NHGN

Hi all- I've been walking around with an idea to start a new business, for about six months now. I've done some basic market research and have spoken with a few similar businesses in the country. I think there'd be high demand in my area. How the heck do I go from "I have a great idea and I have an LLC" to "welcome to the grand opening of my business with all of these shiny new supplies that cost me in excess of $100k (etc)."? Friends and family say the next step is finding an investor. Yeah that's great, BUT YOU CAN'T LOOK UP "POTENTIAL INVESTOR" IN THE PHONE BOOK! Where do you find these people?! Do you create some sort of glorious pamphlet with your concept, research, and what you're looking for for investment? Do you casually leave them in upscale steakhouses and hotels and hope for the best?! Is this basic knowledge my parents forgot to teach me? Help!

It's just one guy's opinion, but check out episode 66 of The NP Dude podcast.

Boston - Well...I've prescribed them once or twice while under physician collaboration. But there is no way I could prove this (ie it's documented in two patients' charts from ~2 years ago). Another experienced NP advised "You can prescribed those, there is no restriction. People will all tell you to stay in your scope but with additional training and add this to your liability insurance, that will be sufficient." I will talk to the BON. I expect them to be vague and not have anything if I ask for documentation.

Jules - there's nothing on their website. I spent 30 mins on hold on the phone only to get disconnected - I'll try again tomorrow! A few experienced colleagues have thought that the BON won't have information on this. Still others said refer to my hospital policy- but there is no hospital and the "company" at this point is one person. I did talk with somebody from the ANA over email since many other professional groups refer to them for scope of practice limits, but they referred me back to the BON too. So I'll make that phone call again tomorrow.

Hi all - As some of you will know, I'm a psychiatric NP with full practice authority in Connecticut. I have been approached by a friend about working p/t at one of those new trendy IV vitamin/hydration "therapy" places (actually this would be concierge). This certainly isn't my calling in life, but I can't say I'm not a little interested. I thought this would definitely be out of my scope, but some of my friends (a paramedic, an FNP, my biller), think perhaps not. How do I ago about determining, concretely, if I can do this (would be standard IV fluid limited to NS and LR, some IV B-vitamins, and meds limited to Zofran and Toradol)? Most people doubt that my state's BON will have given specifics on this. I tried the ANA's website - some vague statements and no contact email/number. I can see this maaaybe being okay b/c I have prescribed fluids and I think once zofran/toradol to an occasional in-patient psych patient. (Plus, can PMHNP's prescribe IV ketamine?) Does it matter that this position wouldn't actually be "treating" any medical (or psychiatric!) problem (okay-aside from hangover-level dehydration)? Yes I need to have competencies with inserting and running IVs, knowing about extravasation etc, (have that covered as an RN)..... what about knowledge of fluid and acid-base balance? I have that, having been a SICU RN, but I haven't received NP-level education on the subject. Do you FNP's have specific lectures/classes on it? Thanks for any thoughts/suggestions/insight!

Well, consider it. Columbia has a well-known DE program, right? Why wouldn't we be as scrutinizing of their results as we are of studies funded by drug companies? There's no need to sensationalize my comment with a "fake news" follow-up.

I imagine that may be quite biased.

It's only been about 6 days since I started with Anthem. I've received three calls since then. So yes, I think there's been more movement. I'll keep you posted!

This sounds super sketchy to me. At least they'll pay you hourly. Basically, you could be working full time M-F (since they say up to 40hrs), with part time benefits and a measly two weeks vacation. If you take it and hate it because they are awful, #2 is a joke. I just reread my post and realized how negative it was. However, that's how I read your post (am I wrong?) and I'm going to leave mine as-is!

I had just started a cash-only practice at the very end of January and wasn't seeing as much interest as I had wanted. I just got credentialed with Anthem and I'm waiting on CIGNA and Aetna. I never thought to hire somebody to do it for me; the applications are not difficult to fill out. Perhaps if you wanted to be credentialed with every single insurance co out there...?!

I am way less stressed as a psych NP then a psych RN (or SICU RN for that matter). I see 15 pts a day max. Usually 12-14 with no shows. Two admissions max.

You're a genius if your subject line was deliberate.

You could use a recruiter?

I think it depends on the individual business. I got a $17/hr raise when I switched from a hospital to an OP community clinic.

