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Psych NP burnout

Posted

Specializes in Med/Surg, International Health, Psych. Has 8 years experience.

I have not been practicing a year yet and I am feeling burned out and utterly depleted! No one mentioned this aspect in grad school. I did not come to the field as a Psych RN. I work at a CMHA and see lots of patients each day. I see the worse of the worse. The vast majority of my patients are drug seeking, always trying to con me out of a script. It is tiring trying to play clinician and police detective. There are exceptions of course, but quite frankly hardly anyone is getting better. There is no pill for the poverty and social ills. The stories of pain and mayhem seem to darken each week. Am I alone out here?

Not to mention the psychiatrists who are nasty to you or simply want to financially exploit you for their own benefit. One offered to pay me $10 per patient for side work and had the nerve to frame the offer as a "paid professional internship" while he is off flying his airplane.

I come home to smiling faces, but still have spiritual junk from the job on me. I have a family to support and poured thousands into this degree. Yet, it is getting harder to go each day. I do like seeing private practice patients, especially college students. They seem so invested in getting better. I also like working inpatient a couple days a week, but neither of those compensate as well.

Any advice from seasoned Psych NPs? I would ideally like to stick it out with my first job for at least 1-2 years before calling it quits. I even thought about getting a therapist just so that I could unload all the negativity that I seem to absorb from my job everyday.

Edited by resilientnurse

StocktonNurse, BSN, LVN, RN, EMT-B

Specializes in Cardiac ICU; CV Nursing; Medical Surg; Psychiatric. Has 13 years experience.

I am not a psych NP..but maybe you should consider working for the VA. Might be a better change of environment and better collegues. You will work with the veteran population which is a mix bag of folks. But if you keep an eye out they hire for psych NP's thoughout the year. usajobs.gov

Psychcns

Specializes in Psychiatric Nursing. Has 30 years experience.

For the drug seekers you may want to have your own rules, ie only give benzos for pts in therapy and try everything else first- ssris, visteral, trazadone etc.

For the burnout. I like swimming- something about water is very soothing to me. I think therapy is a good idea to sort things out. Maybe find a psychiatrist or aprn who will let you problem solve about pt issues as well as the burnout feeling. You might be able to develop a therapeutic style or perspective so you don't burn out. I think any spiritual practice would also help.

I think 1-2 years in a clinic job is good. Maybe there could be more support at work. Ie staff meetings, case conferences, etc

I also find outpt very draining. I do locum tenens so I just do it for 3 months at a time. I am not sure if you can work closely with people with tremendous needs without it being draining. I guess the trick is to bounce back. Best wishes.

I am burnt out too! I can relate to everything you say. I think all prospective psych NP student should read your post before getting in the field. It is very draining. I just hope one day I can realize my dream of finding a 4-day workweek psych job in this upcoming saturated market. That will be a work-life balance for me. But at the end of day, I tell myself it is still what I "prefer" to do for a living in comparison to everything else. At least I made the right decision. I have other hobbies but I cannot make them careers.

Unfortunately, the number of jobs and the varieties of practice setting are limited in psych only. We do not have the luxury like FNP. Anyway, I do not think you should be worried about making sure that your first job last 1-2 years. I do not think it really matters much. You can keep eyes up for new opportunities. My suggestion is to mix with two different types of setting. Maybe one outpatient and one inpatient/or consultation liaison for medical hospital. I am mixing them now and I am experiencing less burnt-out. While figuring out, how about doing contracting VS locum for a while since it tends to pay more? I do not think it will hurt your work history since these jobs are temporary in nature and you are not considered employee.

Although sadly most psych patients do not get better, there are some clinics tends to have high-functioning patients. Most psych outpatient setting are bad and they only want to fill your schedule and see the bottom-line but they are not all equally bad. How is your work load? I, as well as many psychiatrists, are hesitant to work anywhere with less than 30 min for follow-up and 1 hr for initial. I know most places will push more but I am hesitant to do it no matter how much they pay. This is psych, not medical /derm. I need time to talk and build rapport... and that's why we cannot make much.. we can't see patient every 10-15 min (in outpatient settting) I think.. we cannot just quickly scan the patients and put them in a shopping cart like other specialties (figuratively speaking).

Edited by harmonizer

I'm a PMHNP and I love my job. I'm almost euphoric on the way to work every morning. I've tried to get management to open a Saturday clinic so I could come in more often. Most of my patients see great improvement. They have easy access to healthcare, both primary care and behavioral health. I have 1 hr for initial intakes and 30 min visits thereafter. They get in trouble if they miss an appointment. A wife came in to see me this morning concerned about her husband. One phone call and his butt will be escorted to my office. I work in a department of over 50 people and I enjoy working with them all. I have 3 RNs that help me and psychologists and social workers running all over the place. I have physicians who are my patients. I have pharmacists available to do polypharm consults. I have nutritionists and a wellness center to help anyone with fitness and weight reduction. Speaking of weight, I have a Popeyes fried chicken joint right down the road and now that I'm thinking about it I'll be there tomorrow for lunch. On the way I'll probably wave at a few of my Jeep buddies…who wish their Jeep was as pretty as mine.

I work on an Army post treating Soldiers and their dependents.

So basically, it all depends on the jobs but most psych NPs are not as lucky as zenman. Many community mental health clinics are struggling...