New Grad Job Market PMHNP

[middleagegal]

Hello all, I am hoping to get the low down dirty truth here. I've recently found myself at a dead end in my current M.S. level career (not nursing) and need to make some decisions. I have kicking around the idea of becoming an NP. I have a friend who went to PA school and tried to talk me into that, but NP is more appealing to me for a number of reasons. I am especially drawn to PMHNP for a number of reasons, and the fact that I can do it in an AE program in only 3 years adds to the appeal. I do however have concerns about the job market for PMHNP.

I am in a financial situation with current student loans and a family to support that just will not allow me to gamble with this. I spent too many years and way too much money on my first M.S. only to find myself unable to even keep up with the interest on my student loans for over a decade. While I have always been a proponent of doing what you love, at some point I have to make a large part of my decision based on the ability to find employment and make a reasonable living for my family. My first degree was chosen by following my heart and it has been a financial disaster. I can't afford to make that mistake twice.

What does the job market look like for PMHNP? I have read some instances where PMHNP's have complained that they are unable to find jobs or MD's willing to allow them to work under them. I know that money should not be the primary reason you choose a specialty and I realize that FNP or even PNP would offer more flexibility in finding a position. However, I also realize it would take more time, which means more time until I can start earning a living, and I really do keep feeling myself pulled to PMHNP.

I also realize the AE PMHNP programs can be highly competitive and therefor it may not even end up being an option, but I don't want to count it out, if it is where I want to be, then it makes sense to just try for the AE program.

Also, it is my understanding that if you get your MSN without doing NP, then post graduate work can not be funded with student loans, if that understanding is correct then it puts me in a further predicament, once again making the PMHNP AE program seem appealing.

I would appreciate any insight into the realities of finding work as a PMHNP. Additionally, I am located in Texas and would not be able to move in the near future.

[TheOldGuy]

In reading your post, I get the impression that you are not currently a nurse. The rest of my reply is based on that assumption. If I'm wrong, then please disregard what I'm about to say...

I can't imagine going through a 3 year AE program and feeling like I'd be ready to function as an NP. The primary difference between NP programs and PA programs is that NPs are supposed to be nurses first. I don't feel that it is appropriate or ethical for schools to offer NP programs to people who do not know what it means to be a nurse. I don't mean that to sound harsh - its just that your training as an NP is founded upon the idea that you know what you're doing as a nurse. Nursing is hard work. It is demanding physically and emotionally. You will experience things that most people cannot comprehend. I feel that to be a good NP, you have to have been a good nurse first. I make very good money as a PMHNP - but it wasn't easy to get here.

PA programs follow a different educational model and do not count on specific experiences. PAs on the average make more money than NPs do. The PA job market is very good.

I hope I didn't offend anyone with my post. I don't mean to offend. These are just my personal opinions.

[middleagegal]

I hope I didn't offend anyone with my post. I don't mean to offend. These are just my personal opinions.

Not at all. I appreciate your candor. I have actually considered this and wondered, while this may sound crazy. Would I be able to get employment as an RN even with the PMHNP, or would people be hesitant to hire me in that capacity?

That may sound nuts, but my thought process is if I can get the academic preparation for PMHNP done, then gain some experience before actually going to work on my own as an NP, it would mean being able to take my time gaining some experience, not have to feel huge pressure to get a higher paying NP job during a time in my life when I can afford to do that financially while at the same time avoiding that possible DNP requirement in a few years. That is something I really want to avoid as there is no way I can spend the amount of time and money required to get the DNP. I could still do some continuing Ed while working as an RN, then after a couple or 3 years doing RN work, feel more prepared to go to work as an actual PMHNP.

I have a family situation that would allow me to take off work and do school now, but in another few years that will not be the case. In fact, I need to be able to make a decent living within 7 or 8 years from now. (I have a toddler and a husband who will be forced to retire in 7 years; I know; Don't ask) I am really feeling the pressure to go to school now and get that done while my husband is still working full time and I can arrange for child care.

I don't know is that totally crazy? As far as PA, my heart just isn't in it. I could probably do it, I'd need to take a few more prereq classes and do some different types of volunteer work, but that's not a huge issue. It's more just a personality thing, I'm not sure it's really right for me.

I appreciate your insight.

[CCuser]

If you are not already an RN, then you need to do that first. You will need to take the NCLEX. Which is no light test. You will need so much more before you are ready for PMHNP. I've been an RN for ten years, and just completed my BSN. I have many certificates and experience on nursing committees. It is only now do I feel ready to make such a step into graduate education.

You will need nursing experience.

