By Jeremy R. Verhines MSN, RN, PMHNP-BC
Psychiatric Mental Health Nurse Practitioner
Psychiatric-Mental Health Registered Nurse Salary
Overview of the Psychiatric Trained Registered Nurse/Mental Health Nursing Career:
What is a Psychiatric or Mental Health Registered Nurse? The Psychiatric-Mental Health Registered Nurse is a licensed Registered Nurse who has chosen the field of Mental Health as his or her specialty of nursing. Much like any other specialty, the Psychiatric Nurse is trained specifically in the care of the patient diagnosed with a mental illness. Some of the mental illnesses these nurses will care for include the following but are not limited to: Schizophrenia, Schizoaffective, Schizoaffective Bipolar Type, Bipolar I and Bipolar 2, Major Depression, Anxiety, Obsessive Compulsive Disorder, all Eating Disorders, Attention Deficit Disorder Hyperactive and Inattentive types, Substance Abuse Disorders, and all other disorders indicated in the Diagnostic and Statistical Manual, Fifth Edition (DSM-V). There are many disorders listed in the DSM-V but for familiarity sake, I only listed the most common disorders Psychiatric-Mental Health nurses will encounter and care for. I encourage you to thumb through the DSM-V to get a better idea of the various mental illnesses occurring in the Mental Health patient population.
The Psychiatric-Mental Health trained Registered Nurse has a unique skill set that is not utilized often in the majority of Registered Nurses caring for patients in the other care settings. These trained nurses are a part of a unique niche market of caregivers not typically sought out by the general nursing workforce population. The reason for this in part is due to the stigma mental illness receives from the community both in the United States and Internationally. By virtue, mental illness is a disease process that is not accepted and acknowledged as a disease in many populations and cultures. It is often ignored and misunderstood which is at the root cause of the stigma existing today in society and the refusal to acknowledge the disease processes. Furthermore, this unfamiliarity prevents most professionals from exploring this specialized healthcare population.
With that said, there are what I call the few elite who choose to care for these patients. At the heart of each of these caregivers is empathy, compassion, patience and most importantly the ability to work within an environment that is considered high risk, high stress and extremely demanding on the mind and emotions of the caregiver. Psychiatric-Mental Health nurses have at their core the teachings and philosophies of Hildegard Peplau. Peplau gave Psychiatric Nursing some key principles that help guide and structure how Psychiatric nurses care for the mentally ill. A popular theory of care that Psychiatric-Mental Health Nurses follow is called: The Theory of Interpersonal Relations. This theory has four key phases that the Psychiatric- Mental Health nurse must navigate through while caring for the mentally ill patient. These phases are orientation, identification, exploitation, and resolution. With each phase, there is a responsibility both of the caregiver and the patient to get to that place where the nurse-client relationship can begin, trust can be built, care delivered and, ultimately, recovery of illness can take place for the client (Nursingtheory.org, 2018).
Career Path of the Psychiatric Mental Health Registered Nurse:
The career path of the Psychiatric Mental Health Registered Nurse is an open field of opportunity. I say this because I consider it to be the last frontier in healthcare that has so much to be explored and discovered. Registered Nurses looking to get into the field of Psychiatry are setting themselves up for a nice long career with stability and financial security. There are a couple of paths that the Registered Nurse can take as far as becoming a trained mental health caregiver. First, the nurse can enter the field directly out of nursing school. Most psychiatric facilities are favorable to new graduates as there is a shortage in the field. Another option is to float to a Psychiatric floor and gain experience. This is the most appropriate way in my opinion as it gives the caregiver an opportunity to compare their current specialty and to see if it is a field they would like to grow into. In addition, it is valuable for Registered Nurses to have experience in medical-centric areas prior to getting into the behavioral setting simply because basic nursing skills are essential and necessary for every new nurse to grasp and be proficient in. Regardless if you are a new grad or seasoned experienced nurse getting into psychiatry understand this – learning mental health requires time, energy and resources so the decision needs to be well thought out.
