rich2008

I will have to figure out the DEA number thing. I don't want my new job to have any effect on my old job. Thanks!

Thanks!

Anyone have two ierent jobs in two dierent practices? I work four days per week in one practice an got a call rom another one who wants someone one day. I dont want to screw up my 4 day in anyway and was wondering if meicare medicaid billing would be screwed up by this at all? Thanks!

are they making you buy one or just suggesting it? most clinicals had one for me to use.

do what you enjoy the most. I do psych two days a week and medical three days a week. If my medical job became four days a week, i would probably kiss psych goodbye. For me, the psych days are just getting to be exhausting and not in a stimulating way. There are more jobs for FNP but if you want to focus on adults, then just study adults. I think there are changes coming in the psych programs to include more child stuff. good luck.

Thanks! 300 patients for one NP seems like alot! Juan, thanks for the links. I was trying to figure out what a patient load would be for a part time job. If a facility for example had 1/3 of the beds as sub-acute rehad and 2/3 as long term. How many residents would equate to 5 days a week for an NP and how many would be 3 days a week. I know there are probably no standards but maybe there is some rough ideas?

Is there a number of residents that typically is needed for a full time NP? Anyone working in LTC or short term rehab want to share how many beds they are managing? thanks!

Thanks for the comments! The nurses at time need someone to hate and right now its the SLPs.

All I can say is be open and honest with them. They know you are new and if they are not idiots, they will work with you to get up to speed. My first NP job was with a psychotic doctor who had no interest in me so that was a disaster. Ask them what the expectations are. In terms of salary and benefits, the ranges are large so if you are excited about the position, dont sweat the rest. But they should at leat pay for all your licensing fees, malpractice, and some $$ and time for CMEs. Good luck!

Some nurses in the LTC facility I visit once a week have asked me a question regarding patient education on prescription medications. In this facility, Speech Language Pathologists do "memory training" with residents. Part of this training is medication education where the speech language pathologist create a list of medications and the reason the resident is taking the med. The nurses feel this is "wrong" as they think the SLP are not educated in all the meds. I dont know if this is true? They feel they are acting "beyond their scope of practice". Anyone have any thoughts on this?

Some nurses in the LTC facility I visit once a week have asked me a question regarding patient education on prescription medications. In this facility, Speech Language Pathologists do "memory training" with residents. Part of this training is medication education where the speech language pathologist create a list of medications and the reason the resident is taking the med. The nurses feel this is "wrong" as they think the SLP are not educated in all ht meds. I dont know if this is true? They feel they are acting "beyond their scope of practice". Anyone have any thoughts on this?

Hope it wasnt too late to help

I did both adult and geri and wish I had just done family. Many more opportunities fro family rpoviders particularly in rural areas. And also they are combining the adult.gero certification so most schiils are combining the programs.

In a LTC facility can a Nurse practitioner invoke the HCP or does that have to be from an MD. Can a NP determine if a person has capacity to make decisions or does that have to be a psychaitrist? Can a social worker write a note indicating that she thinks the resident lacks cognition in and can not make decisions? I think in some cases its obvious the person cant make decisions but I have a person with mild dementia who wants CPR. The Nurse practitioner did a MOCA or MMSE or both and decided that because his short term memory was not intact, he had poor decision making capacity. Now his HCP is invoked and he is a DNR.

Try to stay positive. Its a tough economy and market out there! If you have school loans get a deferment. DOnt be too proud to collect unemployment! Good luck!

Its interesting that one of the places I did my clinicals in school - a "top" hospital in Boston will only hire GNPs for their outpatient clinical site- so I ownder if all the NPs there will be "retired". Such nonsense.

He seems to be doing fine in terms of $$. He said initially there were more hassles. He was able to keep doing part time at his former place until his practice could support him, his wife, and two kids. His wife just quit her job and is heloing with billing. He is glad he did it. There are good and bad to every situation but this is working out great for him. He doesnt have to put up with the BS of someone else.

I think part of it depends on what state you are in and what the rules are about NP independence. I know a guy who was working in a community health clinic and he started his own practice. He finds the billing to be time consuming as he didnt have to deal with that before. However, he was able to start his own practice after finding a MD to be his "supervising" MD. Its mostly just on paper but I think he has to pay the MD. He started out two days in private practice and within three months he is full time solo.

So I took this fee for service job as nothing else was happenning. It is ok and is paying the bills but I just got a letter in the mail from the company stating that for some services they are "forced" to reduce provider reimbursement. This basicly is a major pay cut. SHould I bother vocalizing my concerns or just start looking for something else agyer just 3 months.

Hi, I am not a derm NP but I did do a clinical in a derm office and I enjoyed it. I dont think you need to be "certified" as a derm NP to be an NP in derm but from my experience those jobas are few and far between and alot of now seems to be cosmetic. Seems like there are more psych jobs out there. good luck.

Do what works best for YOU. In this day and age, companies for the most part do not value or care about their workers. Take care of yourself, "they" won't. Don't make decisions based on what someone might think down the road. They might not come down the road anyway! Go for it!

Thank you RPF. I will wait and see what happens with the mental health certifications. some schools I have looked at seem to have placed their mental health programs on hold. I should call ANCC. I did both adult and gero and was qualified to take both certifications, bit just took adult. when it comes time for renewal maybe I should just take the new exam if its cheaper than renewing. ridiculous.

Sorry to hear what you are gong through. The worst part of nursing are the nurses. Sad.

This streamlining seems like a good idea but some of it makes no sense to me. I wa actually considering getting a post NP psych certificate in adult psych and now I am learning this isnt going to be part of the future? WIll all schools be revamping thier curriculum???

I did adult/gero in my program and just never took the gero boards- I would now with gero population and am glad I took the gero courses because I am sometimes shocked by what some providers are doing with their gero patients meds. I wonder if with the new plan, the schools will be struggling even more to find clinical placements- will everyone who was doing gero only now have to do adult clinical too? Good luck to all those trying to find placements!!