Any Psych NP's with advice???

Nursing Students NP Students

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Hello everyone! I'm new to this site and I want to get some feedback on what psych NP programs are like. I'm a currently working as an RN and I have always been interested in psych. I recently started thinking of becoming an NP because I would like to broaden my knowledge and I think NP is better fit for me. I come across my fair share of psych patients on my neuro/ med surg floor where I work. I know neuro and psych are not the same thing but I am very interested in the psych population. If anyone could give insight on what psych NP school is like and a typical day for a psych NP who works in a mental health facility or hospital it would be greatly appreciated. Thanks 😀

Let me start at the end of this thread and see if I can get through it with any nausea medication. I do 30 minute sessions with both meds and therapy. The most important part of any therapy is the therapeutic relationship…look it up. Kinda of a bummer to spend all that money getting a Ph.D. in a therapeutic modality to learn that. Even more of a bummer to find out that with your new Ph.D. you'll make less than a Psych NP. MSWs make even less than a psychologist. So, if you can prescribe and do therapy you are big cheese.

I'm not quite sure if you were attempting to insult me or be condescending here, but whatever. I understand what the "therapeutic relationship" is...though a LMGTFY link would have been helpful. I would still work as an NP, which would still allow me to make the $$ I would like, however I would have the knowledge-base to do more psychotherapy rather than just prescribing. I do have ambitions of opening my own practice one day, as I have an MBA and have always wanted to work for myself. I just feel as though I'd be more prepared if I cover all bases with my education. Thanks for your lovely comment though!

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NP's often DO have the ability/knowledge to do psychotherapy, but their ability to do so on a regular basis is hindered by the setting and reimbursement requirements of where they work. If you work in the OP setting, the Psychiatrist you work for wants you to see as many patients as possible in as short a time as possible because they make money based on the number of patients they see (aka how many times they can bill insurance). If you work in the inpatient setting, you have a certain number of patients that are assigned to you, and you are required to round on them daily plus do admits and discharges. Admits are when you are most likely to form a relationship with your patient, get to know their background, health history, etc. Sure, you will have a small amount of time to get to know your patients when you visit them daily, but you are only reimbursed for a hospital follow up visit, not for doing psychotherapy (there are other inpatient providers whose job that is).

Your goal of owning your own practice one day, I'm sorry to say is a pipe dream, unless you are not in it for the money (read, you are willing to possibly take a loss). When you bill insurance, you bill based on ICD-9 (or ICD-10) codes (diagnosis codes) as well as CPT codes (procedural/billing codes). A CPT code might allow you say, a 30-45 minute (60 min max usually) consultation and a 15-30 minute follow up based on the complexity of the case. Granted, I am not a PMHNP, but I doubt that you are able to bill for a follow up and psychotherapy. Also, it makes very little sense for you to go through a PMHNP program as well as a PhD. program in psychology when you could just as easily refer your patients to psychotherapy and do a small amount of "talk therapy" with the patient while you are doing a follow up/med check/med refill. You would be spending A LOT of money on schooling, with not a lot of return on your investment. But then again, thats just my .02

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While I appreciate your comments, you're not in my shoes.

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Specializes in Psychiatric Nursing.

I do locum tenens as a psych np, inpatient and outpatient. I graduated from a good program in 1994, have had really good supervision over the years, went to a lot of conferences, and now I read a lot. Outpatient can be draining but I do 30 minute visits and do as much therapy as I can. Inpatient is, in some ways, a more reasonable pace but it is challenging dealing with complex medication regimens and the legal system. I think psych is a great field.

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Specializes in OB/GYN, Psych.

Therapy is definitely incorporated into my med follow up appts, and as a PMHNP (at least in my state) I can bill for a psychotherapy add-on. I imagine that the amount of therapy you get to do and how well you "know" your patients depends a great deal on the setting in which you work. I work in OP private practice and I have plenty of time with each patient.

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I'm not quite sure if you were attempting to insult me or be condescending here, but whatever.

"Let me start at the end of this thread and see if I can get through it with any nausea medication." This thread, not your post.

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Specializes in Brain Illnesses.

Elbumphis02, if the program is offering psychopharm - and across the lifespan, even better! - it'll be great. You'll be ready, for the boards, and for entry level.

I went to Wayne State. Also U-M. Neither program had psychopharm.

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Specializes in Brain Illnesses.

Thanks Jules! You did write that post- during a psychogenic fugue state I think.

Yes - people don't usually like it when others tell it like it really was. I think we're supposed to find something nice to say about the travesty of a program we went to, or to say nothing at all. That attitude is not going to help anyone - especially when what I said (or did you say it)? - is what so many other experience and may think they're the only ones.

I do like the Rx part of the job.. But I LOVE the psychotherapy. And it is entirely possible to make a practice and earn even more than at a hospital or OP job (for a psychiatrist) .....with the right specialty, the right neighborhood, the right rates.....

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Specializes in Brain Illnesses.

If you're a PMHNP, and you work for a psychiatrist OP or for a hospital In or out, you won't BE doing psychotherapy. You won't be allowed - your time is too valuable, so instead, the SW with NO psychotherapy training (or no requirement for same) will be doing the psychotherapy. You will be prescribing to as many as you can in a short space of time.

So if you want to work with the kids, the therapy part - why not just the Psych PhD or PsyD? You'd be allowed to do the therapy. And psych testing. And research. And private practice or as employee........and you'd have the nursing background that would always and ever inform your practice.

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Specializes in Brain Illnesses.

don't know if "happy" or "sad" or whatever figures into this. I bought a service: education opportunity for PMHNP. What I got was substandard, and lied to, to boot. Dissatisfied, and wanting others to know what to watch out for, sure!

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Specializes in Brain Illnesses.

Sounds like you'll be able to do it all...........OR, you could actually do the PMHNP, get a job in that for experience while sorting out where you want your practice, what sub-specialty area/population etc......and take courses in the psychotherapy. Don't necessarily need another degree for any of that.

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Specializes in psychiatric.

OP, I have posted a role delineation study regarding PMHNP's on the student NP board. On page 26 of the report it specifically looks at time spent by PMHNP's on med management, psychotherapy etc. It is a national study performed in 2011 by the ANCC so I think it will give you some solid data.

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