A Craigslist Couch Purchase Changed Her Career Path with Dr Lindsay Hill

A Craigslist couch purchase leads to a first nursing job, and that job leads to a career in psychiatric mental health that eventually includes mentorship, education, and entrepreneurship. We talk with Dr. Lindsay Hill, PMHNP, about the nontraditional path that brought her from “psych was my least favorite rotation” to building a thriving professional community through her Psych NP Boot Camp and fellowship model.

We get honest about clinician burnout and what it actually looks like when it’s not just workload, but a mix of postpartum strain, a traumatic brain injury, the isolation of telehealth, and feeling boxed in by systems that don’t understand a PMHNP’s scope of practice. Lindsay shares how she evaluated her options, what pushed her toward taking smarter risks, and how reconnecting with areas of passion can restore longevity in psychiatric nursing.

We also go deep on vulnerability and self-awareness as clinical tools, including the risks of self-disclosure when it shifts focus away from the patient, and the rewards when it builds safety and strengthens the therapeutic alliance. From there, we zoom out to PMHNP education: why psychotherapy training and clinical application often feel thin, how DBT and dialectical thinking can help new psych NPs navigate real-world pressure, and why “the therapeutic relationship” is the piece of Peplau’s wisdom we can’t afford to lose as AI and productivity metrics reshape care.

If you’re a psych NP, PMHNP student, or mental health clinician trying to practice ethically in fast systems, this conversation will give you language, frameworks, and permission to protect what matters. Subscribe, share this with a colleague, and leave a review with the biggest pressure point you want us to tackle next.

Let’s Connect

Dr Dan Wesemann

Email: daniel-wesemann@uiowa.edu

Website: https://nursing.uiowa.edu/academics/dnp-programs/psych-mental-health-nurse-practitioner

LinkedIn: www.linkedin.com/in/daniel-wesemann

 Dr Kate Melino

Email: Katerina.Melino@ucsf.edu

 Dr Sean Convoy

Email: sc585@duke.edu

 Dr Melissa Chapman

Email: mchapman@pdastats.com

Transcript

Welcome And Guest Introduction

SPEAKER_03 0:31

Welcome everybody back to another episode of Peplo's Ghost. I am I'm really excited about our next guest. Dr. Lindsay Hill is here. I was doing a bit of self-admitted cyber stalking for her. I she was in my social medias, she was all over my LinkedIn, and she was doing some really cool stuff. And I was really just interested to get an opportunity to get to know her and figured the podcast is a great opportunity just to get to meet a fellow Psych NP and share what kind of cool stuff she's doing. So I'm really excited to do this. Also joined with my you know constant co-host, Dr. Melissa Chapman Hayes. So so let's get into it. Dr. Lindsay Hill, um, Lindsay with an A. I've got some friends who want to make that distinction, Lindsay with an E. Sometimes it's a it's a distinction to make. She is an educator, mentor, clinical entrepreneur, and I think entrepreneur says it best. She runs the Psych NP boot camp. She has a prescriber guide, she's a published thought leader. She does so much. It's so great to meet you, Lindsay. And thank you so much for being here on Peplo's Ghost.

SPEAKER_01 1:37

It's eating you. Thanks for having me.

Finding Psych Nursing The Hard Way

SPEAKER_03 1:39

Yeah. My first question really is just maybe to kind of get to know you a little bit. If you've listened to any of our prior episodes, you know, my journey to being a psych NP is, I'll cynically say convoluted. It's not a straight path by any means. So, you know, I start off as a social worker actually, and then a couple of years saw the light and got into nursing. And as we're recording this, it is the end of Nurses Week. So happy nursing day and week to you, Lindsay, as well. But maybe let's start right there and say, do you mind sharing what got you interested? What was your path to becoming a psych NP? And yeah, let's just start there.

