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How To Become a Psychiatric Nurse Practitioner

August 10, 2021 | Staff Writers

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Psychiatric nurse practitioners work with patients who are living with a variety of psychiatric disorders. They help patients live with anxiety, mood disorders, ADHD, and other similar issues as well as much more serious disorders such as schizophrenia or substance abuse.

A psychiatric nurse practitioner will evaluate a patient before they receive care, and monitor their progress as they work to live with their mental health condition. These highly specialized registered nurses deal with sensitive and often complex mental health issues and work with people from all walks of life.

Psychiatric nursing is a challenging field, and someone who chooses to become a mental health nurse practitioner must be good at listening to and communicating with people who are facing long-term struggles. Where some nurses work with diseases of the body, a mental health nurse helps people with the struggle going on in their minds.

Psychiatric nursing can be difficult, but the successes are rewarding. These nurses educate patients and equip them with the tools they need to improve their mental health and cope with their conditions, and also educate loved ones in the ways they can support the people around them who are dealing with mental health issues.

Psychiatric Ns can work in a variety of settings, including doctor’s offices, hospitals, private practices, correctional facilities, and even offering support to employees at large corporations. It’s not uncommon for psychiatric nurse practitioners to open their own practice and focus on one specific area of mental health, such as drug addiction.

Why work in mental health as a nurse?

There are many reasons to focus on mental health as a nurse. For some people, the choice is personal. Perhaps they know someone who has been impacted by bipolar disorder, stress, PTSD, or a similar issue. Alternatively, they may have struggled with mental health in their own past and want to make a difference to others the way a nurse helped them.

Other nurses decide to focus on mental health because it is a field where they get to focus on a small number of patients over a longer period of time. Having been exposed to the ICU, emergency room or family clinics during their ADN or BSN studies, they feel the dynamic of mental health, where patients are treated over an extended period of time, suits them better.

A nurse working in a busy hospital may be exposed to a huge number of patients each year and feel the wards are like a conveyor belt and that the treatments become impersonal. Psychiatric nurse practitioners are expected to maintain professional boundaries, but get to have follow-up visits and work more closely with individual patients, which is something that appeals to many nurses.

The nurses may also have the chance to work with family members, explaining what a diagnosis means, helping people adapt to life with dementia or get on the road to recovery following a traumatic event. This is one of the most positive and rewarding aspects of treatment.

Those in rehabilitation facilities or serving veterans with PTSD may have the chance to see patients recover from their ‘rock bottom’ to go on to lead a successful and productive life. It’s rare for nurses in other fields to have the chance to see how the lives of their patients develop after they have been treated.

What is the employment outlook for a psychiatric nurse practitioner?

Psychiatric nurse practitioners are considered highly qualified nurses, and they have a significant amount of respect and autonomy. The rules regarding the scope of practice for nurse practitioners vary from state to state, but in most states, psychiatric nurse practitioners can diagnose, prescribe and offer treatment plans for mental health issues.

Depending on the complexity of the issue, a psychiatric nurse practitioner may have to work with a psychiatrist, but for common issues, they are often the main health professional that a patient will see.

The pay enjoyed by psychiatric nurse practitioners reflects their status as advanced practice nurses. According to the Bureau of Labor Statistics, an advanced practice registered nurse earns an average of $115,800 per year or $55.67 per hour.

Advanced practitioner-level jobs are in high demand. As of 2019, there were 263,400 open positions for such highly qualified nurses, although this figure covers multiple specializations, not just psychiatry and mental health. Demand for skilled nurses is growing much faster than the general job market.

Psychiatric nurse practitioners can work in a variety of health care settings, giving them the freedom to choose their patient base, to an extent. While studying to qualify as a psychiatric nurse practitioner, a nurse will be expected to learn about all kinds of mental health conditions, but upon qualification, there are opportunities to specialize.

Requirements to become a psychiatric nurse practitioner

Before becoming a psychiatric nurse practitioner, you’ll need to earn a nursing license and become a registered nurse.

This means earning a Bachelor of Science in Nursing (BSN). Some nurses start with the Associate’s Degree in Nursing (ADN), then pass the licensure exam (NCLEX-RN) and complete the final two years to top up the ADN to a BSN while earning clinical experience.

