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TammyG's Latest Activity

  1. TammyG

    Employer holding pay check

    I disagree with babyNP. I am a NP-attorney. State laws require employers to pay wages within a certain amount of time (usually 30 days). Go to your state Department of Labor website, there is an on-line form you can usually fill out requesting payment of back wages. The Department of Labor will be aggressive about this. Second, if they do file bankruptcy, the highest priority of ANY creditor under federal law is back wages. And in most states, there is an automatic lean placed on the company's assets for two months of back wages for all employees. So, I am reasonably confident that you will get your wages with a minimal effort. I would not be embarrassed at all to tell people that you walked off the job (or however you want to put it) when they were unable to pay your check. You did the right thing.
  2. TammyG

    Did I make the right move?

    All new NPs feel incompetent. I promise. It will get better. The BMT role sounds like a good one -- you can use your background in BMT from your RN role -- but you will be bored fast. The same thing happened to me. I went back to hospice/palliative care after a short stint as a primary care NP for the comfort, and was bored to tears in a few months.
  3. TammyG

    Questionable practices?

    The billing is an issue, unless the MD will also be seeing the patient. Private insurers all work slightly differently, but I don't think that any of them would be happy reimbursing him at MD rates if he never saw the patient.
  4. TammyG

    Confused New NP

    I assume you are a fairly new NP. I would take the first one just to get some treatment experience under your belt. Then you can move off to case management or whatever else you would like to do.
  5. TammyG

    I'm glad I have never rx'd xanax

    I understand that the patient was on valium, but in any event, I have prescribed Xanax as well as Ativan in the geriatric setting many many times. No mass murderers yet. It is an extremely helpful drug and it would be a shame if prescribers stopped prescribing because the patient may go out and shoot 500 people.
  6. TammyG

    AANP recert

    That is not the law Dizzijon.
  7. TammyG

    Hospice vs. home health

    Hospice and home health have a lot of similarities. However, hospice is different and that you will get to know your patients and their families much better. You will be with them through the end of their lives, and often when they die, and that leads to a type of connection that you don't have quite the same in home health. You also will probably be with your patients longer as well. Many home health patients only need one – two weeks of treatment. The biggest difference though, is that in home health your patients usually get better. In hospice they do not. There is a huge change and you have to make sure you are ready for it. Good luck in whatever you decide to do!
  8. TammyG

    Young hospice/palliative nurse?

    Nonsense. The only thing that a good hospice nurse needs to have is a passion for her patients. It is a calling. It used to be that nurses often went to hospice at the end of their careers because they wanted to be off their feet. That is not the case anymore. Hospice is it's own specialty, and what with budget pressures on hospices like every other healthcare entity, hospice nurses have larger patient loads and more acute patients. We have many patients in our hospice with TPN feeding, feeding tubes, respirators, LVAs and every other thing. Maybe it was that way long ago, but hospice is no longer a place where you can work short hours and stay off your feet. We have had several very young nurses in our home hospice. Many have not worked out, for whatever reason, they have moved on. But the ones that have stayed are excellent nurses and are much loved by their patients. And every older hospice nurse will tell you that many patients perk up with a young person in the house. I would stop your self doubts and throw yourself into the experience. You will know whether it is right for you, and that will have nothing to do with whether your colleagues think you are too young.
  9. TammyG

    AANP recert

    I disagree with DizziJohn on this. You are making recommendations within the scope of your NP license. This is treatment in every respect. An RN cannot make these recommendations within the scope of her license. Further, if you make an error, you will be held to the standard of an NP. Your recommendations require knowledge of advanced human pathophysiology and pharmacology. So I absolutely believe that you were treating within the legal definition and the definition of your nursing board. If in doubt, you can discuss this with your nursing board. Your work as an NP in hospice require skills and analysis at an NP level by law. Legally, and RN cannot do the certification assessments that you do. Your assessments include recommendations for certain levels of care. In addition, having done face-to-face assessments in hospice, I fail to believe that there is not at least one piece of advice that you gave to the family or patient in every assessment. This is treatment.
  10. TammyG

    Return to the bedside

    Wow lots of judgments passed here. Like the OP, I also hated being an NP for many of the same reasons. I tried several different jobs and disliked all of them for different reasons. I longed to go back to the bedside. I chose a different option however, which is that I stopped working altogether. At least for a while. If I do go back to work, I am pretty sure it will be as an RN. People go to NP school for all different reasons. Telling someone that they "should have known" what being an NP is like is not helpful. It is true that there are many different NP jobs, and hopefully everyone will find one that they like. But one thing that almost all NP jobs share in common is that you bill, and with that comes certain pressures and responsibilities. Although the RN jobs I had prepared me well for being an NP, I found the NP job totally different in all respects. If the OP wants to return to the bedside, to a job she was happy and satisfied with, she certainly can do so.
  11. TammyG

    EKG Resources

    My NP program did not cover EKGs at all, that I remember. That it is rated number one in the country. I had been a tele and critical care nurse so have training from that experience. I have worked in several fields as an NP with no prior experience, including urology, G.I., and orthopedics. No one is prepared on their first day. Almost every NP I have spoken to will tell me about being thrown into situations way over their head when they first started a job. And every MD will stay the same. That is how we learn. I have read post from Boston FNP for years and they are generally helpful and non-judgemental. Not sure why he/she now feels he is in a position to judge competence.
  12. TammyG

    NP with anosmia

    I use my sense of smell much less as an NP than I did as an RN. You should have no trouble at all! Also, like many people with a lost sense, you will learn to compensate with your other senses. Good luck.
  13. TammyG

    How to go to NP school as an RN?

    You can do whatever you want. It is not true that most NPs (or even a substantial number) went the direct-entry route. That's just nuts in my opinion -- how do you even know you will like nursing? Most NP schools require at least 1 year of RN experience anyway. I know of only one NP who went direct entry, and that was in nurse midwifery. I worked for 2 years full time before starting NP school, then went to NP school for 2 1/2 years while working full time, then for another 18 months while working part-time. Almost all of my NP classmates were working as RNs throughout their school years. But, do they even have NP schools anymore? I thought they were all turning into DNP programs?
  14. TammyG

    Any NP here? Advices please

    You absolutely need a BSN to be admitted to any masters in nursing program. Even if you have 20 degrees in other subjects.
  15. TammyG

    1099 employment question

    Your taxes as a 1099 employee will be somewhat higher because you must pay a larger share of your social security tax; normally that is shared by your employer, but now you'll be paying for it all yourself. You also have NO benefits -- no health, 401k, dental, holidays pay, vacation, etc which can amount to quite a lot of money. But, you can deduct a whole bunch of stuff from your taxes which might amount to a sizeable savings. You can find lots of guides to 1099 employment online or in a book store that will spell this all out for you.
  16. TammyG

    Should I inform current employer of APRN license?

    Agree with Neuro Guy on this. I never understood how that got started, but I have heard of some RNs being hassled because of it. Because you have not been hired as an NP, you obviously do not have a collaborating or supervising physician, and you certainly are not provided with malpractice insurance by the hospital. You are not performing in an NP role and would not be expected to execute NP-level judgment. I would not see why you would have an obligation to inform your employer. However, if in doubt or you are concerned, tell your supervisor.