PMHNP in Private Practice

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As some other recent threads have discussed, I'm also torn betwen FNP and PMHNP. I'm fairly certain I'd be quite comfortable/happy with the career that followed getting my FNP, but admittedly, I raised an eyebrow at mental health when I heard about the low supply, increasingly higher demand and apparently higher paycheck.

The more I though about it, the more interested I am becoming (beyond the paycheck part). My biggest thoughts now are: the mental health experience I have had has been my rotation in my BSN program (so yes I'll probably need some more experience) -- but I always felt a little "on edge" in the facilities -- is this the norm (not as in, does one get more comfortable, but does one always need to look over their shoulders with the MH population -- to be frank)? And secondly, in my research, I'm not finding any PMHNPs on the internet that have discussed their private practice. Are there many that practice the um..."therapist" aspect (forgive my lack of knowledge and terminology)? When the PMH first entered my head, I though "ooh, I could do something with sports psychology!!" (I'm a competitve athlete and I think I'd do well with this topic) -- anybody think there's a feasible role for the NP in that? I'm not expecting to be comparable to somebody with their PhD in psychology..

To summarize what I've found on this board, it seems like most NPs work adjusting meds, doing some assessments, etc. This sounds interesting (besides the questionable apprehension for safety I mentioned above), but I don't think it'd be something I'd be extremely passionate about (like the sports psych..or adolescents, marriage, etc). In general, psychology interests me.....but should I really be chomping at the bit with a "yes! I really, really want to try to help sex offenders!!!" (and to somebody in the field, perhaps my apparent attitude answers my question???).

And while it might be obvious to go work as a psych RN to answer my own questions (I work in the surg/trauma ICU now), I'm quite hesistant to do this since I'll have to put off school for a while, and other than learning about the population, it seems the RN and NP roles are quiet different. Especially if I could work as an NP with a "healthy" population. By healthy I mean....well, I guess I mean patients who have...minor issues?

Thanks for any input. I feel bad for asking some obvious questions, but I'm really finding limited resources/answers online.

Eliza

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As some other recent threads have discussed, I'm also torn betwen FNP and PMHNP. I'm fairly certain I'd be quite comfortable/happy with the career that followed getting my FNP, but admittedly, I raised an eyebrow at mental health when I heard about the low supply, increasingly higher demand and apparently higher paycheck.

The more I though about it, the more interested I am becoming (beyond the paycheck part). My biggest thoughts now are: the mental health experience I have had has been my rotation in my BSN program (so yes I'll probably need some more experience) -- but I always felt a little "on edge" in the facilities -- is this the norm (not as in, does one get more comfortable, but does one always need to look over their shoulders with the MH population -- to be frank)? And secondly, in my research, I'm not finding any PMHNPs on the internet that have discussed their private practice. Are there many that practice the um..."therapist" aspect (forgive my lack of knowledge and terminology)? When the PMH first entered my head, I though "ooh, I could do something with sports psychology!!" (I'm a competitve athlete and I think I'd do well with this topic) -- anybody think there's a feasible role for the NP in that? I'm not expecting to be comparable to somebody with their PhD in psychology..

To summarize what I've found on this board, it seems like most NPs work adjusting meds, doing some assessments, etc. This sounds interesting (besides the questionable apprehension for safety I mentioned above), but I don't think it'd be something I'd be extremely passionate about (like the sports psych..or adolescents, marriage, etc). In general, psychology interests me.....but should I really be chomping at the bit with a "yes! I really, really want to try to help sex offenders!!!" (and to somebody in the field, perhaps my apparent attitude answers my question???).

And while it might be obvious to go work as a psych RN to answer my own questions (I work in the surg/trauma ICU now), I'm quite hesistant to do this since I'll have to put off school for a while, and other than learning about the population, it seems the RN and NP roles are quiet different. Especially if I could work as an NP with a "healthy" population. By healthy I mean....well, I guess I mean patients who have...minor issues?

