QEOLAdvocate

I'd love to hear from the experienced PMHNPs (those with > 5 years of experience), do you incorporate talk therapy in your practice and do you know of PMHNP colleagues who work as therapist? Is working as a therapist allowed with a PMHNP credential? I ask these specific questions as my end goal for my career is to be a provider who uses much less pharmacologics and uses more talk therapy and provides a safe space for people to be heard, and I hope that a PMHNP certification helps me achieve this. Thank you all for your time!

Hi all, I'm wondering if there's anybody else on the forum who has successfully and gainfully made the transition from being a nurse practitioner to being a licensed therapist?. I am in my mid 30s and have been a nurse for about 13 years with an even split between RN and NP experience in those 13 years, mostly focusing on palliative care/pain management. I've always had an interest in psychology, psychiatry, but I don't think pursuing a psych NP cert is going to give me the fulfillment or flexibility that I want for the second half of my working life, additionally psych NP isn't going to allow me to really talk to people and help them primarily via talk therapy, in a meaningful manner, that's why I'm not pursuing the psych NP route . I'd love to hear from anyone who has undertaken this journey and any advice, 20/20 hindsight lessons, the good/bad/in between that you can offer. thanks yall!

Hi, I'm a palliative NP at a cancer hospital, we do one week inpatient and one week outpatient, and are acting as consultants as patient's are receiving their cancer treatments. Since I am new to this hospital, I don't get the very complicated cases, those are handled by the physician, but this past week when I was inpatient, some of the things I was responsible for included: Reviewing patient's chart to see what the last provider did/didn't do (to get an understanding of what is going on with the patien Ree what meds have or have not worked in the past/currently Review MAR to see how much of PRN meds are being used and looked the pain score documentation to get an objective sense of if PRN meds are working, which allows me to assess effectiveness of current regimen Monday-Friday 0900, sit in on the IDT meeting with the physician, social worker, chaplain, RN liaison (she helps us coordinate hospice transfers) and hear from the physician what the patients were like over the weekend (the physician rounds on our patients and is on call for that weekend and the following week, so on Monday they present all the patients, and then assign which pts will be seen by the NP and which the physician will see) During IDT physician and I decide which pts we need SW/CH support with and decide on our tentative times we will see each patient and then we go off and see patients .. During pt visits Assess pt's comfort, assess pain, nausea/vomiting, SOB, constipation, PO intake, mental status, plan for the day from the primary team (hematology/oncology), any questions, and if current regimen isn't managing symptoms, than discuss that with patient for potential changes or if not changing, why you aren't changing the meds (is patient too sedated? recently made changes and enough time hasn't passed to assess effectiveness? did pt refuse doses/were doses held? etc..) For routine meds (TID around the clock), you still should assess if it is actually helping the patient.. just cause it is being given, doesn't mean the patient is actually getting relief of symptom from that medicine.. After visits, Send messages to primary team to get clarity on their plan and to inform them of my/our recommendations... Write notes Discuss plans with physician (since I'm new) Put in orders after discussing with physician Make phone calls to pt family/decision makers.. Reassess some patients who need to be reassessed Wrap up the day (put in addendums to original notes if anything changed.. ) Tues-Fri it's the same essential structure, and you rinse and repeat.. There is soooo much information to know and it is overwhelming right now. It is completely different than outpatient palliative/hospice care which I did for 11 years. I know part of me feeling overwhelmed is because each physician's expectations are different, as is their workflow, and physicians have years of being able to read and understand information, and I haven't had that same luxury, so I do need to find a way to have some information readily available and some frameworks that I can refer to quickly. I'm outpatient this week and have a couple of days of WFH where I'll respond to refill requests, patient phone calls for things that come up in between their visits with our team, and I plan to use this time to organize information, so I'm not so lost. Hope that helps!

Hi all! I’m thinking of applying to Vanderbilt, UCSF, and John Hopkins for their psych-mental health NP post master’s certificate for the 2022 school year. I attended a virtual information session for Vanderbilt this morning and not much information was presented and I don’t want to annoy the admissions office with too many questions... atleast not yet. A little bit about me, I’m an Adult Gero Primary Care NP, working in Southern California x 2 years since Oct 2018. I graduated from UCLA for my MSN and from a private college in Atlanta, GA for my BSN. As a RN, I primarily worked in hospice/end of life x 7.5 years. Has anyone attended the Psych Mental Health Post Masters Certificate program at Vanderbilt, UCSF, and/or John Hopkins and graduated from 2018 to 2021? Any information on getting accepted? What to expect during the program/s? Do you feel you got a good education? Thank you! -QEOL Advocate

I’m wondering if I should get a post master’s certificate either in Psych/Mental Health or in Hospice Palliative Medicine in the near future. I have 7 years of experience as a hospice RN and I miss the work terribly, but I’m learning a lot as a primary care NP, but I don’t see myself doing primary care for the next 5 years. As far as Psych goes, I’m very interested in it and thoroughly enjoyed my Geri psych NP rotation. Financially and return on investment wise... what would be the “smarter choice” what’s the best way to do a post master’s cert program (online versus on campus), and is it worth it in the end? For comparison sake I’m making $120K base salary as a new grad NP (working as a NP less than 1 year) in the Orange County adjacent Southern California area. Thanks!!

