Content That Psychcns Likes

Content That Psychcns Likes

Psychcns 10,443 Views

Joined Feb 10, '06. Psychcns is a Psych APRN. She has '30' year(s) of experience and specializes in 'Psychiatric Nursing'. Posts: 803 (41% Liked) Likes: 712

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  • 6:25 pm

    These are all amazing suggestions! I thank you all! I may come out of this shining yet! Having never done this I am maybe over thinking things. I feel so much better now but keep those suggestions coming if you have them!

  • 6:24 pm

    As a risk manager, I write a ton of policies. I am a big believer in not reinventing the wheel. One of the first things I do when writing a new policy is to Google for the policy. For example, I wrote a policy the other day on giving extracted teeth back to patients upon request, and my Google search was 'policy on giving extracted teeth to patients', and I found many helpful policies, links and articles that I used to write my own policy.

  • 1:00 pm

    Heck forget about mailing your resume...stop by and drop your resume off in person! I have many many friends who found jobs that way..usually in privately owned practices. The physician owners are too stressed and too busy to hunt for an NP. You should go to them!

  • 12:26 pm

    There is another way to look at this, rather than it being NPs v Physicians. I would question whether technology is making physicians, if not obsolete, definitely required less than in the past. Is the system stuck in the 19th century and not taking account of standard medical protocols that people with pretty basic training can follow rather than needing specialists. All the information needed is right there at a click of a button. I see people saying nurses can't be surgeons but right now there are robots capable of performing surgery independently, yes they're new and can only do limited things, but it's just the beginning. I can foresee a time when we only have a fraction of the doctors we have now and more specialist mid level practitioners providing a limited range of medical care following country or at least state wide protocols written by the physicians. Robotic Surgery Just Got More Autonomous | AAAS - The World's Largest General Scientific Society

  • 12:21 pm

    Sorry but I had to laugh. Not as highly regulated? Did you really say that? You are obviously not a NP. No NP would ever say something like this.
    We are much more regulated than MDs.

    Quote from AAC.271
    I'm not trying to be rude, but I'm just being honest. Becoming an NP opens up so many opportunities that your won't get from medical school because our profession is not as highly regulated yet. In med school, your board scores determine what physician you become, for NP's, we can go from anywhere from GI to Cardio to FNP to deem to psych. Plus, with independence going on and e3qual pay going on, we can practice and earn just as much as doctors.

    NP profession might become more regulated 20 years from now when they try to equalize with DO/MD and extend the length and quality of education, but at the present, it's the easiest and shortest way to becoming a doctor (I count DNP or DNAP as doctors). Lower requirements compared to MD/DO and many solid state/online programs that are CHEAP. Plus, the curriculum is not as science intense as medical school, but do you really need that much science? Is memorizing kreb's cycle and all that biochemistry stuff really that useful in the long term? So much less stress than having to deal with that intense regimen. You save so much money and can even be working a part time or even full time job while completing your MSN/DNP.

    Basically what I'm saying is, now is the best time to go to NP school while it is relatively easy to get in and the requirements are not very high as compared to MD/DO schools.. AND it is the best because you can basically go into any speciality you want to go into--maybe not surgery--and not be limited by your board scores. My friend is working in a dermatology clinic and she loves it. You can't go into dermatology in medical school unless you have fabulous board scores.

    Also, it's great to not have to go through residency. They are paid so little as BlueBolt indicates.. You start off with a very good salary and once you feel confident, you can practice wholly independently. This is how the profession should be done and that's why I think NPs are the way of the future.

    With DNP degrees required now, we have the right to be address as doctors by our patients because we worked hard for our degrees. MD only has the prestige of being called Doctor, but with every other profession getting terminal degrees, it is no longer as special or prestigious (think DNP, pharmacy, OT, PT etc...). Now becoming an MD is more if a burden than a blessing and honor.

    I initially considered going to medical school, but I just didn't have the scores. I am a very personable person though and I work great with people and I get high reviews from my peers. I like how NP schools don't place such a crazy emphasis on scores, but more on holistic evaluation of the candidate. ITs why our profession generates so many well liked NP's and not the nasty uptight physicians.

  • 12:21 pm

    Quote from nomadcrna
    Sorry but I had to laugh. Not as highly regulated? Did you really say that? You are obviously not a NP. No NP would ever say something like this.
    We are much more regulated than MDs.

