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.
If you're pursuing a PMHNP path because it requires less hours, or is less work , or because the pay is higher , you may be disappointed in the outcome . Maybe I'm misreading, but a practitioner st the PMHNP level should involve rigorous academics , plenty of unpaid clinical, and experience working in the psych field to boot . Preferably as a psych RN . Counseling and social work are admirable paths but don't come close to the amount of medication knowledge you'll need to prescribe, let alone monitor for side effects . Yes, the NP role includes therapy but the role is intense on psychopharmacology, pathophysiology, assessment skills, etc . Combining the NP role with counseling , it's a nice thought but have you considered how that will be a billable service ? Medication management is not counseling.
You might consider a program that splits into BSN , so you can work as an RN , then progress to the PMHNP level . I'm not dissing social workers or counselors but their role and knowledge of psych meds is very different than that of an RN . Some employers try to blend the roles of social workers and RNs under case management, but the SW and counselors will fall short on med and symptom management. Being an excellent psych nurse is an art form in itself. Choose the RN and MSN path after you've thoroughly evaluated it and you're aware of the role differences . It is not just counseling.
For those thinking that an honest perspective from the NP in the south was rude or negative, be thankful for honesty and the perspectives of many . I didn't find anything discouraging about her description about the role , maybe it's not the glitter and fluff fed to students by MSN programs?
Here's a reality check for anyone thinking that differing experiences and perspectives automatically equate to a negative reply... pool your evaluation of a career choice from multiple people and sources . Get the good and the bad , because many people may try to mislead you with the good .
And if your feelings are easily hurt , you might consider another specialty or path. Psych nurses will give it to you straight whether you like it or not . Guess what? So will your patients . If you think that the field of psych nursing and or psych NP is a happy rainbow where you save depressed people every day and all is well , you're in for harsh learning . This is why so many nurses recommend nurse experience first! Psych and other areas ..
Ask for the good and bad and you'll get honest answers, but if its hand holding and a pat on the back you're seeking , good luck .
For those of you who are already PMHNPs, I am wondering about the breakdown of your day. What percentage of your time would say is medication management vs. psychotherapy? Do you think this varies by the setting you practice in? I am considering the field and am trying to get a better sense of day to day life. I have a BA in psych and BSN. Thank you.
I do talk to my patients, those that are capable of having a conversation, but very little of what I do would qualify as real psychotherapy. Supportive counseling, maybe.
For a psych NP, it is all about medication management.There are very few jobs where you will have hour long appointments. None that I am aware of.
You will see 3 and sometimes 4 patients an hour. This sounds harsh, but it really isn't.
I work in LTC, so I do a fair amount of staff education.
Thx for this post! I am returning for my post psych certification and i live in KY/IN and the job market for psych is very lucrative in my area and in different parts of the country! needed the positive energy!THX
Ok these posts are extremely old, but I feel the need to post LOL. I am from NC and as a RN I made very little until I went to an Army medical center. So graduated in 2009 making 21/hr on med/tele. Moved up to Interventional radiology ending in 77,900/yr. Moved to CA in 2017 and my base salary is 118k. Noe I switched to Case management and make 64.93/hr. I will be starting MHPNP school this fall. There is a HUGE need and avg pay is 70-90/hr and a definite solid 6 figure. That being said, the south is infamous for underpaying nurses on any educational level. My friends that are ANPs,FNPs,etc do not make what I make as a staff nurse here in CA. Cost of living? Well, Im in SoCal & pay 2400/ month for rent. To buy Im looking at 470k homes, but my pay compensates for the cost of living. Now, with all that being said, I chose MHPNP because it is my dream, my goal, my passion. Do I have unrealistic expectations. Um No.. My point is the south sux with pay. Always have & most likely always will. Shall that defer you from your goals? No, not in my opinion. Do what you want and let the rest follow... :)
