Should I get my PMHNP at 54 yrs old?

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by Nurse Beth Nurse Beth, MSN (Columnist) Educator Columnist Innovator Expert Nurse

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.


Dear Nurse Beth,

I'm 54 y/o female, been a nurse 36 years, currently a RN for 23 years (first 13 as an LPN) working for a geri-psyche facility for about 8 months. I'd like to go for PMHNP after I first get my BSN, single, single source of income, is this something I should pursue at my age? I anticipate working another 20 years at least. I hear so many nurses saying the field is saturated and a good paying job with benefits (which I really need) is almost impossible to find a job. Please advise, I don't want to incur debt to go to school if I may have extreme difficulty getting a job.

Dear Don't Want to Incur Debt,

There's a lot to thoughtfully consider when going back to school for your PMHNP in your situation. It's true that fifty-four is no longer considered old (in my book) and it's also true that returning to school to become an NP is a costly, time-consuming endeavor. Many nurses who have worked 35+ years want to spend their fifties, sixties and beyond relaxing.

There's career longevity to consider. Let's say it takes 2 years to get your BSN and another 3 to get your NP training and land a job. That puts you at right around 60 yrs of age. If you work until you are 74, that's 14 years of practice, and that's probably your best-case scenario. A non-best-case scenario could mean taking 7 years to complete your studies and land a job, and then working until you're 68, which amounts to 7 years of practice-which still may be worth it to you.

The tricky part is predicting your health and your predicted burn-out with working in general, but either way, working as an NP is less physically demanding than working as a bedside clinician. 

Do a cost-benefit analysis. Wages for  NPs vary greatly, so it's important to look at what NPs are paid in your area.

Your school debt will offset your increased wages. Let's say you make 75K right now (sorry if that's way off, but just as an example) and let's say you'll make 100K as an NP. If your loan payments are 4.5K per year, you'll be taking home 20K per year more than you are now, so around a $750.00 paycheck bump. Which is not nothing, as my dad would say, but only you know what amount is financially motivating.

I know the example is overly simplistic, there are taxes, and possible salary adjustments while you're in school if you drop to part-time, but you can still make an educated best-guess.

Saturated market. We are told by the United States Bureau for Labor Statistics (BLS) that the need for NPs is so great that openings for nurse practitioners in the U.S. will increase 36 percent between 2016 and 2026, substantially faster than the average 7 percent growth anticipated across all occupations during that time. 

On the other hand, when you talk to many nurses, there's a strong sense that schools are turning out so many NPs that there will be a surplus. But that's tempered by a shortage of primary care physicians and an aging population.  NPs do have a growing market in outpatient care delivery and population health as well as a role in filling primary care and rural access voids. 

The surplus/sustainability topic is well discussed right here on allnurses on some very interesting threads.

If you consider this with eyes wide open, and do some soul-searching, then you'll be set to make the best decision for yourself. You could also take some time, and test the waters while you get your BSN. You'll have a better idea if school is for you.

Best wishes,

Nurse Beth

C.Love, MSN, NP

Specializes in CCRN, CPAN. 25 Posts

I was your age when I started my FNP program, graduated 3 years ago, and am having a very difficult time finding a job, because most employers want experience as an NP and want you to work solo.  I'm finding the pay is less and it's very difficult to find a preceptor, and often the preceptor doesn't really have interest in creating a good learning environment. Another difficulty for me is I live in Southern California Suburbs, and most of the jobs are over an hour away, so a lot depends on where you live, if you're willing to commute or relocate. Also to consider, is since you want to go into Psych., there may be more opportunities. I would talk to Psychiatric NP's and find a school with live classroom and tone hat doesn't send you on the hunt for a preceptor. Additionally, I sense a little ageism during my search for jobs. I had much higher hopes for what I ended up with. I attended University of Phoenix which had good live classes and we worked hard and learned  a lot, but you're pretty much on you own for finding a preeptor.