RN after NP school

[mhnurse234]

Hi everyone! I just completed a direct-entry PMHNP program and am now in the licensing/job application process. Based on my NP clinical experiences and interests I would really like to work in inpatient psych. I do not have RN experience in psych, however, and am debating whether I should take a year or so to work as an inpatient psych nurse first. In retrospect, I should have done this before graduating NP school, but this is where I’m at. My main concern is forgetting the NP-specific knowledge/skills that I gained throughout my master's program. While I can continue to study material from my PMHNP coursework and regularly review research updates, I won’t be able to replicate the type of learning/experience from psych NP rotations in terms of the nuances of clinical decision making and practicing the psychiatric interview. Has anyone else worked as an RN after graduating from NP school instead of going right into the NP role? Any tips on how to maintain NP knowledge during this period? Thank you so much for any feedback!

[db2xs]

I did not work as an RN after NP school but something in my gut says not to do it unless you have zero options for any NP job for years and years. I know direct-entry NPs who had no experience as an RN in their specialty and are doing just fine.

Another option is to work concurrently as an RN as you do your NP job but you run the risk of getting things mixed up. I also know NPs who continued working as RNs in their first year of being an NP.

[mhnurse234]

1 hour ago, db2xs said:

I did not work as an RN after NP school but something in my gut says not to do it unless you have zero options for any NP job for years and years. I know direct-entry NPs who had no experience as an RN in their specialty and are doing just fine.

Another option is to work concurrently as an RN as you do your NP job but you run the risk of getting things mixed up. I also know NPs who continued working as RNs in their first year of being an NP.

That was sort of what my thinking was originally, I think I'm just panicking a little since it's taking a little longer than I anticipated to find a job. Thank you so much for your response!

[FullGlass, BSN, MSN, NP]

This is a hard time for a job hunt due to COVID. Take any psych NP job you can get. It is generally easier to get an outpatient job.

[mhnurse234]

33 minutes ago, FullGlass said:

This is a hard time for a job hunt due to COVID. Take any psych NP job you can get. It is generally easier to get an outpatient job.

Good point about COVID. Aside from my general interest in inpatient work, I have heard that physician supervision tends to be a bit more robust in inpatient, which is one of the reasons I've been leaning that direction as a new NP. This is probably something I can find in outpatient as well though, so I should probably expand my search a bit. Thank you for your response!

[KatieMI, BSN, MSN, RN]

The short answer is NO. RN experience generally adds not that much to nothing to your NP prospectives, and if you do that RN year it will just place you in unfavorable category of an "old new grad".

Depending on your local market (although there is a shortage of PMH providers in many places) you might have to work in different setting before you land inpatient Psych job. But you need to start as an NP now because you are NP.

[umbdude, MSN, APRN]

I don't recommend doing that either. Every minute you spend working as a psych RN is minute lost to gaining crucial PMHNP experience.

There are things you could do if you're concerned about jumping into inpatient psych with no experience: find mentors, request close supervision, ask for a reduced patient load in first 3-6 months, and just work 10x harder (these really apply regardless of setting).

Also, even if you have to work outpatient in the beginning, you're still gaining that valuable prescribing/diagnosing experience (which is far more important than RN experience). You can transition back to inpatient when the opportunity presents itself.

[mhnurse234]

Thank you all for your responses!