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What Is a Psychiatric Nurse Practitioner?

August 18, 2021 | Staff Writers

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A Psychiatric Nurse Practitioner is a nurse who has specialized in mental health care. They are advanced practice nurses who have many years of clinical experience and, after having spent some time as a registered nurse with more general duties have decided to focus on one area of clinical practice.

In some hospitals and clinics, a Psychiatric NP has the title of Psychiatric Mental Health Nurse Practitioner. While job titles can vary, the field and scope of practice are fairly consistent. These are nurses who help people dealing with mental illness.

It takes many years to qualify to go into psychiatric nursing, and these nurses have a lot of respect from others in the profession. In some states, a psychiatric mental health nurse is able to operate independently, diagnosing and prescribing within their scope of practice. In other states, they must operate with an arrangement with a  psychiatrist, but still have a lot of freedom.

Mental health nurses work with people suffering from a variety of mental health disorders. The job is rewarding but challenging. A nurse may work with a patient for a long period of time as they diagnose them and develop a care and recovery plan. They will monitor the patient and evaluate their progress as they learn to cope with their condition.

What a psychiatric nurse practitioner does

A Psychiatric Nurse Practitioner is a nurse practitioner with a specialization in the treatment of people who are living with a mental health disorder. Their job is to assess, diagnose and work with patients who have a mental health difficulty. Sometimes they deliver therapies themselves or prescribe medication. In other cases, they refer a patient to a psychiatrist, counselor, or therapist.

Where do psychiatric nurse practitioners typically work?

A Psychiatric NP has the opportunity to work in a variety of settings. Some work in primary healthcare clinics, hospitals, or community mental health centers, but there are many other settings where a mental health practitioner could be in demand, such as:

  • Academia (research-based positions)
  • Corporate settings
  • Correctional facilities
  • Schools and college (student support)
  • Private practices
  • Psychopharmacology clinics
  • Consulting services
  • Substance abuse facilities
  • Veteran’s facilities
  • Government agencies
  • Home health care agencies

Psychiatric nurses may care for individual patients or operate in a group setting offering therapy, counseling, or rehabilitation advice for those dealing with substance abuse issues. A nurse in a school may work with students struggling with anxiety, ADHD, or stress-related issues. Those in care homes may work with individuals who have been diagnosed with early-stage dementia.

There is a lot of scope for nurses working in the field of mental health to choose the type of patient they work with, and focus on illnesses that interest them or they feel particularly passionate about. This is one of the things that makes the field so interesting and rewarding.

What are the roles and responsibilities of a psychiatric nurse practitioner?

A Psychiatric Nurse Practitioner is qualified to a higher level than a Registered Nurse and has a significant level of freedom and leeway in terms of what they can do within their scope of practice without having to consult with other medical professionals.

The duties and responsibilities of a psychiatric nurse practitioner vary from state-to-state, but the typical role of this kind of mental health nurse involves:

  • Assessing patients
  • Diagnosing common psychiatric illnesses or mental health conditions
  • Recommending courses of therapy or interventions
  • Collaborating with a psychiatrist for psychopharmacological treatments
  • Offering individual and group therapy settings
  • Offering counseling for clients with chronic psychiatric illnesses
  • Monitoring the progress of long-term patients
  • Referring patients to other health care professionals as required
  • Offering support, education, and advice to patients and their loved ones
  • Using age-appropriate techniques for diagnosis and care
  • Helping vulnerable patients advocate for themselves in a care context
  • Supporting patients to maintain their overall well-being

Some mental health nurses focus on specific mental illnesses, but many work in more general health care contexts and, as such, will encounter a wide variety of conditions in their day-to-day practice, including:

  • Anxiety
  • ADHD
  • Bipolar disorder
  • Depression
  • Dementia
  • Obsessive-Compulsive Disorder
  • Panic disorders
  • Eating disorders
  • Addiction and substance abuse
  • Schizophrenia
  • PTSD
  • Trauma
  • Personality Disorders

The field of mental health is complex. Some patients may require short-term assistance following a traumatic event, others may have a long-term condition requiring monitoring and ongoing therapy. Psychiatric Mental Health Nurse Practitioners will have the opportunity to work with some patients on an ongoing basis, having the chance to see how their support helps them lead a productive and fulfilling life.

How do you specialize as a psychiatric nurse practitioner?

