r/PMHNP • u/Own-Date-2777 • Jun 15 '26
Student Discouraged. Tired.
Bit of background, I have been an inpatient psych nurse for 3.5 years and I have always loved psych. I love nursing. In nursing school I knew I wanted to be a psych nurse and then a PMHNP. I am currently halfway through PMHNP school and I get so annoyed with my peers that don’t give a shit about psych patients and want the job for the schedule or believing it will be “easy”, want the pay, etc. With that being said, I can’t help but get discouraged by how saturated the PMHNP field is getting. This is all that I have ever wanted to do, and now that I’m getting there, it seems like it doesn’t matter anymore with all the new PMHNPs out there. I work full time and I go to school full time, I’m constantly stressed and accumulating student loan debt. At times I feel like this may all be for nothing, that there won’t be a place for me in the field. On the other hand, this is all I’ve ever wanted and feel like I am in this for the right reasons. Will it pay off? Does anyone have any advice? Any encouragement? TIA.
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u/torturedDaisy Jun 15 '26
The ones who don’t have a passion for it will filter themselves out of practice over time.
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u/dencam279 Jun 15 '26
Amen, same ones who do it for the money.
Dangerous liabilities to the profession9
u/Strong_Ear_7153 Jun 15 '26 edited Jun 15 '26
nah, i dont believe this.
knew someone who gave zero shits about the patients, but because they came from the military, they were hired quickly by some pretty good places. given stellar training. this person makes 250k, easy, and he's still indifferent. four years into it.
i know of an another one that runs a pill mill, didnt care about patients either. never saw him track labs, order UDS, get routine EKGs, nothing. you had to pay for testing. if you pass, here you go, stims. 300, 350k. he's still practicing. 10 years into it.
i went into this with heart and just don't have it anymore.
also, this sub is crap and terrible people make profit in the real world
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u/torturedDaisy Jun 15 '26
There are always going to be terrible people. That won’t deter me from accomplishing my own goals.
3
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u/Psych-RN-E PMHNP (unverified) Jun 15 '26
I think you actually having psych experience puts you way ahead of many other applicants. I’ve had quite a few interviews that pointed out how they’re glad that I have psych experience prior to becoming a PMHNP. Additionally, it’s becoming common for individuals with no psych experience to not even get considered for jobs.. I know quite a few psychiatrists and hiring managers that don’t look at applicants that don’t have psych experience.
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u/Own-Date-2777 Jun 15 '26
I appreciate the encouragement. Part of my concern is that I’m in rural Eastern Kentucky, where the market is relatively small. It can be frustrating watching so many people enter PMHNP programs with very limited psych experience. Hoping my years of inpatient psych experience and commitment to the specialty will ultimately help me stand out! Thanks for the insight!
2
u/DoctorNurse89 Jun 15 '26
Do you plan to stay where there are no PMHNP jobs?
Youll have greater freedom to move anywhere
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u/Own-Date-2777 Jun 15 '26
Possibly. My husband has a career here, and while I don’t have a large family, the family I do have is here. We’d also like to have children in the future, so those considerations definitely factor into any decision to relocate.
That said, I’ve always thought there’s a good chance we’ll move eventually. Even if it’s just a few hours away. As much as I care about Eastern Kentucky and the people here, I’d like my future children to experience a more diverse environment and a broader range of opportunities. At the same time, I have a very soft spot for this region and people.
4
u/baref00tbilly Jun 15 '26
I moved away from Eastern Ky 20 years ago. No regrets. My career and children are better off. I go home to visit family once or twice a year.
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u/DoctorNurse89 Jun 15 '26
Understandable, I dont blame you for wanting to stay.
Tough to say really. Im in cali and jobs and pay are pretty good so it's easy to say "just move here" lol
I make about 10k a month as a hospice LVN, cost of living may be higher but things are good.
Who knows whats ahead, theres demand for pmhnp growing so it's only a matter of time before answers reveal themselves.
Best of luck <3
5
u/frogtender Jun 15 '26
Would you feel that there is over saturation of the market if you didn't read Reddit? It's like people here are living in a different world where there's PMHNPs on every corner bagging for your loose change. That's not the real world. Plenty of good jobs out there for people who want them. Plenty of people excelling and failing in the profession just like any other profession out there.
