Miss PsychNP

You would definitely be an asset...especially in psych. You can completed the second degree program. It sounds like you have the passion and definitely the drive to become a PMHNP. I would look into some schools that you are interested in attending and even talk to some of the PMHNPs that you have interaction with.

To Guttercat...I thought I was hallucinating when she said the statement but she did and yes she was fired. One, it not difficult being mixed race...I'm black...I look black...my experiences is of a black woman and I had one hell of a woman raise me to be strong and never accept race as an excuse. As a child, we could not come home and say, the teacher dont like me because I'm black. My mother would say...ok you're going to be black for the rest of your life...so you have two choices...die now or learn to succeed in spite of the limitations others are going to attempt to place upon you. Two...the professional meeting...I dont know where you work but I work in a very rural area where supposed professional meetings entail people who dont act very professional. We have a histrionic QA person who is up for suspension for telling a wonderful doctor to go and find his own d*mn code. Everyone was appalled. Then the nurse made her comment about me. I asked her to repeat and she foolishly did. I didnt yell...I politely told her she was incorrect and then MH clinic director called our CEO and Exec Dir to address the issue because everyone...was taken aback. I have never met her she worked in peds and had 27 years exp. We met today and she was fired. She only became apologetic once she realized she was being fired. I had no idea that she was going to be fired. I love my job and I love my profession. I know there will be idiots who will come at me all kinds of ways, but I do handle myself quite well. My record speaks for itself. I have the highest pt attendance 87% in mental health with child and adolescents is unheard of, but my goal is not to make friends at the job but to deliver the best care possible. As far the the GI, well...GOD has a great sense of humor. We are slated to interview for GIs on Friday to expand of GI dept. We are looking for a Director too. Wouldnt you know that Dr. Idiot has applied and has made out CEO aware of what he now states was a lapse in good judgment. We are going to have lunch (me, CEO, Exe Dir and Dr. Id) so stay tune! One final side note...my father's side accepted me as a Blackfoot Indian of Siksika First Nation in Canada. I have dual citizenship and I am an enrolled member and never was questioned about my kinky hair or dark skin. I can swing my feathers on my headdress with the best of them. And my black people in the US, always was accepted. I dont call myself mixed and I dont deny my ethnicity. The only time this is a problem is when someone else has an issue. Life is too short to worry about ignorant people and I believe things come full circle as in my case.

So...okay...I did read my post and yes...I was all over the place because I was venting. For those of you who thought I was implying the GI doc exchange was a race issue...sorry...I am very aware he just didnt like that I treated something he failed to do and that it had nothing to do with race. However, racial issues are very much a part of my professional life. I am 40 so 'been there done that' as far as dealing with ignorant colleagues and doctors. I guess what started this rant was an email and a meeting in which I was asked how white professionals could better address the minority people meaning Haitians, Laotians, Blacks, Mexican, Guatamalians, etc...oh but not those individuals from Egypt, India, Pakistan, Iran or Japan, and maybe some Koreans depending on where they lived. I am one of three minority providers. The other two are from India and Egypt. My emotions were all over the place as I felt angry, confused and astonished at the fact I was actually asked to provide a brief overview as if I was the minority spokesperson. At this meeting a white nurse made the statement, "well she's a mutt but looks black and her people probably dont listen to her either. Plus she was a professional student, you know we paid for her to go to school". Yep she really said that out loud and people actually believed her. So I did have to address the situation as I normally do and when I said *** is not a historically black university and I did not get any grants because my parents supposedly made too much money (psych nurses), they were responded with, "oh". Unfortunately my skin color does invite second guessing. Partly because I work in underserved mostly white farming areas and I know that comes with the territory. My patients are easy to address. I either impress them or they wont ever change their mindset but will accept my recommendations. It is usually the 'professionals' who have the issue but I surround myself with other who can care less about my color and want to help the pts we treat. So again sorry about the conflicting rant but I have too many thoughts to keep in. And finally for the record, I learned in kindergarten the playing the race card is never acceptable in my family....a black/chinese mother and blackfoot indian father. Some of us look black, some not so black but we love every shade in each and every 12 of us. My daughter is all that plus white so I get it. Sometimes just sometimes, I would like to not have to prove anything and just treat. So thanks for all of the comments and patience reading my thread. Next time, I be back to my jovial self. Thanks again.

I have worked hard very hard to become a nurse practitioner. Not only am I a Adult psych certified and Family psych certified NP, I am a FNP, DNP and was a clinical social worker with a BSW and MSW...so why is it that my prescription is question..."Do you have a DEA?" (Can you not read...it's on the script next to my name!), but I can't say that because I then become the aggressive minority who has an attitude. I don't like it when my fellow RNs and LPNs say, "Oh, you're a NP?? I don't want to be that. I want to be a PA because you can do more" LIKE WHAT??? What exactly can you do that I can't do? Be supervised by a MD?? Really?? I don't know what the deal is but it is so frustrating to hear these things. I am never one to use race as an excuse because my color will never change. I was brown when I was born and I will die brown. So why do I need to always prove that I really do know that adderall depletes magnesium and can give you horrific legs cramps that typically occur at night when you are extending your legs, or it may thin your hair and make you emotionally labile, and that children who take nasal spray and allergy meds are particularly at risk for emotionally instability including moderate anxiety when taking a stimulant. Even if you may disagree, as a health care professional, you don't not need to call me 'dumb', 'stupid', or a 'disgrace to her race'. I laugh because it is so sad that we as health professionals cannot work together. Case in point, a supposed renowned GI specialist never tested my pt who was having severe GI issues...like a text book case of H. pylori. I had the pt tested and she had active acute H. pylori. I had the records sent directly from the lab to him. He fired my pt then call my office to call me a dumb A**Np who needs to keep her nose in treating the crazies and leave the GI to him. I tried to have him test her. Needless to say she was treated and is doing wonderful but whenever we have the same pts, he tells them to request another provider because I am incompetent. How sad. I apologize for the rant...I guess not being able to respond to a private message due to the lack of activity just was the icing on the cake so I thought I am going to post about something bothering me. And for the record every minority who may or may not fit the description of being black or African American benefits from UNCF. I paid for my education and received scholarships for my 3rd masters. My loans were repaid by the NHSC in exchange for working in underserved areas.

I was a recipient for 5 years and loved it. Had bad sites and transferred. Was really easy as long as you had the new site lined up. Ever went back and got my DNP and 2 postmasters.

Myelin You will definitely be able to work.

Myelin, You will be just fine in your studies as you are asking the right questions. I was fortunate as I worked for a university hospital system that paid most of my initial training for BSN, MSN. National Health Services Corp paid for the rest! (Post-Masters, DNP) , so no loans for me. Depending on where you want to work, you may want to consider the Corp. The money is tax free and it can pay your debt down fast. 4 years 120,000. I had a great experience, moved around the country and seen some cool places...not the horror stories you might of heard.

Totally agree with you...as a Psych NP we can manage 'some' problems and I use the term 'some' lightly for a reason. If you are treating manageable symptoms like changes in BP, as a result of an antipsychotic, yes. If you are treating a UTI, Diabetes, Hypothryroidism...NO...and before the messages start, yes, you may have done this in your practice and never had an issue but, beware. As a psych np, you are not trained to manage diabetes even if your seroquel, abilify, zyprexa or risperdal caused it. There seems to be a thought that since some psychiatrists engage in such practices Psych NPs can too. Well, we can until something happens and it becomes an issue. Case in point, a great friend of mine (a psych NP) worked on an inpatient unit and would round for extra money on the weekends. It was a free standing MH hospital. A patient came in and had to have meds reconciled. The covering doc gave initial orders, but the NP changed the orders once she assessed the Pt as he stated he was taking something else. She changed his insulin to what he thought he was taking which ended up being the insulin he actually had a reaction to. She not only loss her job, she was sanctioned, fined and sue for a lot of money. Her lawyer who was a former psych np herself provided this wonderful pearl: Psychiatrists are MDs who have to rotate in all areas of medicine before specializing. Psych NPs choose to their specialty to practice in psych. You may treat minor medical issues that may arise out of side effects of antipsychotic meds, but diabetes, hyper or hypothyroidism is not a minor medical issue. UTI's are medical issues and although you may know how to treat them, you were not trained to treat them and can be sued if what you are prescribing causes an unintended/adverse reaction. If you want to treat physical health conditions, go back and get certified as a FNP. Needless to say she no longer practices. I am certified as both as have seen both sides of this issue. FNPs prescribing high doses of seroquel as sleep meds and psych nps prescribing synthroid without any real knowledge of treating thyroid disorders. All NPs need to understand the fundamentals. Psych NPs need to understand how physical health conditions and medications affect psychiatric disorders and psychotropics. Understanding and treating is two very different concepts that often get blurred in our profession. You may be asked to engage in such practices, but I would caution you if you can not prove in you training that you completed clinicals and coursework to treat physical health conditions, you need to thinik twice before treating.

