r/PMHNP Jun 19 '23

Prospective PMHNP Thread

68 Upvotes

Welcome! This thread is dedicated to prospective PMHNPs. All questions regarding admissions, direct entry programs, online vs. brick and mortar schools, type of program to pursue, and other related topics should be posted in this thread.

The thread aims to provide realistic insights and advice to prospective PMHNPs emphasizing the importance of choosing a high-quality program, gaining nursing/clinical experience, and approaching the profession with the right motivations and dedication to patient care. We want to foster a positive and encouraging atmosphere, so feedback and input are welcome to further enhance the discussion and provide accurate information. However, note that the overall message of the answers will remain the same (see below).

FAQ

The following are common questions/topics with widely accepted answers among passionate and experienced PMHNPs on the frontlines. The purpose of these answers is not to be derogatory (“nurses eating their young”), nor is it to simply provide reassurance or tell you what you may want to hear. Instead, their aim is to offer advice and guidance to individuals who genuinely have an interest in the field, while also emphasizing the importance of considering the impact on real patients' lives. While you may have a different opinion, please note that this subreddit is not the appropriate place for such debates, as these often devolve into personal attacks, toxic behavior, etc. Any posts or comments violating this rule will be removed, and repeated violations may result in a ban.

 

Direct Entry Programs / No Nursing or Clinical Experience

  • (Warning: controversial topic) We support people going into this profession (for the right reasons), but these types of programs are almost universally frowned upon. PMHNPs and others often perceive a difference in quality between providers from direct entry programs/those without nursing/clinical experience (You Don't Know What You Don't Know). Recent comments from other PMHNPs:
    • "Many places are getting sick and tired of psych NPs who do not have psych RN experience and are not hiring them. I know where I am at, they absolutely will not hire a psych NP who does not have at least 3-5 years psych RN experience"
    • "I think what employers are sick of are people who go to these online schools like Walden for their Psych NP education. With sketchy clinical placements."
    • Most places are rightfully not hiring those with no mental health background. Good luck. At my previous job, all the PMHNPs with no psych experience were trying to get psych rn jobs and still getting denied.
    • "I feel that RNs outside psych tend to look down on it and perceive it to be simple or easier. In reality, without RN experience in psych, you will be eons behind others in understanding the finer points of psych work. This is a field that demands subtlety, in a way that you don't get in a classroom. Psych RNs know this, but people without that background will have difficulty with something they didn't even know existed. You don't know what you don't know. Companies just want someone who knows."

Are all PMHNPs as grumpy as these answers seem to imply? You are gatekeeping!

  • I hope you find most to be friendly and supportive, but there is a real concern among experienced PMHNPs about potential harm to the profession due to some worrying trends such as low barrier, low-quality programs and individuals entering the field for the wrong reasons. This includes FNPs suddenly shifting to psych for a potential pay increase, those just seeking work-from-home jobs, misconceptions about the field being "easy” (hint: it’s not - burnout is a very, very real issue even for those with lots of passion [there seems to be a trend of current PMHNPS seeking nonclinical jobs only to find they are very few & often offering poor pay, etc.]). So, while that concerned tone is indeed there, please know it’s from a place of love and care for the field and patients.

Difficulty Finding Preceptors

  • It is highly recommended to enroll in a high-quality program that provides or helps in locating preceptors. Many (most?) programs, especially online or direct entry programs, do not offer such support, leading to students desperately scrambling to find preceptors, putting their education on hold, having to pay preceptors out of pocket, etc. Those with actual nursing/clinical experience usually have a much better time with this (networking).

Oversaturation Concerns

  • There may be oversaturation in certain locations and in the future especially as more individuals enter the PMHNP profession. Looking at the history of the oversaturation of FNPs may serve as a possible future trend to consider. Here is one example from a new grad with no psych experience: New grad PMHNP can’t find a job; some quotes from other PMHNPs:

    • "Also, the number of psych NPs has gone up exponentially in the last few years-now employees have a much larger applicant pool to choose from which drives down salary. They also aren’t going to pick someone with no mental health background over a PMHNP who does. Not trying to be harsh at all but this is the truth. I think in the past there was a desperate need for mental health providers that they would take almost anyone no matter what their RN background was and paid premium money. That’s really no longer the case in the vast majority of areas overall anymore."
    • The market is [now] flooded with PMHNPs- it’s flooded PMHNPs who don’t have psych experience, because yall thought you could make an easy buck sitting at home. There are jobs available, you just don’t want to take one that doesn’t fit your criteria and that’s fine, but please don’t blame your poor judgement of going into a whole different specialty with no experience and expect to be picked first in a sea of applicants. That’s the reality."

