Jump to content
CrazyBoards.org

Recommended Posts

Heