A complaint against an NP

[Oldmahubbard]

I am about to make a complaint against a grossly over confident FNP who prescribes psychiatric drugs.

Her knowledge level is the 20 minutes they had in FNP school.

She just prescribed Risperdal Consta for absolutely no reason.

The patient had never taken oral risperdal.

[FNP2019, MSN, APRN]

Shameful situation. Do what you gotta do.

Truthfully, its not just an APRN problem. Seems a lot of healthcare providers step into psych without training. We’ve got an obgyn-turned-mental health counselor in our area prescribing psych meds under his MD license. How he still holds that license is beyond me, because his Rxs are totally inappropriate. Opioids for migraine?

[myoglobin, ASN, BSN, MSN]

Here's the thing he's probably in the wrong but I would have "mixed emotions" about filing a complaint. Here are some of my thoughts:

a. Perhaps this clinician has had significant psychiatric experience not reflected in his FNP title. For example maybe he worked as a psychiatric nurse or pursued some post graduate education (short of the PMHNP designation). Depending on the state it may be within a "grey area" depending upon why he is using the medication.

b. Thus, perhaps he had a bipolar I patient or a schizophrenic client who wasn't reliably taking the oral medication or who (at the time) didn't have insurance that would pay for psychiatric treatment and felt that "the greater good" was served by prescribing the medication.

c. Just as I wouldn't want as a PMHNP to have a complaint filed against me for prescribing "Metformin" for antipsychotic induced weight gain (typically the domain of a FNP, but which is evidence based for this purpose and touted by such sources at The Psychiatric Institute, UpToDate and The Carlat Report). I would be reticent to complain against others in the absence of overwhelming evidence of someone being a true menace. I feel that there are enough physicians seeking to limit our scope/ and or create issues without participating in that process. Having said that, without knowing the specifics it is difficult to say what is appropriate. Perhaps the behavior rises to the level of reporting.

[Rnis, BSN, DNP, APRN, NP]

On 10/20/2019 at 2:02 AM, myoglobin said:

Here's the thing he's probably in the wrong but I would have "mixed emotions" about filing a complaint. Here are some of my thoughts:

a. Perhaps this clinician has had significant psychiatric experience not reflected in his FNP title. For example maybe he worked as a psychiatric nurse or pursued some post graduate education (short of the PMHNP designation). Depending on the state it may be within a "grey area" depending upon why he is using the medication.

b. Thus, perhaps he had a bipolar I patient or a schizophrenic client who wasn't reliably taking the oral medication or who (at the time) didn't have insurance that would pay for psychiatric treatment and felt that "the greater good" was served by prescribing the medication.

c. Just as I wouldn't want as a PMHNP to have a complaint filed against me for prescribing "Metformin" for antipsychotic induced weight gain (typically the domain of a FNP, but which is evidence based for this purpose and touted by such sources at The Psychiatric Institute, UpToDate and The Carlat Report). I would be reticent to complain against others in the absence of overwhelming evidence of someone being a true menace. I feel that there are enough physicians seeking to limit our scope/ and or create issues without participating in that process. Having said that, without knowing the specifics it is difficult to say what is appropriate. Perhaps the behavior rises to the level of reporting.

I think that is very fair feedback. I also think talking to the provider to give feedback could be helpful.

[FullGlass, BSN, MSN, NP]

What happened with this? Is this the NP that dressed inappropriately?