PMHNP/PSYCH NP

[Success2011]

Hello All. Considering enrollment into a Psych NP program. Been a nurse for 14yrs 3yrs Med Surg , 8yrs acute hospital case management. 3yrs community health. Any advice is helpful. Pros and Cons. Inpatient or outpatient. I am thinking adult population. Thanks for your kind responses.

[ToFNPandBeyond]

Some of these responses make me chuckle...?

I don't believe you need to work inpatient to know if you really want to work psych.

I never wanted to work inpatient. I currently work outpatient where majority of my patients are stable. The ones who are acute, I refer. If they are in danger to self or others, I 5150. It's how I like it.

And let's keep it 100, it's ideal to get "experience", but no hospital/clinic will allow you to just walk in and request it. That's what school and clinicals are for.

Like ARND stated, if you realize you don't like it after school, or even in practice, then leave. There is no harm in that and therefore, no foul.

[dianearc, BSN, RN]

ThePsychWhisperer said:

Hating? You're precious. Hating on what exactly? I have a military and emergency medicine background, and outpatient and inpatient psychiatric experience. I see some of the sickest patients at their worst while working my main job at a community hospital, and do private practice medication management with brief narrative psychotherapy on weeks off from my inpatient gig. I am also dual board certified in emergency nursing and as a psychiatric nurse practitioner. I am only a few months from my doctorate, and will soon be the coordinating liaison between my psychiatric unit and my emergency department. But yes, I must surely be hating because the OP is younger or cuter or something similar, because that's all it could be, right? ?

Anywho, my original question wasn't meant to be a personal attack. I simply wanted to know what was drawing the OP towards psychiatry when s/he didn't mention any overt experience, and merely suggested that the OP get a little experience with some of the more acute patients before dropping thousands of dollars on a psychiatric nurse practitioner program before learning that's it's not going to be their niche. Psych is a wonderful field but it has some of the most emotionally exhausting patients. Unless one has a true love for the population, providers can get really burned out, really fast.

As for being territorial? Yep. But not the way you might imagine. There's enough mental illness to go around for all of us. What I am protective of is my patients, who deserve better than someone in it just for job security and a cushy desk job. I am not guarding the profession; instead, I am guarding vulnerable patients from those that get into this field for the wrong reasons. I do support those getting into mental health and will be a preceptor for a PMHNP student this fall, but I highly recommend a person getting their feet wet prior to plowing full steam ahead into the field and finding out it's not for them, which truly was the original gist of my response.

Finally, unlike some that believe everyone deserves a "Thata girl!" or a hearty encouraging pat on the back, my first priority is to advocate for my patients. Period.

I'm laughing 🤣 because you sound like you need a PMHNP yourself. Someone needs to advocate for your patients because I have no idea what form of encouragement (if any) that you give them. You think you spat some facts but you didn't. I have an ICU background & I'm doing my DNP in PMHNP. I have never worked as a psych RN. OP asked for pros & cons & not a lecture on getting psych experience. Even if you wanted to "advocate" for your patients, the need in the mental health field is far greater than you can sustain. It's OK for people to make pragmatic decisions on what specialty they want to pursue. So yes, there needs to be more mental health providers in the field (psych or no psych experience). Yes, it may be exhausting & draining but that is the nature of anything that is worth pursuing. The OP has worked in med-surg for over 14yrs & has done case management as well as a background in social work. I'm sure she has certainly dealt with psych issues inpatient, even if minimal compared to you. Some of the best PMHNP programs like the Ivy League Col***** University allows their students from the Accelerated BSN program to go straight into a DNP in Psych without any bedside nursing or psych experience at all. Graduates of that program are some of the most successful & best PMHNPs there are out there, starting their own practices or working inpatient as that top hospital in NYC hires them directly post graduation. It is the only specialty that the university allows their students to go straight into without any nursing experience. And Col****** university is a teaching institution, an Ivy League, meaning it has done research concluding that as much as psych RN experience might help you in being a PMhNP, you certainly don't need it. You will learn during your training & on the job. So to you, I'll tell you this, calm down & stop trying to gate keep the field because you can not. In terms of someone spending thousands getting into the field, most hospitals pay for one to go back to school so no, I doubt OP is just shelling thousands. & even if she did, that's not what her question was about. Someone who has been in the nursing field for over 14yrs has the right to decide what she wants to do whether you like it or not. 
 

To OP- pursue the field & ignore the discouraging naysayers:

Pros:

you can start your own tele health practice

you can serve both adults & peds

you don't have to work inpatient only, you can work in other settings as well

As you help other patients, you can actually learn mental health strategies for yourself & others

it is a very in-demand specialty so you'll definitely get a job 

Unlike FNP, you'll be able to negotiate your salary & it is higher paying than your RN & FNP (especially in the East Coast- I'm also in the East Coast)

You will fall in love with what you do. It is the only specialty that if you chose to work remote (depending on state laws) you can work from anywhere in the world. 
 

Cons:

if your own practice, you have to strategize to make sure insurance pays you. You may have some denials but you'll learn as you go

It can be very mentally exhausting dealing with other people's problems so you will have to strategize some self care routines for yourself 

Workload will vary based on where you chose to work. Some places worse than others, no standardization.

Also depending on patient population that you serve, some patient population for instance in inpatient settings can be extremely wild, so over time, you'll get to chose which workload & setting fits well with your personality and lifestyle.

 

overall, the pros outweigh the cons! 

 

 

[dianearc, BSN, RN]

bryanleo9 said:

I am referring to inpatient and forensics. Outpatient psych patients can easily become acutely ill d/t medication non-compliance which is a huge issue. No matter the setting, the people wanting to complete at psychiatric NP certificate need real psych experience.

We have had ER nurses post here stating they are in psych NP programs. When it's suggested they get psych experience they state they have plenty in ER. Reading off a printed ER mental health screening questionnaire is not psych experience.

Their future patients deserve better. Good luck my post was not to discourage but to keep it real.

No one needs psych RN experience to get into psych NP or psych PA or psychiatry MD. That's just your opinion. The future patients will get better, especially from those who are not gatekeepers of the field like yourself; preventing patients from wider access to mental health providers. You're not "keeping it real" you're plainly trying to gate keep a field that's gaining traction. But I hope you realize you can't stop anyone. Even psych PAs & psychiatry MDs do not need psych experience to get into the field. So I'm not sure where you're getting this idea that RNs need that to get into psych NP schools. Let self funding adults do what they want.