Is it more practical to become a PMHNP or a FNP with specialization/cert in Psych

harmonizer · Sep 3, 2012

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BlueDevil,DNP, DNP, RN · Sep 3, 2012

I won't specify where I live, except to say it is an independent practice state. If you are looking for a psych position, try checking with Home - American Psychiatric Nurses Association.

The 50th percentile for FNPs here is $94,000 annually. Psychiatric NPs are paid significantly better.

myelin · Sep 3, 2012

It amazes me how much NP salary can vary. Psych NPs from my old state (ind. practice) made 106k on average, according to the state's salary website. I also know a psych NP who runs her own private practice (cash only) - she makes a lot of money. Of course, that won't be my route, since I plan on working with the underserved, so I plan on taking insurance, medicaid, etc. Still, I'm hopeful to make enough to pay off my loans.

myelin · Sep 3, 2012

Where is this? There's either no need in my area or employers just simply don't want to pay well. If this is the case, I feel that the pay doesn't not reflect the demand at all at where I live. Due to low autonomy in my state, they can just easily grab the willing FNP providers or PA with no psych background for training. Can't blame on not having enough provider when the pay is below market rate. In the states where NPs are more independent, employers will prefer NP over PA due to less work for the collaborating physician.

That really sucks. It sounds like since your state doesn't have independent practice and also allows just about anyone to practice psych, you're not in a good position to negotiate.

BlueDevil,DNP, DNP, RN · Sep 4, 2012

With bonuses (which should account for 30-40K), I will make more than $150k this year, my 3rd year in practice. I don't have any school loans, I paid as I went from ADN to DNP, over a 20 year span. I wouldn't change a thing.

J-Swish · Sep 4, 2012

Hmm...so this is what I'm gathering.

PMHNP - More or less job offers depending on location, in steady demand for such Psych professionals, different rates vary state to state

FNP - A good overall safety net, more jobs, oversaturated market of FNP's however, able to treat Psych with cert/training

If I go the PMHNP route, I could potentially become an FNP later down the road, correct?

And of course, if I become an FNP first, I could do PMHNP later on as well.

Obviously, I think my heart is set for mental health but my conscious is telling me "No, it's not an economical and financially safe choice." Still, if I were to do FNP > PMHNP or PMHNP > FNP, I would have to pursue a DNP regardless and that's something I am not wishing to go for.

I have the added flexibility of moving to any place, any time but I am looking at California or Texas only to be close to family. I don't have much stuff, I'm single, no kids, just a youngster. I can pack my stuff in an hour and be on my way. As long as there's a Fresh & Easy nearby, my life is set lol

myelin · Sep 4, 2012

Hey J-Swish,

I'm like you in the sense that I am willing to move wherever, don't have kids, no mortgage, etc. I decided to go with PMHNP because it's my passion, and I also feel that it is a very safe choice financially. I think the demand is only going to go up as healthcare reform comes into play and insurance companies will be forced to cover psych, also keep in mind that 70% of psychiatrists are over 50... the need for providers is going to only increase. However, it is a shame how some states seem to shackle NPs and make things harder from them. I plan on avoiding those states.

I also am thinking about going back and re-certing as a FNP later on, but I chose psych for the first go around as it is what I love most. Good luck!

Also, I'm not sure if FNPs can treat psych with just some training. Many states are cracking down on NPs practicing outside their scopes of practice (ie: FNPs working in the ICU).

BlueDevil,DNP, DNP, RN · Sep 5, 2012

A lot of psych issues fall into the realm of family practice and internal med. I'd say 1/3 of my patients, easily, take a SSRI. Perhaps 1/2. So you do get some psych in FP, but you also have to see Zenman's dreaded runny noses, lol. I could do a lot more psych, I just refuse to deal with most of it. If they need haldol, hear voices or have harmed themselves or anyone else, they are out of my league! Unfortunately, it is impossible to get them in with psych, so I send them to one of my colleagues who is more comfortable with major mood disorders, and he sends me everything that needs to be incised, biopsied or cut up in any way. We all have strengths and weaknesses!

psychgirlRN · Dec 9, 2015

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marigoldey · Sep 13, 2016

I know this is an old post, but hoping the posters here can help......which States require additional certification or training to treat psychiatric patients as an FNP? Which certification or training are you referring to, a post-masters cert? I have seen job announcements for "looking for an FNP with psychiatric nursing background" but other than that, I haven't seen a specific ad for FNP with additional psych training aside from getting a certification in psych post-masters level. Thanks for any help. I've often wondered this.

kkit · Sep 24, 2016

FYI. I live near Asheville, NC and every time I get curious and look to see what types of opportunities are out there (Just being nosy because I love my job) it looks like they are DESPERATE for psych NPs here. If anyone is having a hard time finding a job in this area consider the hills of WNC!

ndnursepract · Sep 27, 2016

I am an FNP and have never heard of any special additional certification for FNPs to treat psychiatric patients, though there certainly could be something I am not aware of. Psych practice is within your Scope of Practice an an FNP, but as with anything, know your own limitations, and refer what you are not comfortable or experienced with. Never hurts to get additional continuing ed in a certain area if that's where your interest lies as well. Certainly if you plan to work exclusively in psych, PMHNP is the way to go..