Thoughts on Nurse Nav job for Psych?

  1. Hi Guys! It has been quite some time since I have been on, but I am looking for suggestions/advice/thoughts about a new job. I was hired at a peds practice for a grant-funded position as a BH Nurse Navigator and I start next month. This is a brand new position that the providers were seeking because they feel there is a huge access problem with BH ...i.e not enough therapists/psychiatrists accepting new patients, providers are out of network with insurances, provider/insurance lists are out of date, appointments are being scheduled too far out, parents get frustrated with process and kids don't get needed care, lack of knowledge, etc. The practice felt bringing in a BH nurse would help to bridge this gap a bit. It is very exciting to be part of something new but also a little intimidating because of the unknown.

    I will be responsible for ensuring pts. with MH dx receive comprehensive/coordinated services, conducting BH intakes (hx gathering, review of patient/teacher questionnaires, screening), acting as community liaison for the practice for BH networking and info gathering for community resources, providing education/counseling to patients during office visits and via telephone, and providing practice telephone triage support as needed.
    The only hands-on stuff I will be responsible for is regular f/u visits for kids on BH meds, (mostly ADD and anxiety/depression) where I will check VS and monitor for SE, and if there are any issues then the provider prescribing will step back in. They said these will be billed to insurance as "nurse visits".

    Advice/suggestions on working in this environment(peds practice) with the job description listed above? Have any of you done anything like this that you can share some of your experience with me? Seems like case mgmt with some education/advocating/counseling thrown in, right? Any concerns that you see from what I described?

    (I am an ADN RN (20 yrs), starting a BSN program in January. My background is in acute IP psych, psych ER, and telephonic psych/BH case mgmt. I have years of experience helping kids' families navigate the system but minimal hands-on peds experience. I am NOT a therapist but would like to pursue my NP in the future so I can legally be)
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    About PsychRN98

    Joined: Sep '08; Posts: 31; Likes: 14


  3. by   Oldmahubbard
    You will have your work cut out for you, big time. Fortunately you have a lot of experience, but it is a big gap you are being asked to bridge. I think you probably know how to prioritize cases. But there are not enough providers and some are out of network, meaning extra cost to the parent.

    As difficult as it is to find psychiatric providers in many parts of the country, when I was in private practice we had a 25% no show rate.

    I don't want to scare you, but some of the kids will be on polypharmacy and also misdiagnosed.

    I am guessing after a year you will be either quit, or decide to go the psych NP route.
  4. by   PsychRN98
    Thanks for your input @oldmahubbard. I am actually surprised by that no-show rate! Not sure how long the wait was at your practice, but I do wonder if the no-show rate was partially because those folks ended up needing a higher LOC after having to wait 6-8 weeks or more to be seen. That is what the wait times had been nationally for med mgmt providers in my experience anyway, for past 5-6 yrs, when I worked psych case mgmt.

    Anyway, the grant is for a year, with the possibility to be extended, and it is only PT for now. I am hoping because it's only PT that I won't burn out too quickly. You are correct on the NP part; I already told the office that my long term goal is to become a psych NP

    I am looking at the bigger picture in this job, which is that hopefully if I do well the docs there will provide me letters of recommendation that I will need to get into a good MSN program in a few years and perhaps I will be able to network well enough to find a provider for a collab agreeement.