Rethink my career path: PharmD VS PMH-NP

[oohnurse]

First, I would appreciate you guys for taking time for the advices.

Currently just finished 1st year PharmD curriculum at an expensive private school. I am making a decision whether I should continue with pharmacy school or take a year off before applying for psychiatric nursing. (currently RN, BSN)

I will try to be as brief as possible. Here are some pros and cons for quitting pharm school and go for PMHNP

Pros for quitting PharmD to pursue NP:

-Unlike pharmacy, psychiatric nursing will satisfy my curiosity in the complexity of human minds, allow me to gain more autonomy, and potentially match my personality according to career tests and my introspective view of myself. This may be a very naïve perspective about the field. I am planning to apply for a PRN job as a psych nurse and talk to as psych NPs to confirm my decision and to get the 1st/2nd hand experience.

-Fierce job competition in pharmacy in the future. Lots of bright students in my class. I have the gut feelings that we’ll be competing for residencies and clinical positions in the futures. New grads in my school already have tough time finding jobs even in retails. Also. Hugh financial risk, see below.

-Save $66,174 in tuitions fee and at least $50,000 in opportunity cost for pharmacy residency (2 years residency required for clinical position)!! Huge financial relief. Total >$100,000

-MSN schedule is more flexible, unlike pharmacy school where I have to attend full-time like in undergrad and have to compete with younger geeky college kids :). Even with working part-time as RN, I will be graduating with hugh loans from PharmD.

Cons for quitting PharmD to pursue NP:

1.Already owed $20,000 of student loans.

2.Starting salary for NP may be ~$20,000 less than PharmD? True? (but who know in the future?)

Is the job market also tight for PMH-NPs with more schools and all those online programs?

I am horrified by the idea of still having to work as a bedside RN after completing NP program to supplement the income.

3.Feel like a loser dropping out from school and it’s already to late to apply to PMHNP program this Fall. Have to wait until 2010. Do you guys know which NP schools will start in Spring 2010?

4.I have put lots of time and energy during my 1st year in pharm school. Got good grades, leadership potential, and research involvement.

Please comment/criticize if you have time. It’s a big decision.

One more question? Part-time opportunities as PMHNP or psychiatric CNS?

[zenman]

anyone know why the admission to PMHNP program is less competitive than other NP speciality. Lower salary or narrow scope of practice?

I applied to both FNP and PMHNP programs and they were equal in this regards. With wars and the world falling apart, maybe there is a great need to get more of them.

[RockyCreek]

>

During my early college years, I was pursuing a BSN with a minor in Psych because I really thought I had a 'calling' to the field. It was a very observant intructor that noticed that I was only average in dealing with truly disurbed patients but very good at teaching. She encouraged me to tutor fellow students and then to consider teaching once I had an MSN. Maybe this is a direction that you could consider if you enjoy teaching pathology, making pharmacology undertandable and demystifying calculations!

Best of luck in whichever decision you make!

[westcoastgirl]

I think you need to talk to Psych NPs more in depth and even some psychiatrists. I am on the fence about a PsychNP program (been accepted, but already have my FNP) but because of family scheduling issues not due to lack of interest in it. Psych NPs are in demand and a big part of their job is med management from what I have observed and heard.

PharmDs make what seem to me a lot of money for work that is largely routine (according to my pharmacy friends) but hey the money is good and it certainly suits some people more than others.

Just like psych isn't everybody's cup of tea.

[oohnurse]

Thanks guys for input. School is starting in two weeks and I still can't make decision. Some NPs (not psych NP) encourage me to stay in pharmacy school mainly because of the higher workload and being on call and compensation. Ha.. I hate to be indecisive. Basically, I didn't do anything productive this summer other than being indecisive.

I just started working in psych unit last week. I like talking to patient but I don't like workload as a staff Psych RN. Staff psych RNs don't have the opportunity to perform "official" psychotherapy due to workload. I am working again this Friday and I will do my best to listen to "my inner voice" or "gut feeling", even if I may not be able to shadow an NP in time before school starts.

