New PMHNP

[sdan2020]

Hello everyone!

I am a brand new NP just took my exam this past Friday so of course now just doing on the waiting and licensing things. But I have a job lined up doing inpatient. My question is what should I be reviewing now? I do start shadowing the psychiatrist this week and he asked if I would want to shadow until he can hire me.

I have worked ER for the past 3 years. What is your advice to make a good impression and ensure I get hired? :) Thank you for any advice, I suddenly don't feel ready at all!

[DrCOVID, DNP]

Be personable, willing to learn and make your psychiatrist happy. If he wants you to do something, do it. Don't go in and change everyone's meds around... you should notice patterns in the way they prescribe over time. Basic right?

When I was inpatient - we pretty much diagnosed schizophrenia, bipolar or MDD to bill the highest codes. So if it's like that I would study those and know the DSM criteria back and forth. The psychMD had a template for us to use when doing intakes. Follow ups are pretty easy, but you need to look up the patient before and see what was done.

Do you know how to do a 45-1 hour intake full psych exam (MSE, ROS, MDQ/BDSS questions, Social/Psych/Medical history etc)? If your MD doesn't have a template ready, I would make one. Are you familiar with the EHR? That was the biggest pain IMO and don't know how to learn it without being there.

[verene, MSN]

The most common diagnoses in my inpatient population are Schizophrenia, Schizoaffective, Bipolar disorders, substance use disorders and personality disorders - some of this is likely influenced by my setting (forensics) but you'll likely see all of the above plus MDD in general inpatient. Get comfortable with your anti-psychotics and mood stabilizers. Know the laws in your state which apply to holds/commitments and involuntary treatment, AND if you will be expected to testify at commitment or other hearings get someone to mentor you on providing testimony. Know your criteria for risk assessment (demographic factors, static factors, modifiable factors) and find out what suicide and violence risk assessment tools your organization uses. Learn your policies on restraint/seclusion inside and out.