Inpatient or outpatient PMHNP?

[Nursejesssica, MSN, NP]

I recently interviewed for two positions, one at an outpatient clinic and another on an inpatient psychiatric unit. I liked both positions and the organization but am still debating which would be a better fit. Are there any PMHNPs out there currently working on an inpatient setting? What challenges did you face with this environment? Are you glad you took an inpatient job?

This would be my first job as a PMHNP, although I have many years of psych inpatient experience working as an RN. I like inpatient but am also wanting a setting where I can spend more time getting to know my patients that is less chaotic. Thus the new provider dilemma:

Is it better to take a higher risk job in a more stressful setting where you will learn more and experience more (inpatient) OR is it better to take a more comfortable position with better work/life balance that is potentially less exciting and more redundant (outpatient)? 

[umbdude, MSN, APRN]

You can always do both. If you like inpatient, then start with an inpatient PMHNP job. Once you get the hang of it, take up an outside gig (a few hours a week) seeing patients outside. Both my preceptor and the PMHNP I worked with when I worked inpatient as a RN do this.

[Gentleman_nurse, MSN]

Also consider even with inpatient vs outpatient there are variations to consider such as mild & moderate severity vs chronic, socioeconomic diversity. General vs specialized treatment environments. Regional culture. My advice is to pick a niche. There are many nuances to learn that go beyond content knowledge. 

[Nursejesssica, MSN, NP]

Thanks for your input, umbdude and Gentleman_nurse! I decided to pursue an outpatient position in a community health setting. 

[mangopeach]

I've been a working NP in an outpatient community mental health clinic for a little over a year now and  some days I really dislike it.  I worked in a hospital my entire RN career. I'm at a cross roads to be honest about where to go from here. I miss being in the hospital and I miss working 3 days a week.   Every now and then I picked up an extra shift but to to go from working 3 days a week to 5 days has been challenging.  

I find working 5 days a week really draining. The documentation is never ending. It's not a 40 hr/week job.  Its a good thing I am single with no young kids. I don't have a healthy work life balance.  I relocated for this job so I don't want to throw the towel in just yet. Trying to stick it out for another year. But I keep looking. Recently considered a hospital position with a 7 on 7 off schedule. I procrastinated and did not apply for it.   

 

[FullGlass, BSN, MSN, NP]

On 9/23/2020 at 5:45 PM, mangopeach said:

I find working 5 days a week really draining. 

 

There are mental health facilities that have a 4 ten hour day schedule - look around for one.  Telehealth for mental health is booming, so there could very well be opportunities for you where you could set your own schedule.

[mangopeach]

On 9/25/2020 at 9:13 PM, FullGlass said:

There are mental health facilities that have a 4 ten hour day schedule - look around for one.  Telehealth for mental health is booming, so there could very well be opportunities for you where you could set your own schedule.

I have been looking at Telehealth and doing my research on the various companies.   Some that I've looked at say they want 2 yrs experience, I only have 1 yr so I don't know if that is set in stone. I am going to start the licensing process for other states to get the ball rolling.