Burnout, TBI, And Career Pivot

SPEAKER_01 2:14

Absolutely. It was somewhat non-traditional, I would say. I was in nursing school in a small town in Ohio. And I went to my psychiatric nursing rotation. And it really was my, I hate to say it, but least favorite rotation because I just didn't see the patients getting better on the unit that I was in. And I just felt like, man, this would be really depressing to be doing this on an ongoing basis and not really feeling like these people are really making much progress. And so I just kind of in my mind put it out of my head working in psych nursing. And honestly, I hadn't even heard about the role of psychiatric mental health nurse practitioner until I moved to Arizona, interestingly enough. And I didn't know anybody in Arizona. And so it was hard to get my first nursing job because they were looking for people with experience. And it took me a while to get that first nursing job. And it happened to be through buying a couch on Craigslist, interestingly enough. And I got a community health nursing position at Arizona State University. And it was there that I met a couple of psychiatric nurse practitioners, where instantly I was like, oh wow, whatever they're doing with these patients and these students seems to be making a difference because these students are going from not functioning to now functioning. And I was super inspired by that. And I just kind of knew that's what I wanted to do. So I ended up going back to school after like a year and a half of community health nursing, which I was really nervous to do. I didn't feel like I was necessarily ready. I had some mentors in my life at the time that were really like, you have this opportunity with working here and getting this like discount to go to school. Like just seize the opportunity if you know it's what you want to do. Like I remember the dean of the nursing program at the time telling me, like, well, I have imposter syndrome too. And I was like, really? I would have never guessed that, you know? So yeah, that's kind of how I got into becoming a psychiatric nurse practitioner. And I love it. I think I've been at Psych NP now for 11 or 12 years. And the path has like had a lot of ups and downs. I've had periods of burnout where I didn't know if I was going to be continuing in the field, quite frankly. And I'm in a really good place now. And I feel really passionate about just kind of expanding the role and advocating for mental health.

SPEAKER_03 4:46

Yeah, thank you. If you wouldn't mind maybe sharing a little bit about that, you mentioned kind of reaching a point maybe of burnout. And that's and that's always an area of interest to me. And I talk to my students a lot about, you know, being careful that first job you take, because, you know, don't want to get into a position where you're just in a cynically call like a pill mill where you're just seeing like 25 patients a day and just kind of grinding through. And I remember we had a previous guest, Andrew Penn, who talked about that he was kind of burnt out in nursing as well until he got interested in psychedelics. And now that's his passion and does lots of teaching and talking on that. So what's uh where did you see the burnout coming and and how did you kind of resolve that?

SPEAKER_01 5:27

I saw the burnout coming. Let's see here. I had a really strong mentor at my first job. It was working with higher acuity patients for sure. I mean, I did feel like I lacked resources at times as far as like where to refer people who are struggling with co-occurring substance use and things like that. But I definitely felt supported and like I had that good mentorship and support. I did have a traumatic brain injury in I believe 2021. And I do think that was a contributing factor because I was really just struggling mentally with my memory, and I was also somewhat newly like postpartum. And I just found myself like more irritable and wanting more flexibility to just have more time to be with my son. And and so I realized at a point that as far as being able to impact change, I felt like I had kind of hit a ceiling with that in that organization because various reasons. But I just if I I felt like if my boss could have maybe progressed up the ladder there and been able to impact change more so, but she was also, I think, kind of like stuck at a point where I'm like, I don't feel like they fully understand my scope of practice. And there's just certain things that I I'm always gonna be curious to, like if I don't try doing my own thing. And I went and worked for another company actually first, because I just never saw myself as an entrepreneur. I never, I didn't think that that was in my DNA or just for me, you know. And at that place that I was working, I saw these two one was a psych NP, one was more of the billing side of things. They scaled a group practice and sold it in like a couple years, and like the confidence, even though like clinically they had less experience, was just like really kind of impressive. And I remember they asked me to do a course on DBT because that was my doctoral project. And I was like, I know I'm gonna give my heart and soul to this, and I'll be paid an hourly rate. Like, that's cool that they are even would want me to do that, but like also I could probably just create a course just on my own, too. Like, so it just kind of inspired me to take take some more risks and at least find out if I was gonna hate it or not, being in private practice and doing more for myself. But I will say, just like Andrew Penn, kind of getting leaning into that area of interest, like kind of getting back to areas I'm passionate about. I think I had lost that a little bit just in what I was doing, has been really important for my kind of longevity in the in the field.

SPEAKER_03 8:03

Yeah. Thank you for sharing those things about yourself. And uh it reminds me of a quote I just heard recently, and this is an old quote, and not obviously I'm gonna say it, but I forget I'm gonna not be able to reference it. But uh, fortune does favor the bold, right? It's um and and sometimes that is hard to kind of take that step out. So so thank you again. I'll turn it to Melissa.

SPEAKER_02 8:22

Uh thanks, Dr. Hill. I want to ask you a bit about vulnerability, and in your work you've explored the that this concept, both vulnerability for the patient and then for the provider. Petlaw suggested that the nurse's self-awareness is the primary tool for healing. So, what do you see as the risks and rewards for nurses who allow themselves to be truly present and vulnerable with their patients?

