Torn between FNP or PHMNP

lucianne · Feb 27, 2010

Depending on where you are, I think you will have a better chance of getting a job as a PMHNP than an FNP. In my area there aren't that many PHMNPs but FNPs are all over the place. There is a shortage of psychiatric care--especially child and adolescent-- and if you want real autonomy, private practice for PMHNPs doesn't cost that much to start up.

Yes, you might have trouble finding a preceptor in psych/mental health, but that should tell you something...there aren't enough of them.

HumptyDumpty · Feb 27, 2010

Thanks for the reply! Usually when I look online at job postings, I see more FNP listings, but I suppose a lot of opportunities are posted elsewhere. Do you think the future looks bright for the PHMNP? Any other input from anyone else?

PsychiatricNP · Feb 27, 2010

Hey Humpty:

I am in the exact same position as you. I am will be finished with an accelerated BSN program in May 2010 and am conflicted as to whether I want to go the PMHNP or FNP route. I already have a bachelor's degree in psychology and a master's degree in social work, so I have several years of experience in providing individual, family, and group therapy as well as pretty good insight into the role of the PMHNP and the mental health system overall. That being said, I feel confident that the PMHNP is a role that I would enjoy. In nursing school I have taken opportunities to choose rotations that offered me opportunities to do a lot of primary care, which really got me into the idea of the FNP role. Prior to nursing school, I had worked closely with an FNP in a rural hospital and clinic, so I have a bit of insight into the FNP role as well.

My thoughts on trying to decide on which route to take is much like yours - am I going to be able to easily get a job. I think the answer to this is largely dependent on where you live. In my state, there are ample opportunities for both the FNP and PMHNP - we have a severe shortage of family practice physicians and psychiatrists. Nurse practitioners are independent and require no collaborative agreement with a physician. Which doesn't help me out much, but it may benefit you to talk with both FNPs and PMHNPs who are in practice to see what they feel like the future of healthcare is in your geographical area. In several states that my wife and I have looked in to moving to, there are restrictions placed on PMHNP (requiring extensive collaborative agreements) which may have discouraged me a bit from the PMHNP in terms of mobility.

Ultimately, I have applied to both PMHNP and FNP programs for admission during the fall. I feel that, for the area I want to practice in, and me professional goals, both would be a good fit....so, I will let the admissions process decide for me :) My thinking is also that I can get either the FNP or PMHNP first and then go back and get a post-master's certificate in the other area in just a couple of semesters. Those are just my thoughts. Best of luck as you try to make a decision.

zenman · Feb 28, 2010

As one poster stated there is very little you need to set up a practice as a PMHNP because you are mostly using what you have between your ears. There is a huge shortage and even more of anyone treating children/adolescents. And don't let your your decision be influenced when you see private pay rates such as:

Initial evaluation (60 minutes) $260

Med management (20 minutes) $135

Individual therapy (45 minutes) $160

chellepnp2007 · Feb 28, 2010

I agree, the need for mental health np's is greater right now, and so the salary ranges are higher. You can not function in a mental health role as an FNP, at least not in Texas. I am a PNP and have been approached by a child psychiatrist who needs help in his practice really bad, but I am not able to help him with my credentials. If you are really interested in the mental health area, I would encourage you to go for it.:)

HumptyDumpty · Mar 1, 2010

Thanks for the replies everyone! I am leaning more and more towards the PMHNP route. I really believe its where my passion lies and from everyones input, it doesn't sound like I would have a terrible time finding a job if I am willing to relocate. Now its time to start applying to some programs! I know of a couple, but does anyone know of some online programs?

DrZaphod, BSN, MSN, DNP, RN, NP · Apr 27, 2010

In many states, FNP's can't collaborate with psychiatrists. I've been an adult PMHNP for about 1 year now and I have had some difficulties finding jobs, and I've been looking in multiple states. One of the biggest obstacles I've come across is that I cannot see under 18 year olds. Several of my friends are FNPs and have no difficulty finding jobs, but can't work in psychiatry.

The answer may be to do the PMHNP and then do a post-master's as either FNP or child/adolescent PMHNP. That's actually what I'm currently trying to figure out - which would benefit me more. If I was a dual PMHNP and FNP, then even though I prefer psychiatry, I suppose I could use the FNP credentials to do general med-surge or something. Good luck!

SandBetweenMyToes, BSN, RN · Apr 27, 2010

Is there anyone out there who got their FNP and went back for psych certification? I really would like to have both. I am nearly finished with the FNP, and wonder what would be the fastest/quickest add-on to get the psych cert. Thanks!

lucianne · Apr 27, 2010

Madglee--there isn't a certification for child/adolescent PMHNPs, only family PMHNPs and adult PMHNPs. The advantage to the family PMHNP is that you can treat all ages. Unless someone was adamant they didn't want to treat children or adolescents, I think the family PMHNP is the best choice. I went to school with someone who was an adult PMHNP and returned to get her clinical hours for the family PMHNP certification. All she had to do was take 2 semesters of clinical class.

WyndDrivenRain, BSN, RN · May 2, 2010

Is there anyone out there who got their FNP and went back for psych certification? I really would like to have both. I am nearly finished with the FNP, and wonder what would be the fastest/quickest add-on to get the psych cert. Thanks!

I believe this is the direction I'm going to go because I can get into an FNP program for this year but the PMHNP program I want to attend I would have to wait until fall 2011 to get in. I'm thinking I'll do the FNP and go right back for PMHNP post Masters. I do not want to just sit around for a year and having the FNP will be just give me some additional options down the road. Maybe it will be combining primary care and psychiatric care of children/adolescents or something like that.

Sue, RN

DrZaphod, BSN, MSN, DNP, RN, NP · May 13, 2010

Madglee--there isn't a certification for child/adolescent PMHNPs, only family PMHNPs and adult PMHNPs. The advantage to the family PMHNP is that you can treat all ages. Unless someone was adamant they didn't want to treat children or adolescents, I think the family PMHNP is the best choice. I went to school with someone who was an adult PMHNP and returned to get her clinical hours for the family PMHNP certification. All she had to do was take 2 semesters of clinical class.

Lucianne,

When did the family PMHNP come about? I could swear the only choices when I started in Sept of 2006 was Child/Adolescent CNS or Adult PMHNP. I am SO frustrated - if FPMHNP had existed, I would have just done that, because then I'd be infinitely more marketable. I can't tell you how many jobs I've lost because I don't have the option of seeing under 18.

They do the same amount of clinical hours and same amount of credits and get to see everyone! *******' watered down, but I still would have taken it.

What did your friend have to do? I'm already WAY in debt from the BSN and MSN and was going to try to convince the ANCC to just let me sit for the exam if I had the clinical hours in child - another 500!!

What "extra" classes would I need to take? Where'd they do it? Hmm, 2 semesters...and another 20 grand or something. GRrrrr!