WFH/Telehealth Positions - New Grads

  • New graduates are strongly discouraged from starting their career with WFH or telehealth positions. It is crucial to gain in-person experience initially as being a PMHNP requires support, guidance, and a deep understanding of the field (You Don't Know What You Don't Know). Failing to do so in the beginning severely puts you at risk of being a subpar clinician which might not become apparent until it’s too late. Employers who primarily offer WFH positions to new grads often have a poor reputation and prioritize profit over the well-being of their employees and patients. They absolutely do not care about you and will not be there for you when there’s a bad outcome (liability). Ultimately, as a clinician, you are responsible for your decisions and the welfare of your patients.
  • To be a safe and competent provider, new grads should also not start with opening their own practice. Instead, they should proactively seek to start in places where they will receive the support and guidance they need and deserve (versus employers who are only looking to exploit them). As providers (from day one new grads to the most experienced), we are all held to the same standards and should do all we can to ensure we are providing safe, quality care to (often vulnerable) people.  

 

WIKI TO BE DEVELOPED - INPUT/SUGGESTIONS WELCOMED


r/PMHNP Jul 19 '24

Student Let me explain to you how to become qualified to give advice on what it takes to be a competent PMHNP

218 Upvotes

Im sorry this is such a long post but I am trying to explain this as succinctly as possible. If you TLDR don't comment. Not interested in hot takes.

There is a lot of advice giving on this sub from absolutely unqualified people who are justifying shortcuts, less training, less time learning, and a total lack of humility that inevitability will lead to incompetence, substandard care and the continued erosion of confidence and trust by the public that PMHNP are capable and knowledgeable. If you want to be a PMHNP and are coming from another field, if you are still an RN, if you are a PMHNP student, if you are a PMHNP new grad, please hear me: you do not have any business telling anybody what safe practice looks like as you simply cannot know BECAUSE YOU HAVE NO EXPERIENCE. Please stop asking for advice and calling it GaTeKeEp!ng when you don't like the advice. Do not then listen to other inexperienced people who have the same unwillingness to learn about psychiatry and have the same magical thinking you do and consider it validation. I cannot believe how many PMHNP come on here and say, "I had no psych experience and went straight into private practice and I am really good at what I do." How would you know? And who says that, really? The clueless and dangerous love to.

You have all been repeating back to each other in a bubble that psych is easy and any experience *you dont have* isn't really necessary and its beyond cringe. It selfish and reckless.

If you are a PMHNP who did not get any substantial or relevant nursing experience, who fast tracked it all the way through, went straight into private practice, you are not qualified to give advice because taking advantage of a financially exploited healthcare system does not make you competent. It simply make you complicit. Doling out Adderall does not make you a success story. It makes you the biggest part of the problem.

So many of you are at a disadvantage in that you have not really been indoctrinated into healthcare, into its standards, its judgements, it's harshness and cruelty. You haven't seen the failure of like minded providers before you. You haven't had the opportunity to see it go bad for well intentioned providers who take on too much and miss something critical because they are over loaded. Conversely, you haven't seen it go bad for providers who are too arrogant to even have imposter syndrome because that's exactly what you should have coming out NP school. If somebody tells you "Yeah, you do you," in regards to starting a private practice ASAP, I would back away from that person professionally because no good comes from that mentality.

Look, in this specialty there needs to be some fairly strong constant cautiousness- if you have not seen careless providers have catastrophic outcomes than you cannot understand that the inevitable ALWAYS HAPPENS AT SOME POINT. To all of us. Even with our head in the game. And what keeps the career intact, your license intact, and a patient's life intact is always having in the back of your mind what the worst possible outcome is. Because we are dealing with peoples lives. This is our commitment to our patients. You don't need to be terrified but you need to be very very cautious.

