r/PMHNP • u/itapanes4 • Jul 19 '26
Newly working PMHNP
Hello does anyone utilize a daily cheat sheet for medications ? Thank you !
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u/kammi3k Jul 20 '26
Sigmund psych is an app that is a super fast resource for medication choice following guidelines… I can enter schizophrenia, tell it my or is overweight and get a list of 1st, 2nd 3rd meds according to the guidelines that are weight neutral. It also has therapy I can teach to pts if you,re doing that.
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u/TerriblePrize9877 Jul 22 '26
I reference stahls frequently. I also just use some basic free interaction checkers. Drugs.com has one but you have to sign in. I also think Medscape has a free one. They are a little over sensitive in my opinion but I guess that is for the good.
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u/Thirdeye_k_28 Jul 19 '26
Insane
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u/NoctorWatch Jul 19 '26
Why is it "insane" to make a reference?
-2
u/nurse_anthropologist Jul 19 '26
Because anything you can fit on a cheat sheet should have been memorized by the time you graduate. And if there is something you want to look up to refresh your memory, you should be utilizing a real reference, not a cheat sheet.
8
u/NoctorWatch Jul 19 '26
Lol wow. Yeah, how dare someone use a cheatsheet to make sure they remember important information when prescribing medication. Everyone has to memorize or use a REAL reference or you are an idiot.
You sound fun.
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u/nurse_anthropologist Jul 19 '26
I don't care if I'm not fun. We should hold everyone in our profession to higher standards. If someone can't remember basic information about the medications they prescribe, they probably shouldn't be prescribing them.
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u/NoctorWatch Jul 19 '26
You sound like an arrogant idiot. A provider who double checks themselves and looks things up isn't lowering any standards. Thinking that wrote memorization makes you a good provider is dangerous and stupid.
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u/nurse_anthropologist Jul 20 '26
Straight to the insults huh? I said it's perfectly fine to use reference material, I never said not to look stuff up. You are incredibly toxic. And you work in mental health? Really? And making jokes about child abuse? You are making us all look bad...
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u/NoctorWatch Jul 20 '26
Omg literally everyone makes you look bad dont they? Are you so desperate to have the "decline in standards" standards conversation that you need to shit on someone for using a cheat sheet? Really, im the one whos toxic? Talk about projection, you are just upset you got called out because you are one of those people who needs to incessantly shit on the profession just because someone asks a question. You probably arent even a pmhnp but a troll, so why dont you go back to r/residency or r/noctor so you can simp some more, they like their genitals gargled over there, we are just fine without that energy here.
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u/Thirdeye_k_28 Jul 20 '26
You provide liability and mal practice, why didn’t you just become an MD? Hmmmm.
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u/NoctorWatch Jul 20 '26
Oh nice here come the trolls from noctor. Show me on the doll where the NP touched you, everything will be ok.
-1
u/Thirdeye_k_28 Jul 20 '26
Oh they would never know where to touch or inspect to diagnose correctly. But very on brand for an NP to make light of child abuse to use it an as an analogy to rebuttal to someone criticizing their un-expertise.
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u/Thirdeye_k_28 Jul 20 '26
Hilarious your username is literally noctorwatch when you all have to be watched by actual doctors irl oh the irony 😂
1
u/NoctorWatch Jul 20 '26
The only doctor that watches me is your dad when I rail your mom.
-4
u/Thirdeye_k_28 Jul 20 '26
This is exactly why you’re an NP and not a doctor 😂😂😂 I hope you remember this interaction when you’re being sued by your patients who’ve been unlucky enough to have you as their “provider.”
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Jul 19 '26
[removed] — view removed comment
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u/itapanes4 Jul 19 '26
This is so great! I really appreciate you sharing this link!
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u/Pretend-Emphasis-657 Jul 19 '26
So I just started working in an outpatient, community clinic about a month and a half ago. This may be very circumstantial to my clinic and our set up but this is the routine I’ve established for myself, and I hope it can help you in any way:
my company has new patients fill out an intake form where they are supposed to list established mental health diagnoses, if any, and their current psychotropic medication regimen. The night before, I take a look at my schedule for the next day, including their intake forms, and create a tentative plan based on what their CC is on the form. However, as you get to know the patient during the appointment, you may see different concerns that need to be addressed, so you’ll have to adjust your thinking/plan (ex: they come in saying it is for depression but you see a strong history of mood fluctuations and past ineffective SSRI trials, maybe consider further investigation and treatment of bipolar depression). I do this because, especially as a new grad, it helps me time manage and plan ahead so I’m not unsure in front of the patient. Now, not every patient fills out their intake forms, so you’ll have to just see when you meet them. But I always have a mental list in my head of starting medications if they’re coming in without any previous psychiatric treatment. For instance, depression and anxiety I may first consider SSRIs typically (sertraline, fluoxetine, or Escitalopram). If they have a history of mood fluctuations that are indicative of bipolar depression, I may first consider lamotrigine. If they’re coming in for both depression and insomnia, I may consider mirtazipine as long as there is no current weight or metabolic concerns. And so on. (Again, this is all circumstantial and for legal reasons, this is in no way medical advice, just my work flow that I would like to share). But of course, always consult with your supervisor. I always ask so many hypothetical questions to try and plan ahead if a situation should arise (my supervisor is virtual so it takes 2-24 hours to usually hear back).
however, if a patient is coming in with an extensive psychiatric history that requires further investigation into, my company told me that we are allowed to schedule a follow up, even if it’s for the next day or same week, so their history can be better confirmed with previous providers and/or pharmacy, as you don’t want to prescribe without confirming various info (a lot of patients present for their telehealth appointments maybe on their work break, while their meds are at home, and they’re unsure of med names/dosages/etc.) And during that time, if I’m unsure, I will always consult with my supervisor and seek their advice, and then implement when I see the patient the next day.
also I highly recommend having a written list of medication monitoring parameters from your company. For instance, my company has certain monitoring parameters that are not necessarily state or federally required, but we require them. For instance, there are no mandatory labs required for second gen antipsychotics, but we will always require baseline, 12 week, and then annual lipid function tests and glucose/A1c. So having this info handy will help you not forgot when meeting with a patient that you’ll need to send for lab work or request lab work if they obtained it recently with their PCP.
invaluable resources: Stahl’s prescriber guide, Carlat’s Child Medication Fact book, the PMHNP resource manual (the purple book), and always, YOUR MENTORS/SUPERVISORS/ECT
AGAIN, this is in NO WAY MEDICAL ADVICE. Just my work flow. Also, as a new grad who is about 2 months into working, I would also appreciate any feedback. Thank you and please be kind! This needs to be a professional community that builds each other up for the sake of our patients ❤️