Once you have made the decision to explore this specialty, you have at your disposal a plethora of choices when it comes to gaining employment. Psychiatric Mental Health nurses can work in various behavioral health settings including but not limited to: Acute Care hospitals, Designated Stand-Alone Psychiatric facilities, Outpatient Acute Stabilization clinics, Emergency Rooms, Home Health and Hospice Care, Outpatient clinics, Partial Hospitalization programs, Long Term care and Skilled Nursing facilities, Board and Care Homes, Sober Living programs, Substance Abuse Treatment Centers, Correctional institutions, Academic institutions, and finally State Psychiatric hospitals. Ultimately, it is up to the individual to choose. Most Mental Health nurses are found working in either Acute Care hospitals or Stand-Alone Psychiatric facilities but the opportunities are endless as you can see. Growth opportunities in this specialty are broad as well. The more experience and education one has the higher they are able to climb. If a nurse possesses the RN-BC board certification then they are even more marketable. Psychiatric-Mental Health Nurses are able to obtain their board certification in Psychiatric Mental Health Nursing (PMH) through the American Nurses Credentialing Center (ANCC). Board Certified Registered Nurses are considered the elite when it comes to a specific area of care and career path opportunities for these individuals include some of the following: Charge Nurse, Nurse Manager, Executive Director, Chief Nursing Officer and various other officer positions in an organization. If a nurse wishes to teach mental health then this will require an advanced degree which brings me to my next career path point to offer up for the brave and courageous. The Psychiatric-Mental Health Registered Nurse can choose to expand their education and scope of practice in the clinical realm by becoming a Board Certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC). I discuss this role in detail in another one of my blog posts.
Psychiatric-Mental Health Nurse Salary Ranges and Outlook:
Psychiatric-Mental Health Nurses fall within the same ranges as their other colleagues in the different nursing specialties. This is mostly in part due to the licensure itself. When it comes to nursing, it is all about the license. If you have the license then you are able to be considered for a position in a health care agency that requires your services based upon regulatory laws and statutes that guide certain business operations and code. I wrote extensively on the salary ranges for the Medical-Surgical Registered Nurse in a previous blog here at Pocket Prep and will provide my research findings in this post as well for you to consider.
Much like the Medical-Surgical nurse and other nurse specialties, Psychiatric-Mental Health nurse salaries vary from region to region and state to state. The BSN (Bachelor of Science) trained Psychiatric-Mental Health nurse is expected to be more marketable than the ADN (Associate Degree) registered nurse as acute care hospitals expand their services and become more Magnet driven. However, once employed, the ADN and BSN trained nurse fall within the same pay scale. According to the Bureau of Labor Statistics, the hourly wage range for a Registered Nurse is $23.41 – $50.05 with the mean or majority of Registered Nurses falling at or around $35.36 per hour (bls.gov, 2018). To get a better idea of the different wage opportunities that exist visit the Bureau of Labor Statistics website. Here, information is offered and the different settings given for Registered Nurses. One thing to note with regards to registered nursing salaries is that the pay ranges differ greatly depending upon population, region, and demand. For example, in the Southern California region, and the area I live, non-union Registered Nurses can make anywhere between $37.00 – 61.00 an hour depending upon how much experience they have. I personally have not ever relied upon statistics to understand exactly what my potential is given the volatility of the rates and the vast differences in the areas served. It is always best to investigate a particular organization you wish to work for and inquire as to what their pay scale is. Furthermore, it is important to understand how nurses are paid. If you work for an organization in Southern California then you can expect to get a base hourly rate + time and a half for any hour over 8 hours in a given shift. Most Registered Nurses work 12-hour shifts so their base rate is paid for the first 8 hours and then time and a half paid for the last 4 hours of that shift. For example, a Registered Nurse who makes $40.00 an hour and works 12-hour shifts will get $320.00 for the first 8 hours (8 x $40.00) and $240.00 for the last 4 hours (4 x $60.00) giving the nurse a total of $560.00 for that respective 12-hour shift. Any time worked over 12 hours is paid at a double-time rate or in this case, $80.00 an hour.
When it comes to the Psychiatric-Mental Health trained Registered Nurse, it is important to consider the uniqueness of the calling and the narrow provisions of trained caregivers the nursing workforce has to offer employers. With this in mind and the wage information I have provided, one has the ability to negotiate their worth as a Psychiatric-Mental Health professional, especially if they possess board certification. My advice to you is to not settle for less but advocate for your value, worth, and experience. You deserve it!
By Jeremy R. Verhines MSN, RN, PMHNP-BC
Psychiatric Mental Health Nurse Practitioner
Nursing-Theory.org. (2018). Hildegard Peplau, August 2018. http://www.nursing-theory.org/theories-and-models/peplau-theory-of-interpersonal-relations.php
Bureau of Labor Statistics. (2018). Occupational employment and wages, May 2017: 29-1141
Registered Nurse. https://www.bls.gov/oes/current/oes291141.htm