I dislike nursing but love therapy--PMHNP or LMHC?

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Specializes in PMHNP student.

Hi,

I hope I can get some opinions here. I am a little confused on which path to take. I became an RN (graduated last year) because my job of 16 years became obsolete (the entire profession--medical transcription--no earning potential anymore) and I was newly single again after a divorce and needed a career that would provide for me financially with relatively little schooling. I like healthcare but am finding out I am not enjoying nursing, at least in the hospital setting. I always dreamed of becoming a therapist/mental health counselor but had to get a job where I could earn quickly after a divorce and needed to support myself so I chose nursing, hoping there would be a path for me. I have thought about psych nursing and am interested in this, but am a little reticent because of stories of nurses being assaulted, and I'm a petite female so kind of fear for my own safety. I have also thought about continuing on and getting a PMHNP but my real love is counseling and not strictly medication management. I also know I would probably need psych nurse experience, which I have concerns about due to what I just stated above. I would love to get a master's degree and become a LMHC because the counseling aspect of psych is what appeals to me most, but I hear the market is saturated with master's level therapists and the pay is very low ($40,000 in my area). I need some advice, please--are my fears of becoming a psych RN a little extreme and unfounded? If I were to go for PMHNP, could I get an additional counseling certification so I could do a fair amount of that in addition to medication management? Thanks for any advice any of you can spare.

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I just got hired onto a psych floor, so I'm not going to have as much sage advice as someone whose spent years in behavioral health, but I think your fears are a bit unfounded...but I'm not dismissing them as a real concern that most people have. The potential to get assaulted exists on every floor, as there are psych patients everywhere in my experience. My ED friends can also attest to that. I think really the best you can do is take the necessary safety precautions, and don't let your fears get in the way of something you're passionate about. I think you should go for the psych np because it will give you a bit more versatility as opposed to becoming a licensed counselor, and I also think you should definitely get some experience around psych patients so you can have a good foundation of how all the behavioral disorders/illnesses are manifested.

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Specializes in Mental Health.

As someone already mentioned you can get assaulted in any setting in nursing not just psych. I work at a psych hospital and the patients can be very unstable and often violent so the potential for assault is a real concern. However, if your unit is well staffed and there is good teamwork and communication you should never be assaulted. Patients give off warning signs before they become violent and you will learn in CPI training how to identify these things and how to defend yourself and what to do in particular situations. I think you should try out psych nursing first to get a better idea of mental health care in general as this will also give you a chance to talk to therapists and see what their day is like. Counselors also have a chance to be assaulted but it may vary depending on the setting you work in. Hopefully you will find what you enjoy!

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Specializes in Correctional Nursing; MSN student.

PMHNPs can bill for therapy. You can definitely carve a niche for yourself as well as manage meds. I think the ER is one of the more dangerous environments in health care. Go for what you're passionate about! :singing:

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Specializes in Psychiatric Nursing.

I would go for the PMHNP. And I would get additional training in therapy--there is a lot to learn and it is very interesting.

When I got my MS in the early 90's, my foundation was therapy. Now I think the foundation is more biological.

I do locum tenens now and I have two places I return to. One is medication management but I get 1/2 hour for med follow ups and 1 and 1/2 hour for evals. So I am basically doing therapy and I know my meds very well. My other favorite job is a forensic psych facility. I function as an attending and it is like a fellowship, I learn so much about psychiatry and the law.

I was assaulted a couple of times early in my career- my fault both times. I learned how to approach situations, etc. there is a lot of training available and you learn to manage your anxiety and stay alert.

It is a wonderful field if you like it. Best wishes.

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I am a LMHC and I love it and do well in it. But my biggest regret is I didn't get my license as a psychiatric nurse Practioner as I could then prescribe meds which I can not do and must refer out. I'm lucky to have a lot of patients and make a good living (six figures) but talking to patient an hour at a time is a lot. Prescribing meds every 15 minutes would be nice and then I could do both. But in order for me to be a NP I would have to go to nursing school etc and it's way to much schooling. I wish there was a two year program for LMHC to become Psychiatric nurse Practioners! I'm envious of you!!

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Specializes in psych/medical-surgical.
I was assaulted a couple of times early in my career- my fault both times.

Damn, accepting fault for someone else assaulting you is pretty big!

It depends what you want to do/focus on. Unfortunately, our health system is heavily reliant on medication for reimbursement, therefore you will make more if you can give people medications and once you can give medication, you will likely be used for that since not many professions can prescribe. Whereas, there are many more professions that can do pscyho-therapy.

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