I agree with zenman. Just had a similiar situation come up this week. In the psych clinic, no injections are given. I think this is very strange because I left an agency that administered a lot of injections. The reason why we dont is there is no nurse. Well, one of the docs felt I should be able to give his patient a haldol dec injection because I was a NP. Luckily the Medical Director does not view me as an extender and stated I was not giving any injections. We need to hire lpns. Have I given injections...yes...would I give injections...yes but not as a regularly scheduled duty. I asked him (the doc) if he knew how to give injections? He said I offended him, but he sends the patient to his family doctor to get the injection!!! It gets worse...we have an CNS who works as a therapist and they felt she should give the injections as she did in the past...so CNSs are less??? I think not. She did not speak up, but I did. Yes we are RNs who are trained in advanced practice. It's funny to have other people in different professions get upset when NPs/ CNSs prefer not to give injections. Counselors and Clinical social workers arent asked to work as case workers. I do my own vitals as the last lpn was horrid and everyone essentially had the same vitals.

No, it not just fees and paper work...depends if the state has reciprocity with your home state (the state of your residence). Some states are easier than others...Arkansas was by far the easiest...Maryland the worst (for me)...Missouri was not so bad but I moved there when they first permitted NPs to prescribe controlled substances and well...that was a whole diffferent battle. Then there is your DEA...your DEA is attached to one agency, company...and sometimes this causes problems. Case in point, I still work in Missouri, live in Maryland, licensed in both states for 3 different specialities. My DEA is now attached to the Maryland site as I work more hours there, but I had to make sure they didnt removed the Missouri site (although it doesnt show on my certificate), it is in the DEA system and allows me to prescribe controlled substances in Missouri.

This may not be very helpful...I took the ANCC adult psych NP in 06, family psych in 09 (ANCC) and FNP in 11. I did not use a study guide for the adult, ANCC guide but no review course for the family psych and review book for the FNP and passed all three on the first try. If you like study groups, ANCC or Berkley my be helpful. Most of my colleagues took those review courses and passed...some failed but I dont think it was attributed to the content of the study guide. I worked full-time and did not have the time to attend a review course. I think you just need to go on the website to either to buy the CDs. They can be a bit pricey but may be worth the investment. Good luck

Myelin, I initially wanted to obtained both certifications but went ahead with the adult psych, then earned the family psych to finish with the fnp. I have always loved integrated treatment (medicine) and found out of necessity that I had to learn how medications prescribed for physical health conditions can affect psychotropic medications. No...I would never get 'sick' of psych. It is really my calling. I think you need to have a strong understanding of either even if you choose to work in only one field. As a Psych NP, I have encountered a patients in my appts with medical crises that could easily go unchecked like a child diagnosed with ADHD and Disruptive Disorder of which she had neither, but instead suffered from convergence insufficiency resulting in her inability to read (no even the pcp picked that one up) so I referred her to an opthamologist. No it is not difficult to maintain both certifications. I work 3 days as a psych np and 1 day as a fnp. Once I finish developing an integrated clinic, I will split two days to provide patients an opportunity to have primary care services. In Maryland, I cant work as both at the same time and must specify how I split the time (weird). Adding FNP is not for everyone...I choose to work with undeserve populations so having two certifications to provide primary physical health and mental health allow me provide services to those with limited access to care. Good luck with your studies!

I agree nurse*sunshine. I have worked in Ohio, Missouri, Arkansas, Oregon, New Mexico, West Virginia, Tennessee and now Maryland as a Psych NP and made a very good living. I am now certified as a FNP and the offers were quite low...like by 20k less than what I make now. One company offered more only after they realized I was an adult psych turned family psych add fnp. Then and only then they offer more money....but it was still less than what I make now working only as a Psych NP. My advise to the person having second thoughts is to do what you love. I love working in psych and it wasnt the money that attracted me into the field...but it certainly hasnt hurt either!