[middleagegal]

Ok, maybe this is an ignorant question. If it is impossible to be successful as an PMHNP without several years of RN experience, why do SON offer DE or AE PMHNP programs? I'm not doubting you, just having some difficulty understanding why this avenue exists. Is it just about getting tuition money with no concern for employ-ability or professional success after graduation?

Has anyone out there gone this route? I'd like to hear your experiences.

[CCuser]

They do offer them. You will have to take a whole bunch of pre reqs in nursing classes and you still have to pass the NCLEX. You will need to commence some kind of work as an RN, just to keep your RN license up. You will be considered a new graduate. All the while working toward your PMHNP. It's a lot.

Good luck.

[CCuser]

You will have to pass the NCLEX to be able to move forward with the PMHNP education.

[middleagegal]

Oh i realize I would need to pass NCLEX. The program is set up where you do a full calender year completing RN work then take NCLEX at the end of that first year. After that, you continue class work for 2 more years to complete MSN. You are able to work as an RN during this time and take classes part time as an option.

As for prereq's I have a M.S. in biology so I already have most of those. I will need to take a couple of things because of the amount of time that has elapsed since my degree, but I feel pretty confident about being able to complete the prereq's without much trouble, just a matter of taking the time to do them.

As I mentioned, I am a midcareer individual who has hit a very low ceiling for pay and advancement. An M.S. in biology is essentially useless in the job market. I started out with the idea of a medical career, changed my mind midway through my bachelors as I "fell in love with bio and wanted a research career" and now regret it for both personal and financial reasons. I need to make a career change and am exploring my options.

Maybe I should consider just getting a second degree BSN, I know that can be done in a calender year, then getting a job and exploring applying to an NP program. I just want to get my schooling done ASAP as I mentioned, waiting 5 years is just not an option.

[EveP]

I think the best bet is to go for the second degree/accelerated BSN program, start working as an RN and then go from there.

[CCuser]

Yes I agree. You'll earn money - a decent living in the meantime. Then your employer can pay for your graduate education. :)

[PG2018]

Right now PMHNP seems to be the hot ticket item among APRNs. As the CRNA "thing" has come and gone, I think right now is the moment you could become a PMHNP and seriously get ahead.

In my area, the demand for them is huge because there are few NPs choosing psych, and there are few psychiatrists (or physicians wanting to be psychiatrists). Having said that, you'll find a job, and you'll make a good living.

I think a three year direct entry program is great, and I'm envious. I only became a RN to become a PMHNP, and although I finished the two year BSN/RN program I did start working as a RN when I enrolled in a three year MSN/PMHNP program. However, I haven't worked in psych before, and the first couple of jobs I had were not really good for getting nursing experience. The first was in a medical unit in a 25 bed, rural hospital. I bet the same 90 patients kept the whole hospital open all the time. I detested that job. Next, I worked in an office doing almost nothing related to nursing, and it was pretty nice. I now work in an ER, and it's too much. I don't feel like I don't know what I'm doing. I don't like the speed at which it moves, and for that reason I'm leaving in six days. I've kept a different nursing job for every season of my graduate school experience. Has that hurt me as a PMHNP student? No. I'm very much a biologically-oriented practitioner, and for that reason I'm very studious with such things as neurobiology, psychopharmacology, etc. I'm blessed with a good memory so I've done well with my training. I've gotten great reviews from preceptors, and the patients I work with like me. That said, YES, you can become a PMHNP without ever having been a nurse before.

You sound like I did when I started, and a lot of people were negative. "Be a nurse first for a while." Nah, that's not for me. This area, however, is something of interest to me so when you're really interested in something you tend to really soak it up. Graduate school has been all consuming for me, and I'm really ready for it to be over.

I recommend when you begin your studies that you include as much other psychological material in your reading list as possible. Avoid the nurse-esque stuff because it won't help you a lot. Read Kaplan and Sadock as you can. (It's kind of a long, slow read.) Read all of Stahl. Learn about cognitive psychology, social psychology, and personality theory as that'll give a certain leg up. Learn your DSM as if you're memorizing statutes, and know how to talk with people.

[middleagegal]

Wow psych guy. What a different perspective. I appreciate it as a counter to other perspectives, though it does complicate my decision to get this take. I would really like to hear from some new grad PMHNP's to get their perspective on employment. I have also heard that Psychiatrists can be the toughest specialty to accept NP's. Does anyone know how much truth there is in that?

I also wonder how much different it would be to do the AE PMHNP program and work as an RN during the M.S. portion of the program than it would be to do the BSN first, then work and apply to PMHNP. By the time you completed M.S. you would have some RN experience, but probably not full time. I just don't know. It's really a tough call. All of this is of course assuming I could even get accepted into the AE PMHNP program.