.S. Bureau of Labor Statistics

Another aspect of this that I considered when making my choice b/n clinical psych and psych NP is the time invested....finding a good position that pays well can take years after the 5-7 years in school (on the higher end of that if you are attending a solid, research oriented program). Like even if you get a medical school position, it will take years to advance from an assistant professor to a position where you are well compensated for the many hours you will have to work in an academic setting...I just didn't want to deal with it. The salary and job opportunities just seem better for an NP. Just my two cents.

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