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5 Clinical Pearls Every New Psych NP Should Know
DISCLAIMER
The content provided in this Substack post is for entertainment and informational purposes only and is not intended to serve as medical advice. The views and opinions expressed herein are those of the writer and should not be taken as definitive or authoritative. Readers should not rely solely on the information provided in this post to make decisions about patient care. Instead, use this content as a starting point for further research and consult a qualified healthcare professional before making any changes to treatment or medication regimens.
It has been a long while since my last post. Life has been very busy, in a good way. I appreciate your patience and continued readership during the hiatus. Now that we are back, I plan to maintain a regular posting schedule with high-value, clinically relevant content for psychiatric-mental health nurse practitioners. Let’s kick things off with some practical insights for those early in their psych NP career.
1. Start Low, Go Slow
When prescribing psychiatric medications, begin at a low dose and increase gradually. This approach helps patients tolerate treatment by minimizing initial side effects. “Go slow” doesn’t mean never reaching an effective dose-continue to adjust based on the patient’s response until you find the therapeutic sweet spot (or hit side effects that require a change).
2. One Change at a Time
It’s tempting to fix everything at once, but avoid modifying multiple parts of a treatment plan simultaneously. If you alter a dose or add a new medication, give it time (often a few weeks for many psych meds) before making another change. This way, you’ll clearly know which change is helping or causing side effects, rather than puzzling over multiple variables.
3. Rule Out Medical Causes
Always consider whether a medical condition might be causing psychiatric symptoms. For example, hypothyroidism can present as depression, and a vitamin B‚ deficiency can contribute to cognitive or mood changes. Checking basic labs and ruling out such issues should be part of your initial assessment before finalizing a primary psychiatric diagnosis.
4. Anticipate Side Effects
Every medication has side effects, and being proactive can prevent a lot of problems. Educate patients about common side effects before they start the medication (e.g. SSRIs may cause temporary nausea or jitteriness; atypical antipsychotics can increase appetite). When patients know what to expect and how to manage minor side effects, they’re more likely to stick with the treatment plan. Always have a backup plan as well-such as adjusting the dose, adding an adjunct, or switching medications if side effects become problematic.
5. Use Your Resources & Seek Guidance
Even as a new provider, you’re not expected to have every answer on day one. Get comfortable consulting evidence-based guidelines and using reliable resources (like clinical apps or manuals) to double-check dosing, interactions, and current best practices. If you’re uncertain about a complex case, don’t hesitate to consult with a supervising psychiatrist or a trusted colleague. Patients will appreciate your honesty if you say, “Let me double-check and get back to you,” far more than an unsupported guess.
Regular content is officially back on track. I’m eager to cover more topics that matter to you, so please let me know in the comments or via email what you would find most useful in your practice. If you enjoy these posts, consider sharing them or subscribing for future premium content to support the newsletter. Thank you for reading, and I’m looking forward to this next chapter together!