Psychcns 12,790 Views
Joined Feb 10, '06.
Psychcns is a Psych APRN.
She has '30' year(s) of experience and specializes in 'Psychiatric Nursing'.
Posts: 875 (44% Liked)
I have been doing locums for the past few years as a Psych APRN. I am expected to assume a full pt load with minimal orientation and to be able to navigate the system to complete work.
I think a regular job in a collegial environment would be much more supportive. I think the first few months a new PMHNP should have a reduced workload to have time to consult and look things up though I suppose not everyone needs this.
I suggest putting your resume together and be ready to send it out. I have been doing locum tenens for several years and it is so much easier to work in 8-12 weeks blocks of time and just do clinical work within a constrained time period.
I would not tell them you are thinking of leaving until you are ready to give notice. As someone said to me once, "they start treating you like you already left."
You could call a couple of locums companies to see what is available. I got an email this morning from locumtenens.com that they have "hundreds of psych np jobs" in four of the states I have licenses. I work mainly with Staffcare-I give them my availability, and they try to match me. I usually go back to the same places because it is less stressful for me.
i would reread everything Jules said, start planning your trip with your friend, and start looking for other options
She could also list how long you have been seeing her, how often, that you work on relapse prevention issues to help maintain sobriety. She could also describe your current mental status. I.e. That your thoughts are logical and goal directed, that your thinking is reality based free of delusions, that your insight and judgement are good
i think it is hard for anyone to predict the future.
Is Kentucky independent practice. If not find out about barriers and cost of supervision/collaboration if you want to set up your own clinic.
maybe you could look into,a geripsych or medpsych unit. I think psychiatry evolved from neurology so there is an overlap.
This is a quote from OP above
. I was spoken to the other day for asking the woman who handles our referrals if there was someone local who handled bariatric surgery requests (something I've only had a patient request once) because I should have known the answer.
This is bullsh*t. Not only is it disrespectful to be told "you should have know the answer." It seems they are looking for a list of things to terminate you. How did it get to your boss that you asked The referral person a question about referrals.
Have you sent sent out resumes. Any prospects? You cannot thrive in a non-supportive environment like this.
-if we are "physician extenders"we have to report to medical staff
-if we are regulated by Nursing, people say we could report to nursing
-if we are midlevels, and a lot of us don't like being called this, we are in the middle of nursing and medicine
-I like being called a provider...as long as it is a good job
When people say "bad fit" they want you to resign. Get your resume together and apply for part time jobs. Tell new place job is not a good fit because you need part time and they want full time. Don't say anything bad about employer. Labor lawyer or someone could help you extricate yourself on good terms. There are other jobs and you only need one. Maybe a minute clinic or urgent care to get back on track at part time.
Maybe and this might be bold: Have a meeting with the supervising md and the other relevants to negotiate how you can leave on good terms with at least one written reference. Maybe have a labor lawyer or similar assist. And I think after this you could see if you qualify for unemployment. Sounds awful.
or just have your coworker give you a reference.
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.
OP- people say classes are fluff because they are not related to hard science,diagnoses, or prescribing. I think there are politics and requirements for schools to be accredited. Maybe ask your professors. I don't know how it gets decided what is included in a curriculum. i never felt inadequately prepared and i have learned the most from researching and consulting on difficult patients.
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!
Nurse managers often have a lot of different disciplines reporting to them. NPs should be grouped with other providers in terms of reporting. Makes no sense for providers to cross train as staff nurses. If all providers are reporting to a nurse administrator, that is fine. But it seems some places are expecting NPs to be NPs and staff nurses as one job description. If an NP has that much down time the position should be eliminated.
@trauma. I have written three articles for allnurses. Waitning for inspiration for the next step! I want to be paid and have something regular. I also like literary magazines. I want to write about living as an expatriate and working as a locum tenens. How I took the plunge to do something different like this. The rewards and the obstacles. The shape of this I get bogged down. Thanks for your interest.
The other thing to consider is "what do you mean by managed?" In the chain of command, I understand that nurse managers are responsible for their staff. There is no way a nurse manager could or should be responsible for the work of a provider. However there many be ways of conceiving "managing" that allows providers to treat patients. And if nurse managers take on managing providers, it should be all providers, and they would have to figure out how to partner with physicians.
Advertise With Us