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PMHNP Man

PMHNP Man MSN, APRN, NP

Psychiatry

Hi. It's me.

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PMHNP Man has 7 years experience as a MSN, APRN, NP and specializes in Psychiatry.

PMHNP Man's Latest Activity

  1. I've been waiting since June 2018. Regarding special pay, I confirmed today there are very few special incentive pays for FY20, and those mostly relate to the medical corps. I was just told there are no nurse corps incentives other than loan repayment which many don't need. Like you, I wasn't doing it for the money, but I'm not doing it for free either. I want to see if I get selected by the board, but I'm 80% certain I will back out because of that. Battle Assembly pay is low enough to be irrelevant so the bonus was prudent.
  2. PMHNP Man

    DMAT Disaster Teams

    Google around for your state's DMAT, e.g. Florida DMAT or something. I found onr day by happenstance that my state's DMAT CNO worked in the same clinic I do. This person said "we'd love to have you" and gave a cursory overview of recruitment, but it's not quite what I'm looking for in this season of life. I'm trying for army reserves as a NP, but that's probably not happening either, lol.
  3. PMHNP Man

    Why are FNP paid less than Psychiatric NP?

    I think FNPs come running ready to take any "advanced" job they get and become saddled with low pay regardless of what billing is collecting off of them. In pysch, we are fewer and number and more likely to be reimbursed closer to what is billed sometimes regardless of whether it is collected. With coding, 90792 tends to be a well reimbursed code and you could do one to the same patient every year by some insurances, and the 90833 add on, should you have the patient more than 20 minutes, is easily added to an a new or established patient visit for extra money. Psych doesn't bring a lot of overhead as we we tend to not need any specialized gear or bank of exam rooms.
  4. PMHNP Man

    Will you get your DNP

    Your resolve is admirable although you do present a fallacy of logic. Your patients's care, clinically, will be no greater based on current curricular models with a DNP as there is no added value in the courses offered. Your depth and breadth of study, clinically, will be no different than a master's or post-master's trained APRN. This is the daunting part that I believe precludes working APRNs from enrolling in DNP programs in drives. However, the assumption, as you have, allows the universities to market the DNP just as they have. You, little fish, have bitten the hook. You are correct in that academia, research, and probably the Veterans Affairs will love you for your DNP.
  5. PMHNP Man

    Will you get your DNP

    As I reflect more on this topic, I maintain my immediate thought. "I don't care anything about a DNP." And I don't. I think the entire premise of the degree is vapid. Having said that, there are some things to consider. The opportunity cost is too great. Losing work time is losing lots of money. Losing family time is losing something impalpable that you'll never get back. Billing won't change. Insurances won't reimburse more. There's no "extra" clinical value. Seems disparaging. Presently, I keep working for income. I have no desire to maintain a clinical career, but I will do so because that's what I've got. A career change would be a lifestyle hemorrhage for my family. I'd be ok with it, but they never volunteered for it. Sociopolitically, I don't "fit" with universities but won't say anymore about that. I don't care to advance my field with original research. Increasingly, I don't value administrators in the healthcare system and find the metrics by which their careers are assesses absurd. That leaves me wondering, what can a DNP do for me. At a time, I considered an escape to academics or administration. I would make less money and be less enthusiastic than I am now. What's the point? New grads, I encourage the DNP. The curriculum is shallow and base, but you will be, unfortunately, judged by not having it. Get it, but do it as inexpensively as possible. Use your local state university, work as much as you can plus 15%. But be good at what you do. Our profession has become too dilute and base. For salty men like me, the DNP may as well be another liberal arts BA.
  6. PMHNP Man

    Will you get your DNP

  7. PMHNP Man

    Psychiatry question - Must I provide Therapy too?

    Hence their current dilemma, lol. In a 40 hour work week only 29.5 hours has to be clinical.
  8. PMHNP Man

    Psychiatry question - Must I provide Therapy too?

