Psychiatric nurses are often referred to as psychiatric mental health nurses or PMHNs. PMHNs use evidence-based practice to improve the well-being of patients with conditions such as depression, bipolar disorder, schizophrenia, substance use disorders, and eating disorders. They work in a variety of healthcare settings, including hospitals, clinics, and community mental health centers. Psychiatric mental health nurses work closely with other mental health professionals, such as psychologists, psychiatrists, and licensed therapists.
What Does a Psychiatric Nurse Do?
A psychiatric mental health nurse (PMHN) provides inpatient and outpatient nursing care and interventions to patients with mental disorders. Daily tasks will vary by institution but generally include:
Completing head-to-toe assessments
Collecting health and social histories from patients and caregivers
Evaluating patients’ behaviors and noting changes from baseline
Creating plans of care in collaboration with other providers
Administering medications
Collecting samples, such as blood or urine
Analyzing test results
Communicating changes in patient status with other providers
Documenting patient interactions in the electronic medical record
Teaching patients and caregivers about diagnoses and plans of care
Providing psychoeducation
Conducting or facilitating group or family therapy
PMHNs are responsible for communicating with patience and compassion. The PMHN actively listens, provides guidance, and sets limits. By establishing a good rapport with a patient, the PMHN can help a patient develop problem-solving and coping skills. Patients with certain mental health diagnoses may be aggressive or act in unexpected or bizarre ways. Nurses and other providers receive special safety training to prevent, diffuse, and escape potentially dangerous situations.
Citation: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Registered Nurses, at https://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-5 (visited February 5, 2021).
Annual wages for RNs, including psychiatric mental health nurses, also vary widely depending on geographic location. The top-paying states for RNs are California, Hawaii, and Massachusetts. California nurses reported an annual mean wage of $120,560. As indicated on the map below, RNs are generally paid more in metropolitan areas. Interestingly, healthcare facilities in areas with limited resources, such as Alaska, may also offer higher wages to attract more RNs.
Citation: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Registered Nurses, at https://www.bls.gov/oes/current/oes291141.htm#st (visited February 5, 2022).
Where and When Do Psychiatric Nurses Work?
Psychiatric mental health nurses work with patients in:
Hospitals
Private clinics
Outpatient care centers
Public health centers
Mental health clinics, inpatient or outpatient
Public and private schools
Correctional facilities
Assisted living institutions
Patients’ homes
Mental health is part of overall health, and PMHNs can be utilized at nearly every level of care. PMHNs can seek employment that suits their clinical interests, desired pay, and schedule. For example, a nurse who wants to work with the same children over a period of time would explore opportunities in private clinics, schools, or home health. PMHNs interested in helping patients of all ages through mental health crises may find a good fit in an emergency department, an inpatient psychiatric service, or a mental health clinic.
PMHN schedules vary based on their type of employment. Psychiatric nurses who work in inpatient facilities are often expected to work evenings, nights, weekends, or holidays, at least on a rotating basis. Mental health clinics or other outpatient services have regular business hours, though some may also have on-call requirements. PMHNs who respond to crisis situations in their communities or at an institution may be required to have more on-call hours and unpredictable schedules.
How Do I Become A Psychiatric Nurse?
A psychiatric mental health nurse must first become a licensed registered nurse (RN). After completion of high school, the student can pursue either an associate’s or bachelor’s degree in nursing. A Bachelor of Science in Nursing (BSN) is preferred by most employers. These programs can be completed in as little as 18 months for some qualified candidates, though most programs take four years of full-time study. After graduation, the “graduate nurse” is eligible to take the computer-based NCLEX-RN examination. Upon passing, the graduate nurse becomes an RN. The next step is to apply to a state board of nursing by submitting application materials, fees, transcripts, and the results of a federal background check. This licensure allows the RN to practice within that state.
RNs interested in psychology and mental health disorders can immediately seek opportunities in psychiatric mental health nursing. As a new nurse, employers will often offer additional training, perhaps even a residency. A residency helps graduate nurses apply the knowledge learned in school and provides focused information on their specialty or area of employment.
Certification as a psychiatric mental health nurse is available from the American Nurses Credentialing Center (ANCC) once the following requirements have been met:
Two years of full-time experience as a nurse
At least 2000 hours in psychiatric or mental health nursing
At least 30 hours of continuing education in psychiatric or mental health nursing
The ANCC certification exam consists of 150 questions to be completed within three hours. Upon passing, an RN becomes a credentialed Psychiatric Mental Health Nurse-Board Certified (PMH-BC). Credentialing is not required, but may open opportunities for leadership and increased pay for psychiatric mental health nurses.
The ANCC also offers the Psychiatric Mental Health Nurse Practitioner (Across the Lifespan) certification (PMHNP-BC). A nurse practitioner (NP) is an advanced practice nurse who can assess, diagnose, and prescribe treatments to their own patients with some degree of oversight from a physician. The scope of practice for NPs varies by state, but all NP programs are at the master’s or doctoral level. PMHNs interested in becoming PMHNPs would search for NP programs with a psychiatric or mental health focus option. Most NP programs are two to four years long. As an advanced practice position, PMHNPs earn higher salaries than RNs and enjoy greater independence in practice.
What Are the Benefits of Being A Psychiatric Nurse?
PMHNs are uniquely skilled listeners and creative problem-solvers. It can be very professionally and personally rewarding to guide a patient through a crisis. Some PMHNs assist patients through crises and further help them establish ongoing care plans to prevent future crises. The ability to see patients improve their quality of life over time can be very rewarding. But PMHNs can frequently encounter traumatic patient histories and erratic patient behaviors, including patients attempting physical and verbal abuse of their caregivers. A passionate psychiatric mental health nurse can build a rewarding career caring for the patient population of their choice. The wide range of career opportunities for PMHNs makes this an attractive path for those interested in providing mental health services.
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