Two of the specialization tracks available to aspiring advanced practice nurses are family nurse practitioner (FNP) and psychiatric-mental health nurse practitioner (PMHNP). Let’s explore the similarities and differences between these tracks.
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Family Nurse Practitioner
FNPs provide primary care services to patients of all ages. Their clients can range from infants and kids to adults and geriatric patients.
As a primary care provider, FNPs are providers that serve as the patient’s first point of contact; as such, they help promote healthy living and disease prevention.
70% of NPs in the country are FNPs.
Duties
Similar to primary care physicians, FNPs can:
- Conduct physical examinations
- Order or perform diagnostic tests
- Create treatment plans
- Treat conditions that fall under primary care
- Assist in surgical procedures
- Maintain and update patient records
- Refer patients to other specialists
Practice authority varies per state. In some areas, NPs may prescribe medications independently, while some locations require physician supervision.
Specializations
Although FNPs are capable of caring for all patients, they can specialize in specific fields, such as:
- Chronic disease management
- Obesity management
- Diabetes management
- Pain management
- Telemedicine
- Occupational health
- Integrative medicine
Practice Settings
FNPs are often employed by:
- Clinics
- Health departments
- Healthcare systems
- Community health centers
- Campuses
- Urgent care centers
Salary
ZipRecruiter puts the average salary of FNPs at $127,976 a year or $62/hour. Depending on the location and the FNP’s experience, some can make as much as $191,000 a year.
Job Outlook
There is a huge demand for FNPs. According to Johnson & Johnson, the projected growth rate for FNP employment within 10 years is 45%. The demand is attributed to the aging population, as well as the need for affordable healthcare services and competent primary care providers.
Education
The pathway to becoming an FNP starts with becoming an RN. Options include an Associate’s degree in Nursing (ADN), which takes two years to complete. The Bachelor of Science in Nursing (BSN) program, meanwhile, takes about four years to complete.
An ADN program provides the easiest path to employment, though many hospitals require ADN nurses to complete their BSN in a set time.
After getting a nursing degree, the next step is to pass the NCLEX-RN and gain related clinical experience.
Upon completing the academic and experiential requirements, an RN can now enroll in an MSN program. Typically, a student will need to complete 48–52 units of coursework and at least 500 clinical hours in order to graduate. An MSN program may be completed in as short as two years.
Another option is a DNP-FNP program, which takes about 2 to 4 years to complete. The curriculum requires 69–72 hours of coursework and at least 1,000 clinical hours.
Note: RNs with ADN degrees may also opt to enroll in a RN-MSN or RN-DNP program.
Advanced practice nurses who wish to add the FNP specialty to their credentials may do so by enrolling in a post-graduate program. This takes about 1 to 2 years to complete.
Credentialing
To become a certified FNP, nurses can take the American Academy of Nurse Practitioners Certification Board (AANPCB) exam. Another option is to take the American Nurses Credentialing Center (ANCC), which results in a FNP-BC certification.
Psychiatric-Mental Health Nurse Practitioner
PMHNPs care for patients with psychiatric or mental health conditions, including children, adolescents, adults, and the elderly. They usually work with patients who have anxiety, depression, eating disorders, psychosis, and ADHD, to name a few.
PMHNPs represent the second-largest group of behavioral health professionals in the US. That said, only 2% of NPs in the US are certified PMHNPs.
Duties
A PMHNP works to:
- Conduct mental health assessments
- Diagnose patients with mental health issues
- Provide psychotherapy as needed
- Educate patients and/or caregivers about the condition
- Create treatment plans
- Adjust medication dosages or treatment plans
- Lead therapy sessions
- Maintain patient records
- Make the necessary referrals
Specializations
PMHNPs may opt to specialize in any of the following fields:
- Addiction Medicine
- Child/Adolescent Mental Health
- Military Mental Health
- Geriatric Psychiatry
- Psychosomatic Medicine
- Forensic Psychiatry
Similar to FNPs, PMHNPs may prescribe medications independently (full practice authority is granted to NPs in 22 states and Washington DC) or with physician supervision.
Practice Settings
PMHNPs work in a variety of settings, such as:
- Psychiatric facilities
- Mental health centers
- Addiction treatment centers
- Correctional facilities
- Outpatient or private clinics
- Hospitals
- Assisted living facilities
- Government agencies
Salary
PMHNPs earn a bit more compared to FNPs. According to Ziprecruiter, PMHNPs make an average of $139,486 a year or $67 an hour. Some PMHNPs, meanwhile, are paid as much as $211,500 per year.
Job Outlook
According to the Health Resources and Services Administration, the demand for PMHNPs will increase by 1,850 to 2,190 full-time equivalents (approximately 18%) by the year 2030.
The demand is driven by the need for mental health care access, something which PMHNPs can provide. According to a report, about a quarter of adults with mental health conditions did not receive the treatment they needed due to the shortage of mental health care providers in their areas.
Education
Similar to FNPs, the pathway to becoming a PMHNP starts with becoming an RN, either through an ADN or BSN program.
After passing the NCLEX-RN and gaining at least 2 years of psychiatric nursing experience, a nurse may apply for an MSN-PMHNP program. This requires an average of 42 units and about 500 clinical hours; it also takes about 2 years to complete.
Similarly, there is a DNP option for aspiring PMHNPs. It requires 60-75 credit units and 1,000 or more clinical hours. Program duration ranges from 2 to 3 years.
MSN-educated nurses who wish to specialize in psychiatric-mental health nursing may take a post-graduate course, which requires 25-30 credit units to complete.
Credentialing
To become a full-fledged nurse practitioner, a PMHNP program graduate must take and pass the ANCC’s PMHNP-BC exam.
The AANPCB also offers a 150-question credentialing exam for PMHNPs.
Summary
Both FNPs and PMHNPs attend to patients of all ages (children, adolescents, adults, and elderly). However, FNPs focus on primary care while PMHNPs specialize in mental health conditions.
Both have an overlap in duties, however, PMHNPs lean toward tasks that concern mental health assessment and treatment.
Likewise, the path to becoming an FNP or PMHNP is similar. One must become a nurse, enroll in an MSN, DNP, or post-graduate program, and pass the certification exam.
PMHNPs earn a bit more than the former. That said, there will be a high demand for FNPs and PMHNPs in the years to come.