Applied and got accepted into a well respected and rigorous pmhnp program with a year experience before my first classes (I do plan working while in school) 3 total before moving into practice. I have a few qualms about not having medical experience but from what I’ve observed everyone is medically cleared and medical staff are within close reach. I float a good amount by picking up other shifts with adult and dual dx patients while working primarily with children with psych and behavioral issues I dabble into some detox as well. Should have 3+ years inpatient acute psych before graduating. I’m legitimately startled from what I hear about compensation. Everyone gets a job in my area 140-150k base normal hours. You can pick up two units at a facility near me and make 1k per unit per day as a perdiem during the weekend, if you’re up to the decent work ethic, the math is amazing. Location is crucial tho. Idk about the south but in the northeast you’ll be sitting pretty. I sponge as much as possible while working inpatient. I will challenge myself to help my patient as much I can medically. I’ve considered going perdiem and then picking up a full time job in an ER but find that almost counter productive if I’m working on a APRN Psych degree soon. I do agree with pretty much everything said so far. Would love any feedback from the community
Most do not. It is probably a compensating factor in a borderline admissions scenario but the emphasis will be grades, and GRE (if they require a GRE score). Also there are plenty of jobs in places like Maine, New York, Washington, and Oregon where being able to spend 30 minutes per patient on medical management appointments is the norm and up to 90 minutes on initials. Essentially the more the practices are IP or practices owned by psychologists rather than MD’s usually the better the practice environment.I’m new and in Washington, but spent three hours with a new, complex client yesterday (of course he still only paid my $300.00 cash intake fee, so the decision to spend that much time has financial consequences).
I'm just so curious why for years people have said there is so much money, money, money to be made as a PMHNP and you don't need any, or very prior little experience.
And if that is all the case, how the field is not completely over-saturated by now, considering how ridiculously easy it is now to get any NP degree.
I realize we can't all live in Honolulu, San Francisco, NYC, or Boston.
Some of us will have to live in very dull places like Omaha, or Buffalo, or Cleveland.
Virtually all teaching degrees became useless by the late 70's when there were 100 candidates for every position.
On 2/25/2020 at 1:35 PM, myoglobin said:
Most do not. It is probably a compensating factor in a borderline admissions scenario but the emphasis will be grades, and GRE (if they require a GRE score). Also there are plenty of jobs in places like Maine, New York, Washington, and Oregon where being able to spend 30 minutes per patient on medical management appointments is the norm and up to 90 minutes on initials. Essentially the more the practices are IP or practices owned by psychologists rather than MD’s usually the better the practice environment.I’m new and in Washington, but spent three hours with a new, complex client yesterday (of course he still only paid my $300.00 cash intake fee, so the decision to spend that much time has financial consequences).
I am a major cynic. How does someone with such an extremely complex mental health problem have 300 dollars? Unless someone else has given him or her the money.
I'm just so curious why for years people have said there is so much money, money, money to be made as a PMHNP and you don't need any, or very prior little experience.
And if that is all the case, how the field is not completely over-saturated by now, considering how ridiculously easy it is now to get any NP degree.
I realize we can't all live in Honolulu, San Francisco, NYC, or Boston.
Some of us will have to live in very dull places like Omaha, or Buffalo, or Cleveland.
Virtually all teaching degrees became useless by the late 70's when there were 100 candidates for every position.
I am a major cynic. How does someone with such an extremely complex mental health problem have 300 dollars? Unless someone else has given him or her the money.
That is a reasonable question. Certainly many of the clients that I worked with in clinical (in Florida) were as you describe and had little other than Medicaid (if that). Still many of the clients that I see in Mountlake Terrace Washington earn six figure incomes and yet struggle with issues ranging from anxiety and depression to ADHD, and PTSD from different sorts of traumatic experiences. At my other job in Redmond Washington (well really my second job since my third is doing disability examinations on Sunday) the clientele is even more financially blessed with different needs and creating different challenges. One place in the Washington DC area (where I obviously did not end up) told me that their average patient earned well over 200K and that they did not take any form of insurances whatsoever. However, another job (again one that I didn't get) was in Northern Montana on a Native American reservation where they said about 70% of the children were abused and most of the women that I would treat had been raped (and they would have flown me in for one month stays at a time followed by two weeks off to live in a motel not connected to the outside world except by air). One conclusion is that there is a need (or perceived need) for mental health services that covers a wide spectrum of the social, political, and economic spectrum of society.
