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Psychiatric NP
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NPs4health has 3 years experience and specializes in Psychiatric NP.

NPs4health's Latest Activity

  1. NPs4health

    PMHNP and violent patients

    It's more difficult when you're in an open space like a day room. As an NP, I've always tried to position yourself with your back to the wall when I'm talking to patients and also hold something like a binder or clipboard in my hand. When the patient's aggression/agitation improves then you know you've got them on the right med. If it's their personality/negative coping skills that's a different story. In the outpatient setting it's much easier because you usually have your own office. In my office I make sure there's a clear and easy exit path. In the outpatient setting, I've never had anyone be aggressive towards me unless it has to do with someone seeking controlled substances and doesn't want to take no for an answering. When I sense that happening, I get up close to the door and end the session. I remind them the purpose of their visit, that their behavior is not acceptable and we can potentially discharge them. Of course a drug seeking patient and a psychotic patient would be handled differently. Also, don't assume all initial visits are one hour. In the hospital, I had 40 mins max and in the outpatient private practice I got 45 mins, and in community mental health I got 30 mins and always ran behind.
  2. NPs4health

    AANP Conference 2014 Nashville, TN

    Hi Sharon, not sure if you've already booked something but I might have something for you haven't already found someone or a place please PM me. Thanks!
  3. NPs4health

    What is a reasonable new grad offer?

    curious to what your final offer ended up looking like? I think anything around 100k WITHOUT weekend or calls sounds pretty good. For small companies, the first year seems to be about 1 week vacation time, 2-3 wks with larger companies. The extra productivity incentive is interesting.
  4. NPs4health

    Getting CE's online?

    Hello, I know this varies a bit by state but for anyone getting their CEs (continuing education credits) online, where's the best place to get them? At this time I can't afford big bucks for the in person conferences so searching for any other ideas on option. I know Medscape has free CEs but having difficulty finding ones relevant to psychiatric practice(my specialty) AND qualifying for pharmacology for the same time. Thanks!
  5. NPs4health

    Narcotics and diagnostics...

    Props to you for tapering patient off benzo, we get so many patients just put on benzos long term just because one doctor started it and noone bothered to D/C it. Was the patient referred to a psychiatrist and therapist following her suicide attempt? I love having a therapist on the team because it's like an extra pair of eyes on a high risk patient and they see the patient for a full hour, compared to my 15 minute med visit
  6. NPs4health

    Looking for advice on two job offers

    Congratulations on the job offers. It depends on where you are in life and what kind of schedule you're looking for. how quickly you would be able to see a cardiology patient...would you be able to do more than 3 an hour, 15mins/pt? And what are work hours for the cardiology practice 10 hr days? I used to work at a practice 4 days a week, 10 hr days and had the rotating weekend rounds thing every month. Physicians make a ton of money for covering each other on weekend rounds, it doesn't make sense for us to do it for free. It was a main reason i left my last job. Incentive based pay is nice if the numbers actually pan out to what they need to be...As to whether or not that is a good salary, it depends on what state you're in if you dont mind me asking? Job #2 sounds like pretty awesome benefits and a stable base pay, if you're looking for stability. And I'd want to know what happens during that week of calls, how often do you get paged and what orders are typically given..those are some things to consider.
  7. NPs4health

    Wasteful practices in the OR?

    Hi, I was wondering if anyone has noticed any wasteful practices in the OR? (this can pertain to doctors, surgical techs as well as nurses) I am writing a mock proposal about cost saving strategies from material management perspective for a surgical unit. Would love to discuss anything that has worked for your unit or any cost draining areas you'd like to point out? Thanks for your help!!
  8. Hi, I was wondering if any managers out there have suggestions or things that they have tried in their unit to address the issue of increasing supply costs for their unit? I am writing a mock proposal about cost saving strategies from material management perspective for a surgical unit. Other nurses and doctors have mentioned things like overuse/misuse of gauze or providing a refresher course for sterile technique for OR staff so materials aren't wasted. Would love to discuss anything that has worked for your unit or any cost draining areas you'd like to point out? Thanks for your help!!
  9. That is good to know! But does that already count in the 1% yearly increase for inflation?
  10. Kim, does it really go up much after you start working for a set salary? I was under the impression that NPs pretty much stay within 10K of what they start out making...
  11. Dixiecup, Yes, I meant to come back and correct that. I would say 25-30 now that I've had more rotations. Wish that I could see 10 patients a day only. When you find a place that allow NPs to only see 10 patients per day let us know.
  12. NPs4health

    Clinical Nurse Specialist or Nurse Practitioner?

    It does vary by state, where I'm located in there are more opportunities for nurse practitioners. Clinical nurse specialists mainly work in hospitals whereas NPs can work in a larger variety of places
  13. NPs4health

    Psych/Mental Health NP

    I was pretty excited when I saw how many states allowed for independent practice, but the one problem that I see is that although so many states allow for "autonomous practice" they still require physician supervision with drug writing so this is kind of a false sense of autonomy. How does it work when you need written evidence that a doctor is having oversight of your prescriptions when he's not working with you? I suppose in psych you could just counsel but at the end of the day we would still need that prescriptive authority in order to be truly independent.
  14. NPs4health

    people don't know who we are!!!

    Hi everyone, I'm a nurse practitioner student halfway through my NP program and am amazed that the public have very little knowledge of NPs and the NP role. Everyday in clinicals, patients get really confused when I tell them I'm not a med student. And I've had other health care professionals ask about what NPs do. So I made a website to answer these questions! And to educate the public on NPs are and how much we really do. Just wanted to share. :dance: http://nps4health.wordpress.com/
  15. DrFitness, In most programs in Texas, NPs are required to have at least a year of experience, but there are some programs which will take you right out of undergraduate nursing school. I think that is a bad idea and from what I have seen, those students do not do well in grad school. I only had 2 years of RN experience before starting the NP program and I sometimes find myself at a disadvantage. But at the same time, I'm glad that I'm starting earlier cause there is so much more on this side to learn!
  16. Here are the numbers I used. They are very rough estimates, but you can kinda replace my numbers with yours and calculate your own worth if you can figure out from the front desk people or from billing how much each icd9 & E&M are worth. (My numbers are from a combo of family and internal medicine) - I will be able to see about 35-40 patients a day - Charge for services: Typical E&M codes- 99203, 99213, 99214 - Insurance reimbursement for services: Charge per visit $120, insurance usually only reimburses about $85-$90 per visit - Conservative overhead costs will be about 60% of earnings. So if I see 40 patients per day X $85= 3400/day. 3400x5=17000. 17000x46wks=$782,000 annually If I contribute 60% of earnings to overhead(typical overhead is 40-60%): 782,000-469,200= $312,800 - I will use 30% for employer earnings: 312,800-93840=$218,960 (employer earnings! They make a lot of us!) - subtract 30% for annual benefits: 228,960-93840=$125,120 subtract continuing education/IT materials/miscelanneous: $5,000 - Take home: $110,000-$120,000 But I'll say 100K just in case I overestimated some things.:redpinkhe