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FullGlass

FullGlass BSN, MSN, NP

Adult and Geriatric Primary Care
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FullGlass has 3 years experience as a BSN, MSN, NP and specializes in Adult and Geriatric Primary Care.

FullGlass's Latest Activity

  1. FullGlass

    Total Number of Nurse Practitioners Hits 325,000

    Mental health is ideally suited to telehealth, so physical area saturation is not as important for PMHNPs. Actually, that is not an indication of too many NPs. It is an indication of too few NP residencies.
  2. FullGlass

    Are you ACTUALLY supervised???

    I'm an NP in California. I have no idea what the supervising physician does.
  3. FullGlass

    Is doing therapy as a psych NP realistic?

    We use 90833. I do not see how med mgt takes a full 20 minutes unless the pt is very complicated. This is an outpatient practice and the most common issues are anxiety, depression, PTSD, ADHD, bipolar d/o. If the pt is stable and doing well, how does med mgt require 20 minutes for simply something like Lexapro? It doesn't. How is your mood? Good. Sleeping well? Yes. Appetite? Normal for me. Anxiety? Not any more. Any troubling SE? No. That does not take 20 minutes.
  4. FullGlass

    Is doing therapy as a psych NP realistic?

    We specify how much time on therapy - I can do about 11 to 15 minutes.
  5. FullGlass

    Is doing therapy as a psych NP realistic?

    It appears to be the norm to bill for supportive therapy - I do 20 minute follow up appts and that is enough time for basic supportive therapy.
  6. FullGlass

    Total Number of Nurse Practitioners Hits 325,000

    Why do you all assume that for-profit grads will take NP jobs paying crap? If they can make more $ being an RN, then they will go back to being an RN! Many readers here are assuming that all new grad NPs are going to get NP jobs. They aren't. And an oversupply of crap NPs from crap schools is exactly what will drive those schools out of business. There is also an assumption among many readers that employers are clueless about schools. Well, they aren't. They are more likely to hire new grad NPs from good schools, given a choice. And many will not fill a position with just a warm body. They have liability issues to consider. In the corporate world, we recruited new college grads from certain schools. We would go to the schools like UCLA, UC Irvine, Cal State LA, etc. We would not go to Univ of Phoenix to recruit new grads. I think doctors and nurses are well aware of decent schools. Just because diploma mills are pumping out NPs does not mean that all those NPs will be hired. An oversupply of crap NPs from crap schools is not going to drive down pay. We have a surplus of attorneys, but the ones that work for the good firms still make good money. We have surplus of STEM grads, but Silicon Valley still pays great money for good tech people. I have never seen a profession like NPs where you all are so scared of increasing supply. I'm not. The market always corrects itself over time.
  7. FullGlass

    Total Number of Nurse Practitioners Hits 325,000

    The number of states with FPA is increasing and will continue to do so. I see no indication that doctors are unwilling to work with NPs. Unless the doctor owns their own practice, they really can't unilaterally make decisions like that. And in certain specialities, it financially makes a lot of sense to have NPs and PAs.
  8. FullGlass

    Total Number of Nurse Practitioners Hits 325,000

    Structural Issues Account for "shortage" of doctors Very interesting article from the Harvard Business Review https://hbr.org/2020/03/the-problem-with-u-s-health-care-isn't-a-shortage-of-doctors
  9. FullGlass

    Total Number of Nurse Practitioners Hits 325,000

    States with the worst primary care provider shortages "California has the highest number of Health Professional Shortage Areas in the primary medical care category, according to Kaiser Family Foundation's new report. HPSA designations were determined by the number of health professionals proportionate to the area's population with consideration of high need. An area must have a population-to-provider ratio of at least 3,500 to 1 to be considered as having a shortage. Rankings are based on a quarterly summary of HPSA statistics from the U.S. Bureau of Health Workforce, the Health Resources and Services Administration and HHS updated as of Sept. 30. There are a total of 7,203 areas in the U.S. with an HPSA designation. Here's how each state fared: Note: The list includes ties. California — 626 areas with an HPSA designation Texas — 411 Missouri — 324 Alaska — 301 Florida — 279 Michigan — 261 Illinois — 245 Georgia — 234 Arizona — 217 Washington — 200 North Carolina — 189 Kansas — 188 Kentucky — 175 Oklahoma — 173 New York — 168 Minnesota — 158 Louisiana — 154 Ohio — 150 Mississippi — 148 Oregon — 144 Pennsylvania — 139 Montana — 138 Tennessee — 136 Iowa — 132 Colorado — 119 Indiana — 117 Virginia — 113 West Virginia — 105 28. Wisconsin — 105 30. Alabama — 102 31. Idaho — 98 32. New Mexico — 97 32. South Dakota — 97 34. South Carolina — 95 35. Arkansas — 88 35. North Dakota — 88 37. Nebraska — 76 38. Nevada — 72 39. Maine — 69 40. Utah — 64 41. Massachusetts — 62 42. Wyoming — 47 43. Maryland — 45 44. Connecticut — 41 45. Puerto Rico — 39 46. New Jersey — 36 47. Hawaii — 31 48. New Hampshire — 27 49. District of Columbia — 15 49. Vermont — 15 51. Rhode Island — 14 52. Delaware — 13" https://www.beckershospitalreview.com/rankings-and-ratings/states-ranked-by-primary-care-provider-shortages.html
  10. FullGlass

