March
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March
2008 |
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“My new insurance company rep said there was a long wait to see a psychiatrist,” said Donna. “When she asked if I’d consider seeing a nurse practitioner, an NP, instead, I was surprised.” “’But, I have a serious mental illness,’ I said. ‘Is she qualified?’ This professional has twenty years of psychiatric experience, the rep told me.” “What exactly is a nurse practitioner and is this a good choice for me?’ What are Nurse Practitioners (NPs)? Almost three percent of NPs, or 3,400, are psychiatric specialists, although some NPs have multiple specialties, said Mary Jo Goolsby, EdD, MSN, NP-C, FAANP, Director of Research and Education, American Academy of Nurse Practitioners. They practice in clinics, hospitals, private physician or NP practices, nursing homes, educational institutions and public health departments. “In many states, NPs work in collaboration with a psychiatrist,” said Patricia Hentz, clinical specialist, PMH-NP (psychiatric mental health practitioner), “with whom they can review or discuss any questions or challenges the NP may face.” For a very complex case, she said, she would consult with a physician before prescribing medication. And, in the event a patient required hospitalization, a patient would probably be seen while they were there by a hospital staff doctor. As physicians do, nurse practitioners also publish in medical journals, said Hentz, who developed a biological-based PNP program at the University of Southern Maine. More and more people are choosing NPs as their primary, acute and/or specialty healthcare provider. Almost 600 million visits are made to NPs each year. How are they different from a psychiatrist or therapist? “A psychiatrist has an M.D., which is a different model of education,” she said “Our philosophy comes from nursing.” What king of training and credentials do they have? NPs are licensed in all states and the District of Columbia. Most NPs are certified in their specialty area, including psychiatric/mental health. What are the benefits of using a nurse practitioner for my mental health care? NPs deliver a unique blend of nursing and medical care. They assist patients in making better lifestyle and health decisions. |
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For example, an NP was seeing a patient who had bipolar disorder and was taking lithium, said Hentz. He came to her when he developed tremor, which might have been caused by the lithium. The practitioner, though, recognized other symptoms and found that it was hyperthydroidism that was causing the symptoms. “NPs are trained to recognize what is a physical condition and what is a psychological condition,” said Hentz. “Because they treat the whole patient, they may be more likely to discover drug interactions. I once treated a patient who showed symptoms of bipolar mania. Then I discovered she had been prescribed steroids by her primary care doctor for breathing problems. Steroids can trigger mania in bipolar patients. She was hospitalized, the drugs were adjusted and she was stabilized.” Nurse practititoners compare themselves favorably to psychiatrists or therapists in terms of:
And, their services are less expensive than those of a psychiatrist. “They take extra time to listen,” said Goolsby. “Psychiatrists tend to see three to four patients per hour; nurse practitioners average one to two per hour.“ Treatment in psychiatry varies according to the individual because each person responds differently. “It’s more of an art than a science,” she said. “The nurse practitioner I was referred to was great,” said Donna. “She was the first one to really listen to me about my side effects and suggest remedies. I felt like she really got to know me after our hour together, and she called me a few days later to see how I was doing.” How can I locate an NP?
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“We have an understanding of biology that a psychologist or social worker probably doesn’t have,” said Hentz, “A nurse practitioner will monitor medical symptoms more closely than most therapists would, watching out, for instance, for side effects. That’s my job.”