FNP AND NPP-can they do psych rx

  1. I 've beeing lookingng ad for psychiatric nurses practitioners. But it seems as if one comp any is willing to look at the FNP as well for the practice of psychopharmacology. Here's my question: Once I went to an open house and the director of the fnp indicated that the fnp should really do the psych med component only if the patient is already an estalished pt of hers.( This would make sense from a holistic point of view.)
    Any thoughts?
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  2. 12 Comments

  3. by   traumaRUs
    I can only speak from my own experience. I am an adult health CNS who sees chronic hemodialysis patients on a weekly basis. I do not as a rule prescribe psych meds except for the occasional valium or xanax or ativan used prior to dialysis. The true psychotropic management is best handled by a psych NP IMHO.
  4. by   zenman
    More psych meds are prescribed by family practice docs than by psychiatrists so the same might hold true for FNPs.
  5. by   core0
    Quote from zenman
    More psych meds are prescribed by family practice docs than by psychiatrists so the same might hold true for FNPs.
    Yes more psych meds are prescribed by family practice, but I have noticed a trend for FP's to take on tougher cases with mixed success. I think that simple bipolar for example is doable by FP, but once you start mixing meds (multiple SSRI's/NRI's for example) then psych should be doing this. The hallmark of medical practice (and nursing practice) is to work within your scope. This is an unfortunate side effect of medical licensing that physicians have an unrestricted license to practice medicine. This occasionally leads them to creep into areas that they don't have expertise or experience in. I go to Psych lectures (if there is steak involved) and tend to agree with a statement by a psychiatrist "you should not be prescribing atypical antipsychotics if you are not completely conversant in treating tardive dyskinesia".

    If you are treating simple depression/dysthymia (probably 80-90% of what is seen) then FNP is OK. If you are treating complex depression or other psych diagnoses then get psych training.

    David Carpenter, PA-C
  6. by   spaniel
    Yes that is where I was coming from,David. I am surprised that an FNP would take on a solely psychiatric practice-or that a "psychopharm company" would hire FNPs. Certainly if the FNP already was working with a pt. who needed initial help in meds, I can see it. Anyone else seeeing this trend of FNPs working for psych groups?
  7. by   zenman
    Quote from spaniel
    Yes that is where I was coming from,David. I am surprised that an FNP would take on a solely psychiatric practice-or that a "psychopharm company" would hire FNPs. Certainly if the FNP already was working with a pt. who needed initial help in meds, I can see it. Anyone else seeeing this trend of FNPs working for psych groups?
    This is clearer. No, i don't think an FNP should just be doing psych...or anything more than the "unhappy masses." I don't know of any FNPs working with psych groups but have seen family practice docs contracting to do physical exams for admissions to psych hospitals.

    I'm a psych CNS and FNP student, but thinking about switching to psych NP as I want to work with a well-defined adult population...and parents doing all the "goo goo" crap with their kids almost makes me puke, lol!
  8. by   Psychaprn
    ITA with all of you-stay in your scope of practice for the patient's safety and your own!
  9. by   zenman
    Ita?????
  10. by   spaniel
    Funny thing- it took me awhile too! ITA=I totally agree,right?
    Zenman- on a slightly different trend, there does seem to be a real shortage of decent qualified psychiatrists. And where I live, there are quite a few openings for psych NPs. (I am not a psych NP, but have RN and doctorate,so I do counseling.) At any rate, I am aghast at some of the family doc's rx for complicated cases. I wish they'd take Psychaprn's advice too!
  11. by   Psychaprn
    ITA-I totally agree.
  12. by   peaceful
    What state are you seeing a demand for pysch NPs? Thanks.

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  13. by   zenman
    Quote from Psychaprn
    ITA-I totally agree.

    OK, NIGI.
  14. by   spaniel
    To poster "Peaceful"- I live in upstate NY and there are a fair share of psych NP ads. Again, there are a few psychopharm companies, but also a few urban clinics, as well as a site for people with developmental disabilities- listing ads for Psych Np's. Personally I would not be able to tolerate seeing one person after another just for meds unless I were able to spend a decent enough time with the person. I toyed and toyed with the idea of going back for my Psych NP as I've worked a long time in psych (inpt. oupt.. you name it). But for now, as I am licensed at the doctoral level,I just do counseling. Age is another factor as well as expense....but not the final determinant for me in going back for my NPP.

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