apocatastasis 9,791 Views
Joined: Feb 13, '08;
Posts: 213 (59% Liked)
; Likes: 547
APRN/ARNP, PMHNP; from
4 year(s) of experience
Psychiatry, ICU, ER
It is truly bizarre and inappropriate for schools to expect students to find their own preceptors, especially when the search degrades into trying to find a warm body with an MD or NP after their name who will take you on.
That said, I'm an NP and maintain close contacts with my school's faculty. I understand that it can actually be very difficult for schools to find appropriate preceptors- I imagine the attitude is, why not just dish the leg work out out to the student? It's not right, but until students vote with their feet and attend only legit programs, this trend will continue.
I, for one, would never even consider getting a DNP or post-Master's certificate at a school that didn't help me with preceptors.
I'm a successful nurse practitioner, and a guy, and I have 00g ears. Anyone who doesn't like them is more than welcome not to be my patient.
I'm a psych NP, but I did have to do some primary care rotations-- my ICU experience was not very helpful, but my ER experience proved INVALUABLE. You get to see everything from STDs to wounds to life-threatening medical conditions.
However, there are MANY an FNP working in inpatient roles; in acute care settings.
You need to check with your board. In Texas, the board has really cracked down on scope of practice issues like Adult Health CNS practicing psychiatry and FNPs doing inpatient rounding.
I moonlight inpatient with a psychiatrist (who owns the group) and a NP friend of mine on occasion, I call them both colleagues because I don't consider either one of them to be my supervisor.
In my full-time job, I have a chief medical officer and assistant chief medical officer-- I call them my bosses because that's what they are in my organizational structure. And, even though they're my supervisors, they leave me alone and let me do my job, which is really the important thing.
I work primarily outpatient in community psychiatry, though I have also worked at a crisis facility and do some inpatient rounding PRN. There are a number of specialties in psych which are quite different from the kind of work I do (e.g. substance abuse, working with TBI or HIV patients, crisis work, mobile outreach or ACT teams, eating disorders, liaison work in hospitals [which is very interesting if inpatient and medical comorbidities are your thing]). Psych has much broader applications than most people realize, though you must always be mindful of your scope of practice.
I currently work 8-5, M-F. I'm on call 4 days out of every 3 months unless I want to pick up more, and I am compensated well for it ($300 a night for F/Sat/Sun call and $125 a night for weekday).
I do not do any counseling, but I DO do psychoeducation, try to throw in some basics of CBT, talk about engaging with group therapy, etc. Unfortunately, employer does not want me doing therapy, as that can be farmed out to the LPCs and LCSWs. I have a caseload of over 1,000 patients and have only 20 minute appointments, so I feel like a conveyer belt towards a prescription pad at times. However, you can still make a big difference even given 20 minutes... meds aren't miracles for most people, but I've seen some amazing changes which make the work seem very much worth it.
As far as what I see patient-wise, it depends. I've worked at a few different facilities; at my current position, I have mostly stable patients... however, I am occasionally floated to cover for other prescribers, and the NPs who work at our crisis facility and on mobile crisis team frequently have medically and psychiatrically ill patients. When I was in Seattle, I worked with forensic and supportive housing clients who were about as medically and psychiatrically ill as they come. All this business about NPs don't take sick patients, the MDs take those-- very much NOT true in psych. If anything, I had patients who were quite a bit more ill than what most of the MD colleagues had.
As for the money, a lot of it is how shrewd a businessperson you are. I can't speak for other specialties, but I personally would not take a job as a psych NP in a major market for less than $90k a year. You have to negotiate with employers and insurance companies. A lot of nurses and NPs are not good at this, which is probably part of the reason our wages are generally lower than they should be.
This is true generally. HOWEVER, in urban areas, in specialties, I do not believe this is the case.
Yeah, I saw that, sorry, I finally cleared out my inbox! Is there anything in particular you want to know?
I have licenses in Washington State and Texas. Had no trouble getting a job in either state. There is high demand for psych NPs nationwide from what I can tell, especially if you want to do child/adolescent (I get ten million e-mails per day from recruiters... never give them your real e-mail address!).
And, I for one, am pushing for equal pay for equal work.
Just an FYI for new grads and prospective students reading this thread. People reporting 200-500k salaries as nps are outliers. Most mds do not make that much. I'm not saying its impossible if you're savvy enough and money is a very high priority for you. But it's very far from the norm. I'm in NYC and new grads are being offered 80-90. I know people with 20 years experience making around $120. This is not the career path for someone who just wants to make it rich.
I'm a psych NP, employed in an outpatient community (=not high-paying) psychiatric setting, one year of experience, and make 6 figures..
More than just a few of the psych NPs I know in private practice make between $200,000-$300,000 a year. At least one significantly out-earns both of her psychiatrist partners. I'm looking into starting a telepsychiatry practice, and factoring current reimbursements, no-show rates, etc., working 35-40 hours a week and earning in the $200s is definitely doable looking at the longer term if all goes well with the practice.
Money isn't everything, but, since that's what we're talking about... it's all about how aggressively you market yourself, your business sense, and what kind of market, practice, and practice climate you're in.
I have a MSN and am a nurse practitioner, but I also earned a BA before I became an RN. I worked for 3 years as an RN while obtaining my MSN.
I could never, and still can't, see what the big deal about having a BSN was/is. It's a freaking bachelor's degree, like every Tom, Dick, and Harry has these days... almost embarrassing that we as a profession are arguing about it.
I've heard a number of people try to justify "sontimeter" as a French pronounciation of the word. Yeah, well, I have a French degree and speak French and Italian and studied Latin for two years. The word is CENTimeter.
Whenever I hear someone say "sontimeter," what comes into my mind is, well, google "Emily Howard at the Swimming Pool."
The only reason I would intervene for any reason is if someone were clearly having trouble with ABCs. And, in that case, I wouldn't even ask them, I'd call 911.
I have absolutely no desire to meddle with the health concerns of people who are not my patients.
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