The traditional route into the field of psychiatric nursing involves training as a nurse and earning the NCLEX-RN certification, which licenses a person as a registered nurse. After this, they’ll need to gain some clinical experience, working in a health care setting while upgrading their qualifications to the master’s degree or doctoral level.

It takes many years to become a clinical health specialist of any form. Whether you decide to specialize in working with people dealing with mental illness, focusing on behavioral health, or go into another area of mental health practice, you will need extensive training, academic qualifications, and certifications.

Educational requirements for becoming a psychiatric nurse practitioner

To earn the title of Psychiatric Nurse Practitioner, a nurse must go through a long training process. The typical route to becoming a psychiatric nurse is to earn a Bachelor of Science in Nursing (BSN), then progress to the Master of Science in Nursing (MSN), which takes six years of full-time study in total, but many hospitals require doctoral level qualifications, and many nurses follow other routes with more clinical practice time and part-time study.

What degrees should you earn if you want to become a psychiatric nurse practitioner?

To become a Psychiatric Nurse Practitioner, you must first be a Registered Nurse, this means you’ll need a nursing degree. It’s possible to pass the NCLEX-RN by studying for an Associate’s Degree in Nursing (ADN), and if you’d like to work and study part-time this could be a way to earn some patient contact hours more quickly.

However, topping up the ADN to a Bachelor’s degree (BSN) is essential. Nurses in New York are required to upgrade an ADN to a BSN within ten years if they wish to maintain their licenses, and some other states are considering passing similar laws.

BSN-prepared nurses offer a higher standard of patient care than ADN-prepared nurses, leading to better long-term outcomes. This means all nurses, even those who are not considering becoming an Advanced Practice Registered Nurse or a Nurse Practitioner, should be investing in their skills and education.

Studying for a BSN takes four years full-time. An ADN takes two years, and topping up an ADN to a BSN takes two years of full-time study, but many nurses go the part-time route instead, allowing them to spend more time in a clinical setting.

After earning the BSN, the next step is to enroll in a Master’s Degree with a specialization in mental health. The MSN degree will cover advanced nursing topics and give the nurse the grounding they need to perform the role of a nurse practitioner.

How to apply to nursing school for a Master’s in Science in Nursing

There are many routes into the nursing profession, making it accessible to anyone who is passionate about health care, regardless of their academic background. Entry into an ADN course requires a high school GDP of 2.5 or the GED equivalent. Direct enrollment onto a BSN is slightly more competitive but is still primarily based on past academic achievements.

At the postgraduate level, you’ll find things are more difficult. Your performance on your BSN will be taken into account and you’ll also be expected to have clinical experience and references. In addition, you’ll have to have a current, valid nursing license in good standing. This means completing any continuing education expected of you as a holder of the NCLEX-RN.

If you earned your license through the ADN route then you may be able to enroll on an ADN to PMHNP course, but the most common route into psychiatric nursing is to top up the ADN to a BSN. In this case, your grades on the BSN will be taken into account.

If you found you struggled with certain parts of the course, taking additional science courses and certifications offered via your employer may be useful for increasing your chances of being accepted on an MSN.

Individual schools have a lot of freedom when it comes to deciding who to accept and what grades to required, so if you’re unsure if you aren’t accepted at your first choice of university, don’t despair. There may be many other options, including doing an online MSN.

What sort of continuing education is required for someone as a psychiatric nurse practitioner?

Psychiatric Nurse Practitioners are licensed by the American Nurses Credentialing Center (ANCC). The psychiatric certification is valid for five years, after which it must be renewed.

The recertification process is fairly simple. Nurses are required to undertake continuing education, and back up that knowledge by either providing evidence of 1,000 practice hours or re-taking their certification exam.

Whether the nurse is currently practicing or not, they must hold a valid RN license and have completed 75 hours of continuing education over the five-year period.

What counts as continuing education?

The ANCC accepts six different classes of professional development for nurses, and those who are in the psychiatric mental health field of specialization are required to complete 25 hours of pharmacology-related continuing education, plus at least one of the other categories.

The ANCC’s professional development categories are:

  • Continuing Education Hours (75 hours)
  • Presentations (A total of 5 hours of presentations)
  • Publication in a peer-reviewed journal, or research such as a Ph.D. thesis or DNP final project
  • Preceptor Hours (120 hours)
  • Professional Service (two years of volunteer service)

Continuing education studies can be conducted via a variety of advanced practice and health organization associations. For example, the American Psychiatric Nurses Association offers a range of courses, journals, and conferences for nurses that are recognized for continuing education purposes.