After becoming a registered nurse, you have the option of specializing in a variety of fields, including psychiatric nursing.

The NCLEX-RN covers several subjects, including:

  • Reduction of risk potential
  • Basic care and comfort
  • Care management
  • Safety and infection control
  • Maintaining a safe and effective care environment
  • Physiological adaptation
  • Pharmacological therapies
  • Parenteral therapies
  • Psychosocial integrity
  • Health promotion and maintenance

Registered nurses are equipped to provide a basic standard of care in a variety of settings including emergency departments, clinics, oncology, pediatrics, neonatal care, ICU and public health. After spending a couple of years practicing as a registered nurse, there are opportunities to specialize in other clinical settings.

What do you need to become a psychiatric nurse practitioner?

The usual route to becoming a psychiatric nurse is to study to become an Advanced Practice Registered Nurse by taking a Master’s Degree in Nursing (MSN). Along the way, the nurse has the option of racking up hours of clinical practice and earning certifications such as the Psychiatric Mental Health Nursing Certification, which lasts for five years and indicates that the nurse is competent to work as a mental health nurse.

The certifications are useful, but to be a qualified nurse practitioner, the nurse will need to pass an accredited MSN or a Doctor of Nursing Practice (DNP) with a specialty in mental health care.

It takes two years to complete an MSN, assuming full-time study, and an additional two years of full-time study to complete a DNP after earning an MSN.

There are several certifications that may be of interest to individuals interested in working in the psychiatric field.

How much experience do you need to become a psychiatric nurse practitioner?

Qualifying as a nurse practitioner can take a long time. After earning a BSN and passing the NCLEX-RN examination, nurses are expected to build up a significant amount of clinical experience before becoming an Advanced Practice Registered Nurse.

For someone who wishes to specialize as a Psychiatric NP, it is assumed that a significant amount of this experience will be in an area related to mental health. So, for example, a registered nurse would earn the Psychiatric-Mental Health Nursing certification and spend time working in wards and clinics, building up 2,000 clinical hours of experience plus as much continuing education as possible over a period of at least two years.

The mental health certifications issued by the American Nursing Credentials Center are valid for up to five years. Nurses are expected to keep a record of continuing education credits and re-certify when their certificates expire.

What you can do as a psychiatric nurse practitioner

Psychiatric nurse practitioners work in a variety of settings, diagnosing and assessing patients who have mental illnesses, substance abuse issues or disorders. They assist with treatment plans, educate patients and their loved ones, and can offer psychotherapy or prescribe medications.

Nurse practitioners, in general, have a much broader scope of practice than registered nurses. A psychiatric mental health nurse is someone who has spent a long time studying the field of mental health and is trusted to diagnose, prescribe and treat within that scope of practice.

What is your role as a psychiatric nurse practitioner?

The exact job of a psychiatric nurse practitioner will vary depending on the setting they work on and even the laws of the state in which they are based, however, there are a few things that are often considered a part of a psychiatric NP’s job:

  • Diagnosing and treating psychiatric issues and crisis
  • Recommending psychopharmacologic management, often in collaboration with a patient’s psychiatrist
  • Providing therapy for individuals or groups
  • Counseling clients diagnosed with common psychiatric conditions
  • Coordinating multidisciplinary services for clients with more complex issues
  • Monitoring the mental health of clients on an ongoing basis
  • Providing family mental health education
  • Promoting positive self-care
  • Using age-appropriate screening tools
  • Advocating for mental health clients and their loved ones

Unlike nurses who work in wards or the emergency room, those in psychiatric nursing, and in particular those who become a family nurse practitioner, may deal with the same clients on a long-term basis. It’s common for mental health nurses to support clients for many years, which is something some nurses find rewarding about that part of the profession.

How do psychiatric nurses help mental health patients?

Psychiatric nurse practitioners can diagnose conditions, recommend both counseling and pharmacological treatments, and coordinate care with doctors, psychiatrists and other experts. They can advocate for their clients and offer advice and support about the diagnosis the client has been given.

