r/PMHNP

▲ 16 r/PMHNP

Is this normal?

I’m a new grad PMHNP working in outpatient community mental health in a big city. My orientation consisted of 4 hours of shadowing the senior NP and company wide orientation. On my first day my patient caseload consisted of seeing patients presenting with schizoaffective d/o, schizophrenia, depression, anxiety, and possible withdrawal symptoms from alcohol use d/o, all of whom I saw completely by myself. I have not shadowed anyone and nobody sat in with me during my psychiatric evaluations. We don’t get admin time and our supervising physician is not on site but we are free to email him “when we need help”. When I interviewed I was told that our company is “new grad friendly” and that we would get “a lot of support”, however I am not necessarily feeling very supported. I absolutely am not opposed to seeing patients with serious mental illness or any diagnosis or population. I specifically chose this community mental health center to learn because they see an underserved community from ages 5 and up. However I did think I’d at least get 2 weeks shadowing NPs and that I would at least have someone sit in on my first couple of evaluations to offer me feedback. Alarm bells were going off in my head and I even drafted a resignation letter, but I am wondering if anyone has experienced a similar orientation process as a new grad and if this is just the experience I’ll have if I move on to another job. Thanks for any input.

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u/throwawayacctrddt — 8 days ago
▲ 51 r/PMHNP

Sign of the times 😩

Maybe the flair should be: exhaustion?

I just don't know. But the number of ppl I'm starting to see who are suicidal is just so..... So..... SAD.

and it's all societal/economy related.

I'm so disgusted by how fast we have fallen as a society. It will always be hard for a subset of us. I'm not oblivious to that fact.

But the rate at which even my old used to be stable patients are falling into "i stopped taking my meds because i wanted to take the whole bottle" hole makes my heart hurt.

I'm seeing it in center and via telehealth. It's scary out there. Y'all hang in there and make sure you have your own therapist!

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u/because_idk365 — 8 days ago
▲ 4 r/PMHNP

Prior auth for vilazodone: how to get it approved by insurance?

had several male patients interested in switching to vilazodone after trying a SSRI and experiencing sexual side effects. And yet, all my PAs for vilazodone got denied. The manufacturer of Viibryd does not have a savings card that works.

What are you guys doing?

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u/Mental-Bet5442 — 8 days ago
▲ 1 r/PMHNP

how do I get better at psych evals

Today we did a mock telehealth initial evaluation with a standardized patient and I was so thrown off. No one was prepared prior on how to speak to patients etc I had no real flow. My patient was experiencing auditory hallucinations and ideas of references and broadcasting and did not think anything was wrong with her. Is it the psych NP job to get her to realize there is smth going on or just get info and treat from there? I want to get better at learning how to communicate to patients experiencing psychosis since I have no prior experience. Any recommendations?

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u/Better_Impact1007 — 7 days ago