    1. I never implied the NP field is not tightly regulated. What I was trying to say is as we gain more privileges and independence, the need to regulate the curriculum and training, CME, and other aspects of our practice will increase by necessity if we strive to ensure the best possible care with patients and to show some parity with the MD/DO Degree.

    Also, I am a sNP.

  • 12:21 pm

    As a MD, say Family Practice, IM or EM. You can do derm if you want. You can do peds, you can even limit your practice to cardiology. You have an unrestricted medical license. Very easy to do.

    Sorry but you simply don't understand.

    No, it's only one or two states that try and limit the use of "Dr.". I'm called Dr. in the 3 facilities that I practice at.

    On the residency. 55-60k for 45-50 hour work weeks. Much more than .11 cents an hour. Depends on your specialty. Family Practice, IM and EM the average is 45-50 hrs/week. Anesthesia is about the same. Surgical specialties are more. Just depends.

    AS someone who has had all the various sciences such as Organic, biochem, biology, physics etc. You are right, they are very little help and you forget them very quickly.

    Quote from AAC.271
    What I mean is that you can choose to go into those speciality fields more easily than for medical students since they have to go through a residency and not everyone can receive a residency offer for dermatology. My NP friend was hired to work at a dermatology clinic and learned all the info she needed during orientation and on the job training.

  • May 24

    Quote from Jules A
    Meh. Some decent articles but they are all too old to be considered relevant now especially with the large numbers of NPs with minimal nursing experience being cranked out each year by all schools, not just the for profits with bad reputations. My fear is the outcomes won't be this rosy going forward.

    Anecdotally speaking from the medication regimens I see on the acute psych unit as well as repeated hospitalizations of certain prescribers patients the quality of new grad NPs is declining each year. Multiple antipsychotics which is not supported by any evidence I've ever seen. Benzos and stimulants galore for patients with suicidal gesture history and active substance abuse its both ametuer and dangerous. The physicians are starting to comment on it and its embarrassing.
    I totally agree with some of these sketchy for profit schools somehow getting accredited and churning out new NPs that have no business practicing. It infuriates me to see these
    programs take students with extremely low GPAs, no healthcare experience all because they are willing to pay exorbitant amounts on tuition. Then they come out, go into practice without knowing their ass from their elbow. It reflects poorly on all of us. I know the AMA keeps a tight leash on med schools- with the idea that not everyone is cut out to be a physician. I simply cannot understand what our game plan is.

  • May 23

    Quote from Cwoods
    Hey Jules,

    1st, thanks for your feedback. Your posts are always too legit to quit.
    2nd, how did you land a gig at >$90???

    Do you know any FNPs/ACNPs making that kinda of cash? I am in a dual FNP/ACNP program. Thanks!!!
    FNPs in my area make significantly less than psych right now usually $100,000-$125,000 year and no clue about ACNPs although based on the acuity they deal with I'd hope they are making serious bank! They are rock stars working as hospitalists, I love it, and hopefully they know how to negotiate an acceptable rate.

    As for my rate the $90 an hour was a year ago, I make that at my benefitted job now and my part-time/prn rate, W-2 not 1099, is $115 an hour. They way I got $90 was to ask for it. It really isn't that difficult, especially if the market is strong and one knows their value. Most of the places who approach me for jobs do it because someone recommended me. I have several psychiatrists who are friends and I know how much they make. Paying me well as a NP is peanuts compared to what the Docs make so anytime an employer tries to be cheap its actually kind of humorous and never flies.

    I work several part-time and PRN jobs so every time I talk to someone about starting a new one I inch my salary up and then if I take the job I share this information with my other employers who will match the rate. I usually throw my rate out fairly quickly in the process as I don't want to waste anyone's time. One of the keys is that I absolutely refuse to negotiate, "XYZ is my rate" and if they want my services they will pay it. No biggie, not contentious at all, I simply express my appreciation for their time and consideration and end the conversation. With my present employers when I ask for an increase I am always willing to walk if they won't match my rate which so far has not happened. I don't recommend bluffing or back pedaling if someone balks at your stated rate, it ruins credibility, imo. Good luck.

  • May 21

    Quote from BostonFNP
    Mundinger, M. O., Kane, R. L., Lenz, E. R., Totten, A. M., Tsai, W. Y., Cleary, P. D., ... & Shelanski, M. L. (2000). Primary care outcomes in patients treated by nurse practitioners or physicians: a randomized trial.Jama, 283(1), 59-68.