Thanks for any input. I feel bad for asking some obvious questions, but I'm really finding limited resources/answers online.

Eliza

Some people go into mental health field in order to find themselves and answers, however therapy might be better. As a PMHNP you can chose what kind of population you work with and even set up your clinical experiences to that end. I have an interest in PTSD and and do not want to work inpatient so I have done my clinical on a Marine base and at a VA mental health clinic. While veterans might be "walking wounded" they do not have "minor issues." I had one Vietnam vet this week who has not slept in a bed in 39 years!

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Eliza,

I don't have any advice, but I could have written portions of your post. I would LOVE to work with PTSD patients, but some aspects of psych do freak me out. I am currently in the FNP program, and did try to transfer into the Psych NP program, but the school would not allow it without some years of experience in Psych, which I do not have.

I'm very sad right now, as I'm starting my FNP clinicals this semester and feel trapped in a program that I'm not excited about. I'm looking at other schools. I only have a few more days until the 100% refund period is over at my school (USA).

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I'm a FNP and the longer I practice, the more I realize that everything comes down to psych. Any physical illness can cause mental stress and vice versa. My FNP program was sorely lacking in psych epxeriences.

I also work with PTSD patients and I wish everyday that I had the skills a PMH-NP has. I'm seriously thinking of getting a post-master's certificate in psych.....after I finish my DNP...if my DH promises not to divorce me !!!;)

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I just graduated. While I am comfortable in the inpatient setting, to be honest I didnt want to work the ridiculous hours that comes along with that. I starting a new position in an outpatient community mental health center on Monday. I am interested in severe and persistant mentally ill so that is where I am going to spend much of my time.

My instructor told us the first day of our program that no one is going to pay 90k plus to therapy. If we want to do that to go to school to be a therapist. She said we will be doing intial assessments, and medication management visits with maybe a few minutes to do supportive psychotherapy. That is what I have found in the midwest. We have alot of therapists but almost no one to do the medication piece. So if that sounds interesting to you go for ot.

Also one does have to maintain a bit of vigilance in the inpaitent setting as that is where just as in a med surg unit you find the sickest. You have to be a danger to your self or others to be an inpatient (so that being said) you do have to make sure you are always between the patient and the door just in case. BUt I chose to go to the state mental hospital for my clinicals not becasue I had to. There were many students in my class who never sat foot in an inpatient unit.

Talk to an instructor of the pmhnp program about your concerns before making your decision.

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Zenman: Were you referring to therapy for the people going into the mental health field, or that they should get a "therapy" degree ~ I really wasn't sure which you meant! I hadn't meant "minor issues" as unless the patient has a gaping hole in their chest they aren't in need of aid, I meant more ... non~crisis populations.

Jk: Thanks for telling me about your experience with school. I will be shadowing in my hospital's adult inpatient unit: I guess I'll see how "freaked out" I get and what the nurses say is the norm. I wonder how the roles of the NP and RN difference in terms of a relationship with the patients (I work in ICU now and the RNs spent a LOT more time with pts and families than the NPs, like night and day).

Lisa: I'm realizing that too. And realizing I want to learn what goes on and how people can be helped after the major traumas I'm helping with at my current position.

Mental: Can you elaborate on the crazy hours in inpatient units? I hadn't heard any buzz about that. And can you mention a bit about the differences between inpatient and outpatient? Also, from this board, it sounds like $90k is not outrageous for a starting salary (of course, depending on location, and perhaps the midwest will not be at the top of the range)...? I will definitely be talking to some program directors about this. And shadowing nurses. And I will probably need more RN work experience too.

Thanks, all!

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Zenman: Were you referring to therapy for the people going into the mental health field, or that they should get a "therapy" degree ~ I really wasn't sure which you meant! I hadn't meant "minor issues" as unless the patient has a gaping hole in their chest they aren't in need of aid, I meant more ... non~crisis populations.

!

If you are searching for answers and trying to find yourself, it's usually better to try therapy than spend time and money on an profession that might not be for you.

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