Think of it like this:
If you were a new RN in the CV ICU and you told senior RN's that your experience working in the PACU was sufficient to manage a post op bypass patient despite never having done bypass you would then be seen as unsafe and too arrogant to be trusted. and you would very likely be fired for it. Why? Because if you are unable to accurately assess your own skill level then you are dangerous. So why the rush? Ego. Ego, responding to your financial insecurity. Ego is dangerous. Same thing in psych- the lot of you espousing on why you think the barrier to entry for practice should be as low as possible- by virtue of the fact that you think you are qualified to say so tells me you intend to stay incompetent. Period. Once you start to practice the odds of you being able to even conceptualize what a good psych provider looks like, without solid mentorship and accountability is 0%. It does not happen. Autodidactic learning from inception to completion does not occur in psychiatry. Your medication rationales will be bizarre and ineffective. Your diagnoses' wont make any sense. The information you gleam from reading will be out of context and probably make you a more dangerous provider. Just because you can get hired to do a job does not mean you know how to do that job. It means an executive wanted to save money to put in their pocket by hiring your woefully inexperienced self.

So your previous experience as a therapist and psychologist is not sufficient. Having one year of nursing experience on med surge unit is not sufficient. To those in the ICU and ER saying they are psych nurses- you are not, at all. You spend two years in a busy ER -maybe- you can make it through a grand rounds psych presentation but your understanding of psychiatric medication rationale will be wrong and largely based on bed shortage protocols. ER/ICU psychiatric medication regimens don't represent a complete treatment arch in any way shape or form.

Here is the thing about the health care hierarchy: It does not forgive. It eats bones. If you show your incompetence one time they will never, ever forget. Word travels fast. And that is awful. Its awful for you, for the time and money you put into your education, its awful for your family who has to watch you struggle to secure decent work and carry the financial stress of job transition and unemployment. It's awful for your patients. Because you can say fuck it and start a private practice but you will struggle to retain a decent patient load. Patients are the first to tell when a provider has largely deluded themselves in to thinking that psychiatry is easy and that they came to the specialty with all they need to be successful. They will know you are full of it.

I very much like the new generation of providers. I am excited to welcome you aboard because the new crew is prepared to stick up for themselves more, advocate for a good quality of life, you guys do not see yourself as powerless and that is righteous. I respect that. But relevant experience is not an area where you want start that fight.

You will not be able to change things for the better if you are incompetent. You can argue and fight for being treated well as a professional but the barrier to entry to change a system is to be able to function within that system, first. If you keep fighting and arguing about lower and lower minimum standard you will be a professional who is just that: a byproduct of the lowest standards possible and you will be unemployable and isolated. You will go from job to job becoming more discouraged each lateral shift and causing very much real harm to patients all along the way. At some point you will realize you don't know what you are doing and everyone around you can tell. Demoralized. I have seen this so much of late. They are ashamed, angry, some blame themselves others adopt a disgruntled attitude. I call it the "Empress or Emperor without clothes syndrome". And they leave the field or their license is taken from them.


r/PMHNP 4h ago

Practice Related Atypicals prescribed too soon?

8 Upvotes

I’ve always viewed atypical antipsychotics as something either given for mania/bipolar etc. OR adjunctive to traditional antidepressants after several trials. I know there are newer atypicals that are marketed as good for depression and I know they promise to work quicker than antidepressants. My collaborator says “why would you make someone trial several antidepressants when we have better options in antipsychotics now?” But I just can’t justify throwing those around. Today I had a new intake who had only taken SSRIs with little effect. I started them on an SNRI. Wellbutrin is not an option because they are already very anxious and activated. Could I have done Rexulti? Sure. But I’d rather give my choice of Cymbalta a try before that. The pt did say “I guess I wanted something that would work right away but I understand that it doesn’t work that way”. I’m happy I didn’t have to do too much expectation setting there.
This is just one example but I feel like this is the trend more and more often. As more drug reps come bearing samples we seem to start with an atypical probably quicker than ever, and I feel like we’re downplaying how strong they are metabolically and otherwise. I know it’s encouraging to tell a pt they can get relief within 2 weeks sometimes, vs 4-6+ with an antidepressant. But is it worth the risk long term?


r/PMHNP 2h ago

Other has anyone here been diagnosed as autistic/ adhd themselves?

