PMHNP-low stress?

[Flo., BSN, RN]

I have been diagnosed with a chronic health condition. The doctors are recommending that I change my job to a low-stress position. I currently work inpatient psych and I am thinking of becoming a psych np. Would you consider outpatient PMHNP work less stressful than floor nursing? Thanks for any insights!

[Jules A, MSN]

Physically it is easy, actually boring although there are always the few instances of assaultive behavior or extreme paranoia leading to threats. For me out patient is mentally exhausting and far more stressful than I ever found floor nursing to be so I would guess it depends on what kind of stress you can tolerate and are attempting to avoid.

[DizzyJ DHSc PA-C]

I think outpatient psych med management is much less stressful then inpatient. Once you get most of your patient panel stable on meds, you can breeze through your day with med refills. Sprinkle in a few tough cases to make it a little interesting and it, to me, is pretty stress free.

[entrepreneur_np]

Compared to my CVICU days yes. But depends what setting you get. For me outpatient psych is very stressful BC the population is non compliant, lots of comorbid substance abuse, barriers to care etc and I see all ages. If you end up doing adults where your bread and butter is MDD and anxiety I would say less stress. It boils down to the population and quality of the team and community around you - and productivity requirements. For me it's stressful in a different way than floor nursing.

[ProperlySeasoned]

Agree with above. If you end up in a community health clinic, or in a high risk population with lots of social service needs, the job could be rewarding, but exhausting. Remember that the schooling period itself may be more stressful than the actual career.

[DizzyJ DHSc PA-C]

Private practice is the way to go for outpatient psych. I agree a community mental health clinic would be stressful.

[gettingbsn2msn, MSN, RN]

I am already a NP but considered the PMHNP program as an add on. I dropped out of the program. It made me depressed. My first clinical rotation was at a nursing home. Major meds thrown at these people. The people were so lonely. Meds were believed to solve the problem. It seemed easy enough but i could not stand it. That's just my personality perhaps.

[Jules A, MSN]

I am already a NP but considered the PMHNP program as an add on. I dropped out of the program. It made me depressed. My first clinical rotation was at a nursing home. Major meds thrown at these people. The people were so lonely. Meds were believed to solve the problem. It seemed easy enough but i could not stand it. That's just my personality perhaps.

As more and more FNPs think they are able to "do psych" especially due to the higher pay rates I suspected this might happen. You are very insightful as there are actually no medications with FDA approval for agitation in dementia and yet that was likely most of the polypharmacy you saw. Geripsych is a specialty that in most cases, imvho, shouldn't be managed solely by a NP unless they have significant support and experience with this vulnerable population. Kudos for realizing it wasn't your cup of tea.

[JBMmom, MSN, NP]

As more and more FNPs think they are able to "do psych" especially due to the higher pay rates I suspected this might happen. You are very insightful as there are actually no medications with FDA approval for agitation in dementia and yet that was likely most of the polypharmacy you saw. Geripsych is a specialty that in most cases, imvho, shouldn't be managed solely by a NP unless they have significant support and experience with this vulnerable population. Kudos for realizing it wasn't your cup of tea.

You're so right. As a floor nurse in a long term care facility, I've always been depressed by the number of medications we're throwing at people. For example, almost everyone is on GERD medications. Since omeprazole can cause things like diarrhea, increased risk of bone fractures and low magnesium, then we put them on imodium and magnesium. Then they end up constipated and we add miralax, and the never ending trail goes on and on. The psych meds are rampant, and if they just had something to distract them, and look forward to, they probably wouldn't need half of them. I really like my job and my residents. Some do fine in that environment and some just don't- and throwing meds at them isn't the answer. OP, good luck finding something that meets your needs.