Any Psych NP Students out there?

[NPAlby]

I'm in my second year of a Psych NP program and working full time. I'm getting increasingly frustrated with the required courses I have to take before I get into any of psych part of the program. In particular health assessment and pathophysiology. Yes I understand they're teaching "good to know" stuff. But I feel that's all it is: good to know but necessarily important when doing a psych eval. I'm currently working in a Psych ED and I guess it's getting to me. I see what the docs and residents do and feel that my learning (since it's NOT 4years long) should be geared to what I'll actually be doing in practice. Why in the world do I have a class about neonatal heart defects?!! Why do I need to know about a percussing for a spleen. Like I said I understand it's good to know in case a patient of mine presents with some medical issue. But I seriously doubt I will remember any of this stuff that I'm learning now when that time comes. That's why we have internist and general practice docs and fnps.

Anyway my question of how do you cope with learning all this material as a psych np student when you know you'll pretty much use 15% of it in future practice, goes out to future and present psych nps. Part of my frustration is that I have to drive an hour (each way) for these classes and work full time in a CPEP.

Thanks for letting me vent. Now I have to go back to studying about inspecting patients noses.

[elkpark]

They're teaching you all that stuff because the role/expectation of a psych NP is that you can provide primary care to people and take responsibility for the physical effects of the meds you will be ordering for people. That's the "NP" part of the role (same as psychiatrists all completed all of med school and are (supposedly! :)) competent to do physicals and treat people's basic medical problems in addition to their psych problems). Psychiatrists don't get to only study psychiatry, and the psych NP is supposed to be the mid-level version of the psychiatrist. Hence, the nose-looking and spleen-percussing ... :)

Prior to the quite recent development of the psych NP role, psych advanced practice nurses were all clinical nurse specialists (CNSs). (I've been a child psych CNS for many years now). Our education was exclusively in the psych end of things -- I received extensive, rigorous, in-depth training in psychiatric evaluation, diagnosis, and psychotherapy of children and adolescents (and families), but absolutely nothing about physical assessment, pharmacology, or pathophys -- because that was not an expectation of the psych CNS role. I've never had Rx authority, don't want it, and wouldn't take it if you tried to make me. I've lived and worked in states where I could have gotten Rx authority, and did not pursue that option. But times have changed -- apparently, great demand for a nursing mid-level provider with Rx authority in psych has emerged, and the psych NP role has been developed -- and designed to be v. different from the traditional psych CNS. Actually, because the Rxing part is the part that can kill people if you botch it :), I notice that most of the program curricula I've looked at (purely out of curiosity) look like most any NP program, with a couple little psych courses tacked on, almost as an afterthought, it seems.

Rx authority is a huge responsibility, and requires a lot of in-depth educational preparation to be done safely and competently. I'm sure that thought is not much comfort at this point in your education, but once you graduate and get certified, you'll have a lot more control over shaping your career as you choose. Nearly everyone spends time in their (nursing) graduate program wondering why they have to study what they're being made to study, same as we all wondered why we had to learn so much of the stuff we had to learn in our original nursing programs. Later, after you're out in the real world, you start to see why you had to learn all that stuff. Best wishes with your studies and career! :)

[bijouv]

I can completly relate to your frustration. I am in my third and final year of an accelerated Masters Program and will be graduatiing as a Psych NP. All I can tell you that once you do get to the "good stuff" it is a huge relief and confirmation that you are in the right program. I can say that there is definitly value in learning the medical stuff especially if you will be working with the chronically mentally ill or other groups who often have limited access to medical professionals. Also so many medical conditions can present with psych symptoms and be missed and labeled as "just psych" and we may be the only ones to pick these cases up and get them appropriate treatment. This is easier for me since I've made it through , but you will too. Good luck!

[lippy12v]

Hi,

I am a MEPN/PMHNP applicant for UCSF and UVM. I have been working in the mental health field for the past 6 years as a residential line staff, wilderness therapy counselor, drug and alcohol counselor, and skills trainer for foster children. I am excited about providing both therapy and health care to clients. I love studying the body and often thought about going in to medicine but decided on the PMHNP program because it seemed like the best blend of both worlds.

With all of this being said I very much want to learn how to provide high quality psychoanalysis and therapy. Are there any PMHNP's, or CNS's, who are/were at UVM or UCSF who can comment on their education?

[UVA Grad Nursing]

Lippv12:

It is my understanding that the scope of practice for the PMH CNS and the PMHNP will vary from state to state. In my own state of Virginia, PMHNPs cannot be reimbursed for therapy. One would need a CNS certification to qualify for reimbursement for individual, group and family therapy here in Virginia.

It might be different in California.

[lippy12v]

Wow! So in VA its the CNS's that can provide therapy. Huh. The breakdown as I have understood it is that the CNS's are more involved in teaching, leadership, management, and also patient care while the NP...well why don't you tell me.

Any other Psych/MH CNS's or NP's care to weigh in?

If I want to provide consultation, therapy (individual and or group), while also diagnosing and treating pt health needs what should I do?