    Lenz, E. R., Mundinger, M. O. N., Kane, R. L., Hopkins, S. C., & Lin, S. X. (2004). Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Medical Care Research and Review, 61(3), 332-351.

    Hoffman, L. A., Tasota, F. J., Zullo, T. G., Scharfenberg, C., & Donahoe, M. P. (2005). Outcomes of care managed by an acute care nurse practitioner/attending physician team in a subacute medical intensive care unit. American Journal of Critical Care, 14(2), 121-130.

    Horrocks, S., Anderson, E., & Salisbury, C. (2002). Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. Bmj, 324(7341), 819-823.

    Newhouse, R. P., Stanik-Hutt, J., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., ... & Weiner, J. P. (2011). Advanced practice nurse outcomes 1990-2008: a systematic review. Nursing Economics, 29(5), 230.

    Litaker, D., MION, L. C., Planavsky, L., Kippes, C., Mehta, N., & Frolkis, J. (2003). Physician–nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients' perception of care.Journal of interprofessional care, 17(3), 223-237.

    Sackett, D. L., Spitzer, W. O., Gent, M., Roberts, R. S., HAY, W. I., LEFROY, G. M., ... & GOLDSMITH, C. H. (1974). The Burlington randomized trial of the nurse practitioner: health outcomes of patients.Annals of Internal Medicine, 80(2), 137-142.

    Nice!!!! We do it better!!! Though to be fair the lead authors like m. O. Mundinger are NPs, but data is data!

  • May 20

    I think for the betterment and advancement of nursing increasing the entry level education requirements should be considered, that said some of the best nurses I have ever known are diploma and ADN nurses. To the point of "fluff" courses I think they should actually be encouraged; consider how many physicians we work with are "socially awkward" because most of their training was hard sciences. The classics and humanities may not make for better clinicians but may make for more well rounded human beings. I believe in a classical education that emphasizes art, logic, and philosophy, if nothing else it will elevate conversation at the nurses station.

  • May 15

    I get the OP's point, or at least I think I get what they're saying. Basically "do something about it or quitcher ********".

    Problem is, most of us are not wired that way. We went on to become APRNs because we enjoy clinical practice, whereas these programs are developed by those who enjoy academia. This disconnect between practitioners and academic types exists in many professions. Nonetheless, we the practitioners expected our programs to prepare us to be practitioners. We are dismayed by the waste of precious time and effort studying crap that does not benefit us clinically. This is one of the reasons I have not gone on to pursue a DNP. Doctor of Nursing PRACTICE? I want a program that will help me to advance my clinical skills. This is not evident in the curriculum of the DNP programs I have investigated.

    I, too, am grateful for the nursing leadership and the advances that have been made for us. However, I do wish the academics would realize that we would have a better chance at securing more rights, e.g. independent practice nationwide, if we could demonstrate more relevant academic rigor in our APRN programs. (Oh, and don't get me started on the lax admissions processes...)

  • May 15

    LOL! I thought this thread was about family members' overnight accommodations.

  • May 14

    The same thing happened to me, but I didn't receive the official written offer until my first day of orientation. I don't think it would hurt to call back to confirm your start date.

  • May 13

    Positive impact =

    options for future career changes or opportunities

    potential for more credibility depending on the work environment

    better understanding of administrative and ethical considerations

    terminal degree

    Everyone has their own opinions of the degree's worth depending on their personal and professional situations. Your outlook on the DNP might not apply to me because of where I work or my personal goals for my professional life.

    I agree that the DNP should be a fully clinical degree based on advance practice instead of a catch all for all terminal degree options. Unfortunately this is the way the AACN wants it done. I'm disheartened by the pessimism in this thread because many are trying to apply their personal opinions as fact. Not all DNPs come from Walden or Phoenix. Not all facilities or agencies feel the DNP is a worthless, undifferentiated degree from an MSN.

    Again, I may be speaking totally out of naïveté since I don't start until the fall, however much of the pessimism I've seen has come from others like me who don't have the degree or haven't been fully through a program. If you don't see value in the degree, that's cool. To each their own. For me though, I see that the benefits are worth it to me. If I find that much of it is BS, then I can help to make it more of a worthwhile degree once I complete it and help to shape future practice.

    I relate this conversation somewhat to the people who complain about politics but don't take the effort to vote or be active in the process.