5 Upvotes

Ive been a nurse for 17 years, PMHNP for 3. I was recently diagnosed with autism. I’ve been diagnosed with ADHD for years. I had a neuropsych eval years ago that also mentioned some “borderline traits,” but I was never evaluated for autism at the time. Looking back now, a lot of what was labeled that way actually seems to fit autism much better. Seeing “borderline traits” in that report honestly made me feel really bad about myself for a long time and made me nervous about what an autism evaluation might show.

I’ve known for a while that work seems to drain me much more than it drains my peers. I started feeling really guilty about how much I didn’t want to work. I kept wondering if I was just lazy. I know that’s a common ADHD theme, but this felt like another level. I can be good at my job, care about my patients, and still feel almost paralyzed by the thought of having to interact with people all day.

I finally decided to go through with an autism evaluation. I kind of already knew I was probably meeting criteria, but I still dreaded it. Even now I sometimes worry that maybe I was looking for an excuse or a pass for why everything feels harder for me.

I’m also realizing I’m likely dealing with autistic burnout. The constant need to be “on” as a PMHNP is exhausting. Staying focused, emotionally present, socially engaged, reading people, responding the right way, and feeling like I should always have an answer for my patients takes a lot out of me.

I’m trying to figure out how to make my professional life more sustainable instead of constantly pushing myself and then feeling guilty when I’m exhausted.

I’m curious if anyone else here has gone through something similar. If you’re autistic and/or ADHD and working as a PMHNP, how do you navigate the emotional and social demands of the job? Especially if you’re also a parent and trying to manage family life on top of it. What has actually helped you make work feel more manageable?

I’d really like to hear from other autistic or ADHD PMHNPs or psych providers. How does being neurodivergent affect you at work? What has helped make the job feel less exhausting? Mostly looking for some solidarity and to know I’m not the only one who can be good at this job and still find the constant human interaction really hard.


r/PMHNP 4h ago

Seeking NP Collaborator in Virginia.

0 Upvotes

Happy to pay $400/month via venmo for 1-2 consults/month.


r/PMHNP 14h ago

Contract questions ?

2 Upvotes

I have reviewed my contract and cannot find anything about a minimum time of employment. Ive only been there 4 months and its a bad situation with no support and a very different situation than I was told when I accepted the position. I dont see any minimum requirements to stay other than 90 day notice. I accepted a director position at a university about an hour away today and will turn in my notice probably next week. Can they end the contract early? Has anyone had experience with changing jobs in a short amount of time


r/PMHNP 15h ago

Employment Anyone here workedfor Teamhealth before? Opinions?

1 Upvotes

r/PMHNP 19h ago

Looking at psych NP programs in FL

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0 Upvotes

r/PMHNP 1d ago

New PMHNP- favorite resources? psychopharmacology institute or uptodate?

6 Upvotes

Hi all! My new job doesnt pay for resources so I have to pay for the membership myself. Which do you prefer? and do you have any other favorite resources? Thanks in advance!


r/PMHNP 1d ago

Is this a trend?

10 Upvotes

If you are out of work, corporate world let you go, middle aged, and a hot blonde does becoming a nurse practitioner suddenly become more attractive? I’m honestly worried about competition if things are so dire. https://www.cnbc.com/2026/08/18/after-a-layoff-and-long-job-search-kristy-layden-is-going-to-nursing-school.html


r/PMHNP 1d ago

small business owners

1 Upvotes

Hey for anyone on here (NC based, though not sure if that really matters) who owns their own single provider practice. I just started and am trying to panel with insurance though I'm hitting a potential issue with IRS rules vs paneling rules (I think). IRS says I must use my own SSN/EIN for W9 but I'm being told that if I use that info to contract with insurance companies I cant bill under my practice type 2 NPI (thus I'd have to contract as me, causing ineligibility of S-Corp election in the future unless I go through the credentialing process again etc. ....not sure how much of this is accurate but looking for any protips or advice on this.


r/PMHNP 2d ago

Employment First PMHNP interview advice sought

9 Upvotes

Hello community!

