NP to Therapist

Hi QEOLAdvocate!

I'm probably the last person that would be helpful in this, but it might give perspective. I am in my early 40s. I've been an FNP for nearly a decade and then I went back for my PMHNP and graduated last Summer.

Like you , I have been interested in psychology and psychiatry. Actually I was planning to switch from my FNP program to the PMHNP but then I thought it would be better for me to have a more abroad understanding of nursing/medicine and then maybe later on I would specialize. So I did and that decision worked for my circumstances.
 

Anyway, when I graduated from my FNP program, my first job was in G.I.. for several years and it was amazing and many mental health issues came up during that time, which is probably why it was so interesting to see the gut-brain health connection and then due to hours and obligations. I switched to a family medicine department and that was wonderful too because it was(still is) more expansive and I saw many more mental health related issues in a more direct capacity.

So my PMHNP program was primarily focused on the medications and that was quite defeating and demoralizing at times. It was important though because with this education I've seen (and corrected) in such a short time how devastating poor medication treatment can be in not doing the basic checking of labs, not considering how psychiatric meds impact overall physical health, and the precipitating events, etc.

With that being said, I have my own private practice that is flourishing. All visits are psychotherapy I don't do only med-checks ;  it's part of the overall visit and the wonderful thing about this combination is I can work in real time on the psychotherapy which is the primary reason for visit and adjust meds (if applicable) as well. Everyone gets homework and we meet regularly and it's a very close communication and follow up system since I take a very small amount of clients at a time as the patient-puppy mill experience is not what we're about.

Also, many of my clients have underwent medical trauma as well as severe trauma in their own lives and are drawn to the more holistic-nursing approach.  I  incorporate nutraceuticals and dietary lifestyle recommendations that goes along with it. The individuals that see me like the one-stop-shop type aspect of it as it is inclusive and I do reach out to therapists to bridge care/connect them to therapists since I have a wide network (ex I'll suggest trauma therapists -I'm working on that training) and I  recommend a nutritionists, acupuncture , OT, gastroenterologists, among others that specialize in areas beyond my scope of practice.

On an interesting note, I do work on G.I. issues at to a certain capacity in my practice because they often come up as many with trauma and other mental health issues suffer from significant G.I. disturbances, but at times are brushed off in primary care /their specialist visits .

 I seriously thought about going back for License mental health clinician (LMHC) or PhD in psychology for a time . Who knows where life will take us but for now my children are small and the last program was tough on all of us while working. 

Much of what I've learned is through CEUs and CMEs during and after my PMHNP program. And my clients are thriving and I do have an intense practice to be honest, but it is so rewarding.
 

All to say supporting clients on their healing journey can look many different positive and effective ways.
, a formal education and foundation as a therapist is wonderful and I have mostly therapist friends that I speak with which is helpful. 

With your experience and skill set, the sky is the limit. And there is so much to learn out there and it might seem overwhelming, but by posting this question you have done something incredibly powerful for your future endeavors. Because you care your patients will have the opportunity to thrive.

Hope this answered your question.

FNPRCPR said:

Anyway, when I graduated from my FNP program, my first job was in G.I.. for several years and it was amazing and many mental health issues came up during that time, which is probably why it was so interesting to see the gut-brain health connection and then due to hours and obligations. I switched to a family medicine department and that was wonderful too because it was(still is) more expansive and I saw many more mental health related issues in a more direct capacity.

Your response intrigued me, because I also work in GI (peds, as an RN in an outpatient practice). This is one of the reasons I am considering a change in specialties, and just sent in my first application for PMHNP program. It is reassuring to see that there are people who are utilizing the degree for more than just med management. I am not sure specifically where I see myself in the field (should I enroll in a program), because I have a lot of peds experience (including oncology and complex/chronic care kids), and am hoping to marry the two specialties. I have a long way to go, but I am just lurking here to see what NPs are doing with their degrees.  

Your experience sounds incredible. I guess a question to ask yourself is how much in the patient's health journey do you want to be/feel most useful in the patient's well-being journey. For me, I knew the listening, advising, and teaching which encompasses many fields, but the ordering of labs/imaging/procedures and prescribing (non-pharm and pharm) were also important to me as a type of one-stop shop for many things. Plus these really interest me on personal interest level as well. I've met incredible therapists that have made radical changes with patients, so it depends where you see yourself as most helpful and called.