According to the National Alliance on Mental Illness, 20 percent of adults and 17 percent of children struggle with mental illness; it's the second-leading cause of death for those between the ages of 10 and 34. Untreated mental disorders impact families and communities and can cause physical health problems. And yet, in 2020, only half the children who needed mental health care received it; even fewer adults underwent needed treatment.
Why do so many Americans' mental health conditions go untreated? A shortage of trained mental health professionals contributes to this crisis. The Association of American Medical Colleges (AAMC) projects a shortfall of up to 31,000 psychiatrists by 2024.
There is a resource that could help alleviate the problem. Psychiatric mental health nurse practitioners (PMHNP) perform many of the same duties as psychiatrists. These professionals are highly trained—they hold either a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP)—and face rigorous licensure requirements. They can treat severe mental health issues like schizophrenia and bipolar and eating disorders. They can practice without physician oversight in many states. And because they don't need an MD, PHMNPs can train and start practicing much more quickly than can psychiatrists. For those who can handle its rigors, PMHNP is a rewarding career path that fills a growing need in our society.
This article explores psychiatric mental health nurse practitioner skills and enumerates the qualities of a successful PMHNP. It explores:
Though they don't need a Doctor of Medicine (MD) degree, PMHNPs can prescribe medication as part of a treatment plan. They also offer psychotherapy. During intake appointments, the PMHNP can order and interpret tests to diagnose and develop care plans for mood disorders and mental illnesses. As they continue to see the patient, these professionals may be responsible for medication management.
As nurse leaders, PMHNPs may be responsible for supervising a team of other providers (including psychiatric RNs). That means they won't always perform crisis intervention or individual case management as a clinical nurse specialist would. A psychiatric NP's duties vary by where they work. A rural PMHNP may be required to handle all practice and administration responsibilities for their practice.
Similarly, the job description may change depending on your subspecialty. PMHNPs work in a variety of settings, including with children and teens, the elderly, incarcerated individuals, and more. They can even launch a private clinical practice. Each subspecialty has its own requirements and challenges.
The rural South, where salaries tend to be lower, has the greatest need for PMHNPs. Indeed reports PMHNPs earn an average salary of $140,000 nationally. In states like Alabama and Mississippi, the figure may be closer to $100,000 (or lower), according to Zippa.
This section explores several top PMHNP skills, as identified by O*Net, a government occupation database.
Listening is an essential aspect of this job. When diagnosing or delivering psychotherapy, PMHNPs must hear and react to what patients say. Listening is also essential for communicating with coworkers. NPs are frequently nurse leaders, meaning they manage teams and work with upper-level administrators. Finally, listening to coworkers can be valuable, especially when they're struggling with stress or interpersonal issues. Like professionals in other high-pressure fields, nurses suffer from high burnout rates.
According to one Psychiatric Times article, psychiatrists (and by extension PMHNPs) need a developed "third ear" to decipher the underlying meaning of words. A conversation's tone and pauses can have significant meaning, especially if the patient lacks adequate communication skills. You may even need to identify drug side effects (such as a physical or behavioral change).
Critical thinking consists of several skills. You must analyze a situation to make an informed decision, requiring excellent observational and listening skills. Next, you must craft a solution to the problem. Good nurses are quick and decisive when problem-solving—a difficult balance. Nurses can also use critical thinking when evaluating their performance and striving to improve.
Critical thinking is especially important in the diagnosis phase, when nurses often must make do with the resources at their disposal. Almost nothing happens in a controlled environment; you may not receive all the information necessary for a clean decision. Critical thinking also means predicting further challenges, such as understanding the side effects of a drug based on a patient's medical history.
Nurses must be service-oriented—both to patients and their family members. O*Net indicates they help educate loved ones about mental health issues and discuss treatment. Though PMHNPs are usually paid well, high burnout rates plague this profession. A strong desire to help others, even those not appreciative in the moment, is essential if you want to sustain a long nursing career.
None of the other skills matter if you're a poor time manager. PMHNPs balance seeing patients with administrative duties. According to the American Association of Nurse Practitioners (AANP), these professionals see an average of 15 patients per day. Poor time management may result in disorganization and an inability to function—including in life beyond work.
Successful nurses stay organized and prioritize the right goals, taking care of high-need tasks first. A daily routine can keep them on track, even though conditions change daily. Carving out a specific time to perform administrative duties may be helpful. Proper time management practices can help reduce stress and garner greater responsibilities.
Deciding to become a PMHNP can be difficult; examining the necessary skill set can make it easier. Driven professionals stand a good chance of learning the necessary skills. All advanced practice registered nurses (APRN) complete hundreds (at least 500) of clinical hours in pursuit of their graduate nursing degree—whether they attend a nearby state college or a national powerhouse Yale University (which will start offering the degree online in the summer of 2023). This experience prepares graduates for the challenges of their jobs.
Ultimately, succeeding as a PMHNP may come down to your emotional capacity rather than a single skill. You must feel comfortable working with people in severe emotional distress. Not everybody returns from the depths of emotional tumult; it can take a toll on healthcare providers.
Nurses can struggle with mental health issues, including substance abuse. They experience high rates of PTSD, depression, anxiety, and workplace violence. That's worth considering.
That said, for thousands of PMHNPs, the rewards (including monetary) outweigh the risks. They are among the best mental health professionals in the country and take part in extraordinary success stories. Their accomplishments and the satisfaction they derive from them can fuel them through challenging days.
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