Can a bedside RN conduct CBT?

[TiffyRN, BSN, PhD]

That's pretty much my question.

Quicky intro: I'm an experienced NICU nurse and almost halfway through a BSN to PhD program. My main interest is improving family-centered care to improve infant outcomes. My latest idea (I've been through 4-5 serious contenders for dissertation) is to provide CBT to help decrease or arrest the progression from acute stress disorder to PTSD among NICU parents. There are a couple of studies where they used CBT and I like the idea. Do I know that much about CBT?

So, thought I'd throw this out there with the psych specialists. In you guys opinion, would this be something a bedside nurse could do with some minimal training or should I be looking to recruit a PMHNP or some formal counselor?

Please be kind! I threw this idea out to my professor, she loved it and now I'm seriously having second, third and fifth thoughts about feasibility.

[elkpark]

Psychotherapy is considered a graduate-level intervention, and outside the scope of practice for generalist RNs. It's also not something you can do with no background and "some minimal training." Do yourself and your families a favor and get an experienced psychiatric professional (whether psych CNS or NP, psychologist, or LCSW) to provide your CBT.

Best wishes!

[TiffyRN, BSN, PhD]

Thank you elkpark for the direct and quick response. I have connections with at least one PMHNP as well as some other possible resources. That is obviously the route that needs to be taken. I have no interest in doing things poorly.

[Psychcns]

An experienced psychiatric professional should provide the CBT but there may be a way to involve bedside nurses.at least education about what we know about progression of acute stress reaction to ptsd and what kind of support could lessen that possibility

[MatchesMatches]

a counselor is not the same as other providers, in the way that they may provide advice to a patient. CBT is not about advice, but about assisting a patient in developing new ways of thinking. It takes a lot of experience to guide and lead questions in a manner that is beneficial to a patient.

That being said, acute care is not the time for in depth CBT. CBT often involves "unbuilding" a client's foundation. It can be risky to remove a person's safety net and coping skills (even if they are not good ones) without being able to provide them with continued care.

Maybe look up different kinds of therapy? I personally think that CBT is currently one of the buzzwords, which is probably why you landed on it :)

[TiffyRN, BSN, PhD]

Thank you guys for all your advice. I think I came up on CBT not necessarily because it's the current buzz but because acute and post-traumatic stress are really starting to get attention in NICU parents.

For now, I've had to move on to a project that's feasible for me personally. Someday though, I'd love to help get a formal screening and treatment program for our parents, assisted by capable licensed providers.

Our neonatal practice employs a couple dozen neonatal NPs. I think it would be fabulous to throw in a (or a few) PMHNPs that could round on the parents at highest risk.

[elkpark]

Thank you guys for all your advice. I think I came up on CBT not necessarily because it's the current buzz but because acute and post-traumatic stress are really starting to get attention in NICU parents.

For now, I've had to move on to a project that's feasible for me personally. Someday though, I'd love to help get a formal screening and treatment program for our parents, assisted by capable licensed providers.

Our neonatal practice employs a couple dozen neonatal NPs. I think it would be fabulous to throw in a (or a few) PMHNPs that could round on the parents at highest risk.

PMHNP education is primarily focused on dx and medications; in your situation, your little clients and their families might be better served by a psych CNS or other professional primarily trained as a psychotherapist. I doubt too many of your neonates are going to need psychotropic medication. :)