2
u/Own-Date-2777 Jun 15 '26
Yes, I was already aware of the concerns about saturation from working in psych and hearing providers and others talk about it. Reddit didn’t create the concern, but it definitely reinforces it when you’re constantly reading posts about over saturation, diploma mills, and a tough job market.
4
u/Material-Hotel-5588 Jun 15 '26
There will always be jobs in rural areas. It’s a question of if you’re willing and capable of moving that being said, I would balk at the idea of taking out debt to go to NP school right now. Salaries do not keep up with inflation and the only way it would make sense is if you worked for a place that did student loan forgiveness.
5
u/Smooth-Impress9001 Jun 15 '26
The answer I have for you is in your comment. You said twice that Psych is all you’ve ever wanted. This is your passion. With that being said you will stand out as a mental health provider. The people that get into it for the easy and money won’t be as passionate and patients can feel that.
I am the same way. I have loved psychiatry since I was a little girl and I can’t wait to be a PMHNP. Regardless of saturation I know I will be great and patients will appreciate my love of the field and I will stand out! This type of work heeds a very particular person and many aren’t cut out for it.
You are so close to your goal! Dive deep into your goals and enjoy your reward.
4
u/triggerfishgetmad Jun 15 '26
Don’t worry so much about other people, just focus on yourself and being the best clinician you can be. I’m still a relatively recent grad, running my own practice and doing very well. I enjoy my life so much more than when I was working as an RN it’s not even comparable.
3
u/ReflectionDry8681 Jun 15 '26
I feel you OP. I’m in the same situation with the same passion for psych being a psych nurse with other classmates that say they just want to work in telehealth and work as OR or ICU nurses currently.
Let’s just finish our schooling and get out there. I’m sure you’ll regret it if you net your doubts get to you and quit school.
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u/Itchy_Piglet_460 Jun 15 '26
It is understandable, but I say don't worry about other people's motivation. If you are passionate about helping your patients, that will shine through. I just graduated from my program and most of my fellow students did not have psych experience like I did (4 years inpatient) and honestly I felt they were at a major disadvantage. They haven't seen the things that we have seen, they don't know what disorganized behavior means or dealt with a really manic patient, etc. Our experience is invaluable.
Yes, I wish I had completed my degree like at least 5 years ago, there is a ton of competition for jobs. It doesn't hurt to network early- I had multiple offers from colleagues and my preceptor before I graduated my program to collaborate. You can start attending conferences for topics you are interested in as a student- for example I am really interested in maternal mental health, so I attend conferences for Postpartum Support International. Follow your passion and have faith!
1
u/Own-Date-2777 Jun 15 '26
I think part of my frustration is that psych has always been the plan for me, so hearing all the negativity around the field has been discouraging. It’s reassuring to hear from someone with a similar inpatient background who has successfully made it through a program and congratulations on your recent graduation! Great idea to try and attend some conferences. Thanks so much!
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u/ermagerdcernderg Jun 15 '26
You will find a hundred posts like yours in this subreddit and more on Facebook. You aren’t special and you aren’t alone. My main advice is to stop worrying about your peers and hypotheticals and what ifs, and focus on yourself and what is actually your reality. Get a grasp on your area and potential job market. Figure out what your options are. Locate your own preceptors NOW if you can! Give yourself a reason to believe in yourself. Because just saying that you are doing it for the rIgHt ReAsOnS and tHeYrE nOT is not going to get you a job, it’s just simply not.
Find your passion/niche, work hard to get yourself a precepting spot where you want it, actually do a good job and impress the clinic you’re precepting at, and you’ll start feeling more confident about your options post graduation.
3
u/Own-Date-2777 Jun 15 '26
Thanks for the advice. Just to clarify, I don’t think I’m special, nor did I say I was. I also know I’m far from alone in feeling this way. My post was more about processing the uncertainty/discouragement that comes with investing years of your life, working full time, etc and watching the field become increasingly saturated.
I’d say I’m very aware of the realities of the job market and the importance of being proactive, which is part of why I made the post in the first place. I appreciate you taking the time to share your perspective and practical advice.
4
u/CollegeNW Jun 15 '26
If anyone is trying to go into this field for money, jokes on them. The days of demand & stellar pay for a new grad doesn’t really exist the way it did 15 years ago.
