Any Psych NPs out there?

Specialties Psychiatric

Published

Specializes in Med surg, cardiac, case management.

I'm curious, as I'm considering becoming an psych NP myself.

I initially planned to work in telemetry, then CCU, and then become a cardio ACNP. But my last clinical was on a tele floor, and it was pretty boring. I think that cardiology might be a little limiting for me.

Since I have an interest in the psychosocial as well as the medical side of things, I wonder if psych would be a better fit. One of my advisors, who is a former psych nurse herself, suggested the idea.

On the con side, my experience with a clinical in a locked inpatient psych ward wasn't very good; I never really got comfortable in an environment so bizarre and frought with potential violence, even though most of the patients weren't that bad. As a result I decided that inpatient psych (along with Peds) is a type of unit I'd never work.

On the plus side, I'm very interested in figuring out how people's minds work and why. I did a qualitative research project and really enjoyed interviewing subjects, trying to analyze their experiences. And before starting nursing school I considered going into counseling psychology. And I've been attracted to other nursing fields, like oncology and hospice, which have psychosocial components.

So, what's it like as a psych NP?

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Specializes in Med surg, cardiac, case management.

Guess not. ;)

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Specializes in Psychiatry (PMHNP), Family (FNP).

I think there are some out here, just on various threads. I've been a psych. NP for maybe 18 years, its been great. Its a lot different from working on a psych. floor but it does build very well on that experience. Mostly I lead a team and do a lot of prescribing. I also do psych. evals and diagnostic work, which I really like. I do a little bit of therapy, well, just one case right now. Other disciplines do more of that and are more cost effective. Basically I function as a psychiatrist. In our state (CT) we at this time need an agreement w. an MD for supervision, however this will likely change in the next few years to completely autonomous practice, which is essentially what it is already! If you have the temperatment for the work, its very gratifying. I feel like I help people every day, and sometimes you can really save a life. As to salaries and demand, that must vary quite a bit from state to state but a seasoned NP should be making 100k-140k, thereabouts! (In states with higher cost of living.) Best of luck to you.

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Smitty, could I ask you what you had to do to get your psych cert after FNP? I am entering an FNP program in the fall. What you describe sounds very interesting to me. My first bachelors was in psychology and I loved it, but like Joe, I couldn't see myself working as a staff nurse on a psych floor. I'd love to hear more about your experiences, what state you are in, and how you got there...

Thanks!

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I've been a PMHNP for 4 years and have loved it. I currently work on a college campus and before that I worked for community mental health. I have worked with children and adolescents, as well as adults. I also have a part-time private practice (mostly more trouble than it's worth right now). I'd say about 75% of my practice is medication management, but I'm also free to do some therapy if I choose.

The following is my personal opinion and I would not dream of telling anyone else what area of advanced practice nursing they should pursue:

I strongly feel--and others are free to disagree--that a psych NP really needs some time working as an RN in an acute psychiatric care setting, preferably a hospital. There is so much to learn about mental health patients and the seriously mentally ill that cannot be picked up in an outpatient setting. You need to spend hours at a time with people so that you have an idea of what they might really be like when they aren't on their best behavior. Working an inpatient unit helps you learn firm but kind limit-setting, something that is harder to do in outpatient care. Recognizing when a patient is decompensating, thought-blocking, having flash-backs or intrusive thoughts, etc. is also best learned with hours of observation and interaction. Knowing how to de-escalate a patient or handle one who is agitated also takes hands-on experience.

I've seen several FNPs who have gotten their post-master's certification in psych/mh who do not have the experience with seriously mentally ill patients and it shows in their work and interactions with patients.

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Specializes in Med surg, cardiac, case management.

Thanks everyone.

This confirms what I've read elsewhere...that psych NPs primarily manage medications rather than do therapy, and focus primarily on psychotic disorders, usually in an inpatient setting.

Not really what I'm looking for...my own interests lie more in the adaptations of normal people to severe/chronic/terminal illness, rather than to actual mental illnesses like bipolar and schizophrenia.

But that's helpful to know.

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Actually, most of the psych NPs I know work in outpatient settings. I wouldn't say psych NPs focus on psychotic disorders either, but they do need to recognize and have some experience managing someone exhibiting psychosis or paranoia.

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I am planning to take the Psych NP Certification Exam. How can I find the specific dates offered on the ANCC credentialing site?

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I think you can schedule the exam at your convenience at certain testing centers that offer computerized tests such as the GRE and NCLEX exams. You have to turn in certain documentation to get permission to take the test.

http://www.nursecredentialing.org/certification.aspx

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Specializes in Psychiatry (PMHNP), Family (FNP).

HI all. I think Lucianne is on the mark suggesting that psych. nsg. experience is invaluable in your work as an NP in psych. I've said in other posts, I think that you can pick that up elsewhere too, as there is a lot of psych. in many areas. But there was so much to learn as a psych. nurse, I'm so pleased I did that for 10 yrs. or so, I never would have the scope of knowledge I now have to draw upon. Also to answer "Sandbetweenmytoes" : I first completed my FNP even though my background was in psych. I did that as I believed there was so much psych. in primary care and vice versa, that it would make sense. It was a lot of clinical time however to get credentialled in both areas. I got a post masters certificate as a psych. nurse practitioner, it took about another year. Now I work in psych. but am glad to have the FNP credential as I might like to teach down the road, getting a DNP currently.....And one more thing: I notice a lot of nurses having a bad experience on "the psych floor" - having worked on so many "psych floors" they can be quite different from one another. If you have only worked in one psych. place, maybe try to find a different environment. I worked at one place once that was all affluent clients in a bucolic setting, deer running around and everyone dressed to the nines. So there are a lot of different settings, maybe you can find one you might like! Best of luck!

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Specializes in Telemetry, LTC, Psych.

Lucianne-

Im considering getting my NP in psych as well. I have worked on a acute adult unit for 10 months and completely agree that you need that time on a floor to get a handle on what psych patients are. How long though? I dont know how much longer I have but I know I have to pay my dues.....

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I think 2 years is good. That way you get through the seasonal variations twice and will have another year to build your confidence and hone your skills. I started taking one class a semester during my third year and then the class schedule got to be too much because of the way it was set up at the time and I had to quit. It's been changed since then and would probably be easier for students to continue working at least part-time while going to school. Good luck! I love my work.

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