spdaydream

I have worked in Sleep Medicine for three years now. Day to day, I troubleshoot PAP, review results of sleep studies with patients (these have been read by an MD), and manage medications for narcolespy, IH, RLS, etc. I'll be honest, it started to get pretty boring/routine after about six months. But my schedule allows me to spend a great deal of time with my kids, and I'm able to moonlight at more exciting places. Plus, I don't worry about my patients. There are really no emergencies in sleep medicine, so when I'm done with work for the day, I'm DONE with work. I do like my job, but it is VERY specialized. I rarely do a physical exam beyond heart/lungs/ENT. For preparation, I recommend looking at the AASM website -- lots of great resources. If your current job gives you CEU $, there is an APP module that covers all the basics, and is excellent. The main things I like about my job are the interactions I have with my patients, and the satisfaction of helping people feel better. Frustrations include those who get angry about being RX'd a PAP device, and helping patients manage insomnia. The latter is because it's so frustrating for the patients, too! If you have any questions I didn't answer, feel free to message me!

I have the opportunity to go back to school for a couple years. I'm currently an FNP, working in sleep medicine and with a side gig in substance abuse. If I had to nail down a true passion, it would be working with patients with substance abuse, or eating disorders. My conundrum is this -- do I go back and get a DNP, or do I get a post-master's in Psych? I feel like the DNP is something that will continue to lurk until I bite the bullet and do it, but the Psych NP will open the doors to a flood of job opportunities... and $$$. But is it silly to use this time to get yet another MS degree as I already have two (MS in substance abuse counseling)? I have ZERO interest in teaching and the handful of DNPs I know outside of education do the same job I do right now, and make financially, exactly the same as I do. Any advice is very much appreciated!

I just got hired per diem at a substance abuse treatment facility as an FNP (2 yrs experience). A friend of mine is a psych NP who just graduated this past Summer, got hired at the same facility around the same time. She makes substantially more than me. I knew this going into my interview and negotiated, but was turned down, and told that "psych NPs always make more." I took the job anyway because I love it, but honestly (and please NO offense intended) don't get the salary discrepency. I carry a load of 25 - 30 patients, she has 8-10. I prescribe everything from htn meds, insulin, suboxone, and she only prescribes the mental health meds. I do physical assessments, she does not. Is this difference in pay typical? Again, without sounding like an ignorant buffoon... why?

I'm an FNP with two years experience. I made the decision to start my full time career in adult sleep medicine, and also have a per diem gig at a detox clinic. I chose the sleep job because it is very "family friendly" (I have a 2 year old and a newborn) -- hours are great, MDs are awesome to work with, and patients are generally pleasant. The problem is that I feel pigeon-holed. I barely even use my stethoscope, and I feel like it's too specialized. I'd like to go to urgent care within the next 5 years (when the kids are older), but have a feeling that no one will hire me with my current, very specialized, experience. There are some fellowship programs in my area, but all of them only accept new grads, or NPs with less than a year experience. Any advice/guidance you could provide would be much appreciated!

Thank you very much. I think, like you said, I'm getting in over my head with specifics. Everything is mushing together in my mind and I feel like I know NOTHING. I will check out the FP Notebook app, for sure, along with the APEA questions. Thanks so much!

I am studying to take the FNP ANCC exam in a couple months and am really struggling with memorizing antibiotic classes, and which microbes are to blame for which conditions. I would love to find a "quick and dirty" guide to help these things stay in my brain. I'm studying via Fitzgerald mp3 course and review questions, and BoardVitals. Does anyone have any recommendations? A visual chart would be amazing, but at this point, I'll take anything. Thank you in advance.

I vowed not to date during nursing school. Turns out, I met the love of my life. He was a fellow student and we just celebrated our third year of marriage, and have a baby on the way :)

Who is responsible for interrogating pacemakers? Is that a job an RN, specifically a cardio ICU RN, would be qualified for? Any info on special training/job search ideas/specific job description would be much appreciated. Thank you!

Thanks for the advice, everyone! Becoming a Psych NP is my long term goal, but I was just concerned about "shooting myself in the foot" by specializing in something like psych too soon. I appreciate all the kind words, too.

I'm in an accelerated BSN program, due to graduate in December. I'm very interested in psych nursing and have an MS in addictions counseling. Whenever I tell classmates/teachers/other RNs about my interest in pscyh, I get a very negative reaction. The reaction that concerns me the most is when folks tell me I should not get a job in psych right off the bat b/c I will lose my "basic nursing skills" and look less desireable to recruiters if I choose to change specialties down the road (I'm also interested in the ED). Any reaction to this? I've been told that getting my feet wet on a med/surg floor is the smartest idea as it will prepare me for whatever eventual direction I want to take my career, but this simply doesn't interest me. Advice needed! Will starting at psych put me at a disadvantage with future, more medicine-based nursing jobs? Thank you :)

KelRN-- I'm so relieved to hear that I'm not the only one with massive outstanding debt. I received no monetary assistance from parents, etc. and had to rely on my own income, loans, and a few scholarships to get me through. I have a BA in theatre (mistake, but whatever), an MS in addictions counseling (expensive and haven't officially practiced yet), and am now in a very expensive, but awesome, accelerated BSN program. I will graduate in December with about $120,000 in debt. Yup, that many zeros! Am I scared? You bet! But, at this point, I can't hop in my time machine and undo the past, so I'm gonna have to deal with it. The good news is that it will be much easier to pay off with a nurse's salary than as a medical secretary (former job) or even mental health counselor. I could've made better decisions, but sometimes the education outweighs the cost. If I could do it over, I would've gone to nursing school straight out of high school, but like I said, the past is past. One thing is for sure -- I'm not paying for my advanced nursing degree(s) when the time comes. From now on, I'm getting tuition help from any employment I have!

I'm only an RN student now, but as a former eating disorders patient, perhaps I can give you some insight. I have been hospitalized numerous times with anorexia and bulimia (currently in remission), and can tell you that my assigned nurses are the reason I decided to go into nursing. So, you can indeed make a huge difference in this field if you're good at what you do. I completely agree with tammy -- we are a manipulating group! But (in a strange, convoluted, sick and twisted way) we WANT to get caught. I can't tell you the number of times I lied about not purging, or hid butter, or quietly exercised in my room. The biggest piece of advice I can give you from my perspective is to be aware of "bad" behavior and bring attention to it! The nurses who called me out on it were the ones who were doing their job -- saving my life! The eating disorder is like a demon, it takes over the mind and forces the sufferer to bend the rules in order to keep the disorder happy. I really just wanted someone else to take away the burden by forcing me not to cheat the system. By telling me that it was inappropriate to lie, or having repercussions for hiding food or exercising, my nurses (the good ones, anyway) were punishing the eating disorder demon and making it easier for me to stick up to it. If you think you can make a difference in this population, then go for it! It's tough, for sure. I'm an intelligent, well-educated, kind person, but during the worst of it, I threw food, screamed at nurses, slammed doors... remember, it's the disorder!! Along with the psychological aspect, eating disorders have a physical effect that is horrifying. The brain atrophies, and due to lack of nutrients, the mind does some crazy things. I'd love to work with eating disorder clients, but for the time being, the issue strikes way too close to home and I'd be putting my own health in jeopardy. Good luck!