It sounds like FNP programs in particular are starting to ease off the myth that "FNPs can do anything" but there are still scope of practice issues especially in psych. I recently spoke with a rather smug psychiatrist who has never been a fan of NPs in general. However when he decided he couldn't live without one he advertised at a rate that was about 50% less than what PsychNPs make in this area. Surprise, surprise not only are we in short supply we aren't working for peanuts. He ended up hiring a Adult NP to work in is psych practice.
We were discussing it and he didn't see a problem because "there is such a shortage of providers what else are we going to do, not provide care? Physicians do it all the time" My short list answer was "What I'm going to do is not practice outside my scope". He seemed to care less that the board of nursing might have some objections to this general NP practicing solely in psych or my suggestion for his NP clarify with the board just to be certain their license isn't in jeopardy.
What would you do? I'm torn between the following in order of my choice at this moment:
1. Venting here and to my PsychNP friends but ignore it. The truth is I have more than enough work and I am literally making almost twice what they are paying so does it really matter to me?
2. Calling the NP and give the recommendation to contact the board which I'm sure wouldn't be well received and then would really irritate me, lol.
3. Notify the board of nursing and ask them to investigate if in fact this person is practicing outside their scope. This really isn't my style and I don't want my emotional investment in this topic to be deflected as concern for their patients or license.
I would say just let it go. It's really not your problem. It is up to the NP to decide whether it is within her scope of practice. If you show other NPs that kind of respect, you are showing that you deserve that respect too.
Lol I think you are the only one who actually addressed my question. :) But it has been a great thread anyway. Thanks to all.
If you are top in whatever you do, no matter what you do you probably will not have a problem finding work. if you work harder than everybody else you will be fine.
I believe you! "Top" people will always find work .. with one exception lower or stagnated salary/wage :) It is the law of supply and demand. No matter how top or good you are, you are not likely be paid above market rate.. but money is not everything of course. But it has to be "fair."
I believe you! "Top" people will always find work .. with one exception lower or stagnated salary/wage :) It is the law of supply and demand. No matter how top or good you are, you are not likely be paid above market rate.. but money is not everything of course. But it has to be "fair."
Good point. I truly hope that I will have my foothold in deep enough that although I might not get new offers I will remain at my present rates where I'm established. I'm also counting on the quality of new providers being largely lacking although the Docs having to work with them are the only ones who care about this not the administrators.
Money might not be everything but it is my main focus and the reason I work. The good news is I have not had to compromise on the quality of my team, environment or patient care to make top dollar in my field, so far knock wood.
My clinic pressures us to see psych patients and I don't feel comfortable with it because of lack of education and training. Legally in my state according to BON I cannot manage these patients' care, but that doesn't seem to bother the higher ups in my clinic. I have been collaborating with our mental health NP when I see these patients or suggesting they be seen at a psych clinic. I cannot do actual referrals for external psych because the clinic "forbids" it, so I refer via a conversation with the patient. Our mental health NP is leaving at the end of July though so the patients are starting to freak out about what is going to happen to them.
My clinic pressures us to see psych patients and I don't feel comfortable with it because of lack of education and training. Legally in my state according to BON I cannot manage these patients' care, but that doesn't seem to bother the higher ups in my clinic. I have been collaborating with our mental health NP when I see these patients or suggesting they be seen at a psych clinic. I cannot do actual referrals for external psych because the clinic "forbids" it, so I refer via a conversation with the patient. Our mental health NP is leaving at the end of July though so the patients are starting to freak out about what is going to happen to them.
What a shame but not unusual that employers could give a crap if you are practicing outside of your scope. I would be uncomfortable working under these conditions. If it is true about them forbidding you to refer mental health patients to another provider for competent care I would document it and pass it along to your state's board of nursing as well as medicare who I would guess probably doesn't want to reimburse for care that was provided out of a practitioner's scope.
Jules A, MSN
8,864 Posts
Lol I think you are the only one who actually addressed my question. :) But it has been a great thread anyway. Thanks to all.