SPEAKER_01 8:48

Yeah. You know, I think the risk could be making the treatment or the appointment about yourself, you know, as the provider, if you are maybe using self-disclosure, but not necessarily in a way that's in the patient's best interest. And I think that could be a risk. But I also think that like it can be really powerful in appropriate situations and allow patients to feel more safe and more able to hear you and have a stronger therapeutic relationship with you. I've also kind of, which I despise public speaking in grad school and my whole life, really. And I'm actually speaking at a psychotherapy conference in October, which is kind of ironic. And I'm like, I'm pushing myself out my comf out of my comfort zone. If I hate it, I don't have to do any more conferences, but maybe I'll like it. I don't know yet. But it just sounds scarier to me for some reason, like speaking in person than doing like these podcast epic episodes, or you know what I mean. But anyway, all that to say, like I've I've definitely been more vulnerable publicly. And it's been scary. It's opened myself up to criticism and people misinterpreting my intentions or motivations or speculating or making judgments, which has been hard at times, you know, that kind of like rejection sensitivity feeling. But I would say for sure, like the benefits have outweighed the negatives because I've had so many more people come to me and be like, thank you. This is how I feel. And I thought I was like the only one in different areas, you know, in psych and pe related things, but also in oh, being a mom, being a bonus mom, having a traumatic brain injury, you know. So that's made it really like worth it and honestly kind of helped my sense of having a community for sure, because I did get to the point too where I was very isolated. I felt very siloed. I went from that first job where I had that strong mentor in person for seven or eight years, to now I'm doing telehealth and I'm just here out on an island, kind of. So being in community has been really, really helpful in allowing myself to be seen and not kind of hiding out as much as I did as in my early years of my career, I would say.

SPEAKER_02 11:10

Yeah. And hopefully that that community is is relatable. Especially as a mom if your little one is young too. That's that's and hopefully could shield against some of the, you know, negative comments, judgments, etc., that are gonna come with something like that. Exactly.

SPEAKER_01 11:26

Yeah, of course.

What PMHNP Programs Often Miss

SPEAKER_03 11:27

Yeah. Yeah, it's you know, it's uh it's tough when you put yourself out there. I mean, obviously you're putting, you know, opening yourself up to those kind of things as well. But for what I see, you're doing great work. And so, yeah, I just want to kind of shout out to that as well. But uh one of the things when I was looking at your website and and you know, kind of looking at the work that you're doing, I'm really interested in your thoughts because I I think you have you have a connection to academia, but you know, you're very much an entrepreneur and doing kind of your own thing. And it, you know, it sounds like, and then correct me if I'm wrong, but it seems like you have a real kind of niche of, you know, helping people again, that sense of community we were just talking about, when people just you know graduate from programs from like the University of Iowa where I work and things like that. And I think there's a lot of you know, really desire for that. And people are really drawn to kind of what do I do in those first one to five years of practice? And sometimes people don't have. I mean, I had a great mentor as um as well, and and it sounds like you did too, right out of school, but not everybody gets that opportunity. So, so maybe to kind of you know put you on the spot and let's uh get you a dream wish list and from an academia point of view, what do you think is missing in PMHMP programs? What's what should we be focusing more on? And uh, you know, again, maybe you know, I'm gonna kind of lean towards more of that psychotherapy part you were saying that you're gonna speak on. And that's obviously one of the focuses of this podcast. But but feel free to go wherever you want. I mean, I'm really interested in hearing your thoughts on on what PMHMP programs are missing.

SPEAKER_01 12:51

Yeah, I definitely think the psychotherapy education and application piece, which actually like there was a misunderstanding with the dean of my program when I was doing my project because of kind of me writing my PICO and putting in the background of like why I feel like it's lacking in certain psych and pee programs, maybe not all. And yeah, I felt I felt bad because I I felt like she was taking that very like personally. And she was a great instructor, she was a great dean. But I do feel from what I've heard that most of us graduate not feeling like we truly understand what it means. Like we're kind of like identity confused as far as like, am I supposed to do psychotherapy? Am I not? Like, I'm not a therapist. Like, what does this really mean? And it was just very like not black and white, very nuanced. And it just took me a really long time to feel confident in that area. So I would say stronger education in that in that regard, and you know, clinical experiences and having those opportunities in school, that really was a differentiator for me because I happened to express to my instructors, I really want to like any psychotherapy opportunities, like I want those. And so I was able to go through DBT as a participant, actually, first, and then I was able to co-lead skills groups, but it was going through as a participant that really changed the game for me. And it was interesting because here I was like, well, I'm pretty high functioning, you know, I'm like in grad school. I'm feel like I have it together, you know what I mean? And then I'm like with these teens who are like self-harming and stuff, and I'm just like, I'm learning possibly more than they're, I don't know. Like I'm learning a ton, you know what I mean? And like, wow, it's some really basic things that I thought that I understood about my emotions that I really didn't, you know what I mean? Because I had been to therapy before, but I feel that I got really tripped up in CBT because I'm like, well, I know this stuff, so now I'm just like ticked at myself because I know this stuff and I still can't change my behavior. And so in DBT, just changing your behavior and then having the group aspect and being able to come back and kind of report back and being like, oh, I'm noticing that when I change those behaviors, like this really helped, you know what I mean? So going off on a tangent, but yeah, psychotherapy is a huge piece. And then yeah, just more of the clinical application piece too. I think, you know, Dr. Carlat's content with Carlette Publishing, I didn't discover his resources until, and it was probably uh from being online that I discovered them. But like, I feel like it was like five years into practice, and I'm like, how did I not know about these resources? So that's another, you know, like I've tried to advocate to get more of his content into Psych NP programs because I'm like, his content's great, and it's it's very like content that you can use when you're right there with the patient, right? And those are the kind of resources I think that we need more of in these in these programs.

