Interesting times in psych

Barnstormin' PMHNP · Nov 1, 2014

Are you a Psych NP?

nursetim, NP · Nov 1, 2014

Nope, and the Medical Director knew it.

carachel2 · Nov 1, 2014

A lot of Dr's have zero idea about the scope and practice of an NP. So when you asked specifically about the details of the job they told you it was outpatient with mental and anxiety clients only?

zmansc, ASN, RN · Nov 1, 2014

Nope, and the Medical Director knew it.

Sorry it didn't pan out.

harmonizer · Nov 1, 2014

Depending on the state, psych jobs can be out of scope for non-psych NP, depending on the wordings written by BON. In some states, it is a blurry line so, that's why they hire you and they post jobs like family nurse practitioner with psych experience etc.. But in some states (Texas, Iowa, Arizona, Oregon, Washington as far as I know), they want educational requirement, not just experience, and practicing out of scope is not allowed.

resilientnurse · Nov 7, 2014

How long did you wind up staying? It sounds like you were willing to push up your sleeves and stick it out. Your description of it sounds like it would've been a tough job even for a seasoned Psych NP. I would not have taken it, myself, under the best of circumstances. There are Psych jobs that are less stressful.

nursetim, NP · Nov 8, 2014

They gave me the heave ho after 4 days. I was seeing schizoaffective, schizophrenic, all with tardive dyskeniesia, some with active auditory hallucinations, some with active visual hallucination. The medical director made it sound like I would be rounding on SNF for depression and anxiety, NOT! Oh so not. I could have handled the depression and anxiety. If NP's could handle the more extreme illnesses, what use is there for a psychiatrist?

twinkerrs · Nov 8, 2014

I see schizophrenics with active hallucinations and all of the above problems. It is what I was trained to do as a psych np. But if one of them complains of an ear ache I refer to medical. There is still a need for psychiatrists just like there is still a need for family practice docs even though we are trained to treat the patients too.

nursetim, NP · Nov 8, 2014

As an ANP I saw my job as as seeing the coughs, sniffles, and chronic conditions to free up the MD for the more complicated Pt.s. That's why I was being paid less. Otherwise, why employ an MD? If we do the exact same job and there is nothing an MD can do that I can't do, why is there an MD position? There are limitations.

This may sound disrespectful and I do not mean it as such. If you, or any psych NP, can and do function on the exact same level as a psych MD, why are there psychiatrists? What do they do that you can not? So really, I'm just ignorant.

elkpark · Nov 8, 2014

I don't want to put words in twinkerss mouth, but I read her/his post as drawing a distinction between psych providers and non-psych providers, not between NPs and physicians. As a psych CNS, I've spent years kvetching about how, if we in the psych community were out there treating people's diabetes, COPD, CAD, etc., the rest of the medical community would be after us in an angry mob with torches and pitchforks, but everyone else thinks they are competent to treat psychiatric illnesses. What's the point of having specialities if that's the case? I've never known a psychiatrist, in 30 years in psych, who would say to someone, well, since you're already coming to me for your psych problems, I can just treat your diabetes and heart disease, too, no need to also have a PCP. But, apparently, huge numbers of family practice and internal medicine folks feel that the reverse is perfectly reasonable. I've never understood that ...

Psychcns · Nov 9, 2014

Psych NP and psychiatrists do a lot of the same things: interview patient, diagnose, prescribe medications, etc. Psychiatrists have a lot more education and are trained in a medical model. Same as the similarities / differences between a primary care doc and FNP.