In addition to working with patients, they have some scope to work with family members as well. For example, they may recommend resources or offer advice to help a parent of a child diagnosed with an eating disorder support the child’s recovery, or provide information about dementia to help a spouse understand what to expect and how to support someone who is in the early stages of living with the condition

Psychiatric nurse practitioners are trained to help patients who have a number of different disorders or mental illnesses, including:

  • Anxiety
  • Autistic spectrum disorder
  • Bipolar disorder
  • Depression
  • Dementia
  • Eating disorders
  • ADHD
  • Obsessive-compulsive disorder
  • Panic disorder
  • Schizophrenia
  • Substance abuse
  • Personality disorders
  • Post-traumatic stress disorder

Many psychiatric nurses work in clinics, doctor’s offices, hospitals or community mental health centers, but these are not the only places that a nurse can work.

A psychiatric mental health nurse practitioner who is particularly interested in a specific area of mental health may opt to focus their work on that area. For example, they could choose to work in a correctional facility or a domestic violence shelter.

Other options include:

  • In-patient psychiatric facilities
  • Private practice clinics
  • Consulting for large companies
  • Government agencies
  • Schools (as a part of student support)
  • Residential substance abuse facilities
  • Psychopharmacology clinics
  • Public health agencies
  • Academia (in a research role)
  • Veterans administration facilities

As with so many other areas of nursing, psychiatric nursing and the field of mental health is broad, giving nurses the opportunity to focus their efforts on the parts that interest them the most.

An experienced nurse practitioner has many options in terms of career progression too. If they’d rather not specialize in a specific area of mental health, they can move into education or training, become a nurse leader, focus on research, or use their expertise to move into public health nursing and take on a more administrative role, steering public health policy decisions and resources.

Mental health nurses have the opportunity to support people who are facing challenging issues and can make a huge difference to the lives of their patients. Whether they choose to work in a hospital or to serve a specific demographic of the population, they can feel confident that the impact they have on the lives of the patients they work with will be significant.

How long it takes to become a psychiatric nurse practitioner

Studying to become a psychiatric nurse practitioner can take a long time, due to the high level of academic qualifications and experience required.

In most cases, it takes four years to go from deciding to become a nurse to qualifying as a Registered Nurse with a BSN. It is possible to pass the NCLEX-RN after just two years of study, but it is becoming increasingly common for hospitals to demand nurses either hold a BSN before employment or work towards completing the course within a few years of earning their RN license.

The BSN requirement is something strongly grounded in science. Studies show that BSN-prepared nurses produce better patient outcomes than ADN-prepared nurses, offering a higher standard of care and lower patient mortality rates. This knowledge has led to some states, such as New York, requiring all registered professional nurses to attain their BSN within 10 years of licensure.

After earning the BSN, the next step is to study for an MSN, which takes an additional two years, and then a Doctoral degree, which requires two more years of full-time study. Many would-be psychiatric nurse practitioners opt to study their doctoral degree over a longer time period, such as four years, so they can build up some real-world experience and clinical practice hours while they study.

What is covered in a psychiatric nursing certification?

Becoming an APRN requires extensive academic study and clinical experience. Those who opt to specialize in mental health will need a broad grounding in the subject.

To become a mental health nurse practitioner, a nurse would be expected to have completed at least 500 supervised hours of mental health nursing before they enroll in a doctoral program. These programs usually take three years to complete although many institutions offer a two-year full-time program or part-time programs that can run for up to 51 months.

In the doctoral program, students have the opportunity to learn a variety of skills and concepts, including:

  • How to diagnose and treat mental illnesses
  • Common characteristics of mental illnesses
  • Approaches to therapy such as CBT, group therapy, etc.
  • Leadership skills
  • Clinical problem solving
  • Collaborating with other health professionals
  • Ethical principles

Psychiatric mental health nurses may end up working with patients of all ages and from all walks of life. They may be expected to deliver care in a group setting or to individuals. Some patients may be receptive to the care they are receiving but others may be less enthusiastic.

Because of the variety of patients that a psychiatric nurse practitioner sees in their day-to-day work, psychiatric nurses must be versatile, flexible, and good at communicating both with patients and with other health care professionals.

Psychiatric nurses need to be able to relate to patients and their family members and communicate in a way that overcomes barriers or preconceptions. They often deal with sensitive issues and need to help patients and those close to them understand and overcome the barriers mental health issues can create.

