Psych NP vs. FNP

ANPFNPGNP · Jul 20, 2008

High all, I am a fairly new BNS RN. I am working on my first year experience on a busy IMCU in a large teaching hospital which is a level one trauma center. I have 20 plus years experience as a Licensed Clinical Social Worker. Most of my experience has been in mental health and medical Social Work. I became an RN specifically to become a Nurse Practitioner. Now I am wondering if given my extensive background in Mental Health, if I would be better off becoming a Psych Nurse Practitioner than a Family Nurse Practitioner which would probably be more marketable. It just seems that Psych would be much easier for me. Anyhow I would like as much info and input as possible. Thanks, Mahage

The FNP is definitely more marketable, BUT Psych NP's make a lot more money if you can get a job in that area. Do you live in a large city? If so, you shouldn't have a problem getting a job.

Check with your state's Board of Nursing b/c I've heard that some states allow FNP's to work in psych (Texas doesn't). If that's the case, then there is no reason to do the Psych NP, because you may have few job opportunities. I don't know of any state that allows a Psych NP to work in primary care.

ruralnurs · Jul 21, 2008

Hi,

I was a board certified psych nurse and then recently got my FNP and am now to begin a post-master's program for psych NP, so I have some info for you. As an FNP in most states you have a VERY broad scope of practice. Like a Family Practice doc that can do urgent care, ER, internal medicine and even deliver babies. As an FNP it is likely even in all states (but you would need to check) that you could manage the medications of a person that has a mental health diagnosis. For instance a woman sees you for a PAP and she mentions depressive symptoms then you could prescribe anti-depressants. There may be rules about seeing a person strictly for a psych diagnosis, for instance a person with Bipolar DO seeing you specifically for med management. In my state (Montana) I can work strictly in mental health as an FNP. But I cannot do therapy or counseling of any kind, nor can I do psych evals, I have to be a psych NP for any of that. As a psych NP you can't manage any of the physical problems (I have two very good friends that are psych NPs), so for instance you could prescribe a beta blocker for anxiety, but not for hypertension. If a pateint sees you and has an ear infection you could not prescribe antibiotics.

I live in a very rural area and I have had interest in me when I graduate with psych NP more so even than FNP. It is really all about supply and demand, there are very few psych providers (Psych NPs, Psych PAs, or Psychiatrists) out there.

If your heart is in psych then by all means go for it. If you have any questions about the need, take a look at the free NP journal called Advance for Nurse Practitioners (you can google it to get a subscription, I got a free one while I was still a FNP student) and look in the back you will see LOTS of jobs for psych NPs.

If you really would rather do more "medical" stuff then do FNP and you will still likely see the occasional person with MH issues. But there are so few of "us" (those that like psych) that you would be doing society a favor by going that way. As I am sure you know there is such a huge need for psychiatric care.

One thing you will have to decide is if you want to do Family Psych NP or Adult Psych NP.

Good luck!