PMHNPs - also doing primary care?

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Psychcns

2 Articles; 859 Posts

Specializes in Psychiatric Nursing.

I stick with what I know--the psych meds. However there is an overlap.. Can you recommend some ANP pocket size reference

Books for me. Ie how to recognize and treat new hypothyroidism, how to assess and start bp meds, sliding scale insulin, rashes, etc. so I can follow along. Thanks...

williamd

20 Posts

Specializes in Psychiatric.

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 . 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.

Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

ATPIII for lipids.....JNC 7 for BP control.....UpToDate for quick reference

mtsteelhorse

1,635 Posts

Specializes in Correctional Nursing; MSN student.

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?

Psychcns

2 Articles; 859 Posts

Specializes in Psychiatric Nursing.

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..

mtsteelhorse

1,635 Posts

Specializes in Correctional Nursing; MSN student.
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.

Psychcns

2 Articles; 859 Posts

Specializes in Psychiatric Nursing.

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--

Psychcns

2 Articles; 859 Posts

Specializes in Psychiatric Nursing.

@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.

mtsteelhorse

1,635 Posts

Specializes in Correctional Nursing; MSN student.

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.

myelin

695 Posts

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.

mtsteelhorse

1,635 Posts

Specializes in Correctional Nursing; MSN student.

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?

kris_10

57 Posts

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?

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