Not sure if I'm happy as a PMHNP.

[Angeljho, MSN, NP]

To be clear, I'm fairly new. Idk, I guess the idea of what I'd be doing as a psych NP doesn't match the reality. I work in an acute inpatient psychiatric unit, and I specifically wanted to work in this area because I thought it would be the best opportunity for me to learn. I love the clinical aspect. I love talking with patients, diagnosing, and working to put them on the right meds. The problem is that this job is SOOOO writing intensive to the point that I spend more time writing (or typing I should say) than anything else. I could spend my whole day writing notes or filling out various redunant forms. There's literally no time to spend talking to patients. I have already spent numerous hours of my free time staying well after my scheduled time to finish notes and forms. I do understand that some of this is due to me being new and still learning the EMR (seriously, they only gave me an hour of training) and various paper works, but I doubt it will get any better. I only say this because the psychiatrists I work with normally work through their lunch. Some of them grab any extras of patient snacks that come from the kitchen lol. Maybe outpatient would have been a better experience.

[elkpark]

What were you expecting? How much research did you do about the role before you went to school? I've been a psych CNS for many years, currently working on an inpatient psychiatric consultation & liaison service in a large academic medical center, and, yes, we spend at least as much time writing as we do talking to people. That's the nature of healthcare these days, and it's not likely to change.

In my experience, there's a lot less writing in outpatient (some providers write only brief, vague eval and progress notes), but it's been a long time since I worked in outpatient so I don't know how much that may have changed.

Since you mention you're new, some of the issue may just be getting more familiar with and adept at documentation and your specific organization's medical record system. You will probably get more efficient as you get more experience. Also, in my experience, new people tend to over-document out of their own insecurity (I'm not saying that as a criticism, just a natural part of the process of gaining experience and confidence over time).

Best wishes!

[clunkygirl]

Hi,

I'm not sure if you are still on these boards but you can find something less paperwork-laden than what you have described. However, talking with patients is probably more likely if you also practice psychotherapy. Most inpatient is stabilizing patients and getting them back into the community and outpatient is medication management. In order to be efficient, you will need to be addressing just those things to be accessible to more patients and monetarily sustainable.

Also, when you look for a new position, ask about the support staff, many centers have social workers and other clinical staff that fill out most of the forms, prior authorizations, etc. leaving you to focus on being a provider.

I currently work at a private practice and hardly ever have anything that keeps me after-hours. I am an FNP and finishing my post-masters soon, most places I've talked with are really accommodating and supportive of providers so that they are not doing periphery work. I love what I do and I truly think that you just need to explore your options, you have a lot to offer.