Dangerous to be psych NP

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So I'm working on school to become a psych NP and my family and boyfriend are very worried this job is to dangerous or that clients will come stalk my family. They also worry for the increased cost of this program over family NP it won't return a good investment considering the cost. Any input?

Oh and I'm figuring they are so worried because the psychiatric inpatient unit I work on now has violence against staff often, with one RN getting beaten and just the other night a patient putting a RN in the ER over a injury to the nurses eyes. Should I really reconsider this?

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Specializes in Family Practice, Primary Care.

No, you'll be fine. Providers are rarely assaulted, even in psych. Drug seekers worry me more than those with mental illness. Someone with a psychiatric disorder is far more dangerous to themselves than others. Psych NPs make great salaries and you can work outpatient managing schizophrenia/ADHD/bipolar/depression/etc and not work inpatient. And you'll always be employed considering the need for it. I only know of one nurse whose ever been assaulted by a psych patient, and he was on bath salts when he did so. Never known any psych NP to be assaulted, or psychiatrist for that matter.

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You are much more at risk being an RN in-patient in psych. Pysch providers typically stay far away from being assaulted and can recognize a bad situation from a mile away.

As far as return on investment, if you search around this forum: 120k - 160k seems pretty reasonable to find for a salary. As an Independent Contractor/Entrepreneur you can earn around 200k.

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Wow. Ok that really cleared things up. I will go for my certificate in psych NP like I planned to after I finish my masters in March. Is Drexel a good option? I know they cost like 60k

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I am concerned by your support system's bias against the mentally ill.You are experiencing the stigma as a PMHNP (and you haven't even started the program!) just as your patients face the stigma of mental illness. You are choosing to work in a challenging field.Mental illness is a waxing and waning disorder.You will face the dual challenges of addiction and psychiatric disorders . I enjoy the challenges of being a PMHNP-BC. In my opinion,salary is important but you need to enjoy your profession. Keep in mind there is a reason PMHNP-BC are paid a higher salary .

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Specializes in Tele, Cardiac Post Op, ER.

I always thought psych NP paid loads more than FNP. Esp in my area. Plus look at the context for which you are talking about. Nurses are a going to be placed more at risk. They are the ones who are coming at psych patients (possible substance abuse problems or in acute psychosis) in the ER with needles etc.

Remember, always know your exit strategy.

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I am also going to enter a PMHNP program and my husband is skeptical for my safety. Probably is LEO years. I believe that with the proper training, as a provider you will learn to mitigate behavior, and talk your way around it. You should perhaps take a class on management of assaultive behavior and that will help the family to have confidence in your skills. In my current practice as an RN, I work with patients in crisis. I am usually able to figure out the issue of their acting out, and redirect. However, I also always plan for the worst case scenario and leave myself an exit route. Good luck to you. I think we are entering a rewarding yet challenging field.

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Specializes in Family Nurse Practitioner.
I am also going to enter a PMHNP program and my husband is skeptical for my safety. Probably is LEO years. I believe that with the proper training, as a provider you will learn to mitigate behavior, and talk your way around it. You should perhaps take a class on management of assaultive behavior and that will help the family to have confidence in your skills. In my current practice as an RN, I work with patients in crisis. I am usually able to figure out the issue of their acting out, and redirect. However, I also always plan for the worst case scenario and leave myself an exit route. Good luck to you. I think we are entering a rewarding yet challenging field.

Be very careful because in my experience those who think they are able to "talk them down" are often the ones who overestimate their therapeutic skills when in fact with a psychotic or antisocial patient there can be minimal reasoning. Those who consider themselves to be psych patient whisperers seem to get assaulted more often. Much of this will depend on the setting however if someone doesn't have significant inpatient psychiatric experience I'd be very cautious because there really isn't "proper training" especially not in a PMHNP program to offset the experience of navigating these tricky waters. There is definitely an increased risk of being assaulted for people working in psychiatry.

"According to the United States Department of Justice's National Crime Victimization Survey conducted from 1993 to 1999, the annual rate of nonfatal, job-related violent crime was 12.6 per 1,000 workers in all occupations. Among physicians, the rate was 16.2 per 1,000, and among nurses, 21.9 per 1,000. However, for psychiatrists and mental healthcare professionals, the rate was 68.2 per 1,000, and for mental health custodial workers, 69 per 1,000.1 And it appears that these events may happen early in one's career, as the literature suggests that 40 to 50 percent of psychiatry residents will be physically attacked by a patient during their four-year training program."

From:

Violence Against Mental Health Professionals: When the Treater Becomes the Victim

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Thank you for the interesting statistics. I would not consider myself a whisperer, just lucky I imagine. Unpredictability is, of course, ever-present. Planning for a worst-case scenario, in each room, in each situation helps to be better prepared, but will not prevent. I have a strong enough sense of reality so see this. The article you referenced is interesting, and a little disturbing.

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I have been a Psych NP for 15 years, including 13 years of forensics. Of course, there, we had security staff. I do not think that Psych providers are at any greater risk of violence than others.

The one time I did feel threatened, it was in an outpatient clinic with a drug seeker. I gave him what he wanted, the smallest dose possible, then I called his probation officer. Never heard from him again.

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I did Psych for many years and am currently not working in Psych because the patients seem to be far more violent than in the past. I think it's the meth. The straight mentally ill patients seem to be the easy population. The patients that are acutely psychotic due to substance abuse are a growing population and scare me. Even pot can kick it off in some people. The safety net in this country is very frayed and it is a contributing factor as well. With insurance cutting rates it is harder and harder to get people onto inpatient units and the ones that "qualify" are often very acute and violent. And lastly, the violent Mediaography and video games is a huge problem for some patients and serves to desensitize. Just my two cents. I am not saying not to do it, but it's good to know the risks.

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Nursing can be dangerous anywhere, a nurse at a psych unit in my area was killed by a patient during a restraint. In my area a patient was killed by staff during a restraint (NP's are unlikely to be involved physically in a restraint) at my current facility a med surg nurse suffered broken bones when a patient fell on them.

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