HELP - Goals for PMHNP preceptor/clinicals

Posted
by NurseKateP NurseKateP, ADN, BSN, RN (New) New

Specializes in PMHNP Student.

Hi everyone! 

I just started my 1st clinical rotation as a PMHNP student, and the psychiatrist that I will be with one day per week asked me what my goals are for while I am with him.  He wants me to come prepared with one goal each week to work on.  I don't even know where to begin.

He said he wants to make sure that the clinical hours are worth while and that I am actually getting something out of clinical.

Does anyone have any ideas for things I should focus on?  I feel like there is so much that I don't know.

PsychNurse24

PsychNurse24, BSN, RN

Specializes in Psychiatric, in school for PMHNP.. Has 13 years experience. 142 Posts

Some suggestions that might be useful:  Look at the assigned reading for each week and see if that triggers any questions or subjects that you might want to learn more about; think about possible gaps in your knowledge relating to the weeks’ subject matter; and think about the difference between being a registered nurse and an NP and tackling the same subjects. Hopefully this will help in coming up with goals.  Good Luck!

NurseKateP

NurseKateP, ADN, BSN, RN

Specializes in PMHNP Student. 11 Posts

16 hours ago, PsychNurse24 said:

Some suggestions that might be useful:  Look at the assigned reading for each week and see if that triggers any questions or subjects that you might want to learn more about; think about possible gaps in your knowledge relating to the weeks’ subject matter; and think about the difference between being a registered nurse and an NP and tackling the same subjects. Hopefully this will help in coming up with goals.  Good Luck!

Thank you!  That is what I ended up doing.  I made a list of everything I would like to learn over the course of the entire semester, and the psychiatrist I am learning from has been amazing!

Thank you for providing a helpful answer! ?

FullGlass

FullGlass, BSN, MSN, NP

Specializes in Adult and Geriatric Primary Care. Has 4 years experience. 2 Articles; 1,403 Posts

By the time a PMHNP student is ready to start clinicals, they have completed didactic courses and should have some clue as to what their clinical rotation goals are.  The poor quality of many NP students is why it is increasingly difficult to find NP student preceptors.

Being a good PMHNP is not just about "emoting" - it also requires the ability to diagnose, treat, and provide supportive counseling - without freaking out.  What are you going to do when a patient comes in, crying, because they are working in an extremely abusive work environment?  They are terrified they will lose their job as they are the sole family breadwinner.  Are you just going to pat them on the shoulder and say "there, there?"  Not only do you have to determine the correct dx, you must treat their sx effectively.  And what about the practical aspects?  Should they go to their HR department?  If so, what to say to them?  Should they file for leave?  If so, what kind?  Should they seek legal counsel?  What is the correct way to fill out paperwork so the patient's leave is approved, if that is needed?  All this has be determined within 40 minutes, or less.  An aspiring PMHNP must be able to deal with these situations ON THEIR OWN, quickly and effectively. Just being "nice" is not going to cut it.

What do you do when a patient calls you on Saturday morning, crying, saying the police are at her door and she is afraid to open it?  She has been fighting with her boyfriend and is suicidal.  You had better know what to do, because if you don't, the patient could indeed kill herself and that will be on you.

I will say that my patients appreciate me and I keep getting new patients who prefer me to their previous providers.

I have high standards for NPs and NP students, especially in psych, because the stakes are so high.  

As one of my excellent psychiatrist mentors told me, "Being in psych requires you to be compassionate and caring.  If you weren't heart-broken by some of your patients, you'd be an ***, and not be a good provider.  On the other hand, you must maintain some objectivity to be effective, or you will get burned out.  It's hard to find that balance."

Psych is NOT easy and frankly, most people can't do it well long-term.

 

 

amoLucia

amoLucia

Specializes in retired LTC. 7,735 Posts

Kudos to PP FullGlass for calling like it is and for what many of us others think, but just don't speak it out loud (or post it). No fairy-dust coating which I think is a good thing (JMHO).

16 minutes ago, FullGlass said:

....... By the time a PMHNP student is ready to start clinicals, they have completed didactic courses and should have some clue as to what their clinical rotation goals are.  The poor quality of many NP students is why it is increasingly difficult to find NP student preceptors.

Alas, but this is something that I believe affects all the specialties, not just PMH. I wonder if it may be occurring as more & more aspiring nurse applicants have little or no clinical working practice time PRE-grad education.

I do them fault them in one respect. For most practitioners, it does take some time for their confidence to build to that level of a knowledgeable comfort zone. I fear too many nurses begin their grad NP education without a strong foundation for which makes them more vulnerable to insecure practice goals & expectations.

NurseKateP

NurseKateP, ADN, BSN, RN

Specializes in PMHNP Student. 11 Posts

3 hours ago, amoLucia said:

Kudos to PP FullGlass for calling like it is and for what many of us others think, but just don't speak it out loud (or post it). No fairy-dust coating which I think is a good thing (JMHO).

Alas, but this is something that I believe affects all the specialties, not just PMH. I wonder if it may be occurring as more & more aspiring nurse applicants have little or no clinical working practice time PRE-grad education.

I do them fault them in one respect. For most practitioners, it does take some time for their confidence to build to that level of a knowledgeable comfort zone. I fear too many nurses begin their grad NP education without a strong foundation for which makes them more vulnerable to insecure practice goals & expectations.

On 1/26/2021 at 5:18 PM, FullGlass said:

 


"Calling it like it is."  The person you are referring to knows NOTHING about me aside from that I posted on my first day of clinical practice as a PMHNP student that I was looking for ideas for weekly goals.  She ASSUMED that I have no psychiatric background.  She ASSUMED that I was going into this for money (or well asserted that most people are.)  She also referred to me as clueless.

In fact, I am very clear on my long-term goals.  I have worked with kids with autism and emotional disturbances for my entire nursing career.  I am well-equipped to handle crisis situations.  I was NOT looking for help with my long-term goals.  I just wasn't sure what he was looking for on a week-to-week basis.

I hate that people assume things about a person.  I think assuming things about a person and their character makes people TERRIBLE future psychiatric providers, because clearly you are judging people before getting the entire picture of a situation.  I'm down for not sugar coating things, but I'm not down with being rude.

Before a single person had even responded, I stopped overthinking what my preceptor had asked of me and made a list of goals for the entire semester.  You all can keep judging NP students who display a genuine interest in wanting to learn... you do you!

Remember every expert was once a beginner! xoxo

TheMoonisMyLantern

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 15 years experience. 1 Article; 922 Posts

Part of FullGlass's frustrations are how many people are becoming PMHNP's without any experience in psych and that this is being encouraged. Yet to become an acute care NP you have to have acute care exp, why not for psych as well? Lousy psych providers cause a LOT of harm.

I understand that having people make assumptions about you can be irritating, but you are on an anonymous forum on the internet, assumptions are going to be made.

Good luck to you.

NurseKateP

NurseKateP, ADN, BSN, RN

Specializes in PMHNP Student. 11 Posts

15 minutes ago, TheMoonisMyLantern said:

Part of FullGlass's frustrations are how many people are becoming PMHNP's without any experience in psych and that this is being encouraged. Yet to become an acute care NP you have to have acute care exp, why not for psych as well? Lousy psych providers cause a LOT of harm.

I understand that having people make assumptions about you can be irritating, but you are on an anonymous forum on the internet, assumptions are going to be made.

Good luck to you.

I can appreciate the frustration with that for sure, but I would also never fault someone for wanting to get advice to ensure they had an appropriate focus if they were in fact new to psych (which I am not.)

 

Thank you for the feedback.

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 17 years experience. 5 Articles; 11,078 Posts

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