I perform psychiatric evaluations on chemical dependency patients who are hospitalized on the inpatient detox unit. I assess them for the presence of mood disorders and other psychiatric complications and determine whether or not psychiatric medications are indicated and prescribe them as needed. I monitor the patients daily as detox progresses and titrate medications as indicated. I also manage patients and their medications once they are discharged to the outpatient and residential chemical dependency treatment programs.
About Charlie Myers, MSN, PMHNP-BC: Charlie Myers is a Psychiatric Mental Health Nurse Practitioner at John Muir Behavioral Health Center, where she conducts psychiatric evaluations and manages the medications of patients admitted for chemical dependency and medical detox treatment at the Center for Recovery (CFR), and follows up with patients during their time in outpatient care after leaving the CFR. Prior to her current role, Ms. Myers was a Psychiatric Nurse Practitioner at Johns Hopkins School of Medicine, where she conducted mental health assessments and provided medication management services to patients admitted to the Acute Inpatient Psychiatric Unit.
Before becoming a PMHNP, Ms. Myers was a Psychiatric RN at Mesilla Valley Hospital, and a Registered Nurse in the Emergency Department and Float Pool at Memorial Medical Center. She earned a Bachelor of Science in Biology and a Bachelor of Arts in French from James Madison University in 2005, and subsequently earned her BSN from New Mexico State University in 2008. She received her MSN with a specialization in Psychiatric Mental Health Nurse Practitioner and Clinical Nurse Specialist from New Mexico State University in 2011.
[OnlineFNPPrograms.com] Could we please have an overview of your academic and professional path in psychiatric mental health nursing?
[Charlie Myers, MSN, PMHNP-BC] I attended James Madison University in Harrisonburg, Virginia with a pre-Med major and earned bachelor’s degrees in Biology and French. After realizing how much debt medical school would put me in, I applied to a 16 month accelerated BSN program at New Mexico State University in Las Cruces, New Mexico at the urging and encouragement of my mother, who is an RN. After earning my BSN, I worked in the ED and float pool at Memorial Medical Center for a little under a year to hone my clinical medical skills before transferring to work as an RN at the psych department at Mesilla Valley Hospital (MVH). At MVH I worked mainly with adolescent residential patients, but also chemical dependency patients, acute adult patients, and forensic patients. While I was working at MVH, I started school at New Mexico State University to work on my MSN degree with a specialization in psychiatric nurse practitioner. After completing my masters degree, I applied for several jobs and was hired to work at Johns Hopkins Medicine in Baltimore, Maryland. There I worked performing psychiatric evaluations in the emergency room as well as admitting patients to the acute psychiatric unit and performing psychiatric consults on the medical floors.
[OnlineFNPPrograms.com] Could you please describe your role and responsibilities as a Psychiatric Nurse Practitioner for John Muir Behavioral Health Center (JMBHC)? What kinds of medical conditions and challenges do your patients face, and how do you help them manage their conditions?
[Charlie Myers, MSN, PMHNP-BC] I perform psychiatric evaluations on chemical dependency patients who are hospitalized on the inpatient detox unit. I assess them for the presence of mood disorders and other psychiatric complications and determine whether or not psychiatric medications are indicated and prescribe them as needed. I monitor the patients daily as detox progresses and titrate medications as indicated. I also manage patients and their medications once they are discharged to the outpatient and residential chemical dependency treatment programs. Many of these patients are dual diagnosis patients, meaning they suffer from both substance dependence and psychiatric disorders.
I also facilitate educational groups for patients on the unit on topics such as anxiety management, sleep hygiene, medications commonly used in detox, etc. I collaborate with an attending physician who is an addictions specialist, registered nurses, social workers, and licensed therapists daily to care for our patients.
[OnlineFNPPrograms.com] You were also a Psychiatric Nurse Practitioner at Johns Hopkins School of Medicine. Could you elaborate on your daily responsibilities, work environment, and team in this role, and how they differed from those of your current position at John Muir Behavioral Health Center?
