Best path to PMHNP?

[kubelkabondy, ADN, RN]

So I'm halfway through my ADN program and just finishing up with my med-surg II clinical rotation. Although I've survived, I don't feel very competent as a med-surg nurse, and the fast pace of it as well as the amount of psychomotor skills you have to be proficient at intimidates me. 

I've always been interested in psych and I'm more confident in my ability to deal with behaviors and use therapeutic communication with patients than I am in my ability to perform the technical skills learned in lab. 

The other thing is that I know I don't want to be a bedside nurse long-term. I have psych clinicals next quarter, and depending on how they go, I might decide to pursue a career as a Psych NP. 

Two questions:

1) As a new grad RN, is it a bad idea to start out in Psych? Most experienced nurses I've talked to tell me to start out in med-surg cause then I will have the most skills and I can go anywhere from there, whereas if I start out in Psych, I will be stuck there even if I decide I don't like it. I understand that perspective, but at the same time I'm feeling more and more that I wouldn't like med-surg, or any other super high-acuity field of nursing so starting out in med-surg just cause it's a "smarter" career move doesn't really seem to add up.

2) If I do decide to go the psych route and pursue a career as an NP, what's the best route to get there? I already have a BA. Once I have my ADN, would I be eligible to apply for MSN programs or would I need a BSN first? And how many years of RN experience should I aim for before starting down that path?

 

[pro-student]

I wouldn’t worry too much about going into psych right away as a new grad if that’s what interests you. The advice that every nurse needs a couple years of med-surg is very outdated. Certainly it can be a great place to start but so can many other areas.  That being said, you’ll definitely want to wait until you do your psych clinical before deciding that’s where you want to take your career. 
 

In terms of NP preparation, there are programs that will accept students who are RNs will a bachelors in a different field so it wouldn’t be essential to get your BSN. However, if you wanted to broaden your options, it wouldn’t be a bad idea to get a BSN. Many programs are available designed for working nurses and accessible for new ADN grads. You might even find an employer who will help with the cost. How much experience you need it a hotly debated topic but I think it is, ultimately, a personal decision. Some programs open to new grads without any experience. Others will prefer 1-2 years. The NP role is quite different from the RN role and there is no evidence that experience as an RN translates into better preparation as an NP. Just like the med-surg advice, you will probably hear a lot of opinions about how much experience you need as an RN before going for your NP but there’s just no simple answer. Some people finish their RN program ready to continue on with their education. Some people need a few years to solidify their knowledge and skills and/or to determine what area they want to specialize in. 
 

All NP programs will begin with the 3Ps: advanced Pathophysiology, advanced pharmacology, and advanced (physical) assessment. If you really struggled with these (in an ADN program, you may not even have had full courses in the basics of these 3), then gaining some experience might be helpful. However, just working shifts as an RN isn’t going to improve your knowledge in pharacology or Pathophysiology or your assessment skills. You have to be very intentional about using your experience as a learning opportunity: asking questions of more experienced nurses and providers, looking things up, participating in continuing education. 
 

Ultimately, you have to do what is best for yourself and your career. Take all the advice with a grain of salt. If you feel like psych is your niche, then go for it. If you feel confident with your options without a BSN, then skip it. And when you feel you’re ready to advance your knowledge and skills to become an NP, then go for it. 
 

[kubelkabondy, ADN, RN]

On 11/23/2020 at 9:51 AM, pro-student said:

I wouldn’t worry too much about going into psych right away as a new grad if that’s what interests you. The advice that every nurse needs a couple years of med-surg is very outdated. Certainly it can be a great place to start but so can many other areas.  That being said, you’ll definitely want to wait until you do your psych clinical before deciding that’s where you want to take your career. 
 

In terms of NP preparation, there are programs that will accept students who are RNs will a bachelors in a different field so it wouldn’t be essential to get your BSN. However, if you wanted to broaden your options, it wouldn’t be a bad idea to get a BSN. Many programs are available designed for working nurses and accessible for new ADN grads. You might even find an employer who will help with the cost. How much experience you need it a hotly debated topic but I think it is, ultimately, a personal decision. Some programs open to new grads without any experience. Others will prefer 1-2 years. The NP role is quite different from the RN role and there is no evidence that experience as an RN translates into better preparation as an NP. Just like the med-surg advice, you will probably hear a lot of opinions about how much experience you need as an RN before going for your NP but there’s just no simple answer. Some people finish their RN program ready to continue on with their education. Some people need a few years to solidify their knowledge and skills and/or to determine what area they want to specialize in. 
 

All NP programs will begin with the 3Ps: advanced Pathophysiology, advanced pharmacology, and advanced (physical) assessment. If you really struggled with these (in an ADN program, you may not even have had full courses in the basics of these 3), then gaining some experience might be helpful. However, just working shifts as an RN isn’t going to improve your knowledge in pharacology or Pathophysiology or your assessment skills. You have to be very intentional about using your experience as a learning opportunity: asking questions of more experienced nurses and providers, looking things up, participating in continuing education. 
 

Ultimately, you have to do what is best for yourself and your career. Take all the advice with a grain of salt. If you feel like psych is your niche, then go for it. If you feel confident with your options without a BSN, then skip it. And when you feel you’re ready to advance your knowledge and skills to become an NP, then go for it. 
 

Thank you so much, that's really helpful. I think I will plan on getting my BSN first, just in case I decide not to go for PMHNP. 

Unfortunately, it looks like there's a good chance that Psych clinicals next quarter will be virtual due to COVID which would be highly unfortunate. Fingers crossed!