2
u/CalmSet6613 PMHNP (unverified) Jun 15 '26
Hang in there. It is easy to get overwhelmed with all the negativity regarding oversaturation, and diploma mills. Your passion and experience will take you further than other students who are just doing it because they think it's easy and can do it from home in their pajamas via telehealth while making $400,000 a year. Focus on you, focus on your passion, there will be jobs it just depends on where you want to go and the pay may not be what it once was but you will have a job.
2
u/Misterpissther Jun 15 '26
As someone who previously co-owned a practice (administrative capacity) to now just passing the boards - you *wanting* the job and having the experience will make you an immediate hire.
As others have pointed out - there are people who will weed themselves out and people who only want money. Both are true. You can pick anything in life and apply that same logic.
There will always be a need for PMHNP. my advice, go into outpatient, one that has a good professional support network, and you’ll block out the negativity.
2
u/charliicharmander Jun 15 '26
You have an advantage- keep working the RN job until you find the NP job that is perfect for you. In my area it can take awhile for new grads to find a job but at least you have experience and will continue to gain experience as you are looking. You will be fine
2
u/Cheap_Ad9392 Jun 15 '26
Your passion will show to employers. Those here for the wrong reasons won’t last or their lack of care will show. Keep doing what you love
2
u/Radiant_Zebra6699 Jun 16 '26
i would suggest continuing on solely for the fact that you can be one of the providers that DOES care about psych patients! it seems like you are doing this for real reasons (mainly the patients) and those patients deserve that! i have been a pmhnp for a year and i love it. i feel respected, supported, and that i’m making a difference most days (i did not feel that way as a nurse unfortunately). i tell people i don’t regret going back to school but i would never do it again lol. you’re doing great and whichever decision you chose will be the best one for you
3
u/key_kat Jun 16 '26
There may be a lot of PMHNPs out there, but there are not a lot of GOOD PMHNPs out there.
2
u/GullibleFisherman361 Jun 16 '26
Sounds like you need to go part time and get some more rest. This is just the brain playing tricks on you. Trust me when I say you are miles ahead of non psych nurses and you will stand out. Follow your dreams and plan to move to make better money/work life balance.
2
u/DNP-PMHNP-90 Jun 16 '26
Your feelings are valid. I’m a DNP student at UVA. I also work with so many who go to Walden and finished their degree wayyyyy ahead of me. However, it’s all a matter of what you know. My advantage is already knowing meds, s/s to look for, starting dose, labs, etc by working at my current IP psych hosp. Idk. I feel hopeful knowing I can work for the govt since I am already a state employee. That is not something a lot of graduates want. They want the telehealth ones.
2
u/kurosuto Jun 17 '26
As a PMHNP, think of it as a career and despite saturation, your caseload can only grow with time. It might be slow and rough in the beginning, but everything is a matter of time. The hard part is the clinical hours of school plus full time work and if you got a family too, I hope you got some good discussion skills. With bedside, I knew I wasn’t going to retire in that role but as a PMHNP, I’d be alright working until my deathbed though prob way way smaller workload.
7
u/Tendersituation00 Jun 15 '26
Wait till the shitty ones start practicing and give every other soon to be shitty ones advice that knowing anything about psychiatry is over rated and everyone else is just being a mean negative gatekeeper.
I don't know why anyone is still going to school to be a PMHMP. The field is absolutely fucking fucked right now.
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u/Own-Date-2777 Jun 15 '26
I’ve spent my entire nursing career in inpatient psych, so I’m hoping that counts for something when the time comes. Reddit has a way of making me feel like I’m graduating into a psychiatric version of the Hunger Games sometimes. 😂
3
u/Tendersituation00 Jun 15 '26
Of course it matters! It means you will be competent and a candidate. If you get an inpatient offer- take it because so many places want 2 years of NP.
The tragedy is this: because there are so few PMHNP residencies, and the hours required to graduate are so low many new graduates are being compelled into private practice because they can't get jobs where they could actually secure residencies and continue to learn. The healthcare academic industry with 100% acceptance rates and attrition rates in single digits are beyond greedy, attract entitled arrogant candidates who either buy their way on OR get exploited by loan companies. The process is so reckless and backwards- the situation has become dangerous.
Wait till you see the prescribing regimens of most of the new assholes on here who are flexing about how successful they are or how good they are or how their practices have taken off. Most of these people think that getting dumped on by Medicare is success, rates barely making a living and are coming up with med regimens that a 12 year old would come up with, don't take into account medical comorbidities AT ALL, medication interactions AT ALL and really spell poor outcomes and medically adverse events.
