How can a Family Practice NP ethically work in mental health?

newFNP2015 · Dec 10, 2013

FNP will lead you into a more clinic based setting which will cover minimal mental health issues. In my clinical for FNP, we manage already-prescribed medications and possibly increase the dose. For most other issues, we refer to specialists.

If you want to do primary or acute care, I would suggest doing that first (FNP vs ACNP, etc) with the possibility of adding a psych-mental health post-masters certificate. I'm not sure how ACNP would mesh with psych or if these combinations are even possible, but worth looking into and some other people on the forum may be able to expand.

BritFNP · Dec 10, 2013

I treat anxiety, panic attacks, depression, PTSD, & ADHD all in primary care as a FNP...which is totally ethical...and responsible. If they need more than that (personality disorder, bipolar disorder, severe PTSD, etc) then they do go to a specialist. I'm pretty sure there are post masters certificates for MH.

allnurses Guide · Dec 10, 2013

Same as above.

Unfortunately, at least in my practice area, the lead time to get an appointment with a psych provider is 45 days.

This means that much of the initial management falls on me as a primary care provider. This is well within my scope. I received adequate education and clinical experience in managing most psych issues in my graduate program.

In-patient I used psych consults liberally.

RNwannbe · Dec 10, 2013

Thanks for all your responses. I'm sure that with a couple years of RN experience my desires may change but I just wanted an idea of how things worked. After some research and your reply's, at this point in the game I suppose I am leaning towards FNP with a MH post masters cert.

Ruby Vee, BSN · Dec 10, 2013

Please, RNwannbe and BritFNP, don't use your own photo as an avatar. One day you're going to post something negative or controversial or unpopular, and you don't want to be identified so easily. Posting about your stupid nursing instructor, mean preceptor or clueless boss can be harmless venting -- or it can be the end of your employment if someone recognizes you, prints off your post and slides it under your manager's door. This has happened to allnurses members! Please protect yourselfs and change your avatar.

RNwannbe · Dec 11, 2013

Thanks for your two cents Ruby Vee. I've taken precautionary measures and disguised myself I do see you point though.

CountyRat · Dec 11, 2013

I do not think that there is an ethical problem here, as long as you are clear about your qualifications when seeking a job. You might consider the option of going into ICU nursing first, getting some experience, and then returning to school for your masters. I know that you are getting clinical experience in your current nursing curriculum, and that you will get more in the master’s program. However, I think that you will discover that being the "real nurse" in a clinical area is quite different from clinical time in an academic setting. A couple of years in ICU might make you a better NP in the future. It will almost certainly make you a more desirable applicant when you finish the master’s program and start looking for a job as an NP.

Of course, there are a lot of financial and life-style issues that come to play in decisions like this, so, only you can decide which path is best. I am confident that you will do well on whatever path you take.

Best wishes, brother!

elkpark · Dec 11, 2013

Define "work in" ... I've worked on psych units which employed an FNP to do admission H&Ps and handle medical issues on the unit -- but those individuals did not do psych evals or order psych meds, they just dealt with physical/medical issues. I don't think anyone would have a problem with that kind of arrangement