There is a growing need for psychiatric nurses to help meet the mental health needs of children to senior adults.
Of the over 325,000 nurse practitioners licensed in the United States, only 4.7% (approximately 15,275) are licensed psychiatric nurse practitioners despite the mental health crisis at hand.
If you've wondered about this specialized mental health field, below is inside information from a practicing psychiatric nurse practitioner. You'll also discover what a psychiatric mental health nurse does each day and the education and experience you'll need to be certified as a psychiatric nurse practitioner.
Q&A With a Psychiatric Nurse Practitioner
Modupe Mary Okonofua, DNP, PMHNP-BC, FNP-C, MBA, is a faculty member in Walden's Master of Science in Nursing program and holds dual-board certifications as a psychiatric mental health nurse practitioner and a family nurse practitioner. Her expertise is in suicide risk assessment and prevention.
Q: Why did you choose a career in psychiatric nursing?
As a first generation immigrant to the United States, I quickly learned the value of perseverance, determination, and optimism in the face of daily challenges or stressors. With my personality, I derive pleasure from assisting others, and I was dissatisfied with my first career path as a technician.
So, at the age of 38, I decided to pursue my dream of becoming a registered nurse (RN) after interacting with mental health patients in a nursing home in Dallas-Fort Worth. While in nursing school, my favorite course was psychiatric mental health nursing, where I was very intrigued with how the mind works, the effect on one's well-being, and mental health in general.
As I progressed with my career, I knew with my knowledge of psychotherapy, psychopharmacological interventions, and spirituality, I could help others dealing with mental health issues such as depression.
Q: How have you seen the COVID-19 pandemic influence the mental health and stress of your patients?
The COVID-19 pandemic has had a significant impact on the lives of many patients. Many families' sources of income, jobs, and businesses have been impacted. We are living in unprecedented times, with variants of COVID-19 now infecting children and the unvaccinated population in particular. Adults and children alike are confronted with stressful, overwhelming challenges that trigger strong emotions.
Over the past year, I have seen the impact of the pandemic on the mental health of my patients leading to worsening levels of depression and anxiety. There are parents who are struggling with teaching their children from home, people juggling unpaid bills, families losing sources of income, and loved ones passing away. There is no question that the mental health of patients has been impacted.
Q: While every patient and situation is unique, what might a "typical" day look like for you as a psychiatric nurse practitioner?
A typical day for a psychiatric nurse practitioner varies based on the work location or setting, such as inpatient or outpatient, in person or telehealth, direct patient care, consulting, or teaching.
As a core faculty member in Walden University's Master of Science in Nursing program and a practice owner, my typical day involves teaching responsibilities such as grading and interacting with students, preceptors, and other faculty members. I also consult with patients in person or through telehealth, prescribe medications, and conduct psychotherapy sessions.
Q: What are some of the biggest challenges of your work?
The biggest challenge in my role as a psychiatric mental health nurse practitioner is seen with patients who are not compliant with the treatment plan they agreed to. This poses a challenge with such patients not recovering and becomes seemingly difficult for the provider to help. In such instances, the provider constantly re-educates such patients about the benefits of the prescribed evidence-based psychotropic medications or alternate interventions.
Q: And the greatest rewards?
The greatest rewards in my career are twofold. First, the satisfaction in guiding my students to succeed in their education, and secondly, treating my patients to the point where they are happy and live a fulfilled life.
Q: What advice would you give to those considering a career as a psychiatric nurse?
As a psychiatric nurse, you will interact with patients who have mental health issues such as depression, anxiety, acute grief, alcohol or drug addiction, personality disorders, and psychoses. Therefore, caring for your patients with compassion is very important.
As a psychiatric nurse, you can work in a variety of community healthcare settings, including hospitals, outpatient clinics, and addiction/recovery centers with flexible work hours. In the workplace, mental health nurses are typically part of a healthcare team that includes social workers, psychologists, psychiatrists, occupational therapists, and patient care assistants. Finally, there is a constant demand for psychiatric nurses with a promising growth outlook.
What Does a Psychiatric Nurse Practitioner Do?
A psychiatric mental health nurse practitioner (PMHNP) must be licensed in the state where they practice and nationally board certified. Their education prepares them to care for people who have mental health challenges across the lifespan. Psychiatric nurse practitioners assess, diagnose, and treat mental health needs.
The scope of practice for PMHNPs varies depending on the state. Currently, there are over 25 states where nurse practitioners have full practice authority. This means the law allows a psychiatric mental health nurse practitioner to order and interpret diagnostic tests, manage treatment, and prescribe medications without a collaborative agreement with a physician.
PMHNPs may also choose to specialize further, such as in geriatrics or substance use. Psychiatric nurse practitioners may also find opportunities in emergency care, research settings, or teaching roles. Most psychiatric nurses work in inpatient settings with traditional working hours. However, in states where you have full practice authority, you may choose to work in the community as a counselor.
Psychiatric mental health nurse practitioners often have these key responsibilities and skills:
How to Become a Psychiatric Mental Health Nurse Practitioner
The first step to becoming a psychiatric nurse is to graduate from an accredited nursing program and pass the National Council Licensure Examination for RNs. If you start your nursing career with an associate degree, you'll need to complete your bachelor of science in nursing (BSN) next. Fortunately, you can often work while completing an RN-to-BSN online program that accommodates your working schedule.
The next step is to complete a master's or doctoral psychiatric mental health nurse practitioner program accredited by either the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing. Accreditation ensures your program meets education standards so you can be certified.
To meet the certification requirement, you also need 500 faculty-supervised hours related to the psychiatric nurse role. Once completed, you can apply for and pass the national certification exam. You'll need to renew your certification every five years. It is also important to check with your state board since state-specific certifications and requirements may impact your practice.
How Much Do Psychiatric Nurse Practitioners Make?
Average Annual Wage
Source: PayScale, August 2021
Average Hourly Pay
Source: PayScale, August 2021
The psychiatric nurse job outlook varies depending on your geographical region. Overall, in the U.S. the range for an annual salary as of August 2021 is $89,000-$143,000, according to PayScale. Depending on where you practice and your contract, you may also be eligible for an annual bonus and profit sharing in the business. On average, psychiatric mental health nurse practitioners report annual bonuses between $811 and $15,000 and profit sharing between $2,000 and $11,000.
Your income will also depend on other factors. For example, annual bonuses and profit sharing may be included in your contract if you work for private practice. Your base salary may also depend on your years of experience, certifications, and specialization.
According to the U.S. Bureau of Labor Statistics (BLS), the job outlook for nurse practitioners will grow 45% by 2029, a much faster pace than the average job rate growth. BLS attributes this to an increased emphasis on preventive care.
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