    Total Number of Nurse Practitioners Hits 325,000

    What amazes me is the number of readers of this forum who seem to think that they are ENTITLED to a job. No one in the US is ENTITLED to a job. We have a capitalist economy, governed by supply and demand. If the supply of NPs exceeds the demand, then not all NPs will have jobs as NPs. If we get to that point, then the BEST candidates will get jobs. I am also concerned about all the NP diploma mills. An oversupply of NPs will destroy the diploma mills, which is good, IMO. I am tired of all this overreacting to the latest projections. If you truly want to be an NP, ignore this scaremongering. Go to the best school you can and do other things to make yourself an attractive candidate. Projections are just that - projections. They are not gospel truth, nor are they 100% accurate. These numbers are always gross statistics that do not take into account DISTRIBUTION. Some areas may have an oversupply of providers, other areas do not have enough. There are still many areas of this country that do not have enough providers, of any sort. "The expanding NP population is also a case of supply rising to meet a growing demand. According to the American Association of Medical Colleges (AAMC), the United States will see a shortage of up to nearly 122,000 physicians by 2032. " https://dailynurse.com/number-of-nps-has-doubled-since-2010-will-continue-to-rise/ FPA is increasing, so many more states will provide FPA, which will open up employment opportunities for NPs. Of the cited statistics, we don't know how many NPs are unable to find jobs. And of the total number of NPs, many are retired, working PT, or may still be working as RNs. There is still a shortage of NPs in certain locations and specialties. And if there are too many NPs at some point, good. Competition is good. It will also stop people from becoming NPs for the wrong reasons. This past year has been a bad job market for NPs due to COVID. But many MDs have also lost their jobs or have reduced hours for the same reason. DO THE RESEARCH FOR YOUR DESIRED LOCATION California "An estimated 11,226,111 people in California live in an area that has a shortage of primary care providers." https://www.chcf.org/publication/shortchanged-health-workforce-gaps-california/ "More than half of Californians suffering from mental health issues are not receiving the psychiatric care they need. Within the next decade, the state is expected to see the number of psychiatrists decline by 34 percent. " https://nursing.UCSF.edu/news/california-has-shortage-mental-health-providers-how-ucs-bold-new-initiative-will-address-it#:~:text=How UC's Bold New Initiative Will Address It.,-By Milenko Martinovich&text=More than half of Californians,psychiatrists decline by 34 percent. The above research took me all of 5 minutes. So, I am not scared. And I refuse to live my life in fear or make choices based on scaremongering. A lot of people want to be successful actors or athletes. Far more than actually "make it." Yet for those who have what it takes, the rewards are enormous. No risk, no reward.
  11. FullGlass

    Total Number of Nurse Practitioners Hits 325,000

    Here we go again, more hysteria over this supposed oversaturation. I see no indication of an oversupply of NPs. Has anyone here studied clinical reasoning or logic? If there is a shortage of X, and then the supply of X increases, it is not necessarily true that there is no longer a shortage of X. If I need 1 pound of flour, but all I can get is 4 ounces, then I am still short of flour. If I am able to get another 4 ounces, a 100% increase, then I am still short of flour. In addition, we do not have guaranteed employment in this country. Just because someone earns an NP, does not mean they are guaranteed a job as an NP. You do realize that not all medical school graduates are able to get internships? We have a competitive economy. People compete for jobs and the best candidate for the job is selected. If you don't have enough confidence to believe you can win a competitive employment process, then don't become an NP! That said, demand for NPs varies by location. So do the research on the demand for NPs where you want to work!
  12. FullGlass

    How do we prevent Nurse Practitioners from undervaluing themselves?

