142 Posts
I wish I had more education in psych. I see a lot of patients with psych issues who have nowhere else to go either because of insurance or lack of community resources. I do feel out of my league for anything more complex than simple anxiety or depression. Even the MDs feel this way. We do a lot of "consensus" practicing-the providers talk to each other, look up stuff, and try to come up with at least a short term plan for a patient. It's not pure evidenced based practice by any means, but it's all we have. Thankfully, we recently hired an PMHNP who we plan on keeping VERY busy!
142 Posts
Thanks for the input BCGradnurse. I think that one of the things I hope to put into the program is simple tips and pearls. I have read someplace (don't remember where) that about 70% of anxiety and depression is treated by primary care providers. So you are not alone and will probably continue to see anxiety and depression. And those two do have evidenced based guidelines. My pet peeve (and I may be getting myself into trouble here) is PCPs putting someone with anxiety on long term benzos. But I think one of the most important things is to not stop thinking like a provider just because someone has a mental illness.
I have cared for a person that came in to our in patient unit after a suicide attempt and they had been seeing their primary care provider pretty consistently for increasing depression and after doing labs we found a crazy high TSH. The PCP did not even check!
I have found so many physical problems in folks with mental illness that should have been caught (like UTIs in the elderly and medication interaction with polypharmacy) and may have been causing or exacerbating a mental condition. It seems like many providers see the mental illness diagnosis and stop looking any further.
I think another important point is to know when to refer. And that is a hard one because there is not always someone to refer to, or the person has no $ or ins. I am glad to hear that you will have a psych NP available.
Thanks for your view on things.
1 Article; 2,806 Posts
I wish I had more education in psych. I see a lot of patients with psych issues who have nowhere else to go either because of insurance or lack of community resources. I do feel out of my league for anything more complex than simple anxiety or depression. Even the MDs feel this way. We do a lot of "consensus" practicing-the providers talk to each other, look up stuff, and try to come up with at least a short term plan for a patient. It's not pure evidenced based practice by any means, but it's all we have. Thankfully, we recently hired an PMHNP who we plan on keeping VERY busy!
If you're PMHNP gets swamped, just give me a call!
zenman
1 Article; 2,806 Posts
At Rush University, where I did my PMHNP, the FNP guys were required to take a Major Psychopathological Disorders course. I think they should also take a psychopharm course if they want to be more effective with this population. The single pharmacology course most NP programs require just doesn't cut it. We took 2 courses and that was for psych meds.
If NP programs would combine theory, research and role into one intensive 3 hr course, they would have space for these other needed courses.