Archive for February, 2012

What exactly is a Psychiatric Nurse Practitioner?

February 23, 2012

I am a Psychiatric Nurse Practitioner, but many people don’t know what that means. For example, many are surprised to hear that I prescribe medications. A statement I frequently hear is ” Wow, I had no idea you can prescribe!  I thought only doctors do that.”

So, I would like to explain more about my profession.  In terms of education, a nurse practitioner has graduated from a Master’s program in Nursing. I received my degree from Columbia University and then went on to do post-graduate training in Family Therapy and Mind Body Medicine.  I also completed a Fellowship in Pain and Palliative Care at Memorial Sloan-Kettering Cancer Center.  Nurse practitioners are called mid-level practitioners.  That means that we don’t function as doctors or nurses.  Many psychiatric nurse practitioners like myself establish private practices where we see patients for psychotherapy as well as medication management.  In my practice, I often see patients for initial evaluations in order to determine if medication is appropriate.  Often, patients are referred to me by other mental health professionals but are also referred to me by other patients with whom I have worked.

How does a psychiatric nurse practitioner differ from a psychiatrist?  To begin  with, our education and training are somewhat different.  In nursing education, health is stressed rather than illness.  Everything that has an impact on someone is important to the nurse practitioner.  A person’s living environment, relationships (or lack of relationships), health habits, genetic history, family influences, financial status, and job-related and personal stresses are all taken into consideration when an evaluation or assessment is done.  All of these factors contribute to a person’s well-being or lack of well-being.

Psychiatrists are medical doctors who decide to specialize in psychiatry, and although medical education is changing, the focus has been primarily on the disease and illness medical model rather than on a model of health.  Psychiatrists in the 21st century mostly function as psychopharmacologists; a patient comes to them specifically for medication, and in a short 15-minute follow-up visit, the patient’s medications are the sole focus of the visit. Psychotherapy is typically handled by other mental health professionals, including social workers, nurse practitioners, marriage and family therapists, and psychologists.

What can a psychiatric nurse practitioner offer someone who is seeking help? The answer is comprehensive care that takes into account all aspects of the person’s life.  When seeking the help of a psychiatric nurse practitioner or a Psychiatric APRN (advanced practice nurse in psychiatry), inquire about whether the practitioner is board-certified.  Board certification means that the individual has passed a certification exam that tests for competency and thorough understanding of psychiatry and psychiatric care.

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When and how to take anti-anxiety medications

February 18, 2012

Benzodiazapenes or anti-anxiety medications are very effective in treating anxiety.  Xanax, Klonopin and Ativan are the most commonly prescribed medications for panic disorder and generalized anxiety.  However, all of these medications, while effective, are only to be used on an “as needed” basis.   They are best used for the relief of acute anxiety and not for chronic use. While anti-anxiety medications are not physically addictive, people can develop a psychological dependency on the medication and not make a choice to cultivate and learn other ways to cope with anxiety.  Approaches like a daily practice of relaxation techniques, yoga, mindfulness  and meditation, when practiced on a regular basis,  are excellent ways to deal with chronic anxiety.  In working with patients and teaching relaxation and meditation, I have seen that medications are often not needed at all anymore.. We are reminded once again with the recent death of Whitney Houston that, although the cause of her death is still unknown, it is known that she struggled with prescription drugs as well as other substances and that she may have combined anti-anxiety medications with alcohol – a truly dangerous and potentially fatal combination.  When used properly and with caution, these medications have a place in treating anxiety for short-term use.