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What It’s Like to be a Psychiatric Nurse Practitioner

One of the most challenging aspects of behavioral health or mental health issues is rooted in the fact that individuals often suffer in silence for so long. Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.

Perhaps you understand what it is like living in a world that is challenged with ensuring access to mental health resources, or wished you could be part of the solution to health resource equity. A passion for helping those enduring complex mental and emotional challenges may have brought you to the place of wondering, what’s it like to be a psychiatric nurse practitioner? 

If you are a BSN or MSN-prepared nurse with a strong desire to advocate for patients and families who are living with mental health conditions and their far-reaching effects, the information in this blog might be helpful to you. Advanced practice nurses working in the behavioral health arena are strong individuals, compassionate, and widely sought after to serve in the unique and special role of the Psychiatric Mental Health Nurse Practitioner (PMHNP). 

Let’s explore this specialty area further, starting with the statistics showing an immense need for competent professionals in the mental health field. We’ll then explore real quotes from real nurses who have chosen the PMHNP route for advancing their careers. With this information, you will be equipped to determine whether it’s the right fit for you to pursue the profession of advanced practice nurses who care for patients with psychiatric mental health conditions. 


Why Become a PMHNP and Why Now?

In the year 2020, there were 52.9 million adults in the United States living with a diagnosed mental illness. The highest prevalence of mental illness was found in young adults. 

During the COVID-19 pandemic, those aged 18-24 years old have reported the highest share of anxiety and depression symptoms, with approximately 56% of that age group reporting that they live with symptoms nearly every day or at least more than half of the days in each week. 

Sadly, the effects of the pandemic are ongoing. A snapshot of some related experiences for those struggling with mental health include:

  • Chronic worry and sleep disturbances
  • Job loss and financial distress
  • Substance use disorder and low self-esteem
  • Social isolation and loneliness
  • Reduced access to mental health services

In addition, the shortage of mental health professionals has also been worsened by the pandemic. One survey showed that more than 20% of individuals reported needing but not receiving counseling or psychotherapy services. The trajectory of this need is anticipated to continue rising. Historically when a disaster or traumatic event occurs, the mental health impact is seen longer than the physical impact. The reasons to become a psychiatric nurse practitioner are plentiful. 

If making a difference in the country's health access to care is appealing to you, know that there are many different settings where a PMHNP may work. Depending on the programs offered or the population served, the role may have unique features. Let’s explore the practice settings and job responsibilities in more detail. 


PMHNP Practice Settings and Job Responsibilities 

There is a wide variety of available practice settings where a Psychiatric Mental Health Nurse Practitioner may work. Both inpatient and outpatient opportunities exist, whether in psychiatric hospitals or private practices, correctional or rehabilitation facilities, assisted living communities, school districts or special programs designed to serve specific populations. 

Not only does the PMHNP work in a variety of practice settings, the types of patients seen include but are not limited to youth, elderly, veterans, homeless, those with addictions, those with a history of psychological trauma, assault and violence victims, and patients and families struggling with mood disorders. As you can see, the applications for a degree in the PMHNP specialty are widespread and diverse.

During a typical work day, the PMHNP carries out several activities when diagnosing and managing patients. However, the role of the PMHNP is not one size fits all, as there may be a higher focus on certain aspects of care depending on the setting, goals of specialty treatment, or patient population. A sample listing of job responsibilities includes the following:

  • Thorough health assessment of patients
  • Extensive documentation and counseling
  • Accurate differentiation between physical and mental health conditions
  • Patient and family education for managing psychiatric conditions at home
  • Prescription of behavioral health and psychotherapies 
  • Management of medications for psychiatric conditions
  • Ongoing evaluation of progress with compliance and effectiveness of treatment plans
  • Interdisciplinary collaboration for holistic care using the integrated health model

There are newer psychotherapies continually emerging with evidence to support their effectiveness, such as eye movement desensitization and reprocessing (EMDR) therapy which has been shown to assist in the treatment of post-traumatic stress disorder. A responsibility of the PMHNP is to stay current and focused on the latest research to be a timely advocate who can connect patients with the most advanced therapeutic options for improving their overall health, cognitive function, and well-being.

Next, let’s hear from some individuals who share what it’s like to be a psychiatric nurse practitioner and why they personally chose this profession.


Real PMHNPs Share Real Experiences

One of the most exciting aspects of being a PMHNP is that the human connection is an essential aspect of every patient and family encounter. Communication skills and self-awareness are required along with attention to detail. PMHNPs pick up on the body language and nonverbal communication of their clients, knowing that what is said and what is not said can be equally important. 

One PMHNP working in a psychiatric emergency room says it well. “Mental health nursing is unlike all other fields of nursing. Our assessments aren’t deciphered with machines, our stethoscopes are neglected, and we talk a lot with our patients.” - Jake Johns, PMHNP, MSN

Some patients are a danger to themselves and to others, being placed on psychiatric units involuntarily. Others do not pose a threat of harm and can be seeking treatment voluntarily. One PMHNP who works in a hospital setting stated that in her experience, the role of the PMHNP and the role of the psychiatrist were similar in practice.

“We all perform psychiatric evaluations, intake assessments, medication management, psych consults, and discharge dispositions. The only difference I can think of is that psychiatrists can obtain a special DEA license to prescribe Suboxone maintenance, whereas NPs cannot.”

- Charlie Myers, MSN, PMHNP-BC

The volume of patients and age range can also be surprising. Another provider working in an intensive outpatient PMHNP role stated his youngest patient was 17 years old and his oldest patient was 95 years old, and he estimated his caseload had approximately 1,000 active patients

Telemedicine options are also increasing in the mental health field. The scope of services provided virtually to patients who are remote is substantial. One PMHNP described her telemedicine practice this way: “Interview techniques and establishing a relationship with the client are tailored via telemedicine, and [telemedicine] is fully capable of meeting the treatment needs of the client.” - Laura Hickman, MSN, FPMHNP-BC


Start Your Nursing Career at Marymount University

The entry-level option for students with non-nursing undergraduate degrees is the Online ABSN. In just 16 months, Online ABSN students complete the following requirements in preparation for RN careers:

  • An on-campus residency
  • Clinical placements in Virginia
  • 100% online courses on topics like Research and Evidence-Based Practice

Marymount’s ABSN is accredited by the Commission on Collegiate Nursing Education (CCNE). Nursing courses at Marymount are taught by practicing APRNs who can speak with authority about the profession. The university’s stellar reputation is confirmed by top U.S. News & World Report rankings in its National Universities and Nursing categories. 

If you want to become an RN, contact one of our student advisors to discuss if this program is right for you.


Request My Free Marymount Accelerated BSN Program Guide

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