Any Psych Nurse Practitioner's out there?

[HealingThoughts]

I recently made the choice to switch from a Mental Health Counseling program to an Accelerated BSN program. With the ultimate goal of obtaining an advanced degree (PMHNP). This was an informed decision based on some things I learned when talking to graduates of my old counseling program. The short story being that PMHNP's seem to earn more and get more respect than LPC's.

I'm also an older student (in my 40s) but will start taking my nursing pre-req's soon. I'm very clear about my path but do have some questions.

- Is it true that Mental Health Nursing is not a popular career choice?

- What is a typical day like for an Advanced Practice Mental Health Nurse?

- Do you feel well compensated salary wise?

- What is the job market like for PMHNP (I've heard there's a huge demand).

I'm 100% sure about my career choice. I love psychology but am really excited about learning more "hard science" when it comes to anatomy and physiology. My goal is to work really hard and get started on my new career ASAP.

[myelin]

Carlyjo said:

I am writing this in honesty because I feel like everyone considering becoming a PMHNP should be aware:

I am a PMHNP and graduated Fall 2012. I would like to know where PMHNP are earning 80% of what a psychiatrist earns??? I can tell you in my area of the country, that is not happening. Furthermore, it took me 4 months to find a job after passing my ANCC exam. I started about $80,000 and so did the rest of my classmates, including those who moved to take jobs all over the country. Some states have higher salaries but this correlates to the cost of living. What if you cannot find a job for a few months after graduation? Will you be happy accepting $70,000-80,000 a year, while relocating to get that? Many new grad NPs have problems finding employment. There is definitely an oversaturation of PMHNP in many areas of the country. Also, foreign residents are jumping at the chance to match in psychiatry because this specialty is one that foreign residents can be confident of getting into the US( I am not even going to get started on this issue). Even in the independent states, I think a psychiatrist must supervise a PMHNP for certain reimbursement. Unfortunately, a PMHNP cannot replace a psychiatrist.

That being said, I know 2 PMHNPs who make six figures but they did not make this until they had over 5 years of experience. Their job also requires massive on-call. These same NPs had a good relationship with a psychiatrist who helped advocate for their salary. The average salary for a PMHNP is $95,000 a year and this includes locum rates. Yes, some make higher but most make lower and this average comes from jobs that do not include benefits. Locum rates are good for Psych NP, but I still have children at home and cannot be bounced around.

I plan on returning for my DNP/FNP and I wish that I had gone the FNP route in the first place. A FNP can fit themselves into many roles. Some states still allow FNP to replace PMHNP. I had several FNPs tell me this but I did not listen to them. Reimbursement by Medicaid/Medicare is generally no higher for FNP versus PMHNP. FNP can see more patients a day than PMHNP, and bring a practice more money. Many people will never seek mental health treatment, but all people will have to see a medical provider. Some of the best places for FNP are pain management and dermatology. FNPs in these areas do make six figures.

I love psych, and if you really want to be a PMHNP I do not want to discourage. If you go FNP you could always go back for PMHNP and be very marketable. I do believe everyone that is considering this area of specialization needs to have a realistic view of what the job market is like. Severe oversaturation has occurred in my area. The wild rumor of riches as a PMHNP are not true. If you are willing to relocate, you probably will find a job. Schools also want to promote their programs, most are not honest concerning the job market or salary. Please be aware that searches on indeed also include locum and recruiters where a job may not exist or an employer may have hired several recruiters to market for the same job.

I am a graduate of a great school with an excellent reputation and network. I had to take loans because I was not in a financial position to do otherwise. I have 15 years of psychiatric nursing experience, and my hourly wage as a RN was high. I had to go PRN during school, and my PRN rate was even higher. After my loan payment, I make no more money that I did as a staff RN. This was a severe let down after all of the hard work I put in to get my MSN.