Thanks for all of your advice, I took the ANCC AGPC boards last week and passed and finally the California BRN is processing applications received June 16-30th... so hopefully I'll have my license soon enough. The job search ya been going well enough.... so I'll keep you all updated with what happens. If I was starting over and about to graduate... I would wait to apply until I am licensed and or certified... it is a morale buster to interview well and then not get the job because you're not licensed or certified.

@hafhaf: if you want to work in the acute care setting then you should pursue the adult-Gero acute care NP but I think the best way to figure out the scope and duties of each speciality would be to shadow a local NP who is an acute care NP and a primary care NP. Good luck!

@spiritualnurse913: I don't agree that it is primarily common sense, almost every question there is 2 right answers and it is damn near luck of the draw to figure out which one is the most correct. Good luck to you and I look forward to hearing how you felt after taking it.

I took my ANCC for adult Gero primary care this morning and I passed. I am not happy with my performance, but honestly after taking the ANCC, I feel like there isn't a way to adequately prepare for the test. The wording of the questions and the ultra emphasis on the professional role and that stuff was understood going into the exam, but none of the practice exams or questions prepared me for how information was presented on the ANCC. I feel like I wasted nearly $250 of the $500 for the Fitzgerald review when none of her questions were representative of the ANCC content... Plus I used the 3rd gen Leik book. good luck to each of you taking it! My honest feedback is that if you want to be tested clinically then perhaps look into the AANP.... cause with Adult Gero Primary Care you're not going to get much in the way of clinical diagnosis/planning etc... I would love to hear from other people who have taken the ANCC and how you felt afterwards. Good luck!������������

Congratulations!!! Maybe that means mine is 3/4 of the way here??!?? Wishful thinking!!! Congrats ToFNPAndBeyond!

That's even more worrisome that you submitted yours on June 13 and you still haven't heard back and it's been exactly 2 months sorry to hear that. But definitely does not make me feel better since I submitted mine almost 2 weeks after you. I haven't tried to contact the BRN or any other agencies for the same reason that you stated. It is just nerve racking to think that it will be almost October if they take the full time to process the applications...

I graduated from my California based NP program (not an online program) on June 16th 2018, I submitted my California BRN application + furnishing application on 6/26/18, and it still says pending... my friends who graduated from my program submitted on 5/10/18 and on 5/31/18 and received their NP license on 6/24/18... for the last 3 weeks BRN claims to be processing applications received June 1-15th 2018... with a processing time of 12-14 weeks. I hope by some miracle by the end of August 2018, mine will be processed. This is quite frustrating to say the least!

Any help/advice/words of wisdom/comments from people in the same-similar situation are much appreciated!!! I'm trying to figure out how to by-pass the "well I'm not certified yet..." part of job interviews, and how to keep the employer's interest alive or should i just wait til I'm certified to apply to jobs? ... read below for more information... I want to work in a internal medicine office and working out of state or in another part of the state is not an option. My clinical instructor advised prior to our graduation that we should focus on passing the board exam and then apply for jobs.... I graduated from UCLA's MSN Adult-Gerontology Primary Care program last month on June 16th and I plan to take my ANCC exam mid to late August 2018. I'm finding that because I haven't taken my board exam, potential employers are not willing to take the job interviews/offers to the next step. I've had a very positive phone interview with a housecall group and the recruiter/hiring manager said to get back in touch once I'm certified... but the pay at this place was the same as I make as a RN.... 1 phone interview with a well known medical group with their senior recruiter and that interview went well but since I am not certified it ended up with the same ol' "stay in touch and keep applying and definitely reach out when you pass your board exam". This week I had a face to face interview with another reputable medical group and it seemed to go in the same direction as the phone interview... The clinic manager at one of my clinical sites asked me to stay in touch with her cause one of the MDs was potentially looking to hire a NP, and I'd rotated with the group but with another MD (who knows that this other MD is looking to hire and will speak well of me), so I've emailed her every couple of weeks to check in and I keep checking the office's website. (THIS WOULD BE THE DREAM JOB FOR ME) I'm reaching out to other preceptors and people I've come into contact with prior to NP school just to let them know that I'm actively looking for a job and sending them my resume to pass long/keep with them in case anything comes along their way...

Hi everyone! I'm a second year NP student (adult gero primary care), and next month I'll be starting rotations and this is my first 10 week rotation in the traditional doctor's office, and I am very very nervous about it! I think I'm nervous mostly because the physician I am precepting with, is known to make people cry and be very intense. On the other hand, I am excited for the rotation because it is a very different environment from past rotations and from my field of work (hospice). What my question is... I have 4 weeks before my 1st day with the physician and I want to do some review/prep so I don't make a complete fool of myself... and when I asked him if he suggests any review or prep beforehand he said "know everything in internal medicine or just come here and see what you can pick up" 😳.... so basically I'm hoping to hear from preceptors and second-year NP students and also NPs with 1_3 years experience, for any experience/advice/suggestions for information that I should review and know for the internal medicine. I've been a RN for 5.5 years, mainly working in the hospice speciality, in the "home health" environment, and my rotation last year was in a geriatric clinic at Kaiser and also seeing long term care and skilled patients at a SNF for Kaiser, and my preceptor was the embodiment of "mama bear/older sister/caring nurse". :) Thanks in advance!

Congratulations to all those who have gotten accepted, is anyone looking for a roommate, starting July 2016, I don't have a place near UCLA but wouldn't mind being a roommate, also does anyone know how we can get the booklist for the fall courses? I already tried going to the UCLA bookstore website but it doesn't allow you to view anything except the current term...