coast2coast, MSN, NP 9,931 Views
Joined: Jul 9, '10;
Posts: 405 (42% Liked)
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They're annoying. Had a fight with one agent to stop calling me since I like my current job. A few weeks later he called me again.
They can be annoying but I'm sure they have quotas and data to support bugging the crap out of x number results in x number coming on board and bottom line is they are salespeople, we know they are salespeople. You opened that door and gave your contact information so at this point I'd suggest politely setting boundaries and if unsuccessful simply ignore any further unwanted calls, they will usually show up on caller ID, and will also stop if you continue ignoring them.
The important point I think we are missing here is whether or not this is a good ocums company to work with and while I have no first hand experience a colleague has worked with them for a couple of years, recommended them to me and has continued taking long term assignments from that agency.
That would drive me crazy. I am one of those who prefers emails/texts to phone calls.
I used them when I graduated last year but they never helped out really. I kept getting calls asking if i was interested in a position and whenever i said yes, i never heard from the agent again for some time and then would randomly get another call asking if i was interested in another position. I finally found a position fifty minutes away from home. I basically stopped answering the calls from them.
I've found them to be extremely annoying. They kept trying to steer me away from positions I was interested in, to positions they were having difficulty filling. I decided not to go locums because of them and found my own permanent position.
I've spoken to them but did not pursue any opportunities with them. The big "deal killer" for me was their use of a non-competition clause. The area I live in is too small for such non-sense. I'd never be able to find regular full-time work within a reasonable travel distance if I had taken a position with them.
Our practice act "sunsets" in 2017 so we need to be very mindful and supportive of proposed changes. Here is the latest from ISAPN (IL Society of Advanced Practice Nurses):
We are gearing up for another big push for full practice authority in 2017. We have a lot of work to do and need all APNs in the state to support our efforts.
The socioeconomic and educational level of my patients is pertinent. Less sophisticated people, with poor adaptive skills, are easily swayed by a healthcare system that doled out opiates the past 30 years like candy.
The healthcare system set these people up for this. Now there is a gnashing of teeth about addiction.
Enshrining the pain scale as sacred contributed, in my opinion. The most vulnerable members of society were like sheep to the slaughter, lacking coping skills.
That is a very sad situation. Why not go back to the NP that was understanding of your mom's need for pain meds and anxiety meds? This is exactly what I feared would happen with the pressure for Dr's not to prescribe narcotics, that people will be left with uncontrolled pain. I see this already with nurse friends who are treated as drug seekers if they need narcotics for an injury or chronic back problem.
Is there any way you can go back to the NP with her? Otherwise seek out pain management for sure. Sometimes non narcotics can help such as lido patches or a steroid shot, but narcotics should not be withheld from her. Plus she is dealing with anxieity and dementia. The dementia may be increasing the anxiety as she realizes she is forgetting things. I imagine that would be very unsettling.
while I totally understand your frustration, I must say that your former doctor was very much correct in his tactic, although not in his actions.
As I get it, your mother is in her early to mid 50th. She has chronic pain and tremor, both of unknown origins, some dementia-like symptoms, personality changes and now new pelvic symptoms. It is a description of a complex patient who was, as far as I get it, never was worked up and has no working diagnosis. It is up to your mother to refuse testing, but it doesn't mean that she should be given meds with high addiction potential for this and that symptom just because she likes how they work on her. Your doc was absolutely right in attempting to transfer care, get specialists on board, etc., Sudden changing meds was not appropriate, but he was correct in refusing to escalate dose without proper diagnosis.
Regarding pelvic exam, it is up to provider to determine who is more qualified to do which type of assessment in practice setting. Pelvic exam #1 on difficult diagnostic case needs to be done by whoever knows better, not by whom the patient likes more. Unless the NP was specializing in women's health, she might have very limited experience with abnormal pelvic exams.
Regarding passing info, I can assure you that it is what happens in 100% of cases. No provider in his or her right mind would transfer care without communicating every single detail to accepting care office. Transferring a patient with even traits of "risky behavior" which might affect one's licensing status (even non-compliance, refusing to test, missing appointments, etc) and not telling about it is seen as extremely unprofessional behavior and can kill physician's career.
I do not say that your mother is addicted, but there were several things in your post pointing on developing of at least tolerance. She absolutely should not be treated in primary care setting, it is not safe for her on the long run and you need to understand it. She should be referred to specialists and get diagnosed before making any changes in her meds. As the very least safe step, she should take the same meds in the same doses, but there should be no increasing doses before we know what is really going on.
I have to work on regular basis with highly dependent and escalating patients suffering from chronic neurologic diseases from MS to Alzheimer, and it is incredibly painful, in all senses of the word, for everyone involved. I hope you would be able to convince your mother to get diagnosed and find a capable physician for her.
Be careful with going into a direct entry program. You may have a difficult time finding a job afterwards with no bedside experience. I'm not sure who hires Nurse Practioners with no actual nursing experience.
As a new graduate NP you need to be in the supportive environment.
There's no data to support the idea that "bioidentical hormones" are any safer than synthetic ones- nor are they actually more "identical" than synthetically produced hormones.
I don't see a problem in specializing in hormone replacement therapy, per se. I do a lot of it in my practice, and as long as you are adequately trained it is well within NP scope, barring local regulatory silliness. I do, however, feel a little bit alarmed whenever I hear NPs espouse pseudoscientific health beliefs, especially ones that actually have potential for harm. Bioidentical hormones are largely produced by an industry that is just as profit driven and susceptible to corruption as Big Pharma, and who also benefit from a lack of outside oversight. Actual amounts of hormone in a pill can vary widely from company to company, and even batch to batch.
Bioidentical Hormones << Science-Based Medicine
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