dualboardNP

I am glad that you are having a good experience in the postmasters Minton06. Re: clinical, each student will have a different experience and much of that is guided by their geographic location. Being in California, I found Duke's clinical placement support limited during my MSN and, with the exception of one clinical rotation, had to source my own or delay my graduation which I found unacceptable for reasons already mentioned. This experience is why I opted to go elsewhere for the PMHNP despite my acceptance into the PMHNP postmasters and appreciation of my DUSON education in other ways. However, clinical placements are a challenge across the board. Some PMHNP students that I spoke to at DUSON ended up having to go to Alaska or Montana for their rotations, great experiences no doubt, but this meant time away from their work, their family, which was often isolating for them all for the sake of clinical experience and hours met. This shouldn't happen. However, it speaks to a systemic issue in advance practice training that goes beyond Duke. My biggest advice to anyone wanting to do PMHNP at Duke or elsewhere is to make sure that clinical agreements are in place locally. This will make it easier for you to source rotations stress free. If your PMHNP program has an agreement in place with your local clinic(s) or hospital(s), you are in a much stronger position to train close to home and with ease. Having a preceptor agree to train you means little if your NP program's legal department can't reach an agreement. Best of luck to all!

Not sure if your response was aimed at mine, but since you quoted me... My response was specific to the original poster's question re: financial stability in the State of California between RN and NP not competency. Also, adding a postgraduate certification in psych isn't 'fairly quick and easy' if already trained as an NP as you mention above. Nor should it be. There is a financial commitment for the NP to contemplate, specifically tuition and reduced work time/salary in current roles, an additional 540-750 clinical hours in psych (varies by individual PMHNP program requirements), not to mention the study time dedicated to psychiatric disorders. And I cannot think of a single PMHNP PGC program that gets you what you need in a year on a part-time enrollment basis. It's a year full-time at a minimum just about everywhere in California that offers it at least, but can be 2 years part-time. Most of the FNPs in my cohort feel they lack the foundation and skillset to diagnose and treat mental health disorders in the primary care setting hence why they are doing PMHNP. There is a huge difference in being exposed to a variety of mental health conditions in the primary care setting with the level of expertise in managing the mental health condition no matter how 'common' in addition to understanding the different psychopharmacological interventions and therapeutic modalities. PMHNPs work within a specialty scope, mental health, regardless of how many board certifications they have. So while I appreciate that, yes, there's an advantage to knowing more and having more in your NP tool kit, patients with co-morbidities will, ideally, have their PCP, specialists. RN experience is to be valued. Is it necessary in most specialities and will it make you a better provider? Of course not. But for Nurse-Midwifery and Psych especially, it will definitely provide a serious advantage especially if not doing a fellowship and going straight into practice as a new grad NP.

Nursing will give you financial stability in California, whether you go the RN or NP route. PMHNP is appealing to a lot of folks right now for all the wrong reasons. A PMHNP, the wife and mother of four children, just about to start her DNP at my nursing school, Duke, was tragically stabbed to death in the Fall of 2022 by her patient during clinic. Psych comes with risk, a high potential cost to us, that should always be contemplated, too. My partner is a PMHNP and I am a semester away from completing my PMHNP postgrad cert. I worked as an RN full-time during my entire MSN, something that I do not recommend btw, and made more than him. The responsibility and stress he deals with each shift, especially when seeing between 16-18 complex patients, is substantial compared to anything I ever did as an RN, but I was making $40K more than him a year easy. Considering how much goes into our NP training and how much we are responsible for with every patient under our care, it's unfair to get paid so little at the start of advanced practice. However, we all have to start somewhere and not all of us become NPs for the money. Are you interested in becoming a provider and the responsibility that goes with assessment, diagnosis and management of someone's care? Have you considered the potential risk factor for you as a future psych provider, especially as a single parent? These are the questions that I'd ask myself if I were you. And hopefully this will help guide you in determining whether pursuing the PMHNP MSN is worth it or not. NP school is ultimately more time, more money and more effort, especially if your school doesn't source your clinical rotations and preceptors and the onus falls on you to find those clinical experiences every semester. And if you don't know or are perhaps more motivated by the California RN compensation from the start, perhaps NP isn't for you or just not right now. You can always do NP later if things change. Best of luck to you!

