Derm NP to Psych NP?

[wildcatarnp]

I graduated this past year and was blessed to find a derm office willing to train me. The problem is that now, I am not being trained and the physician and I have personality conflicts. A friend of mine who works as a psych NP has offered to train me and to work at her office as a psych NP (I have an FNP). I just am not sure what to do. I enjoy derm, but the work environment is hostile. I fear that if I switch to psych, it would be hard for me to return to more medical positions, like primary care. I have applied to many positions, but as many new NPs have found, nobody is hiring if you do not have experience.

In looking at my 5 year plan, I do not know what to do. I want to work in an environment where I get along with everyone. That I am paid above 100,000 a year and I enjoy the interaction with patients.

My initial goal was a career as a derm NP, with the idea of becoming a presenter at conferences and to do research. Yet, my experience has me second guessing everything.

Any thoughts? How do you see the psych profession growing? Would this be a bad switch?

[zenman]

I don't think OJT as a Psych NP is going to cut it.

[TashaLPN2006RN2012, ASN, RN]

what about looking into wound care or home health NP? here in FL that's really big, and gives you at least a way out of working under an MD who could care less about you and your future..either that or talk to other Derm MD's and see if they have anything coming open???

[myelin]

I don't get it. As an FNP the only way to become a psych NP is to go back to school and get your PMHNP cert. Anything else is going to open you up to being sued. Yeah, FNPs get trained in a little psych, but you are not trained to be a psych specialist. What if something goes horribly wrong and a patient has a bad outcome? The first thing a lawyer is going to do is point out that you are trained in primary care - not psych. Having a friend train you is not going to cut it. Plus, it's a disservice to your patients, since you aren't licensed in that specialty and have not received the didactic or clinical training that a PMHNP gets - you should be referring out for psych issues. Psych isn't something you can just learn on the job, as has already been stated.

/rantover

[VTach2013]

If you are already trained in dermatology, why not use that to your advantage and apply to other derm positions? You may not have much expierience but the training must count for something.

[VTach2013]

Im wondering now... How long were you in that position and did they actually train you or was it just a promise of training you at your interview that did not materialize?

[wildcatarnp]

I completely understand that OJT for psych is not going to cut it. I would need to receive a post-master's certificate. Dermatology positions are rare and the community is small. I did receive some training, but I need more.

[Retired APRN, MSN, RN, APRN]

Do you have any innate attraction to working in psychiatry or is it simply the propinquity of your friend offering to train you? Is this something you can see yourself doing for the rest of your career or is it a stopgap until you can get a job you love?

[petpeeve:ON] Psychiatry is not a non-medical field. I don't know where you are, but in my experience the kind of patients who are referred to PMHNPs are those need excellent psychopharmacological evaluation and follow-up. There are quite often neurological differentials that we have to assess. There is a host of physical issues that are known to accompany both the meds we use and the patients we care for. Then, of course, there are significant MH skills involved in forming a therapeutic alliance and motivating people to change, often at the cost of significant secondary gain. [petpeeve:OFF]

The challenges and rewards of being a PMHNP are many and they are very special. But if you aren't into psych and psych patients, it's hell. I've seen too many clinicians (nurses and doctors) of enormous potential crash and burn because they ended up in psych as a fallback and it was a terrible match.

Can you arrange to shadow your friend at work? Maybe some of her colleagues? I strongly suggest you stick a toe in before diving! But if you enjoy this kind of interaction and challenge, there is nothing better in the world! :)