Psychiatric NP what can I do?

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Hi everyone,

So I'm interested in psychiatry and I was wondering in the states where NP can practice independently, does that mean a psychiatric NP can do everything a psychiatrist can do? What will be my limitations, or are there any? as opposed to starting over and going to med school and becoming a psychiatrist, which I'm kind of too old for.

Thank you!!

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Specializes in Critical Care, Education.

Scope of practice is regulated by each state. You will need to look at specifics for your state. There is no way that an NP "can do everything a psychiatrist can do".... doesn't even make sense.

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Hi everyone,

So I'm interested in psychiatry and I was wondering in the states where NP can practice independently, does that mean a psychiatric NP can do everything a psychiatrist can do? What will be my limitations, or are there any? as opposed to starting over and going to med school and becoming a psychiatrist, which I'm kind of too old for.

Thank you!!

In Oregon psych np is def the way to go. I worked with a psychiatrist who said these days in OR the PMHNP can do what a psychiatrist can do and she would go that route instead of taking on the debt of med school. It just depends on your state though.

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Okay... one more link. :)

Here's another conversation in Allnurses:

https://allnurses.com/advanced-practice-nursing/pmhnp-practice-state-907404.html

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I do not know how old are you but if you are

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Specializes in Outpatient Psychiatry.
I do not know how old are you but if you are

I am immensely glad my state does not allow NPs to certify disability or involuntarily commit someone. Those are two things I don't want to deal with especially the former.

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I am immensely glad my state does not allow NPs to certify disability or involuntarily commit someone. Those are two things I don't want to deal with especially the former.

I am not glad at all. These should be viewed negatively. It is "double standard." This means that (even in the state where NP practice independently) patients who are under the care of NP do not have equal opportunity to obtain disability no matter how mentally disable they are. Patients under the care of psychiatrists or psychologists will have unfair advantage in obtaining disability. In an community mental health outpatient setting, this will be the additional responsibility for the medical director (psychiatrist) to sign off these disability paperworks for patients who are under the care of NPs. And medical director will be reluctant to sign it because they are not familiar with patient. Also, involuntary commitment is extremely important in mental health field where non-compliance is rampant and where one of the major responsibilities of the psychiatric provider is to determine of patient's ability to contract for safety. Without these legal privileges, NPs are less likely to be hired to do the job.

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Really not that big of a deal. I'm at a community clinic and the medical director handles that sort of thing routinely. Involuntary hold authority is also not that big of a deal. I've been seeing people in hospital emergency rooms, and on medical floors for the last year to assess and place people on holds for over a year. I'm not sure what you mean by extended periods of time. A goal of outpatient care is to avoid inpatient care. We like to use the term adherence rather than compliance by the way....and adherence is more likely when you develop a therapeutic alliance with your patient (client) which is more likely to be established when understanding people from the holistic perspective that nursing teaches....

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Specializes in Psych/med-surge.

I think that restricting NPs from signing disability forms is very serious. If an NP is in independent practice, they cannot sign for a patient that is in need of disability. The patient (or the NP) has to arrange for the patient to be seen by an MD. I can see this issue causing problems in independent practice, big time. Word of mouth in the community is how an NP builds up his/her practice, and if a patient tells others “she cannot even sign my such and such form, she is not a doctor” this could hurt the NPs business.

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Specializes in Outpatient Psychiatry.
“she cannot even sign my such and such form, she is not a doctor” this could hurt the NPs business.

That's fine. We are not doctors, and I couldn't care less if the NP happens to hold a DNP or PhD. I entered nursing expressly to become a psychiatric provider, and the ride getting there has been great.

I can see how individually it might seem detrimental to one's practice, but I don't believe it's prudent to offer "midlevels" this privilege, as a policy, and I'll even throw in psychological examiners as they're a sort of psychology midlevel.

For what it's worth, double standards are not always bad.

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For what it's worth, double standards are not always bad.

It is certainly ok to have double standards for "providers", NOT "the patients." This is for the patient's standpoint. If the patient is independently cared for under NP while psychiatrists in the area are scarce, then the patient will have barrier or unfair disadvantage. What if the patient has no insurance (many mental health patients do not) and cannot afford to pay expensive visit to psychologists or psychiatrists? It is very unfair.

Psychologist can do it. NP can't. Even if the psychiatrist can sign off the paperwork for NP, NP are much more familiar with the psychiatric case of patient under his or her care. And it is true that psychiatrists are not comfortable signing off the disability form for NP in my previous job. PsychGuy, I know this is not a big deal for you but this needs to change. We are not doctors .. I get that.. but this does not mean that we should not advocate for our patients.

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