Differences between PMHNP and PNP: not rookie question

[mtg0884]

I have worked in both psych and peds. I enjoy them both to be completely honest in very different ways. Psych interests me more because I love pharmacology and I love neuro anatomy and physiology in terms of neurotransmitters and the like.

There is so much interesting research in psych with alternative therapies and non-tradition pharmacological approaches to a variety of conditions that makes it very unique and challenging. I've seen the same conditions treated so many different ways. For instance, Tourette's with haldol, tenex, topamax, nicotine, keppra, risperidone, etc. so many different options with completely different mechanisms from crushing dopamine with haldol to boosting gaba with topamax, he'll even going in the opposite direction with a dopamine agonist like pramipexole. Pairing a 7mg nicotine patch with 0.5-1mg haldol to make haldols MOA more efficient. Just an example. Cyproheptadine to reverse ssri sexual sides, inositol to make serotonin more effect, clonidine vs stimulants for adhd. Treatment resistant OCD to an SSRI augmented with anafranil and pushing doses of lets say Zoloft beyond the reccommended dosage of 200mg, increasing up to 300mg based on new research for OCD. Utilizing pramipexole to decrease prolactin which may be raised with an ssri to boost dopamine which will increase libido and counteract the the sexual side effects or augmenting with Wellbutrin for this issue. Benzos vs trazadone vs clonidine for insomnia. Etc, I am very interested in all of this and want to constantly learn it.

Pediatrics I like because I love kids but it is more cut and dry. Very little guess work, no room to be exotic and go outside the box much from what I see.

As an RN, I prefer peds, but as an NP, I feel Psych is a better fit for me. Does that make sense? Based on seeing them work from my 2 jobs, the psych np role def seems far more interesting to me.

The one thing I don't no, behind the scenes, what is the true difference between the two? Not patient care, disorders, etc. but rather the life behind the scenes. When you are not with the patients. The lifestyle and the role on the care team? Peds np seem far far far more busy, running around than the psych nps I've seen. I typically see the psych nps spend far more time with there patients but maybe I am missing things.

Thanks for for any help!!

[Barnstormin' PMHNP]

I never worked as a med-surg RN with peds other than my kids, but I have worked with them in psych. It is a very challenging area with kids and just as much creative thinking goes on in treating them. Psych is a great field with much more collaboration than what I see in other specialties, but that is just my bit of experience. As a PMHNP that specializes in peds, you could write your own ticket, have a great quality of life and never be bored.

[mtg0884]

I never worked as a med-surg RN with peds other than my kids but I have worked with them in psych. It is a very challenging area with kids and just as much creative thinking goes on in treating them. Psych is a great field with much more collaboration than what I see in other specialties, but that is just my bit of experience. As a PMHNP that specializes in peds, you could write your own ticket, have a great quality of life and never be bored.[/quote']

im not looking to specialize in peds per say.. But I wouldn't mind obtaining any certificates if available to become more competent in pediatric psych. I enjoy psych in general whether with adults or kids. I worked adult psych and ped med surge.

[MrChicagoRN, RN]

If you decide to enter a PMHNP program, they are now covering the lifespan, so you would get training in dealing with all ages.

[Psychcns]

Besides all you mentioned above there is psychotherapy and the relationship with the patient. Life behind the scenes depends on the facility. I am at a place now as a locum tenens provider where I see outpatients 1/2 hour at a time. Can do some therapy but mostly med evals. PTSD, insomnia, bipolar 1and 2, schizophrenia, comorbid substance abuse, etc. go to team 1/2 hour per week. communicate with team through email. Do notes and scripts during session. Most of your time is with the patient. Psych is very interesting.