The terminal degree in nursing, whether a DNP or PhD, is the future of our profession for all leadership, teaching and advance practice nursing roles. Ultimately this is what made me go for my DNP and am just getting ready for my oral defense in July and hopefully graduating with it in May of next year. If I were you, I'd have my employer pay for the DNP and then get your post-masters NP certificate after. A lot of what I did in my MSN prepared me for my DNP program, especially the QI and PDSA projects that I read and wrote about. I applied to my local public/state university for the DNP and was pleasantly surprised to receive a full funding scholarship package. I am a trained nurse practitioner and feel that the DNP will open doors in the future. Of course the DNP does not necessarily mean more money, especially for nurse practitioners, but it certainly helps if you are looking for leadership opportunities like Chief Nursing Officer and/or tenured-track nursing roles. In places like California where I live, it will also impact the timing of private practice if/when I decide to do that down that route. Best of luck to you!

I graduated from Duke with my MSN in an NP specialty and knew that I wanted to become dual board certified and pursue my PMHNP postmasters after graduation. While the process for me to transfer to the specialty felt straightforward and I was essentially accepted before graduation, some things to consider: 1) My DUSON experience overall was one that I am satisfied with. My emails would be answered promptly by my professors, all of which were doctorally trained nurses. I felt my education was fantastic and loved the campus. 2) The on-campus intensives once the clinical portion began was a nice way to build community. I choose Duke because I wanted to continue nurturing and growing as an RN, earning as an RN in my area and they were able to support this with the asynchronous learning model. 3) Clinical placements are not promised no matter what they have listed on their website and this became an incredibly stressful part of my DUSON experience while an MSN student there. Despite their pricey tuition, I was doing ALL of the leg work and networking for myself, essentially doing the placement office's work, which took time away from my studies. I made miracles happen and sourced all of my rotations as a DUSON student except for one and never paid a penny to any preceptor registry. For the price that I was paying Duke, I found it unacceptable to have to source my own preceptors. While this seems to be a nationwide issue across the board with preceptors nationally, I felt the school could be more transparent on this and not say they have an extensive alumni network. Not knowing if you are able to graduate on time or progress due to clinical placements isn't a nice a place to be each semester. 4) My experience with clinical placements was not unique to me and something that many students, including those in PMHNP specialty, must grapple with no matter where in the country they're based out of while a DUSON student. 5) The PMHNP is cohort based and starts only once a year, in January and goes on until May of the following year. If you take a leave of absence, you will be delayed as classes are sequential. There are three required in-person intensives for PMHNP each semester that last approximately 4 full days, 7am-5pm. 6) My partner is a PMHNP and saw me go through the MSN at Duke. He told me to really consider my experiences as I told him that I was leaning towards Duke for PMHNP. In the end, despite receiving a great education for my initial specialty, I ultimately chose another PMHNP program over Duke as a result of the subpar clinical placement experience. While Psych offers more options in terms of placements with telehealth, etc., I felt the price was much too high for me. What I mean is, not only would I be paying tuition, but I'd be paying with my own mental health as a result of all of the sleepless nights, worry and networking to find someone to precept me. Obviously having a partner who is a PMHNP would make the process easier for me, but it was still something that I did not want to deal with. Eventually I found a program that was half the cost and was very happy with pursuing the postmasters elsewhere. Best of luck to you. Duke is a GREAT nursing school and even with everything described above, I'd do it all over again (just once) because it suited my life, goals and enabled me to work as an RN the entire time that I was a DUSON student, but the clinical placement situation was truly disappointing.