What Type of Setting Do You Work In? - page 2

by GinaCat

2,904 Views | 15 Comments

Hi, I hope no one minds that I am not a nurse practitioner. I am just very interested and I thought this is the place to find you :) Where do you work? Doc's Office, ED, clinic? I wonder how everyone likes their current... Read More


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    Quote from Psychcns
    I had 5 years prescribing experience before I started locums. I used to like the system issues and trying to make things better as a manager and eventually gave up trying but I have empathy for people in these roles and try to support them. I think my training and experience helps me in my jobs now. But expectations can be different place-to-place so it is also important to know a facility's culture. I liked the cns role but this was all there was for psych in 1994. The psych NP has pushed us aside since 1999. We are grandfathered for now-our credential has been retired.. The psych NP degree is more versatile now..I liked my training because I learned a lot about therapy (as well as meds) and people aren't learning this so much now.
    CNS can prescribe in 36 states, NP in all 50. Probably more role preparation in CNS. But not for psych. Psych is not offering CNS anymore.
    Thanks for the great info. Really helps to know how others have forged their path.
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    psychcns,
    i am accepted to nursing school, and waiting to hear back from PA school. Psych is my primary interest.(im aware of the learning curve of a psych PA...). Correct me if i am wrong, but is seems most psych PA's and NP's simply do short medication management appt's now. How bad is it? any room for psychotherapy left in the system? How much psychotherapy training is there in PMHNP programs? What kinds of jobs are out there for people who want more then the outpatient med-check life? I know inpatient can be tough, but does it give more room for appropriate treatment?
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    Quote from benm93
    psychcns,
    i am accepted to nursing school, and waiting to hear back from PA school. Psych is my primary interest.(im aware of the learning curve of a psych PA...). Correct me if i am wrong, but is seems most psych PA's and NP's simply do short medication management appt's now. How bad is it? any room for psychotherapy left in the system? How much psychotherapy training is there in PMHNP programs? What kinds of jobs are out there for people who want more then the outpatient med-check life? I know inpatient can be tough, but does it give more room for appropriate treatment?
    Look at a school's curriculum and if possible talk to graduates. Some schools value psychotherapy more than others. I learned how to do psychotherapy years before I went to graduate school-on the job-with at least 3 hours of 1:1 supervision per week. This was before the biological revolution and Prozac and the second generation antipsychotics. All you had was theory. My grad school was therapy and theory oriented. Many now are mostly biological though therapy is in your scope of practice as a psych np and you could always find your own supervision.
    Now it appears outpatient is mostly med management. I don't mind it because I don't work 52 weeks per year. I think it is very intense- you are treating psychological pain in 15 to 30 minute med visits and it is hard to do this all day.
    The VA has more varying roles. I have a friend who leads 4 groups per week, does crisis one day and outpatient clinic one day. And therapy with meds two days per week
    How much therapy you do inpatient depends on the facility- a short length of stay- not so much. Though you can make a difference with brief therapy. My next job is an 8 week assignment in an inpt facility in corrections.
    Private practice could be a way to do a combination of meds and therapy.
    PA psych is fairly new I think. And I think your scope depends on your supervising physician. I heard of a state hospital that uses all psych PA's.
    Psych is great. You just need to be able to process or at least reflect on patients and you do some therapy with med management. 30 min visits are better than 15 minutes..one hour with meds is possible in private practice or some places like the VA
    forthebirds likes this.
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    I did CNS only because in my state, IL CNS=APN and I knew APN was the role I wanted. CNS was what was offered by my hospital-affiliated college of nursing so it made it infinitely easier to do that.

    I think my training somewhat prepared me for my new role as a novice APN. However, as I went into nephrology and had absolutely no experience in that area, I had a steep learning curve. I made mistakes along the way (and paid for them too) but now, almost 7 years later, I'm much more comfortable in the role.
    forthebirds likes this.
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    Quote from forthebirds
    Thanks BC! Did you do adult or FNP?
    FNP. I currently see both adults and children in my practice.
    forthebirds likes this.
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    Yeah the VA is most likely where I will find the variety to do what I would like. I know a very experienced NP who has a private practice in my hometown who does 1 hour therapy /med mgmt sessions. She doesn't make much money, so that would have to be more of a retirement job. I just dont think I can do med checks forever, Ill need to do something to let me see more and be more involved in the treatment before I will be able to treat a patient is such a short amount of time.


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