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PMHNP10

PMHNP10

Psych NP
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  1. PMHNP10

    Are We Too PC?

    I'm certain I'll offend but here goes. Society is like a person with a borderline personality in that things are black or white and shades of gray do not exist. The pendulum swings too far in one direction and forces exert their effort to bring things in the other direction, which happens, but then things swing too far in the other direction. Then wash, rinse, repeat. I'd contend amongst a few other reasons this is why the US has the POTUS we have...as a counterbalance to extreme shift to the culture of everyone is a victim, they should embrace victim hood, they should rejoice in this, and everyone should be offended. It never ceases to amaze me to see how far virtue signaling SJW's will go. You can never be in full compliance with the pc culture because the goal post is constantly moved. And no this song isn't an isolated incident, it's happening across this planet and sadly it's not even one of the most extreme examples IMO (thinking specifically of the idea of incarcerating an individual for calling a transitioning male to female, a he or some other scientifically correct pronoun as 1 example). I value the US Constitution/Bill of Rights; single most important document to date. It is the foundation of this great nation. Amongst many rights/freedoms it grants us,freedom of speech is included and our courts have determined there is no such thing as hate speech and only restricts that freedom in limited capacity (e.g., yelling fire in a crowded building). Now should we conduct ourselves as civilized human beings by not calling our fellow man (oops I think I committed a micro aggression) any number of derogatory names; of course. But our current course in this country is certainly worthy of concern, not just because of where things are headed present day but because the farther the pendulum swings in its current direction; the more momentum it has to swing the other direction. Terrifying. I'm all about diversity of thought and the uniqueness of every human being in general but this is one instance I wish we were all kinda moderate, common sense oriented.
  2. PMHNP10

    Nurses smoking weed?

    Actually the constitution states the fed laws supersedes state--article 6 supremacy clause
  3. PMHNP10

    Allnurses needs nurses

    Most unfortunate if this is still happening. Wasn't good then; isn't good now. ok so I'm intrigued. Are they posting pics or are we talking ugly like someone being ugly? I must try to find this thread.
  4. PMHNP10

    Allnurses needs nurses

    I was triggered by your post and felt the need to respond as a good triggerin' is apt to do. I joined a bunch of years ago ('03 I believe) and was pretty active until around 2010. If memory serves my decreased activity was at least in part associated with a time which the website was experiencing a bit of change that some might say was not for the better--cliques were forming amongst various members, people were banned and ultimately feelings were hurt; it got quite nasty unfortunately and a splinter group attempted to start a similar website, but one of the things that most stood out was the very significant increase in mod activity, deleting and editing posts at the first sight of some post possibly being perceived as offensive to someone. I mentioned this because it would seem based on what I'm reading in this thread that the happenings of 2010 were the beginnings of what many of you are reporting today (hopefully with less bannings/post deletions), so it seems like a natural transition over time. I must say I've noticed that it's been more difficult for me to find a thread that might be interesting to participate in or prove helpful, but figured it was because of the changes in the website that made it difficult for me to find stuff.
  5. PMHNP10

    Hmm...that's nice

    interesting question. Unfortunately I had the experience of 4 months of visiting my daughter in the NICU and I did mention I was a NP just as a way to relate to those taking care of my daughter. I tried to make it clear I only treat things going on between the ears and not what's happening below the neck (and I've chronicled my lack of l&d/babyhood knowledge on this website) but I do wonder if we became a topic of discussion (wife is RN too) amongst the numerous nurses who provided care or if they generally didn't care. I know our baby became like a local celebrity during her NICU stay as well as the 2 subsequent pedi floor admissions because they always had her at the nursing station when we weren't at the hospital and others from all over the floor would come by...
  6. PMHNP10

    What makes you say/think "it was a good shift?"

    C'mon, you were asked what makes a good day, not to detail your wildest fantasy. For me a good day is simply that each of my clients show up on time and I do not fall behind. A great day is that a majority are doing well or at least better than they were the last time I saw them and if someone has a need I'm able to address, I do so. A great day may also be hearing that someone decided to act on something we discussed at a prior appointment and this resulted in them making a very positive change. I land in the middle of fantasy island wishing everyone was med/treatment compliant and in remission, but it sure would be nice.
  7. PMHNP10

    STAAR Testing Anxeity

    I have a cure--abolish each and every one of these scourges or our educational system. See...no test = no anxiety about the test.
  8. PMHNP10

    Do you think nurses get special treatment?

    Winry I think you're on to something. In spite of the popular narrative seen in the media, maybe, just maybe all (or even a majority of all) police officers don't make decisions based on race. The preconceived notion is very unfortunate.
  9. I don't want to assume, but are OR NPs given full practice independence/autonomy--i.e., can Rx sched II-V without physician oversight, practice without a collaborative or supervisory agreement, therefore able to open their own private practice and practice independently? I suspect the AMA will do everything in its power to ensure NPs do not become credentialed providers within many PPO/HMO plans. So that's great, you get to make as much as an MD; good luck finding an insurance plan other than Medicare/Caid to credential you. Maybe I'll be pleasantly surprised.
  10. PMHNP10

    Pendulum Swinging too Far on Pain Meds?

