PMHNPs - also doing primary care? PMHNPs - also doing primary care? - pg.2 | allnurses

PMHNPs - also doing primary care? - page 2

Hi everyone, I have a quick question. I was meeting with a student who is in the PMHNP MSN program that I am due to start next fall, and she made some interesting comments. She basically said that... Read More

  1. Visit  williamd profile page
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    Passing the core NP courses doesn't prepare one to manage medical problems, it's a foundation to build on with cliical courses. I work at a community mental health center, and treating medical problems is not allowed, it is outside the terms of our liability insurance. Which is just fine with me, as I do not feel qualified to do so anyway. All NP's have been trained to do H&P's, which is not the same as treating.

    I have seen job postings at the VA, a few health clinics, and some inpatient hospital settings, requiring practicing both in mental health and medical areas. The only thing I can figure out is these places either do not understand how PMHNP training works, or they are looking for someone who's origional training is as an FNP, with a PMHNP cert.
  2. Visit  traumaRUs profile page
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    ATPIII for lipids.....JNC 7 for BP control.....UpToDate for quick reference
  3. Visit  mtsteelhorse profile page
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    This is a great thread. I start PMHNP school in Jan and I'm trying to wrap my brain around all the possible work environments. I certainly don't think I will be prepared or desire to treat medical issues. For you practicing PMHNPs, do you feel the majority of your work is medication management?
  4. Visit  Psychcns profile page
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    When then the PMHNP role came along in the 90's, it appeared it would allow the APN to do primary care and Psych..after you do your physical exam you do your mental status and you treat everything..
    My training was in therapy (and meds) and I was horrified...
    I currently do only med mgt,(only locums)
    I would like to know more about treating primary care problems because I think it helps my med management ( thank you Trauma for the reference info).
    40 hrs per week of med mgt can be draining--it works for me doing it as a locums..
  5. Visit  mtsteelhorse profile page
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    Quote from Psychcns
    When then the PMHNP role came along in the 90's, it appeared it would allow the APN to do primary care and Psych..after you do your physical exam you do your mental status and you treat everything..
    My training was in therapy (and meds) and I was horrified...
    I currently do only med mgt,(only locums)
    I would like to know more about treating primary care problems because I think it helps my med management ( thank you Trauma for the reference info).
    40 hrs per week of med mgt can be draining--it works for me doing it as a locums..
    How do you get into locums? I'm a little concerned about what I'm getting into with regard psych NP school. I want to do more holistic care...more than just pills. Thanks for your feedback.
  6. Visit  Psychcns profile page
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    I have a psych cns friend who has a lot of diversity in her role working at the VA. Therapy, crisis, meds, groups, and some adminTo get into locums just call. I work for staff care ..Psych was more interesting and more holistic before meds took over--
  7. Visit  Psychcns profile page
    1
    @mtsteelhorse. Med mgt is more than just pills. You have to do some in-depth interviewing to get at the symptoms that you can medicate...and it is a great feeling when the meds work.
    myelin likes this.
  8. Visit  mtsteelhorse profile page
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    Thanks for the feedback. I have a real interest in psych and I truly want to make a difference. I currently work in a jail as an RN. I see folks come in all the time on so many crazy meds...from the NP. It's polypharmacy at its finest. I don't want to fall into that trap. How do you all feel about that? Long term use of benzos, etc? I'm no stranger to mental health issues but some of my philosophies may conflict with the role of the NP.
  9. Visit  myelin profile page
    0
    Quote from mtsteelhorse
    I don't want to fall into that trap. How do you all feel about that? Long term use of benzos, etc? I'm no stranger to mental health issues but some of my philosophies may conflict with the role of the NP.
    I actually am critical of the psych field as well... I think there's a lot of crappy assessment and treatment going on (including terrible polypharmacy and rampant-non-evidence-based therapies). But instead of shying away from the field, I've chosen to embrace it and try to make a difference. It's corny, I know, but I think there needs to be people in psych who want to be here (this is more a problem with medicine where psych becomes a dumping ground for people who couldn't score high enough for the specialty they actually want so they end up stuck in psychiatry, but I digress) and who follow what the research actually says.
  10. Visit  mtsteelhorse profile page
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    Good points made. So PMHNP majors are considered flunkies in demand? That makes me feel less excited than ever. I am so excited about getting accepted but have heard the psych programs are less competitive. I don't want to treat everything with pharmaceuticals. Yes, there is a definite need for meds. They can literally be lifesaving. Then there's treating people like my Mom who was told for years all her symptoms were "in head" and the root of her problems were ignored. I'm really concerned about this. I plan to shadow a new grad this month. Hope to glean more insight. Thanks for your feedback. What non EBP do you see?
  11. Visit  kris_10 profile page
    1
    Quote from mtsteelhorse
    Good points made. So PMHNP majors are considered flunkies in demand
    I believe myelin was referring to psychiatry residents, as psychiatry is a less competitive specialty (in terms of USMLE scores, etc.) than, say, dermatology. So people who didn't score as well in med school might get stuck doing a psychiatry residency because they couldn't get into rads or derm.

    And the lack of competitiveness might be because not everyone is the right fit for psych, it's not the most glamorous field, but it is so important and so neglected.

    How did you find a new grad to shadow?
    myelin likes this.
  12. Visit  Psychcns profile page
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    Psych is great----and you can make a difference. Most people will come off their benzos with good explanations of why they arent appropriate for their dx---(not all of course)--some are willing to try something else...some you may have to be firm aabout why they are not getting a benzo..
    People come to psych providers becasuse of psychological pain...I think you have to start there...
    Non psych NP's are usually glad to have someone else do the psych meds....
    myelin likes this.
  13. Visit  mtsteelhorse profile page
    2
    I can't thank you all enough for this valuable insight. I'm so excited about my chosen path. You hit the nail on the head: psychological pain. And there is a huge demand for us. Many people shy away from the field. You're right, it has to be the right fit. I found an APRN to shadow because she's my daughter's NP. She was more than happy to show me the ropes. How great is that?! I can see how my whole perception has been a bit tainted because the psych patients I see on a daily basis are incarcerated. There's a much bigger world out there.
    myelin and Psychcns like this.

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