I want to help people not hurt them

Specialties Psychiatric

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Hello Psych nurses and Psych nurse practitioners

I am a highly analytical thinker so I have put a tremendous amount of research into which career I believe I would be best suited for. I circle back to Psych nursing (eventually NP) often.

One thing keeps nagging me though... I am a supporter of the neurodiversity paradigm. Are any of you familiar with this concept? Essentially it is a belief that many of the conditions/ disorders/ and illnesses present in the DSM are natural variations of the human mind. I learned about it through the autistic community which I am very familiar with, but also extends to schizophrenia, bi-polar, etc. Which admittedly I am not as familiar with these conditions.

It is my belief that as a mental health professional intervention should be done in accordance with the desires of the patient. To clear up a few things, some people who espouse these beliefs like to take meds, some don't, all are pro choice. Also none of them would object to interventions where the person would be at risk of harming others or themselves.

I'm particularly adverse to the idea of pathologizing autism. I would love to be able to work with the neurodivergent community instead of against them. Unfortunately the state I am located in now (Florida) is restrictive to the scope of practice of the NP. I don't feel pursuing an MD is a viable option personally. It is a consideration of mine to move to an independent practice state.

So basically I am worried about investing time and money into a career and then being forced to work under a physician who maybe has opposing views. I would also like to get some feedback about your thoughts on neurodiversity and psychiatry as being able to co mingle.

Thank you!

Specializes in Psych, Addictions, SOL (Student of Life).

Jules,

Kudos to you for being willing to think outside the box. I am very familiar with the neuro-diversity concept as I am Neuro-typical and my husband has Asperger's or High Functioning Autism Which is what the DSM V is calling it now. While my husband is odd as hell he is very high functioning works for the feds and manages quite well most of the time. He does not take any medication stronger than Tylenol.

That being said I have also been an acute psych nurse for 17 years and there are those which are neuro divergent - who truly do need medication. If their condition causes them to be dangerous to self, others or gravely disabled (unable to provide for their basic needs) or if they lack the insight to understand these things they need to be medicated. Sometimes they will do so willingly - sometimes they need to be court mandated. The problem as I see it is that patients feel they don't need medications but they repeatedly show up in the acute psych setting because as soon as they stop taking their medication they decompensate.

We have had some pretty good success with the long acting injectable antipsychotic meds.

As far as the autistic community goes - it depends on where that patient falls on the spectrum of functionality. Many autistic person's suffer from crippling anxiety. when that can be controlled they are able to function at a mush higher level.

Patients are not medicated against their will without reason and it takes a court order to make it happen.

Psych is a great field to go into - if you get your NP and want to work with a Dr. who works with that population go for it.

Hppy

I think that all sounds very reasonable hppygr8ful. I appreciate your response.

Specializes in Family Nurse Practitioner.

Also worth noting as a psych NP the focus is almost 100% medication management. You will see patients for med checks lasting between 15-30 minutes back to back. If you aren't largely into prescribing medication social work might be a better avenue for you to consider.

I did consider social work, but chose psych nursing for several reasons

1. better return on investment

2. Advocacy of neurodivergent population. Social workers are excellent in this capacity as well, but given nursing scope of practice we are in a unique position to help people.

3. Science. I love biology, anatomy/ physiology, pathology etc

Just to reiterate I am not opposed to medication. I actually think psychopharmacology sounds interesting.

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