PsychMaven

I've never heard of a Psych NP doing physicals. My NP program is focused on diagnosing mental illness, therapeutic technique, and prescribing...we rarely ever touch our patients. As for leading groups as a psych nurse I have done a variety of different types, but none that were specifically labeled as "psychotherapy," rather you might lead an unstructured interpersonal group that has a similar emphasis on the process, but is not so specific...it really is a fine line to walk. I was actually trained to lead groups as a Mental Health Specialist, not even a nurse, and it was encouraged that we lead a variety of groups once we received this training. The main difference in scope of practice for Psych NP's is the ability to diagnose and treat including prescriptive authority as well as individual/group/family psychotherapy.

Psych patients are obviously very different from what you are accustomed to and you should definitely make sure that you are comfortable with your switch and the population before delving into anything. Leading a successful group means meeting members at their level of functioning by educating, forming strategies, teaching skills, connecting to others struggles and successes, reframing unhealthy beliefs, and offering hope. Basic Groups Models & Examples Psychoeducational: knowing your illness, medication management, nutrition, dual diagnosis, symptom management, or relapse prevention. * Structured educational group, a good bet for a new group leader. Cognitive/behavioral: distress tolerance, communication skills, behavioral planning, affect/emotion regulation, or stress reduction. * Structured group based in behavioral therapy-derived skills aimed at modifying cognitive and/or behavioral processes; must have knowledge of specific therapies. Interpersonal: interpersonal relationships, grief and loss, self esteem, narrative life stories, or family issues. *Largely unstructured, these groups can get incredibly emotional. You must be able to close the doors that are opened during a session so do not bite off more than you can chew. Leading a Group: Planning: When planning a group, you should have an objective statement so it is really clear to you what you want to accomplish. I was taught that the best size for a group is 7 +/- 2, so 5-9 people is ideal. Be comfortable with yourself and the subject. Choose a group treatment model that suits your style and strengths. Beginning: Introduce yourself, the group topic, and ask patients to go around and introduce themselves; I like to ask people to introduce themselves and say how they are feeling which gives me an idea of the tone of the group as well as eliminates some anxiety on the patient's part. Do not choose a person to start, allow someone to volunteer to introduce him/herself first and then continue in a circular pattern. This allows you to "diagnose" the group dynamic and identify one of the group's leaders (you are the formal leader, but patients will emerge as dominant members as opposed to the isolates). "Scapegoats" may sometimes arise and are often the most ill person in the group, subject to open attack. These patients often serve as the vehicle for crystallizing group issues. Determining the level of leadership that is needed is vital to the group. If a high level of structure is necessary, asking an open question such as "how are you communicating with your treaters?" may be helpful. If a low level of structure is necessary, promote group leaders as they emerge. The "work" of the group: Think of each group as having its own climate, leaders, and process. I was taught to operate by the idea that the group is a microcosm and that each member represents an important role to the group. To kick a person out of the group is to kick out an entire role, possibly one vital to the group's process. Share your leadership role with others. Expect some moments of silence and use them. While uncomfortable, these moments punctuate the experience and often open up opportunities for different group members to interject or shift the focus momentarily. Monitor yourself, especially if you find yourself speaking frequently, and remember that feedback is often most effective when delivered softy and respectfully. If conflict arises, work hard to understand the person's perspective. I often say something like "I'm glad you could express that." Don't reject the rambling on and on of patients, but be sure to contain it. Reach out to group members if they are quiet or reserved. Connect members by forming relationships that are helpful or caring, saying things like "can anyone relate to that?" after a statement or "would anyone like to comment to someone else?" Highlight issues that promote the hope and recognize the pain of group members. Always thank group members after a contribution. Trust the group. Ending: Allow patients time to disengage. Establishing a ritual ending can be helpful, for example asking patients to say how they felt about the group or even give a rating of their personal satisfaction. Follow up on feelings about the group, asking for more feedback about how to make it a more satisfying experience. Thank everyone for participating in the search for meaning and support. This really only skims the surface of group work, but I hope that it will be helpful in starting you off. You will often be impressed by the goodness of others as well as your own awkwardness in not knowing what to say or how to be helpful, expect and honor this. Try to enjoy yourself, you are privileged enough to be included in some of the most intense and meaningful experiences in people's lives. Good luck!

Does anyone know what the general policy is for scheduling a drug test? I know they generally give you a week to schedule, but is that one week from the offer of employment or from your acceptance of the offer? I know it's different everywhere, but what have other people experienced?

I tried the trick right after I took my test this past Wednesday and got the pop-up, but was still hesitant to celebrate too much. I got the pop-up again yesterday, but still felt like I was the only person this would not work for. Well, I just checked my results and I passed! I think after 300 and some posts going back several years, we can safely say that the trick works whether you check it the same day or weeks later...as long as you see that 'delivery successful' message with your pop-up, you can pretty much start celebrating!!! :cheers:

Your friend likely left because she suddenly felt like a burden, reading the responses that focus on passing her on to an authority and getting back to what's important for you right now...the NCLEX. While I certainly don't think that you should be pushing studying aside, you can absolutely address the serious issue with a woman you likened to your sister as well. The reality of this situation is that your friend is in trouble, she is away from her home country, and you were her go to gal. Talk to your friend. While emotional abuse is certainly nothing to cast aside, determining if your friend is in physical danger is indeed the first priority. If this is the case encourage her strongly not to stay with that person and give her options such as the safe houses and church groups that other users have reccommended, but remember that the average abused woman will return to her abuser 7-8 times before leaving for good. If it is reasonable and desirable to you that she stays at your place (this is certainly how best friends often feel), then set a clear boundary about your need to continue studying. What your friend most likely needs right now is someone to talk to without fear of judgement, she needs to be empowered to figure her own situation out...with your, or someone else she is willing to trust's, assistance. It is imMediatant to remember that she probably feels very ambivalent right now, unsure, and helpless. Validating her experience and feelings (regardless of what they are) is extremely important right now and she needs to know that she has you, or someone, behind her. Try to get ahold of your friend, tell her that you are sorry that you violated her trust (you told people, whether or not they know her it is probably very embarassing), but that you are truly concerned for her given that she is like a sister to you and just wanted to do the best possible thing to try and help. When talking with your frind, try to put yourself in her place. How would you feel about the whole situation? What might you want someone to say to you? What wouldn't you want someone to say? It's obvious that you are as great friend, your friend is just in a very precarious situation. Do your best and, of course, don't forget that you need to study as well. Helping a friend doesn't have to take up all of your time...she'd probably just be happy to have a conversation, think about her options, and sit near you while you do your work, keeping you company. That's what friends do after all. Take care of yourself in all of this as well, dealing with such serious issues can be incredibly taxing.

Hi Summer, As I'm sure you can tell by the number of responses, this is certainly an understandable fear. I started an Entry to Practice program last summer (everyone already has a BS in another field) and am finishing with my BS in Nursing this May. Basically I've taken 60 credits and completed upwards of 750 clinical hours in one year. All I can say is that if I can do it, so can you...especially considering you have excellent grades from high school! I had all the same fears as you last year and here I am preparing to take my NCLEX, time will fly. 1. In my program you must maintain a 3.0 each semester, cumulatively. If you fall below that you are placed on academic probation for at least one semester and if you do not bring it back up I imagine you are dismissed. 2. In my experience you must maintain whatever the school's minimum GPA is throughout the entire nursing program. 3. It is possible to be removed, for example my program requires immediate dismissal if you fail a CLINICAL course which is very very hard to do unless you simply are not trying, asking questions, or getting involved. 4. I believe it is acceptable to repeat courses, however if it was a pre-req for the next class in your program that could set you back tremendously. 5. Plan on being dismissed if you do not measure up to your particular institution's requirements, it is possible and it does happen. 6. I know of several people dismissed from our program for their grades. 7. If dismissed from a nursing program, you could get into another program theoretically. The grades that got you dismissed, however, would likely make this very difficult. I would suggest that you look into the exact requirements for the programs you are planning to apply to, everywhere is different. Just do your best and study, study, study. Don't let failure be an option, most schools have tons of resources if you are having trouble and your professors will surely want to help you succeed. Take a deep breath and dive in, best of luck Summer!

if we are going to discuss finances, i don't know about anyone else, but i'd much rather talk salaries :wink2: There was a lot of good info. in this article and a promising number for NYC salaries in particular.... http://www.advancefornp.com/Sharedresources/advanceforNP/Resources/DownloadableResources/NP_2007SalarySurvey.pdf

you seriously don't seem to get it. the reason i am not "keeping to the facts" is because your input is not welcome, the last thing i want to do is further engage this bs. take your pearls of financial wisdom to the designated thread where people want to discuss the glaringly obvious financial issues surrounding ivy league educations. enough, honestly.

waa, waa, waaa...consider making your own thread to take your unwanted advice and relentless complaining elsewhere. you are not helpful and i am thoroughly bored of hearing the same tired and obvious (at least to most of us) message over and over. i love it when people are so clearly unwanted and yet persist regardless...sad really.

How funny this is. I must say that the inappropriateness of columbiaetep04's posts has done more than her whiny banter to convince me of Columbia's shortcomings. I really did laugh when I saw that she actually signed up for allnurses just to post that demoralizing little message...supposedly after years of nursing school. Hehe. You honestly never did the math columbiaetp04??? I suppose when I thought about it for myself I took into consideration that even subtracting $12,000 from my yearly salary as a Psych. NP would be considerably more than I would've made with other two year degrees, such as a LMHC or Social Worker, and I still would still be paying back the money that I'd spent to get those degrees...on a lesser salary. Not to mention the wider scope of practice that a NP has, blah, blah, blah. Everyone has their own justifications and I'm sorry that you did not plan ahead or have the capacity to understand what you were actually signing up for. Take it somewhere else though, WE DON'T CARE...and you so obviously do. I hope NOT to get a response from your sorry little self. Can't believe it's gone on this long really... I expected to see maybe one other message, but you honestly did take it there didn't you.

Um, thanks for your honesty negative nancy...I guess. A message board of people two weeks away from beginning the program is not exactly the appropriate place to be whining about your financial constraints though; perhaps you should impart your wisdom on the '09 program. Everyone here is well aware of how much the program costs and the fact that there are other alternatives. Someone looking to find Psych. NP programs however, can not go just anywhere, most programs do not offer this specialty. Keep in mind that people have many choices in healthcare today and, unfortunately, not everyone knows much about NP's and will often seek out the more familiar MD instead. Besides the obvious cost disadvantages, Ivy League credentials definitely ease people's concerns when choosing clinicians. I could go on, but who cares really...

It's finally starting to feel real...I can't believe that we'll be starting three weeks from now! I'm definitely feeling a bit more anxious as the date approaches, but I guess that's to be expected. Do we need to order our book package from the bookstore before we get there to get the discounted price or will they be available during orientation? Is everyone else as excited as I am?! See you all in NY, whoo.

Finally the news arrived, I will be in room 421! Whew, one less thing.

Still waiting impatiently up here in Boston, crossing my fingers and toes...

Seriously....that f*ing sucks.