Have you ever worked with a psych NP who had no RN experience?

[priorities2]

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So, the nursing forum gets super contentious about this topic. I thought I would ask psychiatrists themselves. Have you ever worked with/hired a psych NP with no RN experience? What did you think, or what do you think of the idea? I'm curious if other providers have the same opinion as many nurses or not.

 

[st2205]

Over here we typically squabble over whether or not midlevels can competently practice a scope of psychiatry given their limited formal training and exposure, of which most of the midlevels invariably agree that they can. From your question I presume you're having the same kind of argument on the nursing forum with those having RN experience feeling it necessary but those without claiming the NP alone is sufficient, correct?

 

[priorities2]

More or less, yeah. Maybe some PMHNPs with RN experience don't believe years of RN work experience are necessary, and maybe some without work history as an RN do believe it's necessary.

So I guess my topic rests on the view that there are at least some PMHNPs who can practice competently. If someone disagreed with that, it would be a different issue.

 

[AnnoyedByFreud]

Honestly, I don't think you're going to find much insight on this issue here, since it's so specific to nursing education, which many are not very familiar with. In my program, there are PMHNP students with no psych RN experience, just regular nursing experience. I find that coming from my background (where I have a lot of psych experience, but no RN experience) is far more beneficial. The LCSWs/MFTs in my class who have no RN experience also feel the same way - they have a significant leg up. I wouldn't sweat it either way. Go to a good program. Learn as much as you can, especially during clinical. Get extra hours if your program allows it. Find a good first job that is supportive and will train you up. I was considering applying to the NP/PA psych residency in Minnesota, but that may no longer be feasible for me.

 

[LimbicResponse]

Way over my head. Wrong forum probably

 

[priorities2]

Wow, it's interesting that other mental health providers who work with psych NPs don't even notice this issue. I think that right there probably really says something about the relevance of psych RN experience to NP competence.

 

[st2205]

Wow, it's interesting that other mental health providers who work with psych NPs don't even notice this issue. I think that right there probably really says something about the relevance of psych RN experience to NP competence.

I find the lack of any real general medical exposure in most (all) the PNP programs I've looked at to be rather concerning. It certainly promotes, unawares, the idea of psychiatry in a vacuum. In that sense, any general medical experience as an RN would be much better than none, in my opinion.

 

[michaelrack]

👍

Way over my head. Wrong forum probably

I am confused

 

[priorities2]

I find the lack of any real general medical exposure in most (all) the PNP programs I've looked at to be rather concerning. It certainly promotes, unawares, the idea of psychiatry in a vacuum. In that sense, any general medical experience as an RN would be much better than none, in my opinion.

*PMHNP

(PNP refers to pediatric nurse practitioner - unless that's what you're talking about)

Thanks for sharing an opinion though.

 

[AnnoyedByFreud]

I find the lack of any real general medical exposure in most (all) the PNP programs I've looked at to be rather concerning. It certainly promotes, unawares, the idea of psychiatry in a vacuum. In that sense, any general medical experience as an RN would be much better than none, in my opinion.

By "looked at" do you mean taking a cursory glance at the online curriculum (which often doesn't even list clinical requirements or is outdated)? Or did you actually call the schools and speak to them about the training? Because all NPs must take the three NP "core" classes (advanced pharm, advanced patho, and physical health assessment) regardless of specialty. That's right, physical health assessment is mandatory for everyone. And there is clinical exposure on top of that. So no, I know of no psych NP programs that do not provide some basic physical health training. The exposure is certainly not equivalent to the training that a physician gets, but no one is arguing that.

 

[snarper]

I'm confused-- how are you/your classmates in an PMHNP program without an RN license? And I'm going to have to say that RN experience certainly matters. Midlevels need to be able to assess a patient medically. As a previous poster said, psychiatric treatment doesn't and cannot happen in a vacuum. A comprehensive background seems (at the very least) prudent. My experience is that any NP with no RN experience is not taken seriously even by other RNs, let alone as competent practitioners by other midlevels and physicians. Clinical experience is what enables one to practice.

 

[st2205]

By "looked at" do you mean taking a cursory glance at the online curriculum (which often doesn't even list clinical requirements or is outdated)? Or did you actually call the schools and speak to them about the training? Because all NPs must take the three NP "core" classes (advanced pharm, advanced patho, and physical health assessment) regardless of specialty. That's right, physical health assessment is mandatory for everyone. And there is clinical exposure on top of that. So no, I know of no psych NP programs that do not provide some basic physical health training. The exposure is certainly not equivalent to the training that a physician gets, but no one is arguing that.

My concern is that there is so little general medical exposure that having a course or two (or twenty) called physical assessment and a couple clinical experiences peppered in is seen as sufficient. That, to me, is dangerous. I understand that the written curriculum doesn't always include everything in it, but the fact that they can't explicitly point out "you will do X amount of primary care months" leads one to strongly believe they don't even do a full month (which itself isn't sufficient) but cluster in a few courses and a few primary care experiences and say people are at least well trained enough to medically treat mental illness.

 

[SeniorWrangler]

There are mid-levels who diligently educate themselves and are always learning more and those who don't. After a year or two in practice, the difference between the motivated learners and others is much more significant than any details of education.

 

[heyjack70]

Do you mean psych ARNP without any RN experience, straight from BSN to Mid level? Or ARNP without psych RN experience, but still some experience working as an RN?

 

[zenman]

I had 37 years of nursing experience, not only in psych, but ED, ICU, home health, rehab, blah, blah, blah. This is probably one reason why I'm always sending Soldiers back to their primary care PA. And I'm nice enough to go ahead and order labs so it's there for the PA when the Soldier arrives. A nurse with no experience before NP school probably wouldn't be able to do this.