I don't see any overt trolling (what am I missing!)? OP- you might get a warmer reception if you gave us some evidence of putting in your own effort in finding this info before asking here. IE "I did a basic google search and it seems like most NPs in (location/Service/setting) make an average of $. I'm wondering if that's true for most people here..."

I agree with the above! I did nursing in undergrad with the goal to be a crna, from the get go. Hated anything but the ICU in school. Started in a prominent trauma/SICU as a new grad. I decided I didn't want to go the crna route and started psych np school. Worked as an RN on a psych unit during school to make sure I liked it. That was pretty easy work, but being in the NP role is much more fun.

At the suggestion of my past Attending/mentor, I'm going to do a cash-only private practice on the side (starting with one day a week). He does the same in my town and charges $500 for intakes (granted he's a physician). He does p/t as well and says he consistently gets calls for new patients, whom he cannot take on (he's full). So I will see what comes my way. My expenses so far have been setting up my LLC ($500, to round up), listing myself in Psychology Today ($30/m), I have a pending email to change my malpractice insurance (this will not go up by much, I think), I checked out a nice office I can rent for $15/hr, and I was recommended an EHR for $60/m. That all adds up to... not a lot. My skeptical brain cannot fathom that I could make a profit in my first month (if I even had just two-three patients), but that's what it seems like. I'm not doing any outreach for now; I'm going to see if anyone contacts me this first week, and go from there.

Um, wait. My state says "collaborate at an appropriate" level or some vague nonsense. So I have a collaborative agreement and I ask my collaborator when I have a difficult case, but none of this is documented. Am I doing this wrong?! I've got 2.5 more months before I can be independent....

It's actually really helpful to hear you guys' positive comments. I had a horrible night's sleep, waking up worried about money - nice to wake up to these posts!

Is it such a faux pas to keep adding to one's own thread? Please excuse all illogical thought, as the below is more brainstorming than anything else (though I appreciate all constructive input!) As my research continues, doing telepsych in schools is an interesting thought. At the c/a clinic where I work, we have lots of contracts with local schools where a therapist will go into the school for several hours. Yet the child has to come to *me* for med management. Lots of kids miss their appointments because they have prior school obligations (like a test), or more so because their parents don't have the time to bring them. With the telepsych, I could "be" in schools. It's none to common that there are so many kids in one school to see who need med mgmt appointments as to fill up an entire day, on a regular basis. But with the telepsych I could "travel" to multiple schools throughout the day, making the virtual in-school approach a practical idea, on my end. I suppose I could even contract with the school to have 'on call' hours if need be....

It still doesn't feel very good, and I honestly enjoyed the job and all the education it brought. Genuinely -thanks for your support :)

This was the most legitimate article I've found so far: https://www.psychcongress.com/article/getting-started-telepsychiatry

No, the $85 was w/o benefits. I tried to rally my peers; the experienced ones took the "we will quietly stop picking up time" approach. And the brand-new ones accepted it (but really, I cannot blame them and would more than likely do the same). I was the only one with the "we are stronger together and if we make noise, they will listen" idea. Ugh. Somebody said "it will be no use to argue. I talked to the director and the rate was given to them by HR." As if HR is God?! Um, folks, they can easily change the rate too. So, I spoke up and I got punished for it. Like I said - I'd rather this outcome than just rollover and take it!

Hmm.. i think my reply got eaten. My rate for that was $120, and they cut it to $85.

Hi all- There have been a good handful of threads started about telepsych on AllNurses in the past few years, but little responses. Yet, according to a recruiter I spoke to today, it's all the rage. So who are these people taking these positions? I only heard of the term a few days ago. On the surface it sounds interesting - seeing OP-level patients in areas with poor access to psychiatric services, while I'm at home keeping my dog company? Sure, why not! Of course, then I start to think about all of the aspects I'm missing when not face-to-face. And what if they need to be hospitalized? What if they need lots of case coordination and I have no relationship with any other people at that clinic (or state!)? Or know the state laws? Some of what I've read up on explains that a nurse is in the room during the session to help, which I can see being useful. Then there are the telepsych tech companies offering computer programs and training so that you can set up a private telepsych practice. ....Do they expect you to see patients in *their* own homes?! Do any of you out there practice with telepsych? Are you dead-set against it? Is it really "all the rage"? Anyone have a pure private practice with it? What other questions should I be asking?!