SPEAKER_03 15:49

Yeah, it's kind of that pragmatic side of things, you're right. I I I really love that idea, that identity confusion that we do experience. That's I think that was so well put because it's something. I mean, I see this kind of written, you know, people trying to use the word integrated and and all these kind of things, but it is it is a confusing part space, and and I think people do misrepresent us outside of the field as well, you know, communities and even patients sometimes, you know. I'm you're just my pill person, right? You're yeah, I'm not supposed to open up to you, I'm not supposed to talk about these deep problems, but but yeah, that's that's gonna resonate. Uh, really resonate with me. Thanks. That's identity confusion. Yeah, thanks.

SPEAKER_01 16:23

Of course, absolutely.

SPEAKER_02 16:24

Yeah, and thanks for sharing what you did, because I don't think that is at all a tangent to talk about your experience going through DBT and what you had learned. I appreciate that.

SPEAKER_01 16:34

Yeah, of course.

Mentorship Under Metrics And Pressure

SPEAKER_02 16:35

So, yeah, Nami, thank you. Again, vulnerability. So you have a deep commitment to nursing education, and Peppa often talked about the nurse as a participant observer. How do you teach new students to step back and observe their own roles within the patient relationship while they're simultaneously learning the heavy clinical demands of the job?

SPEAKER_01 16:55

Yeah, that's a great question. I do it a lot through the coaching that I provide and the education I provide on social media, but in the PsychNP boot camp and fellowship that I run, we do a lot of like just coaching and reflection and also storytelling with like de-identified cases. You know, I think that that's super helpful. And it's how I learn a lot of times is just getting to hear about other people's experiences. And so, you know, I think just modeling that even as far as like modeling my own journey with being that participant, you know, on an ongoing basis, because I still see patience and I still deal with difficult cases and cases where I'm second guessing myself and you know, trying to kind of have that more observing role, uh, you know, it keeps me accountable teaching the students and again modeling that for them, I think.

SPEAKER_03 17:58

Yeah, this is great. I mean, I think kind of maybe going off of that as well, you mentioned you're still in practice doing all this kind of great work. And maybe I know again, kind of further my question I had for you, kind of students coming out and things like that. As you're mentoring and you know, providing this fellowship for people, how how do you deal with this constant tension between, you know, I mean, and again, practices, you know, in private practice, you do have the luxury of kind of dictating what you're gonna do and who you're gonna see and things. The people are in clinics and things, they get a lot of pressure of prescribing and using EHRs and telehealth and just all the metrics that they get kind of measured and dictated by saying, you know, what you're a good provider. I had I saw once recently that somebody was told that they have to see, what was it, like 2.4 patients an hour. You know, it's just like this quick, you know, turnover of patients. So how do you kind of mentor and what sort of things do you help people kind of balance that other thing? Again, maybe going back to even the beginning of our conversation, talking about burnout and things like that. So, how do you talk to your people that you consult with and and develop this community of balancing all this thing while still maintaining your core as a nurse?

