pennyroyal

Hi, I have been a nurse for 42 years and have seen many changes in the functions that nurses "do". I have not seen so many changes in the way we treat each other and the seemingly petty bickering that goes on year after year. I have twice been in Master's level groups, or I sould say one and one that I wanted to be in, that spent a whole year arguing about who could be in the group. The second group, a very small group (5) of ANA certified CNS nurses, decided that I could not belong, even though I was a CNS just like them, because my Master's Degree was not in nursing. On and on it goes. I was most impressed by the "Shared Governance" idea and have seen it work well over the years. Currently it appears to me that economics dictates the status of nurses, atleast in my area. It seems that preference is given to the least educated and the lowest paid when it comes to hiring. I once served on the Commission for Nursing Education for the State of Maine. The whole time was spent talking about the education of CNA's. There was an attempt to make the BS the entry level in the legislature but that was not popular with the hospitals. It has amazed me that the whole mental health center where I work is staffed and run by social workers and LCPCswith psychiatrists being hired to prescribe. In this past 6 months 3 APRN-NPs have been hired just to prescribe medications. They are hated by the social workers and denigrated as "crazy".

I have been practicing independently for about 20 years. I have had a psychiatrist colleague to whom I referred for medication. In the early days nurse's did not have prescriptive rights and now I choose not to have those rights due to high insurance costs and other considerations. Finding good psychiatrists especially for children and adolescents in my area is difficult. Your question was do psychiatrists use me. They refer patients for therapy some times. Those are not always the best referrals.I find that my practice is self referring and that the best referrals come from satisfied consumers. One major problem that I have is if I do want to work for someone else in this area it seems that I have to work as a Social Worker and for what they get paid. All the APRNs (CNS and NP) are used as medicine prescribing machines and do not do therapy or much health teaching. There do not seem to be jobs for CNS, only RN,C.