psych.nurse

I am planning on relocating from Massachusetts to Illinois. I worked as an RN in IL, then moved to MA, became licensed as an RN in MA, and then went on to become an NP while in MA. So...do I need to apply to transfer both my NP and RN license from MA to IL, or will transferring one of them automatically transfer the other? In MA, my RN and NP license number are the same.

I worked as an RN for 6 years before becoming an NP. I went back and forth trying to decide between an FNP/Adult NP and Psychiatric NP track. I chose an FNP program, because I thought it would lend itself to a broader scope of practice and more job opportunities. A lot of my RN experience was in psych (I did some home care, too). My first job out of NP school was at a practice that provided psychiatric and dementia care for nursing home residents. I did this work for about four years, then left clinical practice to complete a PhD in nursing. I want to return to clinical practice, but the perception among prospective employers seems to be either that I'm a psych NP, or that I don't have med surg skills. One place actually hired me and then rescinded the offer once I reiterated that my certification was FNP, not PMHNP (I can't believe they didn't realize this; I had already told them, and it was on my CV). So, I'm wondering if anyone has suggestions on how to break into a new NP role that is not psych related...? I'm also trying to figure out what to do about my malpractice insurance. I bought my own policy when I got the job offer (that was rescinded), and I've been paying a lot for it, but not practicing currently. Grateful for any insights. Thanks!

I'm an FNP with four and half years of experience. I am also about to finish my PhD in nursing. I haven't worked in a clinical setting in 10 months, because I took all of last year to work on my dissertation full-time. I'll be teaching at a university (non-tenure track) this fall, and I'm hoping to work part-time clinically, but I can't find an NP job! My experience is geriatrics and psych. I've applied for positions in mostly these areas, but I've been turned down for the last two I applied for. I'm pretty discouraged. I wonder if I'm not being selected because potential employers think I will just leave when I finish my PhD? Maybe they think I have more academic than clinical skills? Is being out for 10 months a major disadvantage? I'm in Boston. Anyone in the area have feedback on the market here? Thanks!

Hi Karen. I emailed them a week ago, and no response yet. I'll try again tomorrow. Fingers crossed!

Hi. I'm wondering if anyone else here has recently tried to renew their ANCC certification and run into problems? I was first certified almost five years ago, and it's time for me to renew. When I try to renew my FNP certification online, I keep getting the message that I have no certifications on record (?) which I don't understand; I am ANCC certified. I've tried calling the 800 number multiple times, and there is just a recording; any option I press, I get the message "Our office is closed", and then the call is hung up. Huh?! Anyone with advice? Thank you!

I was giving a patient her medications one night. She was always nervous about taking her pills, and wanted an explanation for each one. When I held up her senna, I told her that it was a stimulant laxative. She asked me what that meant. I told her, "It kind of gives your colon a little kick and tells it to move." She nodded very seriously and said, "Oh...so it motivates it!"

I wasn’t sure where to post this question. I’m a nurse practitioner working primarily with older adults. In the past year, a new hospice company has begun serving some of my patients. I’ve been suspicious of their operations for a couple of reasons. I learned that they are somehow getting names and numbers of patients and calling them to see if they’re interested in hospice care. One of my patients who received a call from them was not at a point where he needed hospice, yet the company told him about all of the services and equipment they’d give him. One of the physicians in my group has been firm about using this particular hospice for our patients, in one case arranging for a parent to be admitted even after she told the doctor that she didn’t want to use that hospice. One of my colleagues has told me that she believes this physician has a financial stake in this hospice company. I’m upset about what I’ve seen happening and worried that patients may be getting inappropriate care. What can I do?

I agree that it would be ideal to go through someone at the facility first. Unfortunately, the times I've tried to bring up issues with the nurses or DON, it did not go well. The staff have become defensive. It's not just this one med issue; it's been a lot of issues. The one time I went to the DON, she snapped at time and told that she didn't have time for it. Last week, I realized that one of my patients had been off of one of her meds for two weeks (a schizophrenic patient who was without her antipsychotic). When I asked the nurse why she hadn't had her meds for two weeks, she shrugged and said, "I don't know." When I looked shocked, she asked me, "Is that a problem?", and then gave me the stink-eye for the rest of the afternoon. I think I'm seen as making trouble when I ask questions. I hate being in this position.

