Content That Psychcns Likes

Content That Psychcns Likes

Psychcns 9,977 Views

Joined Feb 10, '06. Psychcns is a Psych APRN. She has '30' year(s) of experience and specializes in 'Psychiatric Nursing'. Posts: 771 (40% Liked) Likes: 671

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  • Apr 29

    Quote from Psychcns
    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.
    You're correct about methadone maintenance therapy, but methadone can also be used as a taper to get people off opioids entirely (including methadone). Two different models of treatment.

  • Apr 29

    ^^ This is one reason I think IUDs are a wonderful invention! Pills are too easy to forget.

    Although we also need to be sure people understand that to prevent transmission of STIs, condoms and dental dams etc need to be properly used.

  • Apr 28

    I agree it is the future of nursing! I think the AACN has made that pretty clear and I agree that their intent is correct, even if their vision is a bit muddied. I know exactly why I am pursuing the degree and how it will enhance my career. I just thought it was interesting that it was difficult to explain to someone outside of nursing who, as I suspect the average layperson might, had difficulty understanding the new degree and it's impact. It's hard to explain evidence based practice to some one who only watches Grey's Anatomy :P And I won't feed the silly troll-it's always amusing that some one would waste their precious time trying to argue with internet strangers! Thanks for your input APN student and to you too, Blue Bolt.

  • Apr 28

    Quote from sauce
    well, if they are doctor title hungry and they go for the DNP instead of MD, they probably just couldn't hack it out in organic chemistry or physics and went the pseuododoctor route
    Another ignorant statement: I have a doctorate like many military CRNAs do. I did fine in organic chem and physics.
    In my NA school we had to take pharm and physiology with the medical students and the SRNAs consistently out scored the medical students.
    A nurse having a doctorate does not mean they are a physician wannabe. It just means that they had a desire to obtain a terminal degree and often a desire to expand their education even further than what was offered on the Masters level.
    Physicians do not own the title of Doctor nor does any academic branch.
    It does not cause harm if a nurse utilizes the title Doctor in the clinical setting unless you consider bruising someon's ego that gets butt hurt when a nurse has a Doctorate and utilizes the title by saying, " Hi I am Dr. X your nurse practitioner".
    There is this great myth among some phyisicians and unfortunately some nurses too that there is this giant movement of rogue nurses that are just getting a doctorate so they can pass themselves off as physicians. This is nothing more than a ignorant myth. Nurses should be happy that their brethren are getting advanced education and not trying to put down other nurses as physician wannabe just because they want to pursue a doctorate.

  • Apr 27

    Quote from sauce
    basically what psychCNS said is if you like real science nursing isn't for you.

    Thanks for admitting nursing isn't real science.

    its pseudopsycholophilosophiEnglish 101

    its not even worth the ology.
    That's not how I interpreted what psychcns said. Psychguy has repeatedly expressed an interest in studying neuroscience, specifically, and his personal dissatisfaction with nursing. I don't see how encouraging him to pursue what really interests him is any kind of criticism or characterization of nursing. Doing so would certainly make more sense than continuing to stay in nursing and continuously kvetch about how much you dislike it, as many people here do.

  • Apr 24

    OP - I actually do believe you when you say you were a casual user of MJ and I feel a lot of compassion for you - this too shall pass but what you want to do is let some time pass on this test. Here is my sincere advice 1. Don't use marijuana again. Even in states where it's legal it's still against federal law. The Nurse Practice Act in most states requires nurses to abstain from criminal activity or crimes of moral turpitude. Since smoking Marijuana is a federal crime - it technically disqualifies you from the practice or nursing. The BON's mandate is public safety in that they apply the reasonable person rule which asked if a reasonably prudent person with good judgement would do this act? The same concept goes for drinking. It is illegal to drive under the influence of alcohol. On average the limit of 0.08 is approximately two drinks so a reasonably prudent person should not drive after having two drinks I would argue that driving after one drink is hazardous but then I'm a sober alcoholic who has paid my dues to the BON. Your BON application only asks if you have ever been arrested for or in treatment for a substance abuse disorder. So unless you are an addict and you successfully find a school that will take you, you can honestly answer this question no. Most states will let a new nurse who is in recovery practice but you have to jump through hoops and stipulations to do so for something like 3 to 5 years. It adds a lot of stress to your life. So stop smoking weed, find a school to take you and go from there. Good luck to you.


  • Apr 18

    Huh. Psychguy, it's not very nice to roundly disparage an entire profession, especially on their own board. I am sure you are very intelligent, and I am glad you have a job you love and are well compensated for it. I am quite intelligent myself, and also love my work. I enjoy being able to stretch my brain past its limit almost every day. I enjoy the challenge of working through a puzzling case. I also enjoy being the one writing the orders, writing the plan, and being a clinical team leader. I like knowing that I have so, so, so very much to learn over these next 5, 10, 50 years. It's exciting. Not everyone likes that stuff though. Nurses who love working the floor are not simpletons passing out dilaudid on autopilot.