What additional certifications are beneficial for someone as a psychiatric nurse practitioner? 

Psychiatric nursing is considered a specialization in its own right, but it is possible for a nurse to focus on a specific area of nursing within that field. For example, a PMHNP can choose to specialize in family nursing, pediatric mental health, or other areas.

The main psychiatric mental health nurse practitioner certification is the ANCC’s Psychiatric and Mental Health Nurse Practitioner (Across the Lifespan) certification, which covers general mental health nursing for all ages. There are other certifications that may be useful for a nurse early in their career, such as the PMH-BC, which is aimed at entry-level RNs who are looking to specialize in mental health in the future.

The Pediatric Nursing Certification (PED-BC) may be of value to nurses looking to work in an educational setting, giving a broad grounding in nursing care for younger patients. This covers many areas of nursing practice, not just psychiatric mental health, making it of value for registered nurses who are looking to focus on one patient demographic.

Expected salary and benefits for psychiatric nurse practitioners

Psychiatric Nurse Practitioners are highly-qualified nurses who can expect to earn more than a Registered Nurse due to their additional academic qualifications and the thousands of hours of clinical experience they have built up over the years.

According to the Bureau of Labor Statistics, a registered nurse who is educated to BSN-level can expect to earn an average salary of $73,300. The starting salary for a registered nurse with an ADN would be lower than this.

Psychiatric Nurse Practitioners must hold at least an MSN, with many opting to pursue a Doctor of Nursing Practice. The average salary for nurses with that level of qualification is $115,800 per year or around $55.67 per hour.

Actual salaries can vary significantly, with some surveys showing ranges between $87,000 at the low end to $142,000 for the highest-paid Psychiatric Nurse Practitioners. These variances can be attributed partly to experience and seniority, and also to geographic differences in salaries, and even the difference between working at a private clinic or a non-profit hospital.

Demand for MSN-holding nurses is increasing, giving nurse practitioners (across the whole of the profession) a high level of job security. If you’re looking to join a profession where you’ll be able to find a job anywhere in the country, and where you’ll have the job satisfaction of knowing your day-to-day work makes a difference, mental health nursing is a good choice.

What are the benefits of being a psychiatric nurse practitioner?

Working as a Psychiatric NP is rewarding and offers a rather different experience to that of a Registered Nurse. Many nurses work on wards or in clinics where they’ll see a high volume of patients, but get limited time with each one.

A Registered Nurse in a doctor’s office may spend their days taking blood samples and measuring vitals or doing initial interviews with the patients that the doctor is about to see. Someone working in a busy ward may deal with patients who are seriously ill and need urgent attention.

Some nurses feel the conveyor belt atmosphere of clinics is impersonal, and the busy nature of wards, especially emergency rooms is stressful for them. For nurses who want to have more time with each patient, or who don’t like dealing with the messier side of A&E, the mental health specialization offers a chance to have a positive impact on patients in a different way.

Psychiatric Nurse Practitioners can work with individuals or in group settings, and since they monitor and assess patients over a longer period of time they get to see the long-term results of their work.

In addition, Psychiatric Nurse Practitioners usually work on an appointment basis. This means they are less likely to have to deal with long shifts, odd hours, or the stresses that flight nurses and emergency department workers are faced with.

Many senior nurses appreciate the autonomy and respect that comes with reaching the Advanced Practice level. Psychiatric Nurse Practitioners can do a lot of their job autonomously. For those who truly take pride in the work they do, that extra autonomy is a reward by itself.

What are the career prospects for a psychiatric nurse practitioner?

After graduating, a Psychiatric Nurse Practitioner has several options for career progression. Some nurse practitioners progress into leadership roles, while others move into a public health position where they’re focused on policy improvement at a higher level.

Another common career progression for experienced nurses is to move into academia, where they can train the next generation of nurses or focus on research, building on the body of knowledge that already exists in the profession.

A Doctor of Nursing Practice will have already done extensive research as a part of their Ph.D. thesis. Moving into an academic setting allows them to continue that research.

Mental health nurses are in high demand and have the opportunity to work in the community, in corporate settings, at not-for-profit clinics and hospitals, or in other settings. They have the freedom to pursue their passions, whether that’s helping veterans overcome PTSD or working in prisons to help people overcome substance abuse issues.