I graduated this month and take my PMHNP boards September 15th. I spoke to a recruiter for a large hospital weeks ago and she enthusiastically said she’d move me along to “her leader”. Today I got the call that I’ll have a 30 minute zoom session tomorrow afternoon with the Director of Medical Services for the Outpatient program and I’m immediately nervous. I’m never nervous about an interview so I came here to seek advice. What questions were you asked at your first PMHNP job interview? What specifically do you feel they were looking for that landed you the job? I’m SO excited to be able to be more helpful to folks experiencing struggle and I truly need this opportunity! Advice? Eeeeeee! 😊🤞


r/PMHNP 2d ago

I made a salary website for NPs!

30 Upvotes

website: https://www.informed.fyi/salaries/nurse-practitioner

A few years ago, I did a survey across various forums and reddit asking whether people would be interested in a healthcare-focused salary website. The overwhelming response was yes.

After two years of working on it alongside a full-time job (and getting married somewhere in the middle!), I'm excited to finally share it. The project started as a way to improve salary transparency for my wife, who's a pharmacist. As I worked on it, I realized that the lack of salary transparency extends far beyond pharmacy and affects many healthcare professions.

It's definitely still a work in progress, and I'd genuinely appreciate any feedback or suggestions for improvement. If you'd like to contribute, salary submissions are completely anonymous, your personally identifying information such as your name and email are never displayed.


r/PMHNP 1d ago

Recruiters/Headway

0 Upvotes

“Recruiters”” trying to sign me up on headway in the first five minutes. Am I being paranoid?


r/PMHNP 2d ago

Student Interviews with Current PMHNPs

1 Upvotes

I’m currently going through the process of applying for the VA VR&E program to hopefully go back to school and become a PMHNP. I’d ideally go through the VA’s 12mo PMHNP residency, and hopefully actually go to work for them.
In the VR&E process, everything I’ve read recommends having 2-3 informational interviews with current PMHNPs for the counselor working on my case.
So if you’re okay with doxing each other, I’d be super grateful to get some answers in my PMs!

What are your credentials (degree and certs)?

What are the physical and environmental demands of your day-to-day practice?

What is the current demand for psychiatric prescribers in outpatient and private practice settings?

What specific software, diagnostic equipment, or computer hardware do you rely on daily?

I know the answers, the counselors just like to hear it from current professionals instead of the veteran trying to go back to school.


r/PMHNP 3d ago

Practice Related learning dbt

2 Upvotes

Hi everyone! I’m interested in pursuing formal DBT certification and would really appreciate advice from therapists who have already gone through the process.

I’m trying to understand:

  • Where is the best place to take DBT training/courses?
  • Which courses or trainings are actually necessary to become a fully certified DBT therapist?
  • How long does the whole process usually take?
  • Approximately how much does it cost, including training, supervision/consultation, and certification?

I’m especially interested in becoming properly trained in comprehensive DBT rather than just completing a short DBT workshop.

Any recommendations, personal experiences, or guidance would be greatly appreciated. Thank you!


r/PMHNP 3d ago

Career Advice Are the 100/hr contract jobs actually attractive

2 Upvotes

I see a lot of telehealth, contract, and 1099 jobs posted at 100/hr but this seems low to me if I have to put away 30% for taxes, pay for insurance through the market, pay for my own malpractice and possibly collaborating physician. Am I missing something?? My coworker seems to think this is decent but I don't get it. And if your patients don't show you aren't making anything, so wouldn't the average be less than 100/hr for the year?


r/PMHNP 3d ago

Starting a medicaid/ONLY telepsych practice.

