New Grad Job Market PMHNP

Nursing Students NP Students

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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.

Hi MAG,

Most accredited DEN programs require that students work as an RN after passing the NCLEX. Of the 2 I'm considering, one requires a year FT, in the specialty you're pursuing, before you start the MS portion of the program; another requires that you work part-time while you're completing the MS portion (1.5 years) in addition to 650 clinical hrs pre-cert and 770 post-cert. As with any job, the bulk of your experience will come once you're working; it will be different from an RN job experience, because it is a different job.

The job market is very good for NPs, less so for RNs, depending on your location.

You clearly aren't going in blind and have an affinity for the work; the job market is strong; so the most important question is, how much grad-school debt can you handle? Does it make more sense to get a BSN and work in a facility that will pay for, or at least contribute to, your graduate coursework, as someone else suggested? It will take a lot longer, but will cost much, much less. Do you qualify for scholarships/grants (a lot more available for undergrad than grad programs)? Will the loans you already have been deferred if you're an FT student again, or will you have to keep paying them? How many years of work will you have before you retire? Enough to compensate for additional educational loans? Could you consider HRSA, Nurse Corps, or Public Health Service Corps positions (loan repayment in exchange for 2 years of service in underserved communities)?

It's a lot to weigh, and I wish you the best in finding the right path for you.

HONESTLY....It would be very dangerous for you to have no experience and an RN before becoming an NP. I have been around new PA grads that I honestly thought knew less than CNA's in regards to certain areas of patient care. We all like to think....ahhh that is not me. But for 99% of us......

Hi, this is an intriguing scenario to me because I'm also in a very similar predicament. I actually teach at college level and always wanted to be a professor. But due to a cap in salary for my degree and changing family dynamics, I find myself gravitating to pursue a different path. Similarly, I cant afford to make the wrong career choice. Still, as understanding as I can be of your situation, I agree that the best and safest route would be to first dedicate some years to gather your experience as an RN and subsequently follow the graduate degree. You still have time within 7 years to do take this approach and be sure that the PHMNP route is where you will thrive.

Specializes in Family Nurse Practitioner.
Hi, this is an intriguing scenario to me because I'm also in a very similar predicament. I actually teach at college level and always wanted to be a professor. But due to a cap in salary for my degree and changing family dynamics, I find myself gravitating to pursue a different path. Similarly, I cant afford to make the wrong career choice. Still, as understanding as I can be of your situation, I agree that the best and safest route would be to first dedicate some years to gather your experience as an RN and subsequently follow the graduate degree. You still have time within 7 years to do take this approach and be sure that the PHMNP route is where you will thrive.

I agree and as others have pointed out the income someone can earn as a BSN would likely pay for graduate school. Win:Win. I financed all my education the old fashion way which sadly isn't very popular right now by working like a dog and The Bank of Jules. :D

I wish financing my education was an option. Just a little fyi out there, I worked full time through my entire undergraduate career but still needed a few small loans. The bulk of my loans are from graduate school, which will never pay for itself. Like I said before, hindsight is 20/20. With the benefit of hindsight I often wish I had never gone to graduate school, but only from a financial perspective. I definitely made some bad choices but I have been punishing myself for those choices for over a decade, it's time for me to let go and move on. For me that is going to mean at least some of my school will have to be borrowed. I live in a very expensive area (again no choice due to husbands job) as frugally as possible, and with retirement closer for my husband than most students all of our extra money has to go there.

Ok, with that out of the way as it seems this thread has kind of gone in that direction.

I am really interested in the differing perspectives here. One thing I wonder about is this. Obviously the school does not have full authority to allow a DE route to PMHNP. The BON has to approve this route as well. So given that the Board of Nursing who oversees the process approves this route, and it is obviously made up of people with nursing experience, why would they approve this route if it was quote "dangerous"? It seems to me they would be in a pretty good position to recognize whether or not this type of program presented a safety risk. Any thoughts?

Specializes in Family Nurse Practitioner.

I am really interested in the differing perspectives here. One thing I wonder about is this. Obviously the school does not have full authority to allow a DE route to PMHNP. The BON has to approve this route as well. So given that the Board of Nursing who oversees the process approves this route, and it is obviously made up of people with nursing experience, why would they approve this route if it was quote "dangerous"? It seems to me they would be in a pretty good position to recognize whether or not this type of program presented a safety risk. Any thoughts?

BONs aren't all they are cracked up to be either and much of this you would know if you were a nurse for any amount of time. It seems like you have made up your mind to do a direct entry and are interested only in responses supporting your path. There have been several already. So just do it.

BONs aren't all they are cracked up to be either and much of this you would know if you were a nurse for any amount of time. It seems like you have made up your mind to do a direct entry and are interested only in responses supporting your path. There have been several already. So just do it.

