ACNP in Psych Hospital?

Advanced Practice Columnist / Guide · Jan 9

My opinion is that we NP's should stay within our lane and practice within the scope of our training. Having said that, in your particular situation, you are in the process of obtaining PMHNP cert, it leads me to assume that you already completed a program and waiting to test. I think you are fine but again, that is my opinion.

FullGlass, BSN, MSN, NP · Jan 10

I agree with Juan de la Cruz. One other comment: in some states there are different NP licenses and there is a specific PMHNP license. The OP should check with their state board of nursing to confirm licensing requirements.

In CA there is only one NP license for all specialties, but that is not the case in all states.

Snowranger19, MSN, APRN · Feb 7

You are required to practice within your scope despite most (all?) states having only one APRN "License". There is no law saying that a PMHNP could not manage hypertension or a WHNP manage Bipolar disorder. The issue would come into play if something happened, or a mistake was made; what in your training made you feel you were prepared to assume care of this patient?

All that said, I have seen PA's and NP's working in areas that were not their specialty but were around for other tasks. Such as an FNP on the psych unit there to perform H&Ps, manage medical medications, etc. That could be their goal as well as you seeing less acute psychiatric patients.

A psychiatrist on site sounds now, but how available would they be for you? If you get a "stable follow-up" that is no longer stable, off their meds, and suicidal how comfortable will you be managing that on your own? These are the questions I would ask myself.

CuriousConundrum · Mar 13

Skeptic said:

Are there any ACNP's here that work or have worked in an Acute Care Psych Hospital? If so, what was your role/job like??

I have an opportunity to work at one. Mostly handling follow up visits on stabilized patients who were admitted for acute anxiety/depression. Psychiatrist is on site at all times. I am in the process of obtaining my PMHNP cert. Any issues with an ACNP in this area? I know the AACN exam does cover acute anxiety/suicidal ideation, etc.

How many patients in the psych hospital are admitted for "acute anxiety/depression?" I rounded on psych hospitals for many years, and the overwhelming majority of patients were seriously mentally ill with a good subset of those refractory to standard treatment regimens. And about 20% were homeless people making up stuff because they were hot or it was raining too much. Usually the people who were coming just anxious, I would discourage or refuse admission because the milieu will worsen that anxiety every time. Psych hospitals can be very austere and traumatizing places and also notoriously understaffed so de-escalation by unit staff is mostly academic. If you're on call, you'd be on the line to order an untold number of injections and PO interventions. I think you're probably under prepared. If you're working there already, and you're doing fine. Congrats.