Psychcns 15,171 Views
Joined Feb 10, '06.
Psychcns is a Psych APRN.
She has '30' year(s) of experience and specializes in 'Psychiatric Nursing'.
Posts: 883 (44% Liked)
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.
Part of milieu management is overseeing a group program so that patients learn coping skills and other things during their hospitalization. It also gives a structure to the milieu. 1:1 meetings with patients to assess their safety and their participation in treatment is also important. Searches, safety checks, visitors..you might want to get a psych nursing textbook so you have a good understanding of the specialty.
To the APRN hecklers, critics and malcontents.Many of you say that your MSN nursing education has too much “fluff”, referring to classes like cultural competency, and management that have no relevance to your jobs. I have read very little about how you will address this with the people that accredit NP curriculums.
I am not sure of the credentialing process at all but I did find the American Association of Colleges of Nursing on the web and this seems like a place to start. In 2013 they developed NP competencies in which we are all expected to be proficient.
These competencies expect cultural competency, trauma informed care, as well as all the things you complain there is not enough of such as pathophysiology, pharmacology, physical assessment. I have been in nursing since the early 80’s and have been through a few transitions in health care and in my own nursing career. Now I just try to keep up. I have no venom to toss at nursing leaders. I am very grateful to the nursing profession for my livelihood. I work locum tenens as a psychiatric APRN. My advanced practice nursing skills allow me to find work in interesting settings on a limited basis. This semi nomadic lifestyle is mine by choice. Everyone wants to hire me permanently.
The APRN role exists because of the dedication of nursing professionals with advanced degrees who have done the hard political work of fighting for the opportunity for all of us to practice to the full extent of our education. This means that our education prepares us to diagnose and treat illnesses in our respective specialties. We have a record of patient outcomes similar or better than MD’s. We are not MD’s and we are not junior MD’s, we are nurses. If we were MD’s we would be regulated by Boards of Medicine, physician extenders of some sort. As nurses, regulated by Boards of Nursing, we are eligible in many states for independent practice. There is an overlap between MD’s and NP’s and this is where a lot of NP’s and MD’s practice: Seeing patients one at a time in inpatient or outpatient settings. Since we are doing the same job as MD’s in many cases we do need to catch up on their rich science background and the intense mentoring they get in residency.
Or we can wonder how much education do we or they really need to do this job? We probably do not need nursing theory at this stage of our development as a profession though I did like my theory classes. We probably do not need healthcare management classes though I learned in those classes also. In today’s day to day NP jobs we need to keep our diagnostic and prescribing skills sharp to give patients the best care that we can. We often have MD role models and some are surprised we are doing the same jobs as them and many are happy to consult on cases and make use of their intense education. To my colleagues who are angry with the nursing profession that benefits you, I would encourage you to review the history of nursing (we were housecleaners one hundred years ago), and as science developed nurses had to fight the AMA to be professionals as opposed to handmaidens or servants.
At one time only an MD could take a blood pressure. Now we are fighting for the right to practice to the full extent of our education. We are nurses and we need to continue to define ourselves differently from physicians. That we are different from the medical profession has benefited us politically and gives us the responsibility to self-regulate our profession.The people with the energy and aptitude to criticize should learn to become political. Start by looking up the website I note above and figure out how to have input into curriculum development. You might have to join a committee. This is how hard work often starts. As in today’s general politics it is possible the nursing leadership is losing touch with its base.
Those who see what needs to be done would benefit all of us by becoming active and help to maintain and improve standards and influence the direction of the nursing profession.Best wishes.
Also, call the person who is prescribing your
medication, tell him/her you are still depressed
and you would like a referral for counseling. You
do not have to suffer alone. Give yourself
time to heal..
You might want to get some psychotherapy to help you sort everything out and be successful at the new job. Best wishes.
OP-since you have an interest in addiction and pain management, have you considered any additional certification. There is CARN (certified addiction registered nurse). I think there is alsocertification in pain management nursing. As elk park says, working with these patients takes expertise and sensitivity. Why not learn more about it. I would think the pt would need to manage her pain without triggerring a relapse or at least be ready to deal with a relapse. I bet there is a role for nursing in all this. At very least to learn how to best support the patient. Best wishes.
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