Urgent pls help!

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I was hired as a PMHNP. I was advised I would not see substance abuse or children. I am now being "forced" to see this population. My actual contract doesn't specify any populations - it just says within scope of a "family psych NP"

My employer is now saying if I'm unwilling to see this population that I "do not meet the needs of their population"

I've explained that addiction and C&A are typically specialties. I asked for additional CME and expert consultation and they said NO.

Full practice authority state.

Does anyone know of any of any official rulings on general PMHNP scope of practice? I cannot find anything that speaks to addiction.

Specializes in Adult Internal Medicine.

If you feel it is outside your scope (beyond your education and experience) then don't do it, in most states you could lose your license for that let alone the ethical considerations and your personal job satisfaction. Time to look for another job IMHO. Good luck.

Specializes in Nephrology, Cardiology, ER, ICU.

Is seeing kids in your scope of practice?

Specializes in Family Nurse Practitioner.
Is seeing kids in your scope of practice?

Seeing kids and addictions would be a reasonable expectation of all outpatient PMH-NPs that are boarded in family. I haven't ever had a patient load that wasn't filled with both.

I'm surprised OP didn't realize this and if it was a major concern they should have gotten it in writing. My guess is they will need to move on because this entire topic is likely to have eroded trust and respect on both sides. :(

Specializes in Nephrology, Cardiology, ER, ICU.

Thanks Jules...

Thanks it's within my scope technically speaking. Ive just never heard of an employer expecting everything under the sun from a psych NP for the salary I'm making and I'm pretty miffed they weren't up front about it. The previous provider at my location did not have to see kids or addiction for example. Thanks aka again for your response.

Thanks it's within my scope technically speaking. Ive just never heard of an employer expecting everything under the sun from a psych NP for the salary I'm making and I'm pretty miffed they weren't up front about it. The previous provider at my location did not have to see kids or addiction for example. Thanks aka again for your response.

A certified PMHNP is expected to see children and adolescents and also be able to deal with addiction. Your salary is irrelevant to this situation. You also did not get your population limitations in writing. Finally, you don't know why the previous provider is gone. Perhaps because they did not see kids or addiction and this employer wants someone who can do so. If you are not happy with your salary or job duties, then look for another position.

I did get population limitations in writing and was very clear and upfront during my interview process which btw was a panel interview with the person I was replacing present. I do not appreciate your tone. Best of luck to you.

Sorry they weren't upfront with you. hope you can work it out with them.

Specializes in NICU.
I did get population limitations in writing and was very clear and upfront during my interview process which btw was a panel interview with the person I was replacing present. I do not appreciate your tone. Best of luck to you.

I'm confused. In your first post you said that "My actual contract doesn't specify any populations - it just says within scope of a 'family psych NP'" but here you're saying that you got population limitations in writing. Which is it?

I did get population limitations in writing and was very clear and upfront during my interview process which btw was a panel interview with the person I was replacing present. I do not appreciate your tone. Best of luck to you.

Your original post said "My actual contract doesn't specify any populations - it just says within scope of a "family psych NP" So I do not appreciate your inability to clearly describe the situation. Normal scope of practice for a family PMHNP does include C&A (that's why it's called family), as well as addiction and substance abuse. You should be happy to increase your knowledge with this job. I work as an NP in an outpatient mental health clinic and I handle adult, C&A, and substance abuse. Many substance abusers have underlying mental health issues and are trying to self-medicate. Therefore, I don't understand how you can be a PMHNP and not be able to deal with substance abuse. Since you seem unhappy with the job duties and with your pay, you should seek employment elsewhere.

Specializes in Cardiology, Research, Family Practice.

Perhaps you could find CME that would help provide a foundation for practice. If it's not in your contract, is it worth it to you to pay out of pocket? Are you willing to spend some of your personal time shadowing either at your clinic or elsewhere?

Also, would your collaborating physician be willing to sign off on all charts for the patients you see from these populations?

If you and your employer want to maintain the professional relationship, there should be work-arounds. Demonstrate a spirit of willingness and collaboration. Otherwise, sounds like it's time to move on...

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