America needs more mental health providers. Nurses want to help, if states let them.

Oldmahubbard · May 15, 2019

Interesting. With the long standing rumor that PMHNP's make great money ( it isn't always true), I wonder why we don't have a huge glut? Especially considering that the bar to enter graduate school seems to be constantly dropping?

Home Health Columnist / Guide · May 15, 2019

Reason why we don't have a glut of PMHNP's ---- Psych/Mental Health clinical experiences limited in many areas, many hospitals without inpatient psych unit limiting exposure to psych nurses; not promoted as a cool, desired or adrenaline action packed specialty where "nurses save lives daily", in my experience.

FullGlass, BSN, MSN, NP · May 16, 2019

On 5/15/2019 at 6:26 AM, Oldmahubbard said:
Interesting. With the long standing rumor that PMHNP's make great money ( it isn't always true), I wonder why we don't have a huge glut? Especially considering that the bar to enter graduate school seems to be constantly dropping?

Psych scares most people.

1. It is not a quick and tangible fix, like I&D, caring for a cold, etc.

2. One must deal with and face their own crap to do well in psych.

3. Many people are scared of the mentally ill.

4. There is still a stigma attached to mental illness.

5. Being a mental health provider requires certain interpersonal skills and personality traits that are not common. A key component of being a good mental health provider is the ability to establish a therapeutic relationship and not everyone can do that.

Personally, I am tired of hearing NPs saying they are going to do psych because it pays more. These people often have no true interest in psych or passion for helping the mentally ill. That makes me very concerned for any future patients of theirs.

Oldmahubbard · May 16, 2019

Does it pay more? Haha. I have known people to do quite well with it, and others not.

I think many people don't have the fortitude to do psych. I wanted to use another word, but fortitude will have to do. Because there are few easy answers.

It can't be done by a cookbook. There is no "BP 130/90, and now do this".

I have had people say to me that any fool can be an FNP, but in psych, you are taking on the role of a psychiatrist. Much harder.

It is perceived as some mystical, ineffable thing that no non-MD could ever fathom.

Completely untrue, and I wish some of you could meet some of the horribly incompetent "psychiatrists" I have known. Mostly people who have come to this country hoping to practice medicine and have zero interest in psych, they just want Dr in front of their name. Any kind will do. Sorry

Not sure how much one has to deal with their own stuff to do this job. You probably can't do it in an acute state of major depression or psychosis. Not while intoxicated.

Not during a panic attack, either.

OK, end of rant.

FullGlass, BSN, MSN, NP · May 16, 2019

3 minutes ago, Oldmahubbard said:
Does it pay more? Haha. I have known people to do quite well with it, and others not.
I think many people don't have the fortitude to do psych. I wanted to use another word, but fortitude will have to do. Because there are few easy answers.
It can't be done by a cookbook. There is no "BP 130/90, and now do this".
I have had people say to me that any fool can be an FNP, but in psych, you are taking on the role of a psychiatrist. Much harder.
It is perceived as some mystical, ineffable thing that no non-MD could ever fathom.
Completely untrue, and I wish some of you could meet some of the horribly incompetent "psychiatrists" I have known. Mostly people who have come to this country hoping to practice medicine and have zero interest in psych, they just want Dr in front of their name. Any kind will do. Sorry
Not sure how much one has to deal with their own stuff to do this job. You probably can't do it in an acute state of major depression or psychosis. Not while intoxicated.
Not during a panic attack, either.
OK, end of rant.

I agree with you. I am applying to post-master's PMHNP programs now and am truly passionate about going into mental health. During my BSN program, I had 3 psych rotations because I requested that my 2 electives be in psych. Most of my classmates were clamoring for ICU, ER, etc rotations and thought me odd.

One of the things that troubled me are the large number of psychiatrists who do not even make eye contact with patients. They just type on their computers and mumble, then prescribe drugs.

I am also dismayed at the heavy reliance on drugs and neglect of behavioral intervention/modification. Here is an example: woman comes in with her 8 year old son, claiming he has ADHD, and wants to put him on meds. She complains the boy misbehaves too much, but it comes out that the son behaves fine when his dad is around. Problem is, dad's job requires him to travel a lot. The "psych PA" gives an rx for meds. I was appalled. This was clearly a case of the mother needing to learn parenting skills. I observed the boy and he seemed normal to me and not requiring medication.

People with mental illness need to establish trust with their provider. Such patients are not stupid and they can tell when a provider is truly caring and can be trusted. One of the NPs in our clinic says he wants to be a PMHNP "for the money." Not once has he mentioned any other reason for being a PMHNP. He also gossips with the Medical Assistants about patients, to the extent that clinic staff will not send their own family to see him for any sensitive issues. His own MA was caught snooping in the charts of a MAT patient, a HIPAA violation. (I'm the NP who gets these patients). He didn't want to be bothered to get an X-waiver to become part of our MAT program (I did). He also has a very thick accent which many patients have difficulty understanding, as well as lacking a good understanding of general American and Latino culture (we're in California) and I think this is a real handicap in psych. And he only applied to PMHNP programs that would take anyone with a pulse. Yet management holds him up as a great example! Yes, I am venting.