    I actually feel like the load is rather light, quantitatively. Our max is 12/day if they're all med checks. I used to schedule that over a 3-4 hour window, but more rapid work was heavily incentived and lucrative. I miss that dearly. I document rapidly and type while the patient is talking. I couldn't handle it any other way. Qualitatively, however, the burden for each visit is the associated fluff each visit requires, e.g. assessments, med reconciliations, suicide screenings, onerous coding processes, etc. I'd love to be a federal retiree, but I'm hard pressed to stay another year much less 20. It has sort of sucked the pleasure and enthusiasm from my marrow. I enjoy the higher functioning population quite a bit, but the bureaucratic antagonism outweighs that. I just don't know what I want to do at this point. I've come to the end of my five year plan and don't know what to do to formulate a new one.
  9. PMHNP Man

    Psychiatry question - Must I provide Therapy too?

    Yeah, it's an odd place. I do a lot of what I'd code 99214 in any other setting, but here they're fixated on the number of diagnoses you treat at each visit and don't like any referen to diagnoses you didn't address die to the quality metrics. I don't want more appointments per hour because I'm not going to get paid more.
  10. PMHNP Man

    Psychiatry question - Must I provide Therapy too?

    30 minutes on the med checks with a 99213 typically. Yeah, it's the desired outcome of each visit with the the therapeutic dialogue and psychoed it's a doable deal. In a revenue generating capacity is favor it, but then in that instance I'd rather do 4-5 med checks per hour and no therapy. I support therapy and order it everyday, but I couldn't care beans about anything not symptom or med related in my professional capacity.
  11. PMHNP Man

    Psychiatry question - Must I provide Therapy too?

    Yeah, I was in public safety myself and have had those same thoughts, but it's not really practical. On a side note, I read something about CISD making trauma worse later down the road. The theory was in sitting around thinking and talking about it you're adding more time remembering and applying words to the trauma which serves to anchor the memory. Interesting nonetheless.
  12. PMHNP Man

    Psychiatry question - Must I provide Therapy too?

    In theory, yes. However, you'd probably have to work independently and accept, exclusively, only cash or insurances that reimburse PMHNPs for psychotherapy. Additionally, you'd want to engage in your own training and certifications, e.g. EMDR, ACT, CP, CBT-I, etc. Frankly, the money is to be made in meds.
  13. PMHNP Man

    Psychiatry question - Must I provide Therapy too?

    Yeah, I'm with the VA. They're very med heavy and very therapy light. Fortunately, the therapy is mostly evidence based and not supportive nonsense that leaves people in counseling for years, yet it is a very rigid, formalized referral process. Previously, I was the only med person (no doc) for around 25 therapists. I think there's a quasi expectation of using the 90833 add on and actually providing therapy or psychoed. All of us know the NPs are not well trained in therapy and a big dump of psychoed in one visit is low yield for the learner. Even if I could do therapy well, I wouldn't want to. I'm not interested in being a therapist and don't really want to "fake it" either. Being a highly politicized organization with therapy-oriented bosses makes it difficult to have people in and out quickly and focus on pharmacotherapy.
  14. Obligatory anecdote: I currently work in an environment in which all the psych staff tend to spend more time with patients engaged in "supportive counseling" or other therapeutic dialogue. Despite being at the cusp of burn out, I really don't wish to do this. I only want to assess symptoms and medication efficacy and frankly feel that's all I'm good at and have a fairly low emotional intelligence of my own. Question: How many of you are brazen enough to say something akin to "How about we just talk about your medication today?" Passive resistance to responses: At my last job I was ok with this, but it was a different time/place/population and until the mortgage is paid I'm hooked.
  15. PMHNP Man

    $200,000 salary as a RN, it's true

    Did he show you a remuneration statement to confirm this? Many years ago I read about cops in LA making well over $100k/ year which they should. Sounds great especially for cops in my area. But a decent house may cause $1.5M there so that 100k isn't squat.
  16. PMHNP Man

    NP still working as a bedside nurse on the side...

    How do I unsubscribe from this thread? I don't want anymore emails about it.
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