    It's one thing to say that being a CNM/NP/PA requires a deeper thought process and a wider knowledge base than nursing. That is true, as a general rule. It is also true that not all RNs have the cognitive skill to be a clinician. That's okay. But in no way does that imply that career RNs are not intelligent, just because they are satisfied with their job.

    I do, however, agree that we have dug ourselves into a hole with the glut of NP grads we are churning out from some very questionable schools. Not good for the profession or for our patients. While I do not support DNP as entry to practice, we need to shore up the standards for NP education, like right now. No more of this find-your-own-preceptor bullhockey.

  • Apr 18

    That mindset is toxic to your well being You must never compare yourself to others.Stay in your own lane,focus your energy on what your interests are and what you need and want. It is even OK if you do not know what that exactly is at this point. The truth is you really do not know all the trials and tribulations they may be going through. It takes years to become comfortable in these areas of nursing and even then its constant learning.

  • Apr 16

    Maybe a good starting place would be to see if there are any existing policies or protocols that aren't being implemented appropriately.

    Also, things like skin care/ turning and positioning are often a shared responsibility between the nurses and CNA's in a LTC. Working with the CNAs caring for your residents to provide them education and defining your expectations for patient care. It also helps if you role model what you expect and build a rapport with the CNAs.

  • Apr 16

    You can do preventative care and advocating for patients when you're on shift and caring for the patients.

    Do NOT go and point out how things aren't done right in your new place. Do not compare the care your coworkers provide against the "well rounded and exceptional" care. You're a new comer. You don't get to rock the boat.

    Lay low for a bit, and after a few months you can start bringing issues up to your manager. But present it in a way that is constructive--"I notice that there is no formal charting on BMs here. It is hard for me to determine whether or not a patient needs to start a bowel routine or not without it. How should I proceed? What do you suggest I do?"

    Do not start turning the place around just right off the bat. You will be seen as a know it all.

  • Apr 15

    That stinks, it does sound like your in a sticky situation, but here is the quickest fix I can think of.

    Well the big thing is that everything is repairable knowledge wise. If you still have your physical exam and health assessment book I would finger through that too, in addition to what was stated above. The most important thing is just taking a good history and formulating a decent ddx. The rest of everything else is stuff that can mostly be looked up. I am not sure how strong your physiology and pathology is, but that does help too. Clinical decision making is pretty much the most important thing though and PE/health assessment books can help with that.
    Looking up the most common chief complaint, memorizing the right questions to ask, most common etiology behind that complaint (pathogensis helps also but is not directly required for diagnosing at the PCP level), and be able to explain it to the patient is of high yield importance.

    There are quite a few common chief complaints, but you can look up online and find the most common. Usually they include (insert body area) pain, diarrhea, fever, weakness, not feeling right, anxiety, depression, fatigue (different from weakness), MS injuries, abscesses, infections, lung issues (look up DDX for all of these), etc.

    It is doable and as long as you take initiative you will probably be fine.

    Drugs, treatment, etc can all be looked up at the time of the diagnoses so focus on those last, but many treatments are self explanatory. Understanding the red flag drug interactions are important though also, but epocrates and Medscape have a decent interaction calculator. It is highly sensitive and many of the interacts below the series/contraindicated level do not occur often.

    At least you have a slow pace to work at though, perfect for learning. Self learning is a powerful tool if used correctly and a year from now you could kick some major a** once u get everything down

  • Apr 14

    Do I understand correctly that he is asking you to waste with him a narcotic drawn up (not in the original sealed vial)? If so I'd be very wary of putting my name on this as you have no way of verifying what you are wasting.

  • Apr 12

    It always varies, but from what I've seen, FNP's can easily get up to $70/h locum tenens. For psych, since it's a specialty and in high demand, they often offer up to $100/h. Definitely shop around and always ask for more than the minimum you are willing to take.

  • Apr 10

    In 20+ years in healthcare i can count on one hand the number of MD/PA/NP I would actually call impressive. Not saying all the others were bad, some were and the majority were decent. The impressive ones maintained their learning lifelong and they shared what they knew. These were not individuals who boasted or bragged about what they did because they were too busy being excellent. I have no idea where they went to school or where they finished in their class, but they set the standard that i aim for and probably will never reach.

    In general everyone else was that person wearing a stethoscope following guidelines and the is no always a bad thing. The ones who do not follow guidelines - those are the ones who scare the P out of me!!

  • Apr 10

    How are you making $200K? I saw you were posting to the student nurse forums in 14. If I pop on indeed, the highest paying job I've seen is around 150K. Do you have give a percentage of your pay to the owner for overhead? I would DEFINITELY like to pick your brain on how to negotiate for a high salary and/or what facilities/opportunities will allow for that kind of salary with a such a "fresh" advanced certification Good for you! I am a single Mom with no help from the Dad and TONS of student loans so would appreciate any advice!