In many states, psychiatric nurse practitioners work under a supervisory agreement with a psychiatrist or doctor. Having the skills to communicate with health care professionals and co-ordinate care as required is important, especially for more complex cases where a person may have a care team advocating for them about a variety of different physical and mental health issues.

Best schools with psychiatric nurse practitioner programs

If you’re considering going to nurse practitioner school to specialize in mental health, you’ll need to find a school offering a psychiatric nurse practitioner program that is recognized in your state. There are some online universities offering MSN qualifications with a focus on mental health, but before you enroll on an online degree it’s important to check it will meet your needs.

What are the pros and cons of completing a psychiatric nursing program either online or in-person?

Studying an online nursing program may seem like the perfect solution for someone who wants to earn an MSN or a DNP since online study makes it easy for a nurse to stay in their home town, continue working and building up clinical practice hours, and fit their studies around the rest of their schedule.

Online study often feels like the most cost-effective and least stressful way of earning a degree. However, there are some downsides to an online nurse practitioner program:

  • The lack of contact hours may make learning difficult
  • Online study requires a lot of self-discipline
  • There’s usually some requirement to travel for labs or tests
  • Some online courses have strict licensing requirements or limitations

If an online course is attached to a real-world university in a specific state, the nurse may be required to take the psychiatric mental health certificate issued in that state at the end of their studies. The cost of the certification is usually only a few hundred dollars, but if the nurse does not want to practice in that state the certification will be of little use to them.

For many nurses, the issue of having to take a second mental health nurse practitioner exam for the state they actually wish to practice in is just a minor inconvenience, however, if you’re faced with a choice between two universities, one of which is in your state and the other is not, the prospect of having to take an exam twice could be a deciding factor.

What are schools with the best psychiatric nurse practitioner programs?

Some of the best universities for psychiatric mental health nursing programs include:

  • Vanderbilt University
  • Duke University
  • Rush University
  • Johns Hopkins University

Vanderbilt University

The mental health nurse practitioner program at Vanderbilt University is considered to be one of the top programs of its kind in the United States. The graduate program has an enrollment of 892 students, and the cost of the DNP is $1,642 per credit. The nursing school has a large faculty and is highly respected for many specialisms, not just the psychiatric nurse practitioner program.

Duke University

The advanced practice nursing programs at Duke University are highly respected. Duke is a very selective university and places are competitive. The institution runs a number of scholarship programs to promote diversity among applicants and support those from less well-off backgrounds. Duke runs programs at the ABSN, MSN, DNP and PhD level.

Rush University

The College of Nursing at Rush University‘s Doctor of Nursing Practice degree is recognized as being one of the best programs of its type, as is its Master’s Nurse Practitioner: Psychiatric / Mental Health program. Rush University is respected for its multidisciplinary studies and its high-quality research programs, as well as for its Office of Faculty Practice.

Johns Hopkins University

Johns Hopkins University is another respected institution with a strong nursing program. Their DNP program is offered for full-time study at $1,772 per credit. Places are competitive, with a graduate nursing enrollment of 788. In addition to the DNP, the university also offers master’s programs, undergraduate study, and certificates in healthcare-related subjects.

What do the best schools with psychiatric nurse practitioner programs have in common?

If you’re looking to enroll in a PMHNP program, but aren’t sure which university to choose, consider the modules offered on the program and how they reflect your interests.

There are many subjects that must be covered by graduate programs, but there is still some freedom for a psychiatric nurse to focus on a specific area such as pediatrics, substance abuse, or even public health and how it impacts mental health. Your graduate studies are a good time to consider those issues.

Academic offerings aren’t the only consideration, either. If you’re looking at universities that are not in your home town, you’ll want to consider things like:

  • The cost of the program (per credit)
  • The cost of living in the city
  • Bursaries and scholarships
  • Student accommodation
  • Facilities on or close to campus
  • The social scene
  • Student support and services

Enrolling in a graduate program is a big commitment, and if you’re planning to spend 2-4 years in a new city it’s worth making sure you’ll be happy there.

Finally, it’s worth investigating any employment opportunities that may be available at the end of your study. Many universities either have their own attached facilities or close links with specific facilities and can help graduates find jobs.

Networking is something every graduate student should do, so they can line up employment once they have received their diploma and taken any relevant certifications. The reputation of the university you study at could make or break your chances of earning employment at a respected hospital or facility.

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