At least, the peer environment will be different for sure. The classroom won't be full of 20s year old like PharmD. My inner voice said that "I like artistic and humanistic materials. I want career that is more than a job. I am a intuitive feeler, not a strong sensing/thinking type" I might have to give up the artistic and free-spirited part of me if I decide to continue with pharmacy school. Another practical voice is saying "Science is more prestigious and predictable than arts. Pharmacy school is more scientifically intellectual. Pharmacy is a diverse career path. I can also do research/teaching etc if I don't like routine... Jobs are jobs... It's ok as long as you don't hate it.

You're an introvert... pharmacy may be better choice due to my introvert personality"

[elkpark]

Staff psych RNs don't have the opportunity to perform "official" psychotherapy due to workload.

Staff psych RNs do not have the educational preparation or credentials to perform "'official' psychotherapy" -- it is outside the scope of practice for generalist RNs, according to the larger nursing community. Graduate level education is the minimum preparation for psychotherapists (in any of the mental health disciplines) -- in the case of nurses, that means psych CNSs and NPs (only).

(BWT, for what it's worth, I'm incredibly introverted, and have had a v. successful and satisfying career as (first) a staff nurse in psych and (later) a psych CNS.)

[oohnurse]

(BWT, for what it's worth, I'm incredibly introverted, and have had a v. successful and satisfying career as (first) a staff nurse in psych and (later) a psych CNS.)

Thanks for reply. I can see why being an introvert is not too bad for psych setting. I think psych requires good listening and introverted/reflective thinking. Congrats on your successful/satisfying career. The bad part of me is that I am the kind of thin-skinned introvert that is really sensitive to criticism... which could be a problematic when the job is more relationship-focused.....I need to be emotionally stronger..

[SandBetweenMyToes, BSN, RN]

Just wondering what aspects of a career in pharmacy drove you to apply and start the pharmacy program? Have those desires changed since you have been in school a year? Personally, I would finish the pharmD degree and pay off your loans with the salary you earn. Then after a few years, if you are miserable and cannot find a creative use for your degree (perhaps teaching?), then look at other options. Just my 2 cents...

[oohnurse]

Just wondering what aspects of a career in pharmacy drove you to apply and start the pharmacy program? Have those desires changed since you have been in school a year?

Sorry…. this is quite lengthy. And, I am also at risk of revealing my identity here.

I had a degree in a foreign language and literature before coming to the US. I restarted my undergrad here. I started the pre-pharmacy course before nursing school. Because of not having money and being a foreign student without the benefit of the in-state tuition rate in pharmacy school, I went to nursing school instead. Due to my introverted personality and lack of confidence secondary to being a non-native speaker, I felt unsuccessful at work or previously at school. Consequently, I was burnt out and began taking music courses at a local college part-time to mentally “escape” from my job. Instead of finding other jobs and researching other nursing options like NP track, I finally resigned from my job and started music school full-time for a few semesters (of course, this was an “escape” to make me feel good)while studying for PCAT (pharmacy entrance exam). I was not working for while.

My decision to apply to pharmacy is the combination of seeking the feeling of accomplishment of attaining my original goal of getting into pharmacy school and wanting to find a “quick” fix to make me feel better about myself after “feeling” unsuccessful for the last few years. Not working for a few months, I feel that pharmacy school is easier to get into because my grades and PCAT scores are the main part of admission process.

Being shy and afraid of criticism had discouraged my optimism about patient and co-worker interaction in nursing. As a result, I had the wrong

self-perception that I would rather doing “routine jobs” rather than jobs which my success will depending on intense personal interaction like nursing.

I was accepted at a local in-state pharmacy school. After shadowing a retail pharmacist at Walgreen, I fear that pharmacy may not match my personality. Again, instead of thinking carefully, I chose to attend an expensive local private pharmacy school that offer the combo degree “PharmD/PhD”, which was not offered at the in-state school. I failed to get in the PhD program. I also found that I was not that type of nerdy scientist who likes impersonal details and logics in science. I hate physics and labs. Boom.. another failure!! Or.. maybe.. I am lucky. If I went to the much cheaper local in-state pharmacy school, I may not be thinking deeply about myself right now. The financial and time investments make me “paranoid” about making another wrong career choice and pressure me to think about myself/my personality..