Hi Carlyjo,

I think your post would be a lot more helpful if we knew what part of the country you're in and around where you and your classmates have been applying? It seems like a lot of NP jobs are very dependent on local markets. Are you in the South? The experience you're describing seems very different from my area of the country (west coast/California), where all the PMHNP grads in my program's most recent class had well-paying jobs lined up prior to graduation.

[wildflower79]

You have a chance at VA hospitals, its always open and its a federal job

[TheDude77]

Carlyjo said:

I am writing this in honesty because I feel like everyone considering becoming a PMHNP should be aware:

I am a PMHNP and graduated Fall 2012. I would like to know where PMHNP are earning 80% of what a psychiatrist earns??? I can tell you in my area of the country, that is not happening. Furthermore, it took me 4 months to find a job after passing my ANCC exam. I started about $80,000 and so did the rest of my classmates, including those who moved to take jobs all over the country. Some states have higher salaries but this correlates to the cost of living. What if you cannot find a job for a few months after graduation? Will you be happy accepting $70,000-80,000 a year, while relocating to get that? Many new grad NPs have problems finding employment. There is definitely an oversaturation of PMHNP in many areas of the country. Also, foreign residents are jumping at the chance to match in psychiatry because this specialty is one that foreign residents can be confident of getting into the US( I am not even going to get started on this issue). Even in the independent states, I think a psychiatrist must supervise a PMHNP for certain reimbursement. Unfortunately, a PMHNP cannot replace a psychiatrist.

That being said, I know 2 PMHNPs who make six figures but they did not make this until they had over 5 years of experience. Their job also requires massive on-call. These same NPs had a good relationship with a psychiatrist who helped advocate for their salary. The average salary for a PMHNP is $95,000 a year and this includes locum rates. Yes, some make higher but most make lower and this average comes from jobs that do not include benefits. Locum rates are good for Psych NP, but I still have children at home and cannot be bounced around.

I plan on returning for my DNP/FNP and I wish that I had gone the FNP route in the first place. A FNP can fit themselves into many roles. Some states still allow FNP to replace PMHNP. I had several FNPs tell me this but I did not listen to them. Reimbursement by Medicaid/Medicare is generally no higher for FNP versus PMHNP. FNP can see more patients a day than PMHNP, and bring a practice more money. Many people will never seek mental health treatment, but all people will have to see a medical provider. Some of the best places for FNP are pain management and dermatology. FNPs in these areas do make six figures.

I love psych, and if you really want to be a PMHNP I do not want to discourage. If you go FNP you could always go back for PMHNP and be very marketable. I do believe everyone that is considering this area of specialization needs to have a realistic view of what the job market is like. Severe oversaturation has occurred in my area. The wild rumor of riches as a PMHNP are not true. If you are willing to relocate, you probably will find a job. Schools also want to promote their programs, most are not honest concerning the job market or salary. Please be aware that searches on indeed also include locum and recruiters where a job may not exist or an employer may have hired several recruiters to market for the same job.

I am a graduate of a great school with an excellent reputation and network. I had to take loans because I was not in a financial position to do otherwise. I have 15 years of psychiatric nursing experience, and my hourly wage as a RN was high. I had to go PRN during school, and my PRN rate was even higher. After my loan payment, I make no more money that I did as a staff RN. This was a severe let down after all of the hard work I put in to get my MSN.

The Psych NPs in my area (ky) are few and far between. The ones I know work outpatient and on call for MDs as well as inpatient. They make as much as they want....very self driven. You can take on as many patients as you would like. I know in some states, Psych NPs are not allowed to open their own practice but in ky you can. I'm sure just out of school new grads won't make 80% of a psychiatrist's salary but once you build up your patient load you will.

[TheDude77]

Carlyjo,

If you don't mind me asking (and you don't mind answering), how much do you owe in student loans?

