Psych Nurse vs. Psych Nurse Practitioner - How Does The Care Differ?

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By Registered

August 18, 2020



Psych Nurse vs. Psych Nurse Practitioner – How Does The Care Differ?

Are you interested in the psychiatric-mental health population, thinking of specializing within your nursing practice, or considering furthering your education to become a nurse practitioner?  The psychiatric-mental health field is currently booming and can be a highly rewarding and varied avenue of nursing. We’ll cover the differences and a few similarities between the care provided by a psychiatric-mental health nurse (PMHN) and a psychiatric-mental health nurse practitioner (PMHNP). Considering the need of mental health awareness, these vital roles are on the forefront of opportunity for travel nurses.

Responsibilities of a Psych RN

“Psychiatric nurses are experts at evaluating complex psychiatric, substance abuse, and physical health needs and problems of patients over the life span” (, 1998). The PMHN provides an important service to people with mental illnesses or behavioral disorders. RNs in this specialty are multi-faceted and have a variety of duties. 

According to Dr. Veronica Doran, Assistant Professor of Nursing at the Malek School of Health Professions, Marymount University, “the psychiatric nurse will operate under medical orders from an advanced practice specialist, mostly an MD or an NP, in terms of medication administration, treatments, or general safety orders.”

Some responsibilities of the psychiatric-mental health RN include:

  • Provide emotional support
  • Administer medications and assess responses
  • Maintain communication with doctors and other members of the healthcare team
  • Follow treatment plans
  • Educate patients and families
  • Provide physical and mental assessments

The PMHN utilizes the nursing process on a daily basis. These nurses may specialize in various age groups or populations, such as addiction treatment, adolescent care, or forensics.

Like other nursing specialties, a psychiatric-mental health RN can become certified by the American Nurses Credentialing Center (ANCC). Do you want to find out more about this specialty of nursing? Check out resources from American Psychiatric Nurses Association.

Their link includes downloadable brochures for those interested in the RN or NP specialty so you can make an informed choice – or just broaden your knowledge base.

Responsibilities of a Psych NP

Psych NPs are certified advanced practice professionals with at least a Master’s degree (and sometimes a Doctorate) who are experts in determining diagnoses and ordering treatments accordingly. Dr. Veronica Doran emphasizes an important difference between NPs and RNs: “Psych NPs need a broader range of knowledge. While I teach my BSN students about the disease characteristics, my NP students need to understand the pathophysiology of the disorders at a cellular level.” 

Like other NPs, PMHNPs have autonomy. They may work completely independently from a doctor or with minimal supervision, depending on the state. Some NPs have their own practices for providing psychotherapy or treatments. PMHNPs are in the position to become policymakers or board members and drive changes across the mental health landscape.

As Dr. Doran notes, “one of the biggest assets to an NP, and this is abundantly true for psych, is that we approach our specialty from a holistic perspective. I would love to see more psych NPs working in collaboration with primary care offices, nutritionists/dieticians, and other medical specialties because we can look at the whole patient and provide care that extends beyond medication management.” 

This type of care differs from that of psych RNs in that the PMHNP can:

  • Maintain prescriptive authority
  • Have advanced assessment skills
  • Create and order treatment plans
  • Diagnose conditions or diseases
  • May serve as a counselor or provide psychotherapy to individuals or groups
  • Educate patients, families, or communities on diagnoses, medications, etc.

Some Similarities

Both RNs and NPs can specialize in varied patient populations and have started their careers as RNs. RNs and NPs can also both serve as educators, participate in committees, and assume leader or management roles. Whether it’s an RN or NP providing care, both individuals are skilled at communicating and understanding non-verbal cues that a patient exhibits. For both roles, providing care involves offering emotional support through the use of therapeutic communication. The care provided by either the RN or NP addresses the entire person and the needs and treatment of that individual. These healthcare heroes also excel in addressing crises and remaining calm in emergencies.

The Bottom Line

Whether you are an RN or NP, your primary goal is to provide excellent care to patients within the scope of your professional practice. As discussed, there are several differences between the care provided by an RN and an NP. Nurse practitioner care focuses on advanced assessment skills, pharmacologic and their effects, diagnoses, and prescribing therapies to treat symptoms or diseases. It also involves treating the patient holistically. RN care is driven by the nursing process and assessments, therapeutic communication, administering medications, and monitoring for effectiveness. Both RNs and NPs can work in a variety of settings. While there are a number of differences between the two roles and the care they provide, both are extremely important in ensuring that this population is heard and helped.

About the writer: Susan Sinclair is a nurse who currently works in home health. She has nursing experience in med-surg, telemetry, research, and education.  She is also a writer and enjoys writing about current nursing topics and elevating the nursing profession.

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