SPEAKER_01 19:04

Mm-hmm. Absolutely. One of the things I do that I want to continue to expand upon is I teach in my program about dialectical behavior therapy and the concept of being dialectical, because I think that it applies in a lot of different areas, right? To be able to have that scale of, okay, what two things could be true about this situation, you know, because we are in these systems where we have these demands and these requirements. And a lot of us have the this like conviction and like really want to help patients. And it sometimes feels like it's like, you know, not possible. So I think, you know, learning that concept of of dialectics, two things can be true, is one of the things I do. And then, you know, trying to teach them about maybe some red flags too in some of these organizations of a place that might be ethically, you know, not practicing in a way that's going to align with with their ethics. So I do do coaching through one-on-one and in my group, just with people who experience that all the time. I had somebody recently actually who started a job and was like, you know, the person overseeing me told me like I shouldn't be asking about sleep, really. I mean that, and I was like, huh. Yeah. So uh stuff like that where it's like, you know, uh, you really want to be an environment where you're supported to practice in a way that ethically it does isn't against your ethics, right? And I think when it does get to that point where you're questioning if then maybe look for a different job situation, you know what I mean?

SPEAKER_03 20:49

So yeah, but it's not easy. No, no, it's not. I mean, especially yeah, when your salary and you know, people you know have mortgages, car payments, and everything else to pay for. But uh but yeah, what a great example. Because I'm like, sleep, why wouldn't you ask? I mean, sleep is so basic. I I I usually tell people in my psycho farm course, you're usually a lot of PMHMPs are pseudo-psych experts or sleep experts because you're you're treating so much sleep with every so many different disorders. And but you know, even going beyond that, that micromanagement of you know talking about what you can and can't talk about in your practice is yeah, not treating you as a professional as you should be. So that was a great example.

SPEAKER_01 21:25

Exactly.

SPEAKER_02 21:28

So kind of future facing here, as you look at the trajectory of nursing over maybe let's say the next decade, what is one piece of Hildegard Kepler's wisdom that you think is most at risk of being forgotten? And why is it the one that we need to fight to keep? Ooh, that's a great question.

SPEAKER_01 21:46

I think that the therapeutic relationship is the most powerful tool. I think we could lose sight of that with AI and just like, you know, it's exciting in some ways and it's Also scary, right? And I I really think that we underutilize that intervention of the therapeutic relationship, and we put so much pressure on ourselves to pick the perfect medication or like refer for the perfect therapy and evidence-based. And it's like there is so much power in that therapeutic relationship. So I just think we're at a kind of a time where, you know, there's so many psych MPs who are graduating too from these programs. And like it's so it's it feels more saturated for a lot of people to find opportunities. It's different than when I graduated in 2015, for sure. So I think that that's one of the most important things that Paplau's talked about that we really need to kind of revisit and remember on a daily basis.

SPEAKER_03 22:53

Which is why we call this Peplow's ghost. Yeah. I think you that's very well said. I mean, it's that relationship piece always it feeds me. I mean, it's it's one of those things that when I get lost in my practice and and feel like, you know, I I if I feel like I don't know how to help this person, I I just I go back to the relationship. I go back to, you know, those validation, those real core foundational therapeutic communications and and look at, you know, what other sorts of psychotherapy you can do. So Yeah. Yeah.

SPEAKER_01 23:20

That's a really great way to put it too. Because I'm just even thinking about a case right now I'm dealing with, and I'm like, we we need to be reminded, right? Because it can be frustrating and discouraging sometimes when we're like really trying to help this patient and we're not, we're like, and it's like, what am I doing wrong? And it's like just being reminded, like, okay, maybe I need to revisit just like the basics and the therapeutic relationship. And it's yeah, it's yeah, great point.

Lindsay Hill’s Work And Closing

SPEAKER_03 23:47

Yeah. Cause I mean, we all work with patients that, you know, will fail medications and have, you know, an army, you know, long list of different meds that they've tried and failed and and for various reasons and such. And so the people that keep getting keep coming back and keep you know striving, I think those are the things we need to kind of focus on is that you know, that they're still working, they're still trying these things. They're yeah, they're still with us for a reason. They want us, they want to get better. And and sometimes, you know, the science is still evolving, so there's still stuff we need to kind of learn, but but the relationship will always be there. So it's true. That's very true. Wonderful. Wonderful. Well, thank you, Dr. Lindsay Hill. This has been great. I forgot to plug this in the beginning, but Dr. Lindsay Hill has a website. It is Lindsay Hill, Lindsay L-I-N-D-S-A-Y, Hill H I L L dot C O. Check out her website, uh, check out her fellowship, check out her all cool stuff that she's doing again. This has been a great experience. Thank you so much for being here, Lindsay. I probably will continue to stalk you on Instagram and other places, but but it's it's been a pleasure to get to know you here a little bit. And so I'm sure the listeners will enjoy this as well. Please stay tuned for more episodes coming soon. Like, comment, and subscribe to our channel. And thank you so much for listening.

SPEAKER_00 25:12

Nurses dance and it's there to stay. We are nurses. So hands to the hands to the hill, the hotel stage study.