resilientnurse

I was wondering if there are any fellow PMHNPs that are rethinking their profession/specialty these days. Frankly, I was burned out prior to the pandemic and have pushed through nonetheless. I have worked in practically every area of psychiatry, except forensics and military, so it is not a question of changing work environments. Not interested in academics. After much sacrifice to obtain my credentials, I am not sure how I can reinvent myself. Are there any non-direct patient care roles for PMNHPs?

Is there anyone who has any insight into the work culture for APNs at the Mayo Clinic (particularly in AZ)? How are the benefits?

Perhaps this topic has been explored here before, so please forgive me. But I am curious about any current thoughts on the topic. I do not touch my patients. Although, on 1-2 occassions I have gone to stand up after a session and to my surprise clients simply lunge towards me for a hug AND JUST TAKE IT. I learned not to touch very early on in my training. In fact, I did clinicals with a psychiatrist who was absolutely up in arms and about to resign because it was suggested that she might have to take VS during an evaluation so that the agency could maximize it's reimbursement. "I will absolutely NOT touch a patient! They could be traumatized." I understood her point and subscribe to the no touching. Recently, I have been working in the Southwest (on locums) and I am amazed at the number of clients that come in, meet me for the first time and extend their hand to be shaked. My clients don't do that back home. This is such a foreign practice for me coming from the Midwest. Ironically, here if the RN takes off the clinicians are expected to take VS. This has happened to me once. I reluctantly did it, but am truly hoping that this nurse stays put.

I know how valuable your time is. I also hear your anger and disgust by the whole matter. I cannot say that I would react any differently. But this situation is like a toothache. It is not going away. I would go in to meet with the hospital's counsel and listen information r/t the case. They are not your counsel, but it's your best resource for now unless you decide to seek counsel on your own. You may not remember the details of the case. I know I would not necessarily remember one specific patient from 2 years ago unless it was something remarkable that happened. You need to know what this case is about just in case you do get subpoenaed. I also would not volunteer any information about the hours you work now or worked at the time.Also, do not feel intimidated. Take along a trusted nurse friend (a super nurse someone soundly versed in theory with good crtical thinking skills) and/or a friend with some legal experience in case you forget what was discussed. Take notes and do not be afraid to refuse to answer questions if you do not want to. But find out what you are facing so that you can plan your next steps. Hope this helps! Good luck to you!

That would've been my exact advice a couple of years ago. However, I feel like a FAT ARISTOCRAT now (not really) :-). I am going back to school for a DNP, but I am doing it one class at a time, and only if it works with my schedule and am the laziest graduate student ever. Meaning, family, making money and relaxing come first. Otherwise, there is no way in the world I would go back to school. There is little motivation to do so, especially since it would not impact the bottom dollar line. So, you stand to lose your motivation and drive. If you have the stamina and those other certifications are important to you, go right ahead! As you get older and more settled, many people look for the nicest paved road to accommodate the smoothest ride.

If you have not made a decision already, I think that your heart will guide you. Commuting is terrible, but there is an upside to it as well. For someone like me who has a full nest and my only escape from my family is when I actually go to work, it can be a time to gather your thoughts, listen to the news or audiobooks, and go on auto-pilot for a minute if the commute is not too demanding. I am currently on a temporary short-term assignment (locums). My real job is waiting for me when I get back home. I'm on a working vacation of sorts. This short-term assignment is very easy.” I almost feel guilty for taking their money. Not really.I have an hour free "record time" when I first come in. So, no coming in and your first patient is already waiting for you. I get 90-minutes for first time patient appointments, so I am done with them in 45-60 minutes and then get to breathe while charting and cleanse myself of their energies before I see the next person. I will get no more than one new patient a day. My lunch is 60 minutes. Then after I return to lunch there is 30-minutes of record time”, so again no patients waiting. Also, my last hour of the day is free for "record time" as well.My real job is the total opposite. They want to squeeze every penny and neuron out of me! I am running from the time I arrive until the time I leave. I usually wind up charting on the measly unpaid 30 minute lunch break or doing it at home. There have been times in the past when I have seen 40 patients in one day! I dare not let on to anyone here that I can work at a much faster pace and simply enjoy this brief change in a practice setting. But the work culture is different. Some work sites simply do not believe is overworking providers.I would get bored with this job if I did not have other things to do in the down time to keep me busy. However, your body assumes the toll for the difference between stress” and boredom” or non-stressful” activities. Determine how stressful the commute will be on your body in the winter months. Not sure where you live. I'd rather be bored (notwithstanding the commute) and collecting a paycheck than stressed out. Do what's right for your mind, body and spirit.I'm looking for an easy permanent NP job. Let me know if you hear about anymore. 

