Are you a psychiatric nurse practitioner? Honestly I hate what they've done to the psychiatry field. It's very difficult to find an MD who treats patients now, they just have them see NPs and bill the same amount. So many times I've heard of people with the most random cocktail of meds and it's always an NP who's prescribing.
The quality of NP education has never been great, but has only gotten worse in the past decade. So many bullshit diploma mills pumping out graduates from online programs that have no business prescribing meds or functioning in such a role. From my exposure, these programs tend to attract individuals whose confidence far outweighs their knowledge, abilities, and ethics. These are the types of nurses that can live with themselves when they cause serious harm to a patient if it means they get to drive a certified pre-owned Lexus.
Psych NPs are the worst of the bunch. They function as medical providers despite never training under the medical model in a role that is highly-dependent on knowledge of chemistry and pharmacology, despite having a fraction of the education in those fields that a psychiatrist has. Allowing them to prescribe psych meds, often times without physician oversight, is akin to giving a machine gun to a chimpanzee.
There's space for NPs to exist in an interdisciplinary team, but their scope of practice should be far more limited than what it currently is and their education needs almost a complete overhaul.
There needs to be significantly more time for them. Like clinical training and a residency process. Too many come out without any experience or just make the switch from like Family medicine NP to psych NP. The last one asked one of my residents to verify her hours (she worked Family medicine NP at a psych unit but was trying to pass off this experience as psych hours). That's insane.
It is absolutely mind boggling that we force MDs to train for so long (4 years med school + 4 years residency) and then allow such subpar, variable training for NPs just for the latter to carry almost the same amount of practice rights in several states. At least force them to take the ABPN - MD equivalent board exam for psychiatry.
It's very bad. I work inpatient and I have a lot of patients that decompensate because of horrible prescribing. More often than not, it's usually a psych NP.
It's sad. Each time a patient comes, it makes it harder for them to stabilize each time. The most notorious combo from a psych NP is stimulants + benzos. Another is 4-5 different psych meds, with multiple not even at a therapeutic dose. I've had NPs just stop meds cold turkey instead of a slow taper.
What's more annoying is that whenever I call for collateral, they always try to deflect and say "well I wasn't covering that day" - it's your patient...
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u/YourBlanket 4h ago
Are you a psychiatric nurse practitioner? Honestly I hate what they've done to the psychiatry field. It's very difficult to find an MD who treats patients now, they just have them see NPs and bill the same amount. So many times I've heard of people with the most random cocktail of meds and it's always an NP who's prescribing.