Pre-PMHNP specialties

[ksola]

I'm in school now for my RN. I'm incredibly drawn to psych. I've worked in direct care with a lot of very interesting behaviors and I honestly love it and feel like it's where I belong. But I'm trying to keep an open mind because I know a lot of people who go into school leaning towards a speciality often don't end up there.

I still really think I want to end up with my masters in PMHNP, but maybe I'll play around somewhere else first. Does anyone have any suggestions? Trauma and ED sounds interesting, and probably have the chaos that I crave. Is there anything else I should be looking into?

[umbdude, MSN, APRN]

It doesn't really matter. The only true "pre-PMHNP" specialty is psych. Working in psych is quite different, and the environment and treatments aren't the same as when you're on a medical unit where treating psych isn't the primary focus. If you work inpatient psych, you will have your chaos. Before spending time and money on a PMHNP, it's best to work with this population (as a mental health tech or RN) to see if you really like it. I've seen some people who are convinced that they love psych and left after a couple of days.

[elkpark]

If your goal is PMHNP, don't "play around somewhere else first;" get some solid psych inpatient experience. Also, if you are serious that you "crave chaos," this may not be a good choice; the goal in psych settings is always to avoid or at least minimize chaos. In my experience over the years, having people who enjoy and thrive on excitement, chaos, activity, working in psych tends to turn out badly.

[ksola]

I guess my feeling is that I've worked with a lot of interesting psych cases already. I know I love it, but I want to explore other specialities before settling right into psych. I'm looking for something more med based, but still with all the excitement and fulfillment that comes with psych.

I should also clarify that. I understand why what I said may be misleading. I've worked with people who enjoy the behaviors a bit too much and will at times instigate. I confront them about it because it bothers me so much. I like the chaos because its a challenge. Yes, it's why I love my job-- but not because I like to sit back and laugh at the craziness. I like to get my hands dirty fixing it. I turn into a whole different person when situations get tough, and it's not until everything's calmed down that I look back and think "holy sh** I actually handled that." I like being that person and surprising myself with what I'm able to do. And I guess I want to know if there's any other speciality that will give me that feeling.

[elkpark]

You say that you've worked "with a lot of interesting behaviors" and "a lot of interesting psych cases." Does that mean you've worked in an actual psychiatric milieu, or you've just encountered psych issues in other settings? If you haven't worked in actual inpatient psychiatric treatment, you should do that for some significant amount of time before making any decision about going into psychiatric advanced practice.