If you want to work in psyche, PMHNP will put you in a far better position professionally than being a PA will. I could go on and on how I’m glad I chose PMHNP vs PA, and particularly because I’m working in an independent practice state. I pull in about $100,000 more per year vs what I could as a PA working in psyche. My professional mobility is significant as well. My negotiating power is far better than any PA I know, even those with more experience. I would never suggest to someone, especially an RN, that they should opt for PA vs NP, especially in psyche. PAs are trained well, but on a purely financial and professional basis, for a nurse it just doesn’t make much sense.
As far as how you choose to train to be an NP, being a “top” school is a bit of a misnomer. Finding the right school (one that isn’t a purely online for profit program) is better than finding the most expensive program attached to a big name. I went to a hybrid online program with in-person components, and thought that was a good balance. Find out why those “top” programs say they are “top” programs. You don’t have to spend a lot to go to a good NP school.
You really should get experience as a psyche nurse. There is a difference between those that have it and those that don’t, and it shows. Nurses outside of psyche think that they see enough patients with psyche issues that it gives them enough to go on, but compare that to the nurse who spends 12.5 hours at a time dealing with the same patient, day after day. As a psyche nurse, you have such a wealth of exposure to how psyche meds work, how patients handle things, how you respond to patient interactions.... the list goes on. You get a feel for who is BSing you, who is BSing themselves, who is legit. You make mistakes and discover your mistakes, you learn about your biases. You see people get better and realize that you misjudged them. You see people get worse and realize that too. That kind of experience is what made me valuable and marketable as a new grad vs other PMHNPs, particularly those with less RN psyche experience than me. I’ve been tested, and I can go on and on to an employer about past experiences that have forged me.
So that’s the advice that I’d give someone I care about. It might not be universally applicable to everyone. Maybe there’s a hot shot cardiac nurse that would fit seamlessly into psyche without prior experience. But I don’t give advice that focuses on outliers. You have 2-4 years before you hit the ground as a new grad psyche NP, you might as well be doing what you can to immerse yourself in a field that really needs you to be trying your best to understand it.