Not true. I am really interested. You are right, I am not a nurse, which is why I am asking. As an outsider I would assume that these programs are vetted and there are science based reasons they are approved or not approved. Obviously you have a different opinion and I am interested. Like I said, I don't want to make a mistake here. I feel like in my first M.S. I was mislead as to the utility of my degree in the job market, primarily because the school was more interested in getting my tuition money than in me being successful, so I know that happens. On the other hand, my program did not require licensure from an outside body so there is no oversight. Not the case with nursing, thus my question. As a lay person, I am surprised and maybe a little alarmed to hear that insiders don't hold the licensing agency in very high regard. I'm just trying to collect information and get as many opinions as possible here in order to help make my decision, please don't fault me for that.

Specializes in OB/GYN, Psych.

I sent you a PM...

Specializes in Outpatient Psychiatry.
HONESTLY....It would be very dangerous for you to have no experience and an RN before becoming an NP. I have been around new PA grads that I honestly thought knew less than CNA's in regards to certain areas of patient care. We all like to think....ahhh that is not me. But for 99% of us......

Really? I've found just the opposite. Yes, just this week I met a PA student who didn't even know how to place electrodes on a patient's chest, but that's a practical skill. There isn't a lot of cognitive ability involved. Rather, I've found most new PAs to be better prepared clinically.

Specializes in Outpatient Psychiatry.

OP, if you want to become a PMHNP then pursue that route with fervor. You don't have to have worked as a RN to do exceptionally well. Personally, I don't thing anything from undergraduate nursing, sans becoming accustomed to APA formatting, has transferred well to graduate nursing. It's an island of its own. Nursing is a very defined area that doesn't extend itself around diagnostics and prognostication. There are innumerable RNs who would make great APRNS without needing any further education, I'm sure, and I know there are some really incompetent APRNs who are new and others who were experienced RNs. Nursing is a shallow field, and it is up to the nurse to have sufficient wherewithal to understand, that to know the field and do well, he or she must engage in autodidactic study. Nursing academics are not really conducive to clinical excellence. It's your decision, and I encourage you to forge a path you'll be happy with. I truly enjoy the advanced practice side of things, but I, personally, have found nothing about general RN work to be satisfactory or pleasurable. Nursing is not my vocation, and having the nursing license for me was merely a means to end or the route to doing a job (PMHNP) that I initially found intriguing but now find passion with. If I could not be a psych NP then I would go find other work. I have very focused interests, and so I have built upon them. Heed your thumos.

Warm regards,

Specializes in mental health / psychiatic nursing.

As with many things the job markets seems to vary based on location. At this point in time though there seem to be many openings for PMHNPs - particularly once one starts building experience - over much of the country. Not sure what it will be like in a few years as PMHNP seems to be the hot specialty of the moment judging on posts here. Also you mention that PMHNP is faster to get through than FNP - this is completely contrary to what I have seen in looking at programs as the PMHNP course is typically 1 year longer than the FNP at most schools.

I'm not sure why if you are focused on getting an NP license you would do a MSN that does not lead to the ability to sit the licensing exam - if you are unsure of the path or think it would be best to get a couple years experience as an RN before perusing advanced training then a second/accelerated bachelor's program would likely be a better fit. It would be both cheaper and less time consuming than a master's, though it is still competitive entry.

I am in a similar situation in that I am looking at the potential of a direct entry PMHNP program with out prior nursing experience. There are pros and cons to the path of BSN + work experience then returning to MSN education or going straight through. I've had opinions online be largely negative towards the latter concept. However speaking to people currently in the field (psychiatrists/psych nurses etc) who actually know me and my background, several have really encouraged me to jump into DE with the caveat that I will need to be proactive at gaining experiences while in school, and to use care in selecting my first position out of school so as to be in a supportive environment that will continue my growth as a new NP.

Have you shadowed/interviewed a current Psych NP? Do you have personal connections in the psych world you can talk to for advice in perusing this path and the pros and cons both for you personally and in terms of how different options may affect your professional path? If you don't, I highly suggest networking and seeing if you can do some informal informational interviews with practitioners in your community as these individuals can give you the low down on what things look like your geographic area.

Personally, I am currently leaning towards DE programs that award both BSN & MSN degrees as part of the program, that way upon finishing the BSN portion I can evaluate myself and see if I still feel confident about advance training with out much work experience. If I'm not, I can drop the program with a BSN and work as a nurse for a few years before coming back to school, but it also does streamline the process if at the time I am ready to continue on in my education.

I don't know if this would be a sensible option for you as well, as your financial situation and timeline for completing education are likely some what different from mine.

In any case I'm enjoying reading the opinions and advice in this thread, and I hope you are able to figure out a path that works for you.

Specializes in Outpatient Psychiatry.
Also you mention that PMHNP is faster to get through than FNP - this is completely contrary to what I have seen in looking at programs as the PMHNP course is typically 1 year longer than the FNP at most schools.

This.

FNP is the shortest advanced practice specialty at my university hospital/medical school affiliated institution. All other specialties take an additional semester longer to graduate from, and the psychiatric specialty is the only specialty in which TWO pharmacology courses are taken. We take the same pharm that everyone else takes, and we take psychopharm that the other students can't even enroll in. We all share the common core, but the psych program has that extra training for the intricacies of the medications we use.

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