Questioning a new job

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Hello,

I am a relatively new FNP who was previously worked in primary care. I was recently offered a job as a psych NP that I'm really interested in; however, I have some concerns. I have my degree as an FNP and do not have any experience in psych. The place that hired me assured me that they have hired FNPs before and that it is alright and that they would give me about a week of training/ orientation, but I'm not sure if that is enough time. They said I would mostly be doing med management and not any psychotherapy. I'm a pretty new NP as well. My other concern is that since I will have a hard time finding a different job not in psych if I decide that it isn't a good fit for me since it is very different than a lot of other NP jobs. Has anyone previously worked in psych as an NP and went on to work in a different specialty? How hard is it to change specialties? I'm not sure if I should take the job, but the place seemed really nice and I'm interested in going into psych so any advice would be appreciated!

Thank you!

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3 hours ago, FNP8145 said:

Hello,

I am a relatively new FNP who was previously worked in primary care. I was recently offered a job as a psych NP that I'm really interested in; however, I have some concerns. I have my degree as an FNP and do not have any experience in psych. The place that hired me assured me that they have hired FNPs before and that it is alright and that they would give me about a week of training/ orientation, but I'm not sure if that is enough time. They said I would mostly be doing med management and not any psychotherapy. I'm a pretty new NP as well. My other concern is that since I will have a hard time finding a different job not in psych if I decide that it isn't a good fit for me since it is very different than a lot of other NP jobs. Has anyone previously worked in psych as an NP and went on to work in a different specialty? How hard is it to change specialties? I'm not sure if I should take the job, but the place seemed really nice and I'm interested in going into psych so any advice would be appreciated!

Thank you!

You are not a psych np. You have no business working as one. Get a post masters or find a job commensurate with your training.

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I worked as a psych RN for some years and now am in FNP. I would not work as a psych NP because my 30 minute lecture on psych drugs in NP school did not prepare me to medication manage psych patients. While I am apt at weeding our drug seekers and malingerers, in no way do I feel qualified to manage patients with actual psych issues.

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I would disagree that you can't work in psych....

It really all depends. When you were working in primary care, how often were you treating psych issues? What did you typically treat? What was your breadth of knowledge in regards to meds you were prescribing?

I have written regarding this topic before...I am an FNP that works in psych outpatient full time and primary care per diem. Although it is ideal to have your psych cert when working in psych (and particularly if you are managing more complex mental disorders), it is not unreasonable to work in outpatient psych as an FNP if you have prior experience in primary care working with mental illness, and if you get some training, support and mentorship by a psychiatrist. Of course, you'd want to check with your BRN in your state for regulations.

You will also want to ensure you go back to school to get your psych cert so that you can become even more proficient in the field of psych. I am in the process of doing this myself.

You should also consider still working within primary care part time or per diem just in case you are let go and in need of getting a job. It will be more difficult to work in psych without a cert as that is what's preffered.

You will get a mix bag of responses regarding this topic...I say, if you are comfortable in taking the leap and will have the support to do a good job, go for it. If not, don't. That simple.

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Update: it should be noted that if you are primarily responsible for treating more complex mood disorders, like uncontrolled bipolar disorder or schizophrenia, this should be managed by a PMHNP or psychiatrist

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10 hours ago, ToFNPandBeyond said:

Update: it should be noted that if you are primarily responsible for treating more complex mood disorders, like uncontrolled bipolar disorder or schizophrenia, this should be managed by a PMHNP or psychiatrist

The problem is these NPs aren't managing simple psych issues. And as she noted, 1 week!!!! of training with ZERO psych background. She laid out all the reasons she SHOULDN"T take the job. We manage low level psych issues in primary care regularly for sure. Sometimes we are stuck with more complex stuff simply because access is limited. But I don't believe for a second this somehow can justify a FNP to work with more complex cases as a primary job. Those are the patients that need to be followed by psychiatrists and similarly trained staff. IMO if she does this she is completely out of her scope and anything short of a PMHNP certification is borderline malpractice by both her and the physician stupid enough to hire her. "Only be doing med management and not psychotherapy"?! That is primarily what PMHNPs do in the first place. That doctor wants a script writer and wants some buffer when that script writer has their own license to risk.

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Yeah, one week of training does not sound right. In (primary care) NP school, they teach you to leave the more complicated psych issues to the specialists. When I get a bipolar patient, I'm like, "Next."

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