I am introverted. I may appear aloof to others but I am not nerdy/geeky. Internally, I am very emotional and sensitive and seek connections with people. The fear of criticism, shyness, and my sensitivity, not the nerdy personality, made me afraid of people-oriented jobs. If I can gain a little more confidence and assertiveness, I will change to be myself. My skin has been thicker over the last two years though… I also found that I don’t like routine/detailed- jobs and a structured/task-oriented environment, which are the main reason I am dissatisfied with bedside nursing jobs. It’s not the human interaction part. If I can get over the fear of negative criticism, my ideal jobs would have a relationship-focused, intuitive, spontaneous environment. However, I could not make a living being a musician or teaching literature… Therefore, I think psychology/psychiatry is the only thing in medical field that would be a good compromise between the ideal and the practicality.

Personally, I would finish the pharmD degree and pay off your loans with the salary you earn. Then after a few years, if you are miserable and cannot find a creative use for your degree (perhaps teaching?), then look at other options. Just my 2 cents...

It would take more than a few years even if I earn six figures!! Yes, regardless of the fields, teaching is always the area I am interested in. But you can teach in any fields. I think I would have to like career in general, not just teaching. Pharmacy is more practical. However, if I want something that match the personality type then psych or other fields in humanity would fit me better..

[oohnurse]

and have had a v. successful and satisfying career as (first) a staff nurse in psych and (later) a psych CNS.)

Elpark, can you compare psychiatrist VS PMHNP/CNS. Beside money, is there any other things that you will be missing out as a NP instead psychiatrist such as less research opportunities for quantitative medical research or opportunities to order some tests.

I was shadowing a cardiology NP and feel discouraged to see some lacks of autonomy. Yes, they have autonomy at some level but they are still do many other assistant jobs that MDs don't want to do (preparing H&P, discharge summary call,calling family member). Still have to consult MD for almost many decisions they make......

I have not had an opportunity to shadow a psych CNS. I don't know if things would be different in psych setting.

I got only one life to live.. so I try to make the most out of it..

[Joe NightingMale, MSN, RN]

I was shadowing a cardiology NP and feel discouraged to see some lacks of autonomy

That can be true of NP positions, they can lack autonomy. But it also depends upon the setting...I saw a community clinic FNP practice at a satellite clinic on her own without an MD. It also depends upon where you work...some states offer NPs greater autonomy than others.

Just my

[oohnurse]

the two fields you're considering seem highly disparate to me.

Pharmacy is a very dry field, with logical/intellectual bent and little patient interaction. Psych, on the other hand, involves very intense patient interaction and requires more emotional and intuitive skills.

I think you should think more about your personality and values, and decide which way they're directing you.

Joe, actually, I have been thinking about my personality and values. The problem about INFP like me is that I believe that life is quest to seek my identity. As a result, I am indecisive and tend to lack the sense of self-identity.

Actually, I am inclined to be more intuitive and emotional than intellectual/rational and structured.

Per MBTI, I am an very strong “idealist INFP” rather the “thinker INTP” or “scientist INTJ”.

http://www.personalitydesk.com/infp-type-description.php

Having worked a few shifts as a psych RN, I can feel the following personal pros and cons, which make senses considering my MBTI type.

Pros for Mental Health

-strong enthusiasm to understand their problem and their personality

-I am extremely sensitive, emotional, and empathetic

-more intuitive and creative at least than other types of nursing

-Fascination with the detachment from realities and the sub-consciousness of the mentally ill. (I am quite aloof and have my head in the clouds). This could fit me well.

- I like listening to them

Cons for Mental Health

-I tend to be gullible and get absorbed in the conversation. I may have troubles detaching myself and become more analytical.

-As an INFP who like to avoid conflict, I "sometimes" tend to “please” the patient rather than therapeutically communicate with them. This is typical for INFP who like to take things personally.

- “Control problem.” Frustration with incompliance. Unlike concrete medical science, I am a partner, not a fixer. I am frustrated and feel unsuccessful when I cannot get them to do what I want.

-lack of quantitative or interesting psychiatric nursing research

- It is not in my nature to be persuasive and forceful. I am very “perceiving” and “open-minded” type. I don’t like to guide or impose ideas on people even if they are mentally ill.

[oohnurse]

Decided... PharmD. Right now. I am either wanting to go into academia, research.

I want both degrees but I can't. At least, I have made a decision.