FNP to PMHNP

NJnewRN · May 6, 2013

No. If you know that you want to work strictly with the psychiatric population, I would advice you to find a FPMHNP program. That way you can work with all different age groups. If you are having doubts or not sure about strictly working with the psychiatric population, then go for FNP and do a certification as a PMHNP. I think you already know what you want. Good luck.

harmonizer · May 7, 2013

Yes, it is. The knowledge learning from being an FNP is extremely helpful. There are lots of comorbidities in psych (Parkinson's, hypothyroidism, HTN, pituitary issues). It will be best if you can manage both. You can work in the setting that you can utilize medical and psychiatric portion. Medical knowledge is very important for doing consult in nursing home or even as consultation liaison While you will get trained for the medical aspects as PMHNP, you will have more in-depth knowledge after working as FNP.

mzaur · May 7, 2013

IMO its totally worth it to take out $80 to 100k to pay for the PMHNP program. You can get loans to cover the whole cost. Then you can do an NHSC loan repayment program where you get $60k toward loans for a two year contract (on top of your salary). You'll be starting at $80k+ as a PMHNP, and if you are willing to move from your location, you could be making way more. I've seen positions in certain areas that start at $110k. My point is that the loans can easily be paid off. If you are willing to live frugally, they can be gone in

myelin · May 7, 2013

I also agree that you should go for PMHNP if you really want to treat psych patients. As a FNP, you're not going to be trained in very much other than basic psych, it's a separate specialty. Also, some states do not like FNPs practice in psych and more are cracking down on that. Also, I think psych NP is more lucrative. As with everything, it's all about your location. Can FNPs practice psych in your state? This will influence the demand for PMHNP services.

harmonizer · May 8, 2013

While a number of universities in my area offer the MSN-PMHNP, all are too expensive for me to attend

How expensive? If I were you, I would not do anything over $30,000. I went to in-state school. It only cost me ~$18,000k. I would not pay anything over $30,000 for just an MSN/DNP, PMHNP FNP ANP or whatever unless I can pay out of pocket without loan (6.8% interest). Try in-state school. Do not go to expensive online / private school. It's not worth it to pay high tuition. You can talk about living frugally to back loan.. but practically, you will be surprised how little you can save after $80k salary minus tax.. only if you want to leech on to parents longer and stay with them... it's a torture to save, not being able to eat out and starve, not being able to afford a plane ticket to enjoy vacations... it's a torture to pay back the loan..

chuckster, ADN, BSN, RN, EMT-B · May 8, 2013

Thanks to all but I think some further explanation on my part is needed.

I was really asking if it is feasible to transition from FNP to PMHNP and what was involved in doing so - not if it was feasible to practice as a PMHNP with "only" FNP recognition.

As to cost, the difference between the FNP at the college I'm considering and the PMHNP programs at the other local universities is quite large. The FNP will run less than $28k, the range for the PMHNP programs is from about $60k to over $100k. I was hoping that I could get the FNP, then only have to take a few additional classes to get qualified to sit for the PMHNP exam. My fist degree was in psychology, which is why I'm interested in PMHNP

Regarding student loans, they are not an option and I believe that they should also be out of the question for most folks. Borrowing $100k at the current 6.8% interest rate spread out over 10 years equates to a monthly payment of over $1,150. Add rent or mortgage payment of say $1,000 (a very low figure in most places these days) and then some other necessary items (insurance, utilities, transportation, etc) that will total perhaps $800 and you now are paying nearly $3,000 each month. In order to handle that kind of expense load, you would need to earn over $100k. And you would not be able to put much, if anything aside for retirement (the average person today will need a retirement nest egg that is well over $1 million to live reasonably comfortably - even adding social security to the mix). Starting salaries for NP's in my area are only in the $75k range because of the general oversupply of all advanced practice nurses. PMHNP's earn more but not that much more and it will take a number of years for any new PMHNP to get to the $100k level. It would be extremely difficult for the average PMHNP to keep their head above water with that high a debt load.

