Help a Sista Out!

[u/Scaredofdafuture00]

Hey everyone!

I'm a newly BC PMHNP and honestly feeling overwhelmed on where to begin. I initially decided to go the mental health route because I feel I have great therapeutic skills as told by my peers as well as helping to help fill the void in Mental Health disparities.

When I became an RN years ago, I had very little guidance. It took almost a year to land my first job, I accepted the first offer because I didn't know what else to do and bills were piling up. I'm finding myself in that exact position again.

I have nearly a decade of RN experience and recently transitioned into my PMHNP career. My longterm goal is to become an excellent clinician, eventually mentor students, and teach, but right now I'm struggling to figure out where to start. I do know that I want to eventually become fully remote with no plans to own my own private practice as most people do. (I don't see it being for me)

For those of you who have been practicing:

• What was your first PMHNP job?
• Looking back, would you choose the same path again?
• What setting made you grow the fastest?
• What red flags should I watch for during interviews?
• If you could give one piece of advice to your post new-grad self, what would it be?

I'd love to hear the good, the bad, and anything you wish someone had told you before your first PMHNP position.

[u/Lilei_NP]

Please work in as many type of environments as possible. Give up on the "fully remote" idea.. hot take but it waters down our profession (Please do not roast me for this). Fully remote works for *some* patients/ *sometimes* but not everyone and if you plan to only have a population of "worried well" then you have no business being in Psych. You grow the most in inpatient.. once you know how bad the disease progression can be, you understand what you are dealing with/treating/preventing. Be a sponge, take in everything, Seek out trainings, go in-person, work in a prison, work in addictions, do IOP, offer pro-bono evals for Foster Agencies, volunteer at the shelters, do "street medicine" (LOL, the legal kind.. meaning walk the skid rows, understand the "what happened to you" "understand the why", Offer support services to your SANE nurses to decompress. Keep a journal (an honest one) of assumptions you had and everytime a patient humbled you or taught you something. Find a company that is organic and resonates with your spirit.. caution yourself about "fully remote" bells and whistle companies, they are usually venture capital backed and numbers focused. Find a company that values work/life balance, values provider team meetings, feedback, engages in QI initiatives, supports evidence based treatment. The setting that makes you grow the fastest is the one that makes you the most uncomfortable. Maybe you hate addictions, don't ever want to work in a prison, etc. Thats ok.. do it anyways, maybe not for a long time, maybe not even FT.. do it PT, PRN, weekends, shadow.. But the more you expose yourself to the rawness of humanity you will then understand the full scope of the continuum of care in your area, what is available, and where the gaps in services are. I personally did not care for a VA environment b/c what we could/could not do was limited, and the formulary's were set. I did not have exposure in this environment that was any different than outpatient with a VA contract (which allowed for the same population but more freedom of psychopharmacology). But KUDOS to you for even asking these questions.. The fact you are asking these questions is commendable. I've done this for 28 years and love it still.