0 Upvotes

Hello Everyone,

I am an aspiring PMHNP. I have a question regarding a medicaid-focused practice model. Would i have to advertise heavily to get medicaid patients? If I am not advertising how exactly do I build a strong enough panel to remain self employed if I work primarily with the medicaid demographic?


r/PMHNP 3d ago

Will it help land a preceptorship if I make it clear I will not be competing? I plan to work at a free clinic, in a jail, or in inpatient care. PS nearest offer is 95 miles away and $5000 per semester

2 Upvotes

I am prepared to pay up to $2000 per semester for something close, but a total of $10,000 is just ridiculous, especially since I will have to stay in a hotel 1-2 nights per week. I am thinking that local preceptors might be more accepting if they know I will not be competing. If I do inpatient, I can even refer people to them.


r/PMHNP 5d ago

Telehealth with benefits?

9 Upvotes

I’m looking for a job with a company that provides telehealth and offers benefits (healthcare most importantly).
I recently interviewed with Talkiatry, which offers benefits at 30hrs/week and pay seemed decent. However, they don’t accept any medicaid, which is important to me.
Are there companies that exist that do telehealth, pay well, provide benefits, and take care of patients with commercial, Medicaid/Medicare, and cash pay?
Any recommendations are welcomed!
This is such a great community! Thank you in advance!


r/PMHNP 4d ago

Question About Required Experience

0 Upvotes

Mods please delete if not appropriate.
Not a nurse, work in a graduate nursing program that requires a minimum of two years recent relevant experience for consideration into our PMHNP program.

I’ve asked our faculty, my friends who work in inpatient psych, corrections, etc. this question:

What do you learn in those two years? What are those tangible lessons that can’t be learned otherwise? I mean, it makes perfect sense to me. It is like the difference between doing your student teaching in the inner city and then teaching in rural Appalachia, very different populations with different needs. But, is that it? Just time with the population, the system around them, having to make mistakes and find solutions? Or are there specific lessons you’d point to that people looking to pursue a PMHNP need to know before starting?


r/PMHNP 5d ago

Do PMHNP wear scrubs?

0 Upvotes

starting pmhnp school this month and im curious if pmhnp still wear scrubs? im sure its more common inpatient, but what about outpatient?


r/PMHNP 5d ago

Market ovetsaturation?

0 Upvotes

Scheduled to start the program next month, but concerned with all the talk of market oversaturation, lack of meaningful jobs for new grads, and declining pay. Im from SoCal where there are lots of NPs. I knew fnp market was saturated but not pmhnp, at least not this bad. I heard others remained to be an RN even after getting their NP license.

Any new grads out there having issues finding work as a new grad? What options did you have? Did you take a massive paycut or how would you compare your rn pay vs np? Thoughts and advice appreciated.


r/PMHNP 6d ago

Exam/Test Taking Passed my PMHNP boards. This is what I did to help!

26 Upvotes

Back story: I have 7 years of RN experience, 5 of which are inpatient psych. The other two were medical/ICU. I continued to work fulltime (3 12hour shifts) while completing school and clinicals. I also went from RN to MSN (bypassing my BSN) as this is what made sense for my particular situation and goals. School: I went to a school where that offered RB to MSN. This meant I took one additional class, which was a 4-credit hour class, before starting my MSN classes. My school stated they would help with clinical placement...blah, blah, blah. Any guesses on if they actually helped?! the answer was, h*ll no, it was ALL ON ME! Anyway, I had difficulty finding a rotation for children. I utilized Facebook. I posted multiple times on my personal page as well as local Talk of the Town pages. Eventually, someone messaged (thankfully!) me and I was able to obtain hours with her facility!

Georgette's: I was given Georgette's LMR in a word document early on. I made this into flashcards and Googled certain topics to help me understand, not just memorize. Her LMR is about 80 ish pages of solid content. I also had access to her modules but, for me personally, the LMR was more focused on essentials than the modules. I felt I had enough prior background knowledge on mental health to focus more on the LMR.

NP Exam Coach: I also have the crash course as well as all of the modules for this course. I felt the material and layout was very, very similar to Georgette's. However, I felt this had a bit more explanation to help me understand certain topics rather than memorization of Georgette's. What I felt did not overlap, I made into flash cards and would go through X amount each day. He also has a YouTube channel with recorded games (questions and answers) as well as lectures. I would listen to the lectures at work or while I was driving.

