Question for the Psychiatric Nurse Practitioners

[rock hopper]

I have always been interested in the field of psychology and mental health. I thought for years that I'd want to go into Psychology before a few professors didn't actually tell me (wink wink) that it would be almost impossible to break into a faculty position once I got my PhD and that i'd be better off going to medical school, business or another route. I ended up choosing to go toward the healthcare field and instead of medical school, chose nursing.

Short story long, I'm still very much interested in mental health research and patient care and the role of a psychiatric nurse practitioner is very intriguing to me. I'm not going to sit here and romanticize about it like it isn't grueling, which it probably is. But i'd like to find out from a few in the field more about how an average workday goes, patient and patient caregiver interaction, roles taken if different than what most people think an NP does, level of autonomy, etc. I would like to be involved in research as well if that is an option down the road for me.

Attending nursing school next year for my BSN and highly interested in any responses. Thank you!

[LessValuableNinja]

I'm also curious on the responses.

[LPC2RN]

Rock Hopper,

First of all, I would like to say hello to a fellow former psychology student. I too enjoyed the psychology route and wanted to become a psychologist. It was not until a failed PhD in Clinical Psychology application process, followed by a failed PhD in Counseling Psychology application process that I decided to switch goals as I was not about to spend 150K+ on a PsyD to make roughly 70K a year. I decided to go the RN route but looking back on it, I probably should have chosen the MD route. Yes it is more school and hence more expenses and will take a little longer but when the payout is double what a Psych NP makes (and they are at the top end of the NP salary bracket), it works out over time. Is it too late for you to take that route?

To give you more current background on me, I will let you know up front that I am not yet board certified as a PMHNP but should be hopefully next month as I graduate this month. I have spent many hours in clinical experiences in both in-patient and out-patient and in private organizations and government organizations. Your level of autonomy is based mostly on the state in which you practice. I went to school in a very restrictive state and will be moving to a very autonomous state. With that move will come an ability to give additional medications, which would not be possible in the state I currently reside and it will provide me with a larger income.

The work itself depends largely on the workplace setting. Do you want to work in community mental health? If so, you will be exposed to a large, diverse patient population, many of whom are lower income. In this type of setting you may feel busy as you may be expected to see 3-4 patients an hour for med management. If you work for the VA, your patients' psychopathology will be pretty predictable (mostly PTSD and depression) but the workload may be lighter (2 per hour for med management). If you are in a private practice, you decide how many patients per hour, how many patients per day.

Regarding the "grueling" aspect of the training, yes it is. Where abouts in the training process are you? There are different decisions that will make the process either easier or more challenging. Will you go to school FT or PT? Will you work FT, PT, PRN, or not at all during your training? How long is the program? Is it an MSN or DNP? If you want to do research in the future, you may want to consider going through an MSN route to be able to start working as a provider and then enroll in a PT PhD program (if one exists, I wouldn't know as I have not looked into them) because most research is done in a university setting and most professors who are involved in research have a PhD as you well know.

Sorry if these responses are vague. You can PM me if you have more specific questions. Good luck.

[NightNerd, MSN, RN]

Also interested in the psych NP route, though I've got a few years to go before entering a program. Is it possible to work exclusively performing psychotherapy in this role? Or do most jobs typically end up being a mix of prescribing, therapy, etc.?

[elkpark]

Also interested in the psych NP route, though I've got a few years to go before entering a program. Is it possible to work exclusively performing psychotherapy in this role? Or do most jobs typically end up being a mix of prescribing, therapy, etc.?

The psych NP role parallels the role of psychiatrists -- predominantly diagnosing and med management, with little or no formal therapy. PMHNP programs don't really prepare people to be psychotherapists, and there are people in other disciplines who get paid a lot less to do therapy and are actually good at it. If you are self-employed, you can do whatever mix of activities (med management, therapy) suits you. But if you're employed by another individual or an organization, it will be primarily to do med management.

[LPC2RN]

Pretty much what elkpark said. Although you can find some PMHNP programs that have a stronger emphasis on therapy. I know the University of Missouri - Columbia has more therapy requirement hours than other programs. But this program is also DNP only.