Psychcns 16,407 Views
Joined: Feb 10, '06;
Posts: 883 (44% Liked)
; Likes: 873
30 year(s) of experience
I assure you APRN's (depending on state) can practice medicine. I work for a hospitalist group here in Oklahoma at Integris Baptist. In the state of Oklahoma, Advanced Practice Registered Nurses can indeed practice medicine. TraumaRUs, thanks for the back up. No snark taken. By the way prescribing medications, diagnostic orders, referrals, ect. are all a part of practicing medicine.
Matthew McGill APRN-CNS,MSN,CCNS,CCRN
I would say Vinyasa yoga, restorative yoga, pranayama would lead toward "emotional intelligence". Yoga is mean to be the unity of mind-body-spirit and emotions are part of that. Mindfulness is meditation which is also part of yoga. Emotional intelligence as I understand it is paying attention to your emotions and trying to feel-sense the emotions of others. Attention to the breath helps. Deepening the breath also helps.
I went part time; it took about 3 years. Glad there was a part time option. Most people I knew needed to work full time while in grad school. I was already working in psych. My education built on what I had already learned in previous classes and what i had learned on the job. I actually prefer that it was not "an immersion experience." I had a high GPA and have had a successful career. I think many employers value work experience at least as much as education.
One way to manage anxiety is with structure. Have a consistent approach for each patient- a template. Have your own decision trees of when to ask for help. Negotiate for a reduced patient load for the first few months. Find a mentor. Find support. Try to stay calm. Best wishes. You can do it!
I drive on long, winding, country roads. The roads are paved here--always a shock when I come to the United States from my expatriate home in Costa Rica. I am in the first world now: it is early spring, still chilly from winter, no leaves on the trees. I am in my second locum tenens job ever--the lady on my GPS directs me so I don't get lost. I provide psychiatric care in a rural setting where patients have poor supports, poor health, and poor dentition. "Working here is like being in Appalachia." My colleague says. I am given a schedule of continuous appointments. The mental pain that people bring to me is draining. My role is to provide psychiatric diagnoses and to prescribe medication for their mental disorders.
I am trained as a therapist--psychopharmacology came later. As a therapist , I learned how to connect with people, how to provide a safe environment, and how to draw out a history. As a psychopharmacologist, this approach helps me to find symptoms that I can medicate. I try to listen, with all my senses. I am alert for counter transference, the feeling the encounter elicits in me. "Tell me your understanding of why you are here today. What's going on with you?" I say.
And their replies: "I don't like being around people." "I moved up here to be close to my kids and now they don't have time for me." " I suddenly found myself with a loaded gun in my mouth. I thought I was dreaming." "I was drinking and I ran my car off the road-I could have killed someone." "I can't sleep." " I get panic attacks when my uncle visits." "My boyfriend abused my daughter." "I sexually abused my daughter when she was 7."
Staying with myself I am grounded. I start with what I am told and look for ways I can be helpful. I ask questions. I provide emotional support. I end each session handwriting a few prescriptions while I mentally review the encounter to see if I missed anything. Sometimes patients need medications but can't afford them; in these cases, I may give samples or choose from the Walmart prescription discount list.
Time passes and the work gets easier. I am still swimming in mental anguish, a new patient every half hour, but I am getting used to it. Sometimes, I have a patient new to the facility and I can spend one and one/half hours doing a full diagnostic assessment. People wait months for these full assessments and look forward to finally having the possibility of some relief. I now have friends at work--clinicians I can talk to, a great support staff, and a helpful supervisor. My company finds me a house, a large homey condo with high ceilings so I can move from the hotel. I join a club so I can swim after work. Now, after hours of immersion in human misery, I swim refreshing laps. Driving home in my rented Nissan, I feel my tranquility and my humanness. I take care of myself. I no longer am drained. I can be there for my clients.
I meet a hospice nurse. We reflect on our jobs, how it can be difficult to find peer support. "We are in the deep waters." She says. I feel brave to dive into other peoples hell and help them bear their feelings. I talk to my husband in Costa Rica every day on the telephone. He can't listen to much about my work day. "It's hard enough for me to keep my own head above water." He says.
When I see a patient for a follow-up session, I often find that the meds I chose are working. People tell me: "I am sleeping through the night." "My anxiety is better." "My depression has gone. I feel like myself." "I feel better-no more mood swings." "I don't want to kill myself anymore." When people give me this feedback, I feel a sense of accomplishment. I tell myself I am a good clinician. I also know that patients can improve due to many factors including the placebo effect of medication, the relationship effect of the therapeutic encounter, or just the passage of time. What I love about my work is to know that I am a witness, or sometimes a guide, to an inner psychological place of mental and emotional healing. Sometimes I feel profoundly honored to participate.
I would take the H and P job. You would be working as an NP and keeping your pension and other benefits. It sounds like you could also keep the one day per week job for more experience.
As a psychiatric provider I have the same role expectations as a psychiatrist. Yes, we are regulated by our state BON, and we are usually credentialed as part of the medical staff.
More jobs for fnp.. Depends on how you want to spend your time. I only do psych and would not want fnp at all. Psych is about treating emotional pain, helping people find hope. You get to do counseling and prescribe meds. I'm sure fnp is interesting too. But I like psych..
If you don't pass take a review course. You need practice in how to take the test.
Those of you with criticisms of np education should figure out how to be involved in np
curriculuum development and accreditation of np programs. The field needs to evolve and would benefit from hearing from people with criticisms.
I worked in methadone in the 80's. Mental health and addictions were different than now. More services though this was when psychodynamic theory ruled. Client had mandatory individual and group therapy once week. Excellent supervision; a committed staff. Part of a teaching hospital with all the heavy intellect involved in training residents. Many clients on this program had jobs and had families despite their psychological impairments. Clients need for the methadone always seemed to me to be more than physical.
I worked in methadone maintenance as an RN a long time ago and there were always debates about the model. Clients found it stabilizes their addiction and their lives. Counseling was mandatory. Clients organized their lives around their dosing schedules with some driving many miles to be dosed between 6am and 9am when the clinic was open. A lot of axis 2 patients. Methadone seemed to have a psychological function as well as limitating craving for opiates. I learned a lot there.
Methadone uses a harm reduction model. It stabilizes the persons opiate addiction so they can develop coping skills. I worked in methadone for several years and I was always intrigued why people stayed on it. People organized their lives around getting their daily dose between 6am and9 am and there was mandatory individual and group counseling.
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