What exactly do you do as a Psych NP?

TheCommuter, BSN, RN · Mar 27, 2017

Moved to our Nurse Practitioners forum for the best chance of eliciting a reply from one or more psych NPs.

https://allnurses.com/nurse-practitioners-np/

oceanblue52 · Mar 28, 2017

Not a Psych NP, but I have worked with quite a few...would depend on the state, but in my state they are almost equivalent to a Psychiatrist, at least with respect to medication management. The majority of their responsibility is managing side effects, figuring best medications to manage symptoms without adverse effects, monitoring lab work, and delegating to RNs and MAs basic things like prescription refills, ordering labs, etc. If you are in private practice, you could probably do some counseling, but in more traditional settings, you only get about 30 minutes per patient, or maybe an hour if they are new and require taking an extensive history. It is a fascinating job but a lot of responsibility to manage medications responsibly.

PsychBoss · Apr 5, 2017

Im in Psych NP school, actually on lunch break of a clinical rotation now. Psych NP's act in the same capacity as psychiatrists in most states, especially in outpatient therapy. Many states have varying degree of physician over site. For instance, the state I will practice in requires physicians to "review" 20% of charts and sign off on controlled substances. Some prescribe solely through the board of nursing and act essentially in the same capacity as psychiatrists with minor restrictions. In most practices, in my experience, the acuity of patients seen between psychiatrists and psych NP's is relatively the same. Day to day life varies depending on setting. For instance, the clinical setting I'm in now is a community health center. The NP I'm following spends somewhere from 10-20 minutes with most patients depending on the acuity for follow ups and around 30-45 for new intakes. Their day is often loaded with patients but there will be varying degrees of gaps due to the high rate of no shows and call outs with patients that receive insurance through the state. Private practice is typically more lenient and the clientele expects you to be more thorough. At the settings I've been, NP's spend anywhere from 15-30 minutes with patients for routine follow ups and 45-60 minutes for a new patient admit. For NP's in most settings you'll be doing medication management of psychiatric medications. You'll dabble very little with medical problems such as hypertension and headaches etc, but the vast majority of that will be referred to a PCP. NP's are also doing rounds in inpatient hospitals and partial programs. Some NP's practice counseling in the private practice setting but I don't see that much, and its usually in affluent communities. For most people its cheaper to someone for your medication management and someone else for therapy. I like it because I enjoy specializing in a specific area of medicine more than the variety that is typically seen in an FNP setting. The patients have a reputation for being more irritable or manipulative than a typical PCP setting but in my opinion that is overblown. Almost every patient I see for Psych problems see's a PCP anyway. People love it or hate it. I strongly recommend shadowing a provider before going down this path and also think it would be worth working in a psych hospital or clinic a little while as an RN to see if its for you.