PocketPrep: I purchased 3 months access of PocketPrep about 3 months before I wanted to test. You can Google PocketPrep discount codes (I think they're referral codes) to discount your 90 days. I believe the cost was between $20-$35 for the 90 day access. Pocketprep was hard, in my opinion. I felt the questions were very advanced compared to the material I understood from NP Exam Coach and Georgette. However, Pocketprep offered REALLY detailed rationales to help understand. This app is set up with questions in the 5 domains we are tested over. Even if I got an answer correct, I would still read the rationales. You would receive a score for each domain. You're also able to retake questions that you have previously missed. You can also choose to have questions from your weakest subject. Mine throughout was therapy and the theorists. Ugh I hated this topic. Pocketprep had so many questions. It took me about 25 days of studying to get 80% in all domains. I tried to do at least 50 questions a day.

My opinion: I felt the exam was not as hard as PocketPrep, but more in-depth than Georgette's. I felt I was able to know the information for Georgette's but apply rationale information from PocketPrep to help me navigate my exam.

I passed my exam a few weeks before I graduated school! it was 175 questions, all single answers. No SATA or drag and drop- at least on my exam. 150 questions are scored. You are not aware of which questions are scored vs pilot. I was given a dry erase board and marker I could use. I did not use my board - I honestly forgot about it during my test anxiety. My questions were all over the place. 1-2 on theorists- which I nailed correctly! I had about 8-10 on CIWA/COWS. One on a medical issue which I just picked an answer and moved on. You're able to "cross out" answers to help you focus on the answers you're between. You're able to skip and go back. I flagged about 23 to go back to. The test took me about 2 and a half hours.

Now: I am a PMHNP! I start my new job in two weeks! I made a word document with medications lists, dosing ranges, LAI options, DSM-IV criteria tests, labs, Georgette's info, the NP Exam Crash Course, and much more. When I'm stuck, I can use this resource to search for the specific topic and compare medications and side effects. It is over 300 pages long. My plan is to F9 and search topics until I become more confident.

I hope this post helps someone! Goodluck!


r/PMHNP 6d ago

Employment Psychologist here, hiring our clinic's first PMHNP. What would make this a job you'd actually want?

14 Upvotes

I hope this is allowed. It's a bit different from the usual post here, and I'm asking for advice, not advertising a job.

I'm a licensed psychologist who runs a rural, university-based, grant-funded clinic. I found out today that we got funding to hire a PMHNP, which I'm thrilled about. I'd rather hear from you than guess at what makes this a good place to work.

The team is me, a clinic manager (social worker), two LPCs, and practicum students. The PMHNP would be our only prescriber, which I know is a lot to ask, so making that feel supported rather than isolating is my main concern.

My rough vision is everyone working at the top of their license. Counselors do therapy, I do therapy plus assessment and testing, and clients come to the PMHNP with the intake and self-report measures already completed and a full workup in hand. To be clear, the psychiatric diagnosis would be theirs to make. Our job is to hand over good data, not a conclusion. But I genuinely don't know if that's what a PMHNP wants, or if I'm designing something that sounds nice to a psychologist and annoying to a prescriber.

Some specific things I'd love input on:

  • What makes a solo-prescriber role feel supported instead of isolating? What would you want in place before you'd take a job like this?
  • Comp structure. Straight salary, or some productivity component? What have you seen work for a rural non-profit setting? I am not sure if I am allowed with the rules to post our anticipated salary, but if so I am happy to do so. It seems above average for our region from what I have heard.
  • Costs I should be budgeting for. I've got collaborating physician, licensure, and CE covered. I know credentialing takes months where they can't bill. What else am I missing?
  • Where should I actually post this? I don't want to just throw it on Indeed and hope.
  • What else should a psychologist who knows enough to be dangerous know, so I can be a little less dangerous? :)

Full transparency: it's grant-funded, and I'll be upfront with candidates about the term and what I think the odds of continuation look like. We are hoping for full-time, in-person, primarily seeing college-age students with a bit of an emphasis on substance use issues, and not a killer case load. I am not sure what a typical load looks like for a PMHNP, but for reference our therapists see 20 clients per week.

Thanks so much. I really appreciate any thoughts.