About our Portland Psychiatric Practice
Greetings! My name is Justin Rice I am a board certified Psychiatric Mental Health Nurse Practitioner (PMHNP). My primary focus in psychiatry is medication management and therapy.
My nursing education started at Los Angeles County College of Nursing where as a student I worked in the (now) fabled ER C-booth trauma bay at USC medical center and in the trauma ER at Harbor/UCLA medical center. They even filmed a documentary where I went to school called “Code Black” which, unfortunately, is now a fairly inaccurate representation of emergent critical care (IMO). After graduating nursing school as class president I worked as a mixed specialty ICU nurse in a trauma center. I obtained my MSN degree from Gonzaga University with a focus on psychiatry and have been working as a nurse practitioner in multiple practice settings with a diverse array of people and conditions. While in graduate school I was inducted into Sigma Theta Tau, the honor society of nurses.
My transition to mental health came after several years working as a R.N. in critical care, around my patients who had experienced trauma both physical and emotional. Having a part in helping the human body heal from illnesses, wounds, disease, and traumatic injury was intensely challenging and rewarding. However, I could not help but notice that the physical recovery was at times superficial. My patients felt lost, confused, angry, depressed after their experience of hospitalization. They felt like their personality changed, who they were at their core. Many returned to my care with similar or different ailments usually from self neglect or poor life choices.
After much reflection it occurred to me that what was missing from my patients treatment regimen was good psychiatry and consistent therapy. Being critically sick is a traumatic experience; from an emotional standpoint, vulnerability is the order of the day. But vulnerability is a great place to heal from, everything out in the open and nowhere to go but up.
Motivated by this realization I transitioned to working as a psychiatric nurse in a Portland psychiatric hospital. I have worked with people healing from eating disorders, chronic and severe mental illness, drug addiction, alcoholism, and PTSD. I also spent time working with active duty soldiers returning from deployment overseas dealing with behavioral issues, PTSD, and chemical dependency.
My passion as a Nurse Practitioner, as well as the guiding philosophy for my practice is the concept of mindful recovery. William Anthony, former director of the Boston Center for Psychiatric Rehabilitation describes this concept perfectly; he identifies recovery as “a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles.” Recovery from constant anxiety, depression, disorganization, overeating, feeling irritable around family and friends. All of this requires an awareness to our own thoughts and feelings. I encourage mindful exploration- essentially becoming aware of our emotional interaction with the world and not judging our perfectly understandable human response. Change is absolutely possible!
In practice this requires an honest and sometimes hard look at ourselves. Taking to heart the question, “What is my part in all of this? In my own distress? What can I let go of?” Change is absolutely possible! While my focus is on medication management, I offer therapy and counseling to my clients. If a client does not wish to see me for therapy I generally recommend they establish with an outside therapist.
– Thich Nhat Hanh
“The best years of your life are the ones in which you decide your problems are your own.
You do not blame them on your mother, the ecology, or the president.
You realize that you control your own destiny.”
– Albert Ellis
My primary focus is on the use of medication to treat and begin to manage symptoms of emotional distress such as depression, anxiety, grief, fear, insomnia and inattention. I believe that psychiatric medication in combination with therapy is an invaluable tool to help reach recovery. In practical application this means helping you feel better!
I am often described as very direct, down to earth, and funny. The statement I most often hear from my patients after a few sessions is, “You are a lot different than I thought you would be! This was really helpful!”
I provide counseling, therapy, and motivational interviewing to help identify what symptoms you would like to treat. I believe in being direct and compassionate with my clients. At times I am very frank; this is in the hopes of staying as honest as possible thus helping you move forward at a more productive pace. It is very rewarding to see my patients accept things as they are, it is what it is.
Please note: I utilize therapy and medication management as my primary treatment tools. However, if you already have a therapist this is not problematic and I will defer to your therapist in this area. I enjoy consulting with other providers.
Many times clients ask me, “Do I have to take these pills for the rest of my life?” My philosophy is that it is entirely up to you. Some people prefer to take a medication like an anti-depressant or mood stabilizer indefinitely- they simply feel better and feel normal doing so. It is my opinion that some conditions require long term medication management, but again, this is up to the person taking the medication. Making a decision to care for mental health issues we may have, with or without psychiatry is called recovery. On the other hand, some of my clients use medication to reach a level of emotional balance so that they can work on their issues (grief and PTSD are often such conditions) and then they stop. It is not a weakness to take psychiatric medication. For most of my clients, this is part of self-acceptance without judgment. I encourage my clients to express their feelings around taking medication in non-judgmental terms. Instead of thinking, “I am always so depressed that I have to take psych meds” this sentiment can be reframed as, “I am taking medication because I am taking care of myself and moving forward in my life.”
What is a Psychiatric Mental Health Nurse Practitioner (PMHNP)?
Psychiatric-Mental Health Nurse Practitioners (PMHNP), and nurse practitioners in other specialties, are trained to competently assess medical symptoms, order laboratory tests, and conduct physical examinations in order to diagnose and treat ailments.
PMHNPs are specialty providers with additional training in psychological and psychiatric treatments, including counseling and medications. PMHNPs collaborate with primary care, specialty, and complimentary healthcare professionals, if authorized by individuals in treatment. PMHNP’s practice psychiatry.
All PMHNPs have undergraduate degrees obtained before or during their work as Registered Nurses (RN). Most often, nurses practice for several years and then pursue masters or doctoral level education in psychiatric nursing. After completing an advanced degree, PMHNPs take a comprehensive national examination to become board certified. Thereafter, PMHNPs are licensed by the state where they practice. PMHNP’s specifically practice psychiatry. All of these steps are legally required in Oregon.
To maintain a license and board certification, PMHNPs pursue a variety of ongoing educational opportunities in fields related to mental health and illness.
In Oregon Nurse Practitioners practice independently. We evaluate patients, make diagnoses and prescribe medications to treat conditions. When necessary we refer to other providers and different levels of care.