Other specific areas of focus could include depression, anxiety, or eating disorders. These are all fields where there are opportunities to study and pioneer new treatments, and where nurses with expertise are always wanted.

What sort of additional certifications or degrees can you achieve in order to gain a higher salary as a psychiatric nurse practitioner?

It’s possible to become an Advanced Practice Psychiatric Nurse with just a master’s degree. Those who wish to reach the top of the mental health nursing profession should consider studying for a Doctor of Nursing Practice.

This high-level qualification requires an additional two years of study but allows nurses to pursue the most senior positions and the higher salaries that come with them.

The fastest way to become a psychiatric nurse practitioner

There are no shortcuts to becoming a nurse practitioner, but there are ways to get experience in the nursing field more quickly. Those who simply want to try out the nursing profession could qualify as a Licensed Practical Nurse (LPN) or a Licensed Vocational Nurse (LVN).

This is not the same as being a Registered Nurse (RN), but it does allow someone to see what the nursing profession is like, and there are options to upgrade those initial qualifications to an ADN or BSN if you wish to continue down the nursing career path.

How quickly can you become a psychiatric nurse practitioner?

Someone who commits to full-time study could become a psychiatric nurse practitioner in six to eight years, assuming they complete the BSN in four years, pass the NCLEX-RN first try, and then go straight to a two-year MSN, followed by a two-year DNP.

The reality is usually rather different from this. It’s not unusual to complete a BSN in four years, but most nurses will opt to work in a health care setting and spend some time getting invaluable clinical experience while studying part-time, doubling the length of time it takes to complete their MSN or DNP.

It’s not uncommon for DNP programs to take four years, but there are many benefits to this slower form of study. Firstly, the would-be Psychiatric NP will have far more hours of clinical practice behind them when they come to take their certification. Secondly, some hospitals and clinics offer financial support or will pay for higher-level qualifications for nurses who are employed there long-term.

Given the expense of earning RN licensure, many nurses may find the prospect of paying tens of thousands of dollars more per year for a Master’s or Doctoral program rather intimidating. Scholarships, loan forgiveness programs, and employer sponsorships are invaluable for nurses who are worried about student debt.

What do most psychiatric nurse practitioner programs look like?

A Psychiatric Nurse Practitioner is expected to hold a Master of Science in Nursing, with a focus on psychiatric mental health. The MSN degree covers a relatively broad range of subjects, equipping nurses with the advanced skills they need to work as nurse practitioners.

When you study for a Psychiatric Mental Health Nurse Practitioner (PMHNP) degree, you’ll be taught the scientific, clinical, and soft-skills required to take care of patients who are dealing with mental health difficulties, as well as how to communicate with other health-care professionals.

Nurse practitioners deal with a variety of patients with brain disorders, psychiatric disorders, and addiction or substance abuse issues. Mental health is a sensitive topic and nurses must be able to communicate clearly, effectively, and compassionately.

The degree will likely cover:

  • Managing care for your patients
  • Care across the life span
  • Pediatric-specific issues
  • Public health and policy advocacy
  • Technology and health care
  • Evidence-based practice
  • Leadership and interprofessional collaboration
  • Profiles of mental health disorders

Students will have the chance to work alongside experienced mental health nurses to learn how skills can be applied in the real world.

How can you find a psychiatric nurse practitioner program that works for you? 

Once you’ve decided that you’d like to qualify as a Psychiatric RN, you’ll need to decide which institution you’re going to study with, and whether to study full-time or to try to fit your studies around working at a hospital or clinic.

There are some universities, such as Walden University, that offer online MSN degrees. This can be a good option for someone who wants to study for an MSN while working, especially if they don’t have a brick-and-mortar university offering nursing courses in their city.

Studying online is often slightly more affordable than studying at a traditional university, but the overall cost of the course may still be expensive. Be sure to look at scholarships and bursaries before making your final decision, because these can greatly reduce the overall cost of the qualification.

If you’re planning to study at a traditional university, look at the cost of living close to that university, and the amenities the city has. If you’re studying at the master’s degree level, it’s likely you’re a mature student and you’ll have already had the chance to enjoy the social side of university life, but that doesn’t mean you should overlook that issue this time around.

Master’s degree and Doctoral degree qualifications are intensive and demanding, so it helps to have a good support network and a friendly social scene so that you can relax in your spare time. Studying is much harder if you feel isolated or unhappy with the city you’re living in.

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