Interested in being a psych NP...not sure how I feel about being a psych RN. Is this a terrible idea?

[Pavlovian]

I'm considering going back to school to pursue becoming a PMHNP. For background context - I majored in biology and psychology at a great school, graduated with a very good GPA and research experience, and have been working at a non-profit providing services to clients with disabilities.

I'm very interested in medication management and psychopharmacology, and would ideally like to work with an outpatient population. I love working with clients at my current job, and I think I could make a decent PMHNP! But to be honest, I'm personally a little uncomfortable with the idea of working in an inpatient facility, and the vast majority of psych RN positions understandably seem to be in inpatient facilities. Obviously, I'd need to gain psych experience to be hired as a PMHNP, but I'm afraid I'm signing up for something I would hate.

Incidentally, I also think I'm a bit squeamish to make a good med-surg RN, and am worried about how I would perform in med-surg clinicals.

I kind of suspect the answer is "either suck it up or don't become a PMHNP"? I'm open to feedback along the lines of "don't become a psych NP, idiot." I'm worried I'm trying to wade into something that would require doing several things that I'm not very well-suited for, and I'm trying to get a reality check. I'd really appreciate any advice that people are willing to give me (and thanks for your time if you do!).

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[Pavlovian]

PMHNPs work in a number of settings, not just inpatient facilities. As long as you don't care too much about compensation, since a glut of new graduates is on the horizon, then give it a shot.

Thanks so much for your reply! What I'm more worried about is gaining psych experience after becoming an RN but prior to becoming a PMHNP (and therefore being competitive with a glut of new graduates on the horizon ).

 

[pamac]

I posted just a few minutes ago. You should read what I said about experience.

You may hate being a psyche RN, but you probably won’t hate it as much as being a medical RN. I’ve done both, and really loved being a psyche RN.

But you really need to think hard about skipping that step, because it makes a big difference in your future. Prospective psyche NPs need to put a lot into networking and helping themselves stand out to employers. Nothing quite equals the insight you gain from dealing directly with patients in a mental health setting, and in a position of real responsibility... the kind of experience you get from being an RN. If you don’t have that, then someone like me who has input on giving you a job will not even talk to you. We are the gatekeepers for the good paying jobs with the good work environment, and we want to work with people who we think are quality. The difference between a good job in psyche and one that sucks is vast, and you want to set yourself up to qualify for the good jobs.

 

[psychnurse]

I'm curious to know your reservation about working inpatient psych.

 

[pamac]

I'm curious to know your reservation about working inpatient psych.

Me too.

If one doesn’t work inpatient psyche, one isn’t taking advantage of one of the most important insights that can be obtained by a psyche NP. You get front row seats to what happens in severe mental illness, you recognize clues that help you elsewhere, and you see direct results of what happens when you screw up as an NP and don’t treat your patients. Further, you get a chance to read countless provider notes about patients. The list goes on. But it’s what you make of it. One can be an inpatient nurse and avoid delving into a lot of things that will help you later on, but it’s not common to miss out on everything you could be gleaning from the experience. But I’ve said a few times that I won’t even entertain the notion of precepting a student who doesn’t currently work as an Inpatient RN, and I’m now even considering requiring them to have several years of experience. I’m polite but blunt about that when someone calls.

Folks need to get the experience.

 

[CrossfireHurricane77]

Working as a Psychiatric RN will give you a tremendous amount of experience. You get to see many different patients and get to work closely with the Psychiatrists. Obviously I am not comparing working as an RN to Residency, but if you work many years as a Psych RN first, you'll get a ton of experience with this population and it'll benefit you in the future. If you don't think you'll like working as a Psych RN, then I don't think you would like being a PMHNP. I personally love working as a Psych RN even when there are many high acuity patients, but decided that pursuing more education would open more doors. You could even work per diem as a Psych RN to see if you like working with that population. It is a hard job since you can have days where you'll be working 12hrs with some potentially dangerous or high acuity patients. Unlike the Doctors or many of the other staff who can go into their office, you'll be the one essentially stuck constantly deescalating situations and utilizing every trick to keep the unit calm. In the end you'll learn a ton on how to work with this population effectively. It is an art, and no amount of schooling can prepare you 100%. Good luck!

 

[pamac]

Working as a Psychiatric RN will give you a tremendous amount of experience. You get to see many different patients and get to work closely with the Psychiatrists. Obviously I am not comparing working as an RN to Residency, but if you work many years as a Psych RN first, you'll get a ton of experience with this population and it'll benefit you in the future. If you don't think you'll like working as a Psych RN, then I don't think you would like being a PMHNP. I personally love working as a Psych RN even when there are many high acuity patients, but decided that pursuing more education would open more doors. You could even work per diem as a Psych RN to see if you like working with that population. It is a hard job since you can have days where you'll be working 12hrs with some potentially dangerous or high acuity patients. Unlike the Doctors or many of the other staff who can go into their office, you'll be the one essentially stuck constantly deescalating situations and utilizing every trick to keep the unit calm. In the end you'll learn a ton on how to work with this population effectively. It is an art, and no amount of schooling can prepare you 100%. Good luck!

“Using every trick to keep the unit calm....”

Thats completely true. And the part about being there 12 hours and seeing everything unfold.