[Carlyjo]

Yes, I live in SC. Oversaturation currently exists in SC, TN, KY and NC is filling up as well. There are very few jobs in KY, a girl in my class from KY had to move Arizona to get a job. She told me places in the area were skittish about hiring a new grad. I also think that a big problem exists with some MDs in the area being territorial in the South, I know this is true in SC. My husband is disappointed as well, but he is firm on not moving West. In the West jobs are still available, but that is the point I was trying to make. The South is not a good area for PMHNP and those that live in the South contemplating on PMHNP need to know this.

[myelin]

That's such a bummer about how tough things are in the South. Correct me if I'm wrong, but did you attend an online program? It sounds like many of your classmates were spread throughout the South? That can also be hard for networking (as opposed to an in person program affiliated w/a med center).

[TheDude77]

Carlyjo said:

Yes, I live in SC. Oversaturation currently exists in SC, TN, KY and NC is filling up as well. There are very few jobs in KY, a girl in my class from KY had to move Arizona to get a job. She told me places in the area were skittish about hiring a new grad. I also think that a big problem exists with some MDs in the area being territorial in the South, I know this is true in SC. My husband is disappointed as well, but he is firm on not moving West. In the West jobs are still available, but that is the point I was trying to make. The South is not a good area for PMHNP and those that live in the South contemplating on PMHNP need to know this.

I politely disagree with this. KY One Health will soon be hiring PMHNPs, there is great need in the areas right outside Louisville, correctional facilities and the VA are always posting PMHNP positions. The psychiatrists on my unit encouraged me to enroll in the program to help them out. There is no one to be on call for them currently with the accept ion of two Psych NPs. It could be that we work in a facility that will not turn ANYONE away. The MDs have so many patients and so little time. I think it's more about who you know than searching for job postings.

[Carlyjo]

Actually, I went to The University of North Carolina at Chapel Hill. The program is ranked 11^th by Us News & World Report. They are mostly distance learning, so my classmates were spread throughout the South. Vanderbilt is “online” now, BTW. Vandy has a large class planned next year so there will be significant competition in your area. Vandy graduates are the cream of the crop. Sure hope you are going there or you have a good network, cause you’ll need it!

[TheDude77]

So did you just decide to come in here and bring everybody down because you aren't happy? And I guess you were too busy thinking of pessimistic things to say instead of reading my post where it says I'm already being offered jobs through my employers.

I really enjoy how you live somewhere else and think you have an expert idea of "my area". You don't live here or work here. You don't know how understaffed the region is. You don't realize that my "area" is a Mecca for the homeless who end up in my psych facility. You are not an expert on the fact that my "area" does not have enough mental health professionals in ANY job category.

Please post something positive and constructive instead of bringing your gloom and misery here.

Go get your FNP and prosper.

[TheDude77]

I'm sorry. I shouldn't have said some of the above things. BUT, a lot of us are looking for encouragement and while you have every right to express your opinion, I do not think you should discourage us and preach to is about our "area". Again, I apologize.

[Carlyjo]

Ella86rn,

I did not mean to offend you. I also do not mean to be pessimistic, just honest. If you already have a job offer from your employer, this is excellent. If you have the heart for psych then you need to be a Psych NP. The main point I am trying to make is that overall in the South, PMHNPs are underpaid and jobs are not on every doorstep. Other areas of the country must be in need of psych providers. I know salary ranges for jobs with benefits in the overall Southeast region start around $80,000. Those with a great deal of psych NP experience may hit six figures, but coming out of school this is not realistic in the South. Inpatient may pay a little more because it involves on-call, JCAHO, being responsible for seclusion/restraint, etc. I love my job and what I do, but I do not like how limited I am. The OP wanted an honest answer from a PMHNP that has been in the job market. If you have the backing of a psychiatrist, opening your own practice could be an option. I think Arizona/New Mexico is where PMHNPs make the most. And I plan on getting my FNP for sure!

[TheDude77]

Again, I apologize.

Do you currently only do outpatient?