On top of all that, changes in the law have made student loans essentially non-dischargeable. That means, if you get ill, loose your job or have a lot of unplanned expenses, you still have to pay your student loan back - it cannot be discharged by a bankruptcy court (technically it can but it happens very, very rarely). At present, the amount of outstanding student loans is over $1 trillion - only mortgage debt is higher. My advice, as someone with an MBA from a top 50 school, is that borrowing for education really should be an absolute last resort. Besides, I'm still paying off my kids' college debt (which I financed out my retirement savings because I did not want them to borrow).

Sorry for the soap box on student debt but I really think that it's a ticking time bomb that is poised to take down a whole generation.

Again, thanks to all for the input.

mzaur · May 10, 2013

I know you're worried about student loans, but the government guarantees them, and the US government isn't going anywhere. Maybe it is a bubble, but it's not going anywhere anytime soon. You shouldn't worry about not paying off your loans. Like I said, it can be done in 4-5 years, especially if you do NHSC. You'll have no problem getting a job as a PMHNP. The demand is very good. I'm not sure what changes in law you're referring to, but the fact that student loans cannot be discharged in bankruptcy is not a new phenomenon.

As for transitioning, you can look at specialty certificate programs for those who already have an MSN. BC has one Additional Specialty Certificate - Connell School of Nursing It will be expensive I'm sure. In the end I think you'll be spending more money doing the FNP -> PMHNP route. Also take into consideration that you'll be spending extra time doing this, time that you could be working. Factor in that you'll be making at least $80k per year, so that's how much you'll lose by taking an extra year to do the PMHNP specialty course.

mzaur · May 10, 2013

Starting salaries for NP's in my area are only in the $75k range because of the general oversupply of all advanced practice nurses. PMHNP's earn more but not that much more and it will take a number of years for any new PMHNP to get to the $100k level.

If you are willing to move, you can earn more. Like I said, I've seen job listings starting at $90-100k for new grads.

It would be extremely difficult for the average PMHNP to keep their head above water with that high a debt load.

You are clearly scared of debt, and I understand, but what you're saying isn't true. Student loans are income based, and there are a lot of programs out there for nurses (scholarships, loan repayment programs, etc). And even if you are making $75k, you can live frugally for 5 years and put away $20k toward loans per year (if your debt was $100k). Again, if the pay sucks in your area and the cost of living is high, you can always move.

If you have dependents, then this is probably not a good idea.

On top of all that, changes in the law have made student loans essentially non-dischargeable. That means, if you get ill, loose your job or have a lot of unplanned expenses, you still have to pay your student loan back

This is not technically true. Student loan payments are based on your income, so if you are not working for whatever reason, you can defer your student loans.

My advice, as someone with an MBA from a top 50 school, is that borrowing for education really should be an absolute last resort. Besides, I'm still paying off my kids' college debt (which I financed out my retirement savings because I did not want them to borrow).

That was your choice. IMO, not a very good one.

FuturePsychNP · May 10, 2013

As others mentioned, the FNP would be helpful. It seems that psych patients generally have other diseases, as mentioned, and many don't really live a long time (subjective experience). Although the FNP knowledge and credentials would be a boon to you and your practice I do not see it as necessary. In my rural state, the FNP programs are cranking out grads who are having trouble finding jobs. The market is nearly saturated in all but the most BFE-type locations. The psych grads are currently writing their own ticket. If I were you, I'd wait and find a program that can give you that psych credential at the outset so you may go to work in your chosen capacity. If interested, you can always do the FNP anywhere as a post-master's cert.

spaceinthesky · May 13, 2014

I would like to jump in on this with a question.

I have 30k in loans from undergrad and prereqs by the time I'm done (went to cheapest in state school).

I am wondering what people propose as best idea for one who does not have rn or bsn or a bio major and needs to go to school more? I would like pmhnp. The direct entry is indeed expensive but it's in demand and I could keep moving on with my life toward my goals that way.

With the advent of the dnp, it looks like I would be the last to be able to do the msn.

Those loans are huge and scary. But working now not making enough is also scary. :) advice appreciated.