Which Path? Want to be a PMHNP.

[verene, MSN]

Hi all,

I would like to become a nurse practitioner. Hopefully specializing in psychiatric/mental health. I'm not sure what path makes the most sense for me from getting where I am now to reaching that goal. I'm hoping the nurses and NPs of this forum can shed some advice and opinions.

Where I am now:

I am a late-twenties career changer. I hold a BA in a completely unrelated subject to nursing, and the majority of my work experience is in support capacity (admin, paralegal) in Intellectual property law.

I've started going back to school to work on nursing pre-reqs, so far I have English, Intro to Psych, and Lifespan Psych completed. I'm currently working on Bio. I've picked up a CNA license and am working as a caregiver in a Mental Health Assisted Living Facility.

My options:

I'm fortunate to live in an area with several different options for nursing education. There are two schools in the area that offer MSN options, and I have strong preference for one over the other. At my preferred school the options for entry are: BSN into MSN program, RN + BA/BS into MSN program, or BA+pre-reqs into Immersion-MSN program.

I'm trying to figure out which path of getting to these options, and which of these options is most likely to set me up for success both in school, and in career practice.

Do I just complete my pre-reqs and apply to immersion program? It's certainly the quickest option for me, but I'm unsure how feasible it is to do a masters program and study for the NECLEX at the same time. (NECLEX is end of year 1 in a 3 year program). Especially because the immersion program requires nearly twice the number of semester credits in the first year compared to the regular MSN program.

If applying to the regular MSN program I would need to complete either a ADN or BSN program and apply. There is one school that offers an accelerated BSN program - I'm not sure it is worth it, but it is an option. There are several schools offering BSN programs in the area, but already having one degree I don't really want to start all over again. Two programs offer RN to BSN completion options. At this point I think I'm leaning more that way, but there are very few employment options in this area with just the RN, so even though schooling would be cheaper, compared to the BSN/Accelerated BSN, I may spend that year not making any money any way.

In order to get into the RN program at the local community college, it is required to first have CNA, then complete LPN program, then bridge to RN. So it would take a while, though I already have CNA and have several of pre-reqs to LPN program complete.

So which path?

Should I try the Immersion MSN? Going through the LPN program to get some nursing experience and more skills education then do the MSN? Apply directly to BSN? Or work up the chain from CNA to MSN to give myself time and experience at each level?

I think the immersion MSN makes a lot of sense in terms of time and affordability, but I'm not sure if anyone would be willing to hire a new grad NP who doesn't have any nursing experience. Then again I know there is huge demand for Pysch NPs in my area so perhaps it isn't as much of an issue?

I know I have some time to figure things out as I won't have pre-reqs done until at least next fall, but I'd rather think on this earlier rather than later.

Please share your thoughts. Thank you.

(Also if any NPs particularly PMHNPs want to chime in on general strengthening of self for job and things to consider please share!)

[verene, MSN]

Anyone willing to respond? I'll simplify my question:

I have the option to become a Psych NP via early entry masters program where I would get my RN at the end of year 1 and then continue on immediately into the masters program.

I also have options to go through LPN->ADN to BSN or MSN entry programs. Given my long term goal of working as a pysch NP should I try to get more nursing experience before applying, or should I save time/money in school and just apply to the early entry program.

I feel that the second option may make it more difficult to get a job, but given my interest areas (community health/marginalized populations) and the very high demand for psych NPs in my area, it might not hurt me that much.

Does anyone currently working in the field have advice on pros and cons of each path when it comes to future practice, or any advice in general?

[mzaur]

I'm currently in an immersion program at Vanderbilt for PMHNP. I've sbadowed NPs/MDs and spoken to them at great length about my career before embarking on this path. There are certainly people out there who disagree with the immersion model for non nurses, but the fact of the matter is, you will have no issue finding a job without a BSN and no RN experience. There is a lot of demand out there, as you already know. And if you're willing to move geographically, you'll have no issue finding your first job. I have friends in the second year (last year) who already have jobs lined up and we don't graduate until August. 100% of psych grads in my program have jobs lined up before graduating. And once you have a year or two of experience, absolutely nobody will care about your RN experience at all. But by then you should be thinking about going into private practice anyway.

PM me if you want to talk more about this career, programs, the admission process, etc

[Jules A, MSN]

I really appreciate that you are working as a CNA in mental health now and feel that this experience will serve you well. In my area anyone who can fog up a mirror held close to their nose can get a job if they have the PsychNP certification so I wouldn't be too worried about finding employment. That said in my experience those with actual inpatient psychiatric experience as RNs tend to be more skilled at diagnosing. I highly recommend working as a nurse before attempting to be a competent prescriber. As for your program I'd figure out which one you can actually get into as well as adding up the expenses and time it will take and go with the best one from those angles. Good luck with this endeavor.

[verene, MSN]

Thank you both for responding -even if this thread was posted a over a year ago! At this point I am planning to apply to both direct entry masters programs and BSN programs. The direct entry programs save me both time and money in getting to my goal of psych NP, but there are advantages to going a bit slower through the BSN portion and having the opportunity to gain more exposure to both general and psych nursing. I think I'll see who accepts me, and make my decisions from there. Either way I'd be learning and working towards my goal.

I had the impression that there is huge demand for psych NPs and that "anyone" it seems can get a job. That is comforting on one level to know that I could get a job coming out of school and that job placement is high for new grads. I do however want to be a competent clinician so I appreciate the advice to get more experience, particularly in-patient.

The agency I currently work for will be opening a high-acuity SPMI home in the near future - essentially a half-way home for those coming out of long-term psych hospitalization at the state psych hospital with the goal of additional stabilization before transition to more residential care. My supervisor recently asked if I would be interested in transferring to that facility once it opens - I think it would be really good experience for me. At least 3 of the programs I am looking at applying to highly encourage their psych NP students to work as psych RNs while going through the program - I do plan on picking up per diem or part-time pscyh RN work once I qualify for my RN license. So I do have opportunities to gain more experience at my current level and above.

Also, any thoughts on doing a psych residency after MSN? There don't seem to be many out there but I feel like not having a lot of psych RN experience having my first year as an NP in a more structured/mentored environment could be a good thing.

Are there any more experiences or considerations either of you would recommend pursing?

[Jules A, MSN]

I hope at some point residencies will be a requirement but until then I can't really justify doing one unless the person had no psych experience and felt it would be worthwhile. If you get some inpatient exposure as a RN and make good contacts in the field so you can line up sharp preceptors I would guess you will be as ready as possible to start practicing when you graduate. For me passing out hundreds of psych meds, getting to know the dose ranges, desired effects as well as witnessing the adverse effects while working as a RN was invaluable.

[umbdude, MSN, APRN]

Hi verene - I was in a similar position as you. I'm now in a traditional BSN program (this is a 2nd BS degree for me) and after this semester I still have 3 more to go. I've been working in acute inpatient psych for about a year PT, and now per-diem (hoping to pick up another per diem). I hope to get an RN job in psych after I graduate and go for a part-time psychNP program (takes 3 years), so I'm going *really* slow and I'm not young. The downside to this is if I can't find an RN psych job after graduation it'll take me even longer.

[degratrj]

Mzaur, How are you liking Vandy? How are the online students doing? Is there high attrition? I'd love to know as much as you're willing to share. dg