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Hi everyone,

I am currently about a third of the way through my Graduate Entry PMHNP program and am attempting to learn as much as I can, both inside and out of the classroom. Right now I work as a psychiatric care technician on an inpatient adolescent unit (perfect for me, as I plan to work in peds psych) with the hope of continuing to work there as an RN after taking the NCLEX. I'm wondering if anyone can speak to additional experiences that would be helpful to have moving forward as I work towards becoming a Psych NP.

Thanks in advance for any thoughts you may have.

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Specializes in Family Nurse Practitioner.

Kudos for getting RN experience and I would definitely encourage you to also do some time on a locked inpatient acute adult unit. With children and adolescents what you are mostly seeing is behavioral, trauma, ADHD, depression and anxiety with the extremely rare psychotic or bipolar disorder in an adolescent. If one has not seen multiple presentations of the actual real deal bipolar or psychotic disorder it seems to be very easy to erroneously diagnose children with either. I cringe at the number of times I see a child with a terrible home life who is oppositional and aggressive yet gets a diagnosis of bipolar disorder and is put on a hard core mood stabilizer or antipsychotic. It is nothing less than malpractice, imo.

Become well versed in the subset with affective dysregulation, usually personality disorder and/or SUD, who also get the most wonderful crutch of a Bipolar disorder diagnosis when they don't have it either and will not have lasting growth without serious therapy. Spot those working you for benzos or stimulants. Learn how to manage and see first hand detox from the various substances.

Lastly seeing the effects both good and bad of these medications that you will soon be prescribing. See what they do to their metabolic profile, their weight, their neurologic system. Take special note if how old someone with schizophrenia looks at age 40 or 50 as compared to their peers. Although there is lifestyle factors including poor self care and neurodegeneration with chronic psychosis there is also the long term polypharmacy which can result in long lasting irreversible detrimental effects and no the 2nd or 3rd generation aren't any better just different. I love medication and what it can do when prescribed judiciously but have seen horrendous adverse effects at the hands of incompetent prescribers. Please remember this as you consider prescribing for a child whose brain isn't even fully developed.

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Specializes in Cardiac (adult), CC, Peds, MH/Substance.

A kitten dies every times normal angsty teen is diagnosed as bipolar and medicated for this. Save the kitties.

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Specializes in Family Nurse Practitioner.
A kitten dies every times normal angsty teen is diagnosed as bipolar and medicated for this. Save the kitties.

Or someone with BPD or SUD.....

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Thank you for the excellent advice Jules. Luckily for me the facility I work in also contains an adult acute inpatient unit, to which I am occasionally floated. I appreciate you taking the time to reply and will keep all of this in mind as I progress through my program. If anything else comes to mind, please let me know :)

Nick, I'm not really a cat fan, but I do have a soft spot for kittens. I'll guard them with all of my power.

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Specializes in Cardiac (adult), CC, Peds, MH/Substance.

Which program are you doing?

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Hey sorry I never got back to you here. I'm in the direct entry PMHNP program at Ohio State.

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Specializes in Nephrology, Cardiology, ER, ICU.

Moved to Student NP forum

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