Hi, I am in Addicition setting RN in PMHNP program ,9 years of psychiatric experience outpatient setting CNS from Israel
Now I work per diem in OASIS program
RN in Alcohol/ Drug outpatient full for profit setting Manhattan /Quince NY We are doing outpatient detox for Alcohol and non IV users "non- complex" cases, sent by union, ACS,TASK, Federal probation, HR and Self referrals. My primary job is health assessment and "pre psych assessment", referrals to XRAY for "TB clearance" /PPD testing/infection control "collaboration " with Health department regarding TB/smoking sensations /education/referrals to acute care settings/ first help and Vivitrol administration.
•Do you like what you do?
As RN, I do not have other choice, it is PER DIEM JOB 3-4 Times a week and I am "covering 3 clinics" all medical staff work in OASIS programs as perdiem, since we are "covering" other clinics and the "boss" wants "profits".
Our MD/NP work here as per diem and as I know in all OASIS clinics/programs it is the same in NY- salary, no benefits.
•What career pathway did you take to get to where you are now?
I was 4 years Acute Dialysis RN, 2 years RN PRECEPTOR in nursing school/ internal unit /nephrology care.
•AV coordinator RN, 3 years in oncology/immunology clinical research.9 years CNS in outpatient psychiatric care
•Do you use medication assisted treatment with drugs like baclofen, naltrexone, suboxone, etc? Are you seeing good outcomes with this form of treatment?
I am not prescriber yet, but our NP'S and MD/DO use per protocols and it works( just like all psychiatric medication, if medication is really taken by the patient, we have low compliance and low adherence")
•Do you see a growing need for addictions NPs? There is a question what NP can do, NP can not prescribe suboxone/ schedule I medication, so I am not sure.
How hard was it to find a position? as per diem for low salary in OASIS PROGRAMS- it is easy, but nobody will train you and the "musical cheers" of all health providers/counselors/RN/LPN/NP/MD- they come and go.
The job is difficult , since you need to be "handy" and nobody will train you. You could see 20 patients in 6 hours and in some days patients will "no-show"
your relationship with MDs who specialize in addiction medicine? ok, I am RN and I am not autonomic caregiver, but our NP's are very knowledgeable and they are responsible for every step that they do. We have a lot Federal/ Medicate/ Health department cheek ups and every client has his privet lawyer. So it is advantage and disadvantage "autonomy" , may medical professions left positions because of "no training" no supervision, low pay/no benefits and the non compliant patients .
w much autonomy do you have in your practice? I am RN , so I email every step to my Medical director, then clinical director and compliance officer .
What do not you like about what you do?
If the patient is "no show" I can study, read and it is the most important for me write now.
• If you had the power to change something about your work, what would it be?
Oasis programs has no "monitoring systems" for clients, there no option do not do labs / liver function / kidney function / depacote levels
It is risky to prescribe, since "the system is loose and no continues care plan"
• How much stress do you feel? Do you feel like you have enough down time?
I am not stressful person as a personality.I do not see any difference between substance abuse clients and dialysis / oncology cleints
Most of the clients are "regular people" with "issues", most of my clients could benefit from therapy / counseling / AA meeting- without medication.
My philosophy will be in the future not to "overprescribing", there are legal consequences in too much medication (suboxine / methadone / opiates as pain managment) but "complex patients with multiple admitions need medical monitoring and more medical education, in some cases medication and other treatments.
• Do you feel like you have a natural talent for this type of work, or was it something that you developed over time?
My talent is nursing scales mesherment tools / symtoms monitoring and patient education, all this sckils are well traned by every "primary care setting"
I belive in preventative care and I want my client to stay away from hospitals / acute care. My sckils could be benefisial in every "primory care" setting, I am tiered of hospitals.
• If you had it to do over again, would you choose this line of work? If you plan to do something different in the future, what is it?
As I told I am RN, and in the future I will be NP, my clients will be same cleints in every settings.
My clients will be same people that just trying to do their job well, they are just like us, sweating, make mistakes, they can be annoying, they have a weakness and have power, they are not blind and deaf not more than ourselves.
As a Nurse with all my experience , I accept death, suffering, pain and relapse in my patients. Without understanding some disadvantages of relapse, some psychiatric patients will never admit to start treatment. So, Patient is part of God/ nature as therapist part of God/ nature and we are in the same level. All are equal, there is no authority.