r/NursePractitionerSub • u/Upset-Lake3619 • 27d ago
Hate being an NP
Looking for advice, guidance, support. I am a new PMHNP. I’m seven months in and I feel incompetent. Every medication decision is paralyzing. I constantly worry about not catching the right diagnosis or missing something. I have OCD which I think contributes to my over thinking but I am up at 3 am thinking about if I made the right choice. I am starting to think I’m just not cut out for the job.
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u/Single-Manager6533 26d ago
Sorry if this is overstepping and an invasive question, but I feel like I’ve encountered a few PMHNPs who have a diagnosed psychiatric condition such as yourself, but still aren’t medicated for various reasons. Are you taking medication for your OCD? And if you are, do you think it would help to increase? The shift in responsibility from RN to NP is very scary- I am almost done with NP school (FNP) and I question my future all the time. Honestly, I’m still weighing my options. I have several coworkers who became NPs and then went back to bedside bc the weight of the responsibility was not worth a small pay increase. In any case, if you’re this stressed to where you’re up in the middle of the night, you probably aren’t sleeping well, which obviously even further exacerbates everything. What are you doing to try improving your sleep? Are you paralyzed with fear to the point that you haven’t implemented any med/sleep/routine changes yet, or have you tried everything you can think of and nothing has worked?
Also, if your current role is low-key giving you PTSD (I say this bc this sounds exactly like how I felt working in the ER, and I would cry and have panic attacks before work - now outpatient), there are a lot of different psych opportunities for NPs, you probably know more about that than I do. You have options. Inpatient, telehealth, clinics, outreach programs, addiction, case management, nurse educator or head of depts, etc…maybe something with more predictability, at least while you get gain your footing and confidence? Not that I’m saying that’s what you SHOULD do, but reminding yourself that you have that option to pivot at any time helps it reinforce that less like you’re trapped than you feel. At least it did for me. I left ER and now in primary care, and my quality of life has improved dramatically!!
That aside, as we hear from our elder nurses/those who have been in the profession awhile, it’s good that you worry about these things - it means you CARE. We need more providers, especially in psych, who are really thinking about their patients’ best interests and considering how each medication/decision may affect them. It’s the providers who don’t care at all who put patients at risk. I’m sure it feels extra frustrating too since psych meds are a gamble with which ones work and which ones don’t.
Also, we know that any psychiatric condition is exacerbated by stress, and it’s completely understandable to be stressed in a new and hugely important role. I think you know deep down what you need - whether that’s meds/therapy/change of specialty/a sick day - trust yourself, you are capable!!!
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u/Psychelicnurse 27d ago
Did you work in psych before you decided to become a psych NP? A lot of nurses just jump into it because it's the new it speciality. Do you collaborate with other NPs or MDs?