[Charlie Myers, MSN, PMHNP-BC] At Johns Hopkins Medicine, I worked performing psychiatric evaluations in the emergency room as well as admitting patients to the acute psychiatric unit and performing psychiatric consults on the medical floors. The types of patients I saw were more varied in their diagnoses and often much more psychiatrically unstable than the patients I see at John Muir Behavioral Health. At JMBHC, I work mainly with patients who are suffering from chemical dependency and are undergoing treatment for detox. While they may have comorbid psychiatric conditions, they are not a danger to themselves or others such as the patients I was caring for at Johns Hopkins. The patients I am caring for at JMHBC are all in the program on a voluntary basis, while many of the patients I was caring for at Johns Hopkins were in treatment and under involuntary psychiatric holds due to being a danger to self or others or gravely disabled due to psychiatric illness.
[OnlineFNPPrograms.com] In your opinion, what are the main differences between PMHNPs and people in other helping professions, such as clinical social workers, psychotherapists, and psychiatrists? Is one of the main differences that PMHNPs can do health evaluations and administer medicine? What is the difference between a PMHNP and a Psychiatrist?
[Charlie Myers, MSN, PMHNP-BC] In general in the places where I have worked, the social workers and psychotherapists tend to focus on performing psychotherapy and groups with the patients and the PMHNPs and psychiatrists tend to focus on the psychiatric evaluations, diagnoses, and medication management side of things. I have only worked in a hospital setting, but do have some NP friends who work in private practice and do perform psychotherapy with their patients. In the places I have worked, there are minimal differences between a psychiatrist and PMHNP role-wise. We all perform psychiatric evaluations, intake assessments, medication management, psych consults, and discharge dispositions. The only difference I can think of is that psychiatrists can obtain a special DEA license to prescribe Suboxone maintenance, whereas NPs cannot.
[OnlineFNPPrograms.com] What motivated you to work in psychiatric/mental health nursing, and what professional experiences helped you determine that this area of advanced practice nursing was the right one for you?
[Charlie Myers, MSN, PMHNP-BC] I actually decided that I wanted to become a psychiatric nurse practitioner when I completed my clinical rotation in the psychiatric hospital during my BSN program. Before that, I had not really enjoyed any of my other clinical rotations, and thought that nursing school was just ok. But going to the psychiatric hospital was really interesting and exciting for me. I chose psychiatric nursing because every day would be different, there are tons of interesting patients I would get to meet and work with, and I would never know what to expect when coming to work.
[OnlineFNPPrograms.com] What have been some of the most rewarding aspects of working as a psychiatric mental health nurse practitioner? On the other hand, what specific challenges have you encountered in this field of work, and how have you managed these difficulties?
[Charlie Myers, MSN, PMHNP-BC] The most rewarding part of working as a PMHNP is the opportunity to work with patients so closely and get to hear their stories and get to know them on a personal level. I am inspired daily by many of my patients. The feeling you experience when a patient thanks you for helping them and making a difference in his or her life for the better is extremely gratifying. The flip side of this is it is extremely hard to lose a patient to suicide or drug overdose. The way I manage situations like this personally is to be sure to practice good self care–make sure to get enough sleep, meditate, do yoga, exercise, spend time outside–to prevent becoming overwhelmed or burned out from the things I experience at work.
[OnlineFNPPrograms.com] For current and prospective MSN students who are interested in becoming psychiatric mental health nurse practitioners, what advice can you give them about optimally preparing for this field while pursuing their degree?
[Charlie Myers, MSN, PMHNP-BC] I would definitely advise current and prospective MSN students to gain experience working in the psychiatric mental health setting before deciding to pursue this specialty. If you are an RN, work in a psychiatric hospital or psych emergency room to gain some experience there first. If you have not yet obtained your nursing degree, you can prepare by taking psychology classes. Many of my colleagues also believe that going to psychotherapy themselves makes them better clinicians. I am also frequently reading books written by psychiatrists about their work and their cases/patients. My advice is that you should definitely be interested in and passionate about psychiatry if you are going to specialize in this field. If you are not, the chances of burn out due to stress are extremely high. However, if you find that you are suited to work in the mental health field, it is an extremely rewarding career.
Thank you Ms. Myers for participating in our APRN career guide interview series!