Psychiatric NP - job security?

[tofcancer]

I'm facing a dilemma. I'm 26 years old, and I've been working as a bedside nurse (psychiatry) for just over three years. I LOVE my job, and I'm great at it, and to those who would say psychiatric nurses aren't "real" nurses, I'm not even insulted, because I recognize that our skill set and job demands are extremely divergent. Although I work at a medical center and therefore care for psych patients with some serious medical co-morbidities, I would be truly lost on an acute med-surg floor. I would probably be as lost as the med-surg floats are when they try to de-escalate a psychotic patient.

I feel that I am stagnating, however, and my good friend recently applied for and was admitted to a university to obtain her NP as a family nurse practitioner. Neither one of us has any experience on a med-surg floor.

I am interested in continuing my education, and pharmacology was my favorite course in college, but I'm not sure whether to pursue FNP or psychiatric NP. My relevant concerns are not only which I will enjoy more, but which is more employable, especially given where our healthcare system is going. For instance, I can see FNPs caring for clients with "basic" psych issues the same way primary care doctors now prescribe antidepressants and anxiety medications.

I question whether I shouldn't try to get experience in med-surg before I make a decision, but that is easier said than done around here. I work at a union hospital with great pay and benefits, but the transition to med-surg while staying with this healthcare system is very difficult because most "entry-level" med-surg nurses are only able to get a foot in the door as per diem, and I need the insurance and benefits of a staff nurse right now.

Ultimately, I might be looking at waiting for another year or two before gaining med-surg experience. I'd prefer not to make that commitment unless I'm sure that I'll be pursuing my FNP rather than NP.

Sorry for the long post. Any insights?

If it's relevant, I live in Boston, MA.

[TheCommuter, BSN, RN]

Your thread's been moved to our NP forum for more specific replies.

[PG2018]

Med-surg nursing has little to do with primary care medicine (FNP). Don't waste our time. Psych NP s presently a hot ticket. Sone of your skill set would transfer toward the latter.

[sadiemae1123]

I agree with the above. Med-surg isn't the end all/be all of nursing. I started out there, but spent almost a decade working in L&D and newborn nurseries before returning to school. Now I provide primary care for inpatient psych patients.

The FNP is going to give you a lot of flexibility in your career. You can work outpatient, urgent care, specialty, and in some areas - acute care. The main emphasis of the FNP is going to be primary care - i.e. chronic disease management, minor acute illnesses, and preventive care. That's not something you're going to see a lot of on a typical med-surg unit.

The psych NP is probably going to be more financially lucrative, at least for right now. With the growing awareness of mental illness and substance abuse, I don't see a decrease in job opportunities anytime soon. You'll be confined to treating psychiatric patients, but you would still have options in terms of outpatient vs inpatient or focusing on specific mental illnesses or subpopulations - i.e. forensic, children, adolescents, etc.

Of course, if you're really ambitious, you could always get dually certified.

[tofcancer]

Thank you for your input - I had not put 2 and 2 together that FNP duties are not really related to those of a med-surg nurse. My heart is leaning towards psychiatry.

[Psychcns]

Go for psych now and if you are still interested or if jobs are less available add the FNP later. Being dual certified means keeping up practice hours in two specialties.

[LoveRNBSN]

Is it a possibility that the current demand for psych NPs will be gone soon while FNP will maintain it's strength in the number of jobs available? Already, they say that there will be 6 medical positions available for every 1 FNP graduate. I don't hear the same thing in the psych world? However, I still say you should go after what you love most.

[tofcancer]

Well, I completed my application for NP with focus in psychiatry, so if I get accepted and can find a way to pay for it, I suppose I'll have my own answer and let you all know. Thank youuu

[Aik0]

Where did you hear that for 6 medical positions there is 1 FNP graduate? I'm currently trying to gauge the job market for FNPs. As for psych NPs, a lot of the positions I see that pay pretty well are for Psych. I've worked med-surge, ICU, etc and let me tell you...I can't ever do what psych nurses do. Each specialty is unique and contributes to the overall care of patients. I don't ever believe it when people say "so and so isn't a real nurse..." I've worked in about 5 different areas of nursing and have been a nurse for nine years. Each area has its challenges...

[xenogenetic]

I can definitely see our population not having a shortage of things to get them either depressed or agitated going forward. There will more Lil Waynes, Justin Beibers, and Kardashians to spur on demand for complicated psych services in the future.

[sailornurse]

I would say follow your heart and go for Psych NP. I had about 25 years med surg experience including orthopedics/tele/er and while it helps me somewhat to understand when patient come in for followups after being hospitalized, it does not help in primary care. I have been working for the last 10 months at an inpatient psych hospital doing the medical H&Ps and I am learning so much. I wish I had worked as a psych RN before becoming a FNP! And locally the Psych NPs are in high demand with salaries in the 6 figures. And yeah if the market changes you can always get a post master's cert.

[LoveRNBSN]

I agree. I am also a believer that every area of nursing has it's own challenges. I've worked in many different areas myself from ER, ICU, Med Surg and even Psych and each area has it's own distinct difference. Many of the nursing skills are transferable to other units, but you will still see their own difference.