What is a PMHNP?
The “literal” definition
In the United States, a PMHNP (Psychiatric-mental health nurse practitioner) is quite literally an advanced practice nurse. What is this? It’s a nurse who went back to school to further their education. What this means is, after becoming a nurse, they decided that they wanted to have a different role and become a “prescriber”. Specifically a PMHNP works in mental health. We are trained to diagnose, conduct therapy, and prescribe medications with psychiatric disorders, medical organic brain disorders, and substance abuse disorders. We are also wonderful consultants and educators for families and staff.
What sets us apart from doctors?
Most doctors choose to get their bachelors, then go to med school, then complete a “residency” in psychiatry. NP’s go to four years of nursing school, get some experience in the field as a nurse which is more bedside and hands on training. Then they apply to graduate school which ranges from two to four years to further get their educations.
Both professions are able to assess, diagnose, prescribe, and provide therapy. The largest difference is reimbursement from insurance companies and in 23 states, an NP is required to have their prescriptions “co-signed” by a doctor. Though in 27 states, this is not an issue and PMHNP’s are allowed to practice on their own. NP programs began in 1965 when people began to use nurses to help them deliver babies.
Most NP programs require a certain amount of time of bedside nursing in order to get an adequate view of the field, see first hand the prescriptive decisions and gain bedside manner. This is why most believe nurse practitioners are wonderful at the rapport and relationship with patients.
Why can’t we practice independently in all states?
The medical field has had a difficult time accepting nurse practitioners as some tend to feel like we aren’t trained as efficiently as we started off as nurses. Some also feel like “doctor” should remain a title for MDs and DOs as this is how it’s been traditionally. Some are worried that we will make them less needed though there is a growing demand for health care providers everywhere.
Statistics show that NP’s generally have less complaints, less lawsuits, and less malpractice claims. But as we all know there are good MD’s and good nurse practitioners. There are also bad ones of each category. So why can’t we let the people decide who they want based on their experience. It allows people more choices to find a provider they feel like understands them better. Lets not limit choice. Let’s continue to offer more provider and more support because of the large need.
Why I’m proud to be a PMHNP
I have been trained as a nurse and I would never change my background. I have literally struggled with patients for longer hours and have developed some great relationships through my experiences as a nurse. I’ve seen first hand the effects of medications and I have developed my own thoughts along the way. I never introduce myself as a doctor as I’m proud of being a nurse practitioner. I’m proud of my time as a bedside nurse. I learned how to advocate for people. I’ve literally spent my entire day with tons of patients helping them eat, shower, and provide them with small comforts and gestures. It’s a skill set that is very special to me.
Truth is… there will always be judgement
People tend to be skeptical of everyone, meaning even MD’s judge MD’s for where they went to school. NP’s judge other NP programs. MD’s judge NP’s and NP’s judge MD’s. It’s a cycle that is unlikely to change in the near future. So I employ you to find providers that you feel care and you feel listen to you. Find providers that you don’t feel like you’re settling with. Each MD, DO, and NP are different. We all have different skills and different belief systems. It’s up to you and to us to change the health system to provide better and more holistic patient care.
This is why, I’m proud to introduce myself as “Sarah, a nurse practitioner here”.
Other resources
https://thedo.osteopathic.org/2010/03/as-nps-push-for-expanded-practice-rights-physicians-push-back/ (Different perspective)
Pearson Report: https://www.researchgate.net/publication/313527893_The_Pearson_report_the_annual_state-by-state_national_overview_of_nurse_practitioner_legislation_and_healthcare_issues