    You make some excellent points. However, new grad NP is not in a position to make this argument. I think a good NP who has been at a practice for awhile could certainly make this argument. There are some practices that would consider this. What has occurred to me is that in primary care, NPs and PAs may be subsidizing MD pay. In most professions, pay is relative to revenue generation. In its simplest form, the salesperson that sells the most earns the most. However, in primary care, I don't see how this is possible. I don't think MDs in primary care are really generating more revenue, yet they get paid 2x as much! In certain specialties, MDs can focus on procedures, which generate more revenue, and leave more mundane task to NPs and PAs; tasks which do not generate as much revenue. I don't know what the solution to this is.
  13. FullGlass

    How do we prevent Nurse Practitioners from undervaluing themselves?

    We don't know if the new grad in the OP's example was selling herself short. NP pay varies greatly by area and specialty. That is also true for MDs. $96K could very well be good pay for a new grad NP, depending on her location. NPs need to be REALISTIC and know their local market salary ranges. My first NP job paid $125,000 including base pay and bonus, but it was in California, in a rural area where it was very hard to attract providers. The same job in a city like San Diego would have paid about $100K. It's supply and demand, people. This is basic economics. If there are more NPs in a given area than there are job opening, pay will be less. The opposite is also true. This also applies to specialties.
  14. I think it boils down to developing inner strength and toughness. For various reasons, I've always been a bit different, and in my senior year in high school, a very nice girl who was also very popular told me that I would never "fit in," but that was okay. I should not let people try to fit me into a box and should be proud of my accomplishments. I have remembered that and it was very liberating. Bullies sense weakness. They only go after weak people. They are like predators. Predators in the wild only go after the old, the young, and the sick or lame. I'll give you a couple of examples: 1. A long time ago, I used to go running in a park every day. There was a German Shepherd that would growl and menace me. So, I bought an expanding baton that fit in my pocket. The next day, I went running with my baton in my pocket and the German Shepherd took one look at me and then did not growl, but walked away! He sensed my inner confidence. 2. I've always been a good student, but math is my weakest subject. Calculus was my downfall. I took it again at a community college and struggled. I was asking a lot of questions and some guys in the back of the class would make fun of me. This went on for some time. So, one day, I literally stood up in class when they were snickering at me, turned around to face them, and chewed them out! I told them to STFU and they could meet after class if they wanted to confront me like real men instead of snicking like nasty little junior high school boys. Well, that shocked the crap out of them. The teacher just smiled and those guys never caused me problems again. 3. In nursing school, I was one of the older students. Two nasty little girls who were very young decided to make fun of me and roll their eyes constantly, because I was slow to learn certain manual skills. I complained to the professor, because I was partnered with them in lab and it was negatively impacting my learning. She switched me to another group and evidently gave them a hard talking-to. They would glare at me after that, but I just glared right back. I ended up making friends with very nice students that I am still friends with. I have no idea what happened to those 2 idiots, but I ended up on the Dean's List, National Honor Society, etc., and became an NP. Those 2 are probably scrubbing toilets or something. In other words, don't play their game by their rules. You do your own thing by YOUR rules. It's actually quite entertaining to mind-f**k bullies. Be creative and have fun! One of the best weapons is ridicule. I'm very good at making up hilarious nicknames that stick, because they fit well. Once that happens, people will be calling the bully that name behind their back. And every time you look at them, you know their secret nickname. It really takes people down a peg. Politicians do this to each other all the time. President Richard Nixon had the nickname "tricky Dicky," bestowed on him by a female congresswoman, and it stuck. Whether or not you like Trump, he is a master of this, and it drove his opponents nuts. Look, those mean girls aren't going to beat you up or anything. And they can't negatively impact your grades unless you let them. Ignore them. Hang out with other students. If there are older students in your classes, make friends with them. Figure out who the best students are, then make friends with them. I'm one of those straight A type students and am happy to help anyone who asks for it. Most good students are this way. There are plenty of nice students in college.
  15. I am very sorry for those students dealing with bullies. But, honestly, people, you are adults now! Why are you giving these morons power over you? Throughout my life, some idiotic bully has tried to pester me in school. Here is what I do: 1. Ignore them. That sucks the life out of them 2. Fight back. I have a quick wit and a sharp tongue and have been known to demolish people to tears with a few words. That will stop the bully. 3. Do well in school. You are there to learn to become a nurse. Just focus on that. You will never see these jerks again, so who cares what they think or say? 4. What I found was the high school "queen bees" generally amounted to nothing in life. They were very boring, generally loser, adults. Remember, bullies are essentially cowards. Do not give them power over you. Junior high is over, people. Focus on building a good career and bright future for yourself. There's an old saying, "Living well is the best revenge."
  16. FullGlass

    New NP needing advice

    There are women's lab coats that have good-size pockets. I use one of those when I need to wear a lab coat.