    I would say it is. The VA I recently left instituted policies where it would almost take a letter from congress to get an opiate and if you were on an opiate, you were likely going to be switched to tramadol whether it worked or not. We had a pain mgmt. clinic but it was pathetic when it came to medicating. If someone tested positive for a benzo or barb or amphet they would automatically dc the opiate and refer them to substance use; never mind that they were on Zoloft or ibu or Wellbutrin; they didn't want to take the time to further investigate. And the opiate ban like the 3 strike criminal laws--permanent--althought you only got one strike in this case. Typical fed govt idiocy. I of course would have to deal with these individuals when they came to the crisis clinic and reported they were going to commit suicide rather than deal with the pain. I get that. Pain is debilitating. From an anectdotal POV, I severely sprained my foot a year ago. I was out of town and went to an urgent care clinic thinking something very well could have been fractured given the pain/swelling and discoloration. The doc/staff were quite surprised nothing came up on x-ray, but then again the swelling may have covered up a crack. So while I was there they gave me a lor-something. This was a Saturday. I asked for a Rx for 3-4 days. He said that if I wanted something beyond the 1 he gave me I'd have to go to my MD. So most PCPs don't do weekend hours and even if they did at least Saturdays, I wouldn't have been able to get home before their office closed. Also, it's not always a guarantee that you'll be able to get an appt. same day, so no guarantee I would be seen on Monday. So I had to live with ibu. I like ibu fine for most issues (fortunately I don't have any chronic pain issues), but yeah that was quite a miserable weekend and by the time I got in to see the doc the pain was manageable by ibu. When I was earning my MSN I did a paper on the misuse of prescribed opiates. I ran across a source (which I could never find again) which said the US uses like the upper 90% of all opiates in the world (and I wanna say it was 99%). I'd be curious to see more recent statistics to see how much the pendulum has swung, if at all.
  11. PMHNP10

    Nurses smoking weed?

    Not sure what's ridiculous about it--I'd love to find an original research article, but here's a link to a Medscape article on one study indicating there is in fact an increase in violence in individuals with PTSD: Medscape: Medscape Access I don't know that I totally agree, but once again, more studies needed to get a definitive idea. Smoking Marijuana Not Bad For The Lungs - Medical News Today Not correct. I don't know how much experience you have working with schizophrenic patients, but have you ever noticed why schizophrenics smoke like chimneys (and at a significantly higher percentage than the general population)? Also, if you observe them they often take real deep hits of their cigs. There is a reason for this. Schizophrenics have a really hard time with congnitive function such as focusing on a particular stimuli. So if you are speaking with them in an empty room and are trying to educate them (because that is what we do as nurses) the air coming through the vents, the sounds of traffic and/or people outside the room and any other noises take equal precedence to your voice. When nicotine hits the nicotinergic receptors in the brain they achieve brief moments of mental clarity, so to speak. Unfortunately nicotine's action on these receptors last a few seconds, hence the need to smoke 'em while you got 'em. If someone makes a blanket statement that marijuana is safer than alcohol (i.e., without a qualifying statement such as abuse, addict, misues, etc., which a few did make blanket statements), I say that is a false assumption as I stated in my OP. For example, a glass of wine with dinner for most people who do not have a history of an unhealthy relationship with alcohol is less problematic than casual use of mj (whatever one might consider casual use given there are no established safe guidelines for mj use). I did not say or even imply mj use predisposes anyone to schizophrenia. I said there is an increase incidence of mj users later meeting criteria for a dx of schizophrenia; there is no causative relationship, rather a correlation. To be clear, individuals can have the genetic predisposition for schizophrenia and never exhibit a psychotic symptom. Perhaps chronic mj use is that environmental factor (or one of many possible factors) that result in the expression of that schizophrenic gene. I'm not a genetics specialist, so I can only speculate about the possible details of the link between mj and the dx.
  12. PMHNP10

    Nurses smoking weed?

    I'd only advise caution in general on this--While your employer may not do random drug tests, it is possible that if you were to get a needle stick or other exposure to bodily fluids or some other injury on the job, or if the narcotic count is off, drug tests might be a part of the standard protocol.
  13. PMHNP10

    Nurses smoking weed?

  14. PMHNP10

    telepsych questions

    I don't know that I'd be billing as I'd be working for a company that would take care of the billing.
  15. PMHNP10

    telepsych questions

    I have a few questions: 1) What do you think of telepsych? 2) What should one expect for reimbursment? Revenue split? Hourly (what rate)? 3) What should one look for/expect from the telepsych company? 4) What do you feel have been the positives of delivering psych care through a monitor for you? Negatives?
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