Hi Psychns,I appreciate your post. I am curious what are the typical things that you can deduct as business expenses while on a locums' assignment.Thanks!

I am sorry to hear about your situation, but I was wondering the same thing as this particular responder. How do you pick and choose the anxiety and depression patients? You NEVER know what you are going to get until after they come in and sit down and start talking. Psychiatric care is nothing to take likely. Also, there is no guarentee that the anxiety and depression patients are the easiest ones. Not to mention the drug seeking, Axis II and substance abuse. People die on you and the depressed ones are the first ones to go. Psychiatric care is very stressful and you have to work very, very hard at self-care. Everything is psych is "hard core!"But if you understand that, the one thing that it may be able to afford you with three children (although not immediately) are options and reduced hours if you get a high enough paying job. Psych NP jobs are abound and you can negotiate a fairly decent salary which will allow you more time to be home at home. Good luck to you and your family!

Greetings, Can anyone shed light on work as a VA Psych NP? The pay makes me want to cry, and the application process seems long, but I'm seriously considering it because of the benefits. Is the low pay worth the benefits? Any input you can offer would be greatly appreciated. Thanks!

I am hopeful to connect with any Psych NPs that work in Arizona. I am moving from a restrictive practice state to Arizona and would like to learn more about what it is like to work in an independent state. Is it simply that you are not required to collaborate with a delegating physician? Has anyone else made such a move? Any pearls of wisdom? Any insight you can provide will be greatly appreciated? I do understand that there is a regional area to post this inquiry, but it appears to be dominated by interests in particular nursing schools.

You're a good person. We need more Geri Psych providers. Welcome aboard!

Psych can be hard core! It's no joke! I am not going to lie to you. Not all of us are so lucky to love our jobs. There may not be anywhere for you to move to at times if you get bored or burned out. Patients die too (on purpose). You may find yourself in a job for the sole purpose of what feels like evaluating and writing scripts--nothing more, nothing less . . . except impact your volume, increasing the number of patients you see. Shadow multiple Psych NPs AND FNPs working in various settings, inquire (as you are doing now), and do some self-analysis as well. "How would I deal with perpetual occupational negativity?" I don't mean to sound like a "Debby Downer" but the advice you received was probably to help expand your horizons and professional opportunities. Best of luck to you.

Search this site for additional insight. There was a NP poster who felt that he was being stigmatized in the employment marketplace as he looked for jobs after his correctional work experience. He felt like no one would hire him because of it.

How long did you wind up staying? It sounds like you were willing to push up your sleeves and stick it out. Your description of it sounds like it would've been a tough job even for a seasoned Psych NP. I would not have taken it, myself, under the best of circumstances. There are Psych jobs that are less stressful.

Despite countless self-introductions as Ms. [my last name here]. I have found that patients will call me basically "whatever the heck they want to." Usually Dr. [my first name] or simply my first name. Despite repeated corrections, they persist. I no longer bother to correct them anymore. However, today I heard the oddest phrase. Patient's wife: "We were at dinner, but I told the family that we had to go see Tom's shrink nurse". A "shrink nurse", really?! "Oh, we mean that affectionately." Of course. What do patients call you?