Things I'd Do Differently as a New PMHNP If I Could Go Back
Starting my first job as a Psychiatric Mental Health Nurse Practitioner was exciting—but it was also overwhelming. There was so much to learn beyond diagnosing patients and prescribing medications. Looking back, there are a few things I would do differently that would have made my transition into practice smoother.
If you're a new PMHNP or about to start your first position, these are the lessons I wish someone had shared with me.
1. Have a Mentor Lined Up Before Starting Your Job
If I could change one thing, this would be it.
Having an experienced PMHNP or psychiatrist available to answer questions can save you an incredible amount of time, stress, and second-guessing. Every new provider encounters situations that weren't covered in school, and having someone to help you think through those moments is invaluable.
A mentor doesn't have to work in your office. They might be a former preceptor, a trusted colleague, or someone you've connected with professionally. The important part is knowing who you'll reach out to before those questions inevitably come up.
Looking back, PMHNP mentorship is by far the biggest thing I wish I had arranged much earlier.
2. Learn Your EMR Like It's a Clinical Skill
Many new grad PMHNPs focus on improving their clinical knowledge, but becoming proficient with your electronic medical record (EMR) can have just as much impact on your day-to-day life.
Spend time learning:
Documentation templates
Order sets
Smart phrases or text shortcuts
Medication favorites
Workflow features specific to your organization
If your employer offers optional EMR training, take advantage of it.
The couple of hours you invest upfront doing this can save you countless hours later.
3. Track What Slows You Down
When you're new, it's easy to assume everything takes a long time because you're inexperienced.
Instead, start paying attention to where you're consistently losing time.
Ask yourself:
Is charting taking longer than it should?
Are medication orders slowing me down?
Am I constantly searching for the same information?
Is my workflow inefficient?
These aren't permanent weaknesses—they're skills that improve with intentional practice.
Once you identify your biggest bottlenecks, you can focus on improving them one at a time instead of feeling overwhelmed by everything.
4. Figure Out What "Done" Looks Like for Documentation
Perfectionism can be one of the biggest productivity killers for new PMHNPs.
Early on, I spent far too much time trying to make every note perfect.
Instead, find out:
How detailed your documentation needs to be
What your organization expects
What your collaborating physician or supervising providers prefer (if applicable)
Your documentation should be thorough, accurate, and clinically appropriate—but it doesn't need to be a masterpiece every single time.
Understanding what "good enough" actually looks like can dramatically reduce the amount of time you spend charting.
5. Keep a Running List of Questions
One habit I wish I had started sooner was keeping an ongoing list of questions throughout the day.
Instead of stopping your workflow every time you're unsure about something, write it down.
Then review your list:
At the end of the day
At the end of the week
During meetings with your mentor or supervisor
This approach helps you stay focused while also ensuring your questions don't get forgotten.
Over time, you'll notice patterns in the questions you're asking, which can help guide your learning and highlight areas where your confidence as a new grad PMHNP is growing.
Final Thoughts
The transition from Psych NP student to practicing provider comes with a steep learning curve, and that's completely normal.
Focus on building systems that support your growth—finding a mentor, mastering your EMR, improving your workflow, setting realistic documentation expectations, and keeping track of your questions.
Those habits will likely have a bigger impact on your confidence and productivity than trying to memorize every clinical pearl.
Explore our resources for more tips for the new PMHNP starting out in practice.