One of the nursing facilities where I work has some bad practices when it comes to medications. I've seen patients overmedicated, had nurses lie to me about which medications were being given, had nurses ask me to order meds to "keep the patient quiet", and most recently, saw a PRN antipsychotic medication hand-written into a patient's MAR when there was no order for it (I had recently discontinued the medication because it wasn't being used and the patient was no longer agitated). I've mentioned my concerns to a few of the nursing staff, and it definitely hasn't made me any friends there. I go home feeling sad and angry. I've thought about making an anonymous complaint about these conditions, but I'm not sure how I would do this, or if I should. I work in MA. Any suggestions?

Thank you for your feedback, everyone. So, to clarify, what I've found that I really don't like about working as an NP is the pressure to see as many patients as possible, as quickly as possible. My work is psych-related, which I like, but I find it hard to provide the kind of care I want to give when the time pressure and pressure to keep numbers up is so intense. I'd been thinking about the PhD off and in for several years, and my decision to go ahead and start applying was largely related to how disillusioned I've felt so far as an NP. I've had some good moments, but a lot of stress and disappointment. There are also the physicians who treat NP's like they're not good enough and should never expresss a difference of opinion with their supervising MD's.

After working as a nurse for four years, I went to NP school. Most of my RN experience was in psych, and I thought about becoming a psych NP, but with the advice of peers, decided to become an FNP, since I was told it would be a more useful, fulfilling, and marketable degree. I felt fortunate when I received a job offer two months after graduation. There are so many NP's here in Boston, and the job market is competitive! I stayed at my first job for 11 months, during which time I became miserable and burnt out. I took a couple months off and just started a new job, but I don't feel confident that I'll be happy. I'm applying to PhD programs right now. For awhile, I've known that I'd like to teach and do research. I now wish that I'd just stayed an RN and proceeded with the PhD. The NP program cost a lot, and now I'm paying it off! Colleagues have given me positive feedback on my work, but I have yet to feel good about the work I've done, or happy as an NP. I'm wondering if there are other NP's, especially newer NP's, who feel the same way?

Thank you for the support, everyone. So, here's what happened. On Monday, I ended up taking the day off work because I was feeling so stressed out and overwhelmed by everything that I didn't feel I could function at work that day. I sent my boss an email saying that I felt some things were going well, though I had concerns about some aspects of the job--specifically, the ones that weren't consistent with what was described to me when I started. We met today, and came to the mutual decision that this is not a good fit for me. She complimented me on my skills and abilities, and expressed that she felt I'd do better in a position with more structure. I agreed with her, and decided to resign. She said she'd support my seeking another position within the medical center. So...I guess that could have gone a lot worse. Still, I am very scared and distraught about becoming unemployed. I was offered another position before I took this one, and I saw online that it hasn't been filled yet...so maybe I'all reach out to them again? I have enough resources to stay afloat for a couple of months, but this is still scary.

So, here's an example of what's been happening. On Thursday, the nurse in charge of home care approached me and told me she'd like me to see some patients for one of the home care nurses who was out. The home care division is apparently having a huge staffing crisis right now; they can't keep up with their patient load. She asked me what supplies I had. I didn't have any, because I don't do home care nursing. She loaded me up with supplies and told me I'd be fine. I told my supervisor that I wasn't entirely comfortable with this, and she told me she thought I'd be fine. So, I got up super early to go and see these patients, had to figure out their dressings on the fly, and then had to head back to the office so the home care nurse could check my documentation. I did what I could and then waited three hours for her to approve my documentation. She told me that I had to go back and enter a full ROS for each of them, which I was not told. I left exhausted and angry. She was not happy when I told her that I didn't feel this was in line with my intended responsibilities. My supervisor sees no reason why I shouldn't be pulled to do whatever: "You're an NP; you should be able to do any of this." I can't afford a car right now. I'm stressed out and upset. I see a therapist for depression, and without having some predictability in my schedule, I don't know how I'll be able to keep that up. I'm sorry if I sound like a baby. This just isn't what I was told it would be.