Also, I don't know that there is "so much money" in PMHNP nursing just that "at the present time in specific markets" there exists a combination of supply and demand and scope of practice that can facilitate a good income (or in my case potentially one sufficient to make some progress on my debt). Is it great compared to other options? That is hard to say. One of my best friends from the Orlando area who is "just" an RN with an associates degree is working as a Travel nurse in the San Francisco area with his wife (also with an ASN and just over one years experience) and they are each earning around 150K or nearly triple what they earned in Orlando. Is there a great deal of money to be made as an RN? Well, maybe depending upon the market, your individual circumstances and your ability to adapt to the situation. Any situation which overcompensates will tend to "self correct" and eventually what was "great pay" and tremendous opportunity will tend to diminish (the law of supply and demand is a real pain). Thus, my SO started working as a tele health provider straight out of NP school back in 2016 with absolutely no mental health experience earning $85.00 per hour and working from home (1099, really good money for Florida). However, in 2019 I found "those" types of jobs wanted two to three years of experience and even then rather than "guaranteeing" 40 hours per week were just going to pay "when they had a need". Furthermore, that $85.00 per hour which was great when she graduated has become less "golden" now that she has four years experience and the appointments which used to be 30 minutes have been cut to 20 and the charting computer system has become so slow that she has to spend about ten hours per week "off clock" to get her work done (not to mention she cannot get her Medicaid clients counseling most of the time and even when they are clearly homicidal or suicidal she often can't get the local crisis team to respond so she gets to play "license roulette bingo" every day). Thus, the "telepsych" market has at least to some extent "self corrected". So maybe today Seattle pays great, but maybe tomorrow I will have to work in Point Barrow Alaska to make less money, and work 50% harder. Then again perhaps Covid-19 will intervene for me and settle my destiny sooner either financially by disrupting client flow or physiologically in a more direct manner.
My goal isn't to present anything as a "sure thing" but rather to present the facts as I understand them. Thus, I have listed (in other posts) actual companies where I have been offered positions (for example Phoenix Mental Health in Flagstaff Arizona which offered me $100.00 per hour 1099 with a paid lunch and one hour of paid admin time per day) to Heart Centered Counseling in Fort Collins Colorado where a great guy name Adrian offered me 60% of insurance (to increase to 70% after one year) to work as a PMHNP and where most of the NP's earned in the 150-225K range (and had full authority to set any appointment lengths they felt appropriate) to Behavioral Health Services North in Plattsburgh New York which offered me 175K with benefits. These are real jobs that others might benefit from knowing about (or at least the locations) All of these jobs offered to someone who graduated with an MSN (not DNP) with minimal psychiatric experience and the interview, and social skills of jabba the hut.
hrnurse
26 Posts
If you're pursuing a PMHNP path because it requires less hours, or is less work , or because the pay is higher , you may be disappointed in the outcome . Maybe I'm misreading, but a practitioner st the PMHNP level should involve rigorous academics , plenty of unpaid clinical, and experience working in the psych field to boot . Preferably as a psych RN . Counseling and social work are admirable paths but don't come close to the amount of medication knowledge you'll need to prescribe, let alone monitor for side effects . Yes, the NP role includes therapy but the role is intense on psychopharmacology, pathophysiology, assessment skills, etc . Combining the NP role with counseling , it's a nice thought but have you considered how that will be a billable service ? Medication management is not counseling.
You might consider a program that splits into BSN , so you can work as an RN , then progress to the PMHNP level . I'm not dissing social workers or counselors but their role and knowledge of psych meds is very different than that of an RN . Some employers try to blend the roles of social workers and RNs under case management, but the SW and counselors will fall short on med and symptom management. Being an excellent psych nurse is an art form in itself. Choose the RN and MSN path after you've thoroughly evaluated it and you're aware of the role differences . It is not just counseling.