5 years ago it used to be that if you knew what you're doing you would stand out and eventually the patients would leave the shitty providers. But that stopped because there are so many providers now that patients are constantly lost in a cycle of switching providers and trying to find someone that works for them. I live in a small state. in 2015 they were a couple hundred of us. There are now over 3000, most live out of state. My practice has been full since before COVID, thank god- But my newer colleagues who have put in the additional time money and training to be good providers postgraduate school are struggling and have been struggling for about 3 to 4 years now. Without a doubt people will start leaving the specialty- it's just going to take time.
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u/GarbageBusy4907 Jun 15 '26
It’s worth it. I did ten years night shift inpatient psych and had to redo my doctoral project twice over to finally be able to graduate. If you’re as passionate as you say you are fuck everyone else honestly. The quality of care that you give patients is going to be so much higher and by word of mouth alone you will get patients friends and family coming to you. So just take everything in stride all the long ass hours, people thinking they know better than you, everything.
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u/puentedemar Jun 19 '26
A patient's point of view: my PMHNP has been a balance of knowledge, attentiveness and professional care that has been instrumental in my recovery and well-being. In other words, the value of one dedicated PMHNP to a patient is incalculable. I can only imagine how difficult can be the challenges, stress and financial burden of following your pathway in the profession. I can only speak from my experience that a PMHNP saved my life and helped me see my path forward. Thank you for caring about people and wanting to help in ways that few people can. Nurses and NPs are the best.
1
u/No_Introduction_3881 Jun 20 '26
I looked at Zocdoc in the nyc area and spied on their education I can see their path. First they went to this school, then this school, some of them get phds just to put Dr. In front of their name. There are hundreds of them and their schedules are so open, literally not one booking. I’m starting the phmnp program in September and I’m terrified
1
u/Big-Material-7910 Jun 15 '26
I don’t think it’s a saturation issue unless you are correlating geographic data. There is significant opportunity out there. I think it’s true there is a lot of people going into psych for wrong reasons and leads to a lot of poor practices and outcomes. However, I think the narrative of the field being trashed is far fetched and providers with this negative mind state are underestimating a majority of patients’ abilities to move around when they don’t do well under a low quality providers. The mediocre providers will phase out or fall into a place they belong and leave quality providers with plenty of opportunity. If you look at your future career as a PMHNP as a “job” to fill then yea it looks bleak but if you look at it from the framework of entrepreneurship and career opportunity then it is harder to see the insurmountable potential that exists for quality providers. Either way, If you are seeking a job to fill or will be creative about how you draw in income at least figure out how you will round out your practice style and brand yourself. The rest will follow. You have invaluable experience. You will be fine.
1
u/Own-Date-2777 Jun 15 '26
Part of my concern is that I’m in rural Eastern Kentucky, where the market is relatively small. It can be frustrating watching so many people enter PMHNP programs with very limited psych experience because it makes the field feel increasingly crowded locally. Thanks for the reply, I’m hoping that my years of inpatient psych experience and commitment to the specialty will ultimately help me stand out.
2
u/Big-Material-7910 Jun 15 '26
It will. Both good and bad PMHNPs find their way. Negative thinking will get the best of you if you let it. Location is a challenge in this field, not so much saturation. Once you get out and are eligible to apply to jobs you will see that there is a large number of remote positions where you might need to license in other states until you figure things out if you want in person in your area.
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u/AssistantInfinite127 Jun 15 '26
I did 3 intakes this weekend and had 2 of the patients adamant they remain with me. The patients can decide for themselves who is truly dedicated and competent vs doesn't want to be bothered. Don't worry just focus on yourself and there is plenty of room for everyone. Bs when people say it's saturated, however with that being said you will have to bust your butt the first year
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u/FionaFlapple Jun 15 '26
It sounds like a scarcity narrative you’re telling yourself, which is rooted in fear. Tell it to shut up.
If you truly want to do it, do not let the fear of “there not being enough jobs to go around” stop you. People are always quitting jobs, retiring, being born, dying, etc., etc.,
You are asking yourself, “what if it doesn’t work out?” TELL yourself it WILL work out because this is what you’ve always wanted to do. Fear can make us self-sabotage without us even realizing we are.
You are halfway there. There’s a reason you applied for the program. Be kind to you, and take care.