I'm trying to figure out what to do here. About a month ago, I accepted an NP position with a local hospital. I am the first NP that the department has hired. I was told that this was a new position, and that I'd been hired specifically for this new role. It's a good hospital, the pay and benefits are great, and most of the people here are really nice. Here's the issue: the definition of what my job is and what I'm responsible for seems to change a few times per week. I thought I was going to have control over my schedule; now it seems that I won't. I was told that I would occasionally do home health visits, then told that I wouldn't be doing home health, then yesterday I was suddenly told that I had to have a car because I was going to see four home health patients. (I don't own a car because I live in a big city where a lot of people don't since it's so expensive). I'm frustrated and upset. I'm wondering if I made a mistake by taking this position. I don't know what to do. I don't know if I can be happy here, but I think it would look bad on my resume to only stay in a job for a month.

Is anyone else here currently waiting to receiving their NP license from Professional Credentialing Services? I am in MA, which uses PCS. It's been awful. I got an NP job, and I can't start until my license is issued. Every time I call PCS to check the status of my application, I either end up on hold for so long that I eventually have to hang up (more than 15 min), or talk to a woman who tells me that she'll call me back by the end of the day, and never does (the same woman). They don't answer emails. I was told that they never received a transcript, which was sent weeks ago. Every time I think about it, I want to cry out of frustration. I need to work, and this is holding me up! I feel powerless to do anything here. Anyone have any ideas, or a similar experience?

Thanks for your feedback. Yesterday, I chatted with a nurse friend of mine who's done home care for years, and she basically said the same thing: agencies have a hard time finding and keeping staff to cover assignments, so inconsistencies and disorder are pretty much par for the course. I have just accepted a full-time job that will begin at the end of next month, so I know that I won't be taking any more assignments from the agency after this one. So, I'm going just cover the case part-time and deal with it. Thank you for your perspective.

I've been on staff with a nursing agency for the past two years. Until this summer, I was just doing per diem clinic work for them, since I was going to school full-time. Last month, they offered me a part-time 5-week home care position, which I accepted. It was due to begin next week. Two weeks ago, they called me to ask if I'd cover another client for 3 days this week. I accepted. It went fine, though it was a draining assignment. Yesterday afternoon, after I finished my third and final shift with the client, the agency called and asked me if I wanted to work with this client full-time for the next 6 weeks, because they don't have anyone lined up for the client. I was very surprised at this, since the client's mother (it's a pediatric patient) told me that new nurses would be starting next week; she had been told that there was coverage. I reminded the agency person that I had already committed to another assignment with them, and she said it didn't matter, because that client was easier to cover, and someone else could do it. I told her I'd be willing to cover the client part-time, but couldn't do five days a week (honestly, it's because this assignment takes a lot of energy). Well, today the agency called me back and said if I want to cover 2-3 days per week, that's fine, but then they'll reassign my original case to someone else, because they don't want to split that one between two nurses. I'm frustrated with this whole situation. It's not fair to the client's mother, that she was told there was coverage when there wasn't. And why should I have an assignment taken away from me because they couldn't fulfill a commitment? I'm also mad at the agency because they made a mistake with my last paycheck. Plus, for both cases, they gave me inaccurate info about the client's; I didn't know the actual ages, genders until I met them. Is this stuff pretty common to staffing agencies, or is this one more disorganized than most?

I took the course in Boston last month. I wish I'd brought a sweater, because the conference room in the hotel where it was held was freezing! I asked the staff if anything could be done about the temperature, and they told me that it depends on what the speaker wants. I was able to take all of my notes in the workbook provided, but you might want to bring extra paper.

Overall, I think the program is good. It definitely felt intense at times! I really learned a lot. I've been told that Simmons has a reputation around Boston as being the "boot camp" school. As far as clinicals go, I saw a lot of patients on my own. The way it usually seems to go for students is that we go in and get a history, do an assessment, and then present the patient to our preceptor. The preceptors will then often ask for some differentials and our ideas for next steps. I guess this is similar to what led students and residents would do. Finding placements for all the students has been challenging in recent years, so you may not get what you want. If you have ideas for potential placements, do some footwork to try to make it happen! Best of luck!!

I'm about to graduate from my FNP program (in one week--yay!) I'm planning to take boards sometime next month. I've started my job hunt. I desperately need a job. I haven't worked full-time as an RN since started the FNP program two years ago, and I'm broke. I'm worried about not finding something soon enough. Will I even be considered for an NP position if I haven't taken boards yet? When I was an RN, I was hired with my license pending; it was a few weeks before I was scheduled to take the NCLEX. Do any places do this with NP's, too? One of my clinical preceptors has talked me to up to the hiring manager at the clinic, but I don't know if I'll be seriously considered since I'll be a new NP. Does it make sense at this point to look for a temporary RN position until I'm board-certified? What have others done during this waiting period? Thanks!

Hey! I'm about to graduate from the FNP program at Simmons. Let me know if I can answer any questions for you or otherwise be of help.

I'm in a FNP program, due to graduate in May. My instructors are recommending the Fitzgerald review course. It's really expensive; I'm wondering if it's worth it. If I went to the Fitzgerald review live class closest to me, it would be the one in Boston at the end of May. Can anyone offer recent feedback on the Fitzgerald review? What other review courses have nurses here really liked? Thanks!

Hi. I'm about halfway through the FNP program at Simmons, but I've been thinking that maybe I want to be a psychiatric/mental health NP instead. I was accepted to a psych NP program, also in Boston, but decided to go with the FNP because I thought it would be more versatile. I'm starting to feel that I might be happier in psych. I talked to someone in the psych NP program at BC, and she told me that I may be able to transfer some of my credits. I am already an RN (not doing Direct Entry), and have worked in psych in the past. Has anyone here switched specialty tracks? To what extent would I be able to treat psych patients as an FNP? Thank you!

I'm in one of the FNP programs in Boston (don't want to name the place right now--don't want to offend anyone). I'm frustrated with the clinical placement situation. We were told that the program would place all of us, that there were plenty of options available. Well, we're a week into the summer semester, and I still don't have a placement. I was told that I had one, then told that I had one but a contract needed to be made, then was just told that it may not work out after all, that the contract is expired and that I should look for some options on my own. Some other people in my program haven't been placed yet, either. As it is, the tentative placement I was given is in a location that I may not be able to get to, and I told them this months ago. Is it like this everywhere in Boston?? I have actually been considering transferring to a different NP program, because I have had issues with disorganization at my school. Overall I like the classes and instructors, but the administrative stuff has been a huge headache. I'm wondering if it would be better anywhere else, though. Thank you!

I recently took a job with a private research company, where I am in charge of running a few clinical trials testing psychotropic medications. My background is in psychiatric nursing, and I was recruited because of my psych experience. I am having an issue with the ways in which my boss is pressuring me to recruit study participants. She is always standing over me, asking me to call people again (even if I just called), asking me to double-book, and be more aggressive with getting people into the studies. She has just started pushing me to call around to shelters to try to recruit people that way (for one particular study, there may be a good number of people who would meet the study qualifications). I feel a little uncomfortable with this. Many of the potential participants I talk to are very vulnerable (i.e. depressed, anxious, unemployed, traumatized), and as much as I want to find participants, I feel very strongly that it's important to be sensitive to the needs of patients with mental illness, and that they should be comfortable with what they're doing. I can tell that this makes her impatient. She recently pressured me to recruit someone at a time that I thought was inappropriate for the patient (who was at the office for another reason). I have been leaving work feeling angry, resentful, and distressed. How can I deal with this? Am I in the wrong workplace? I like what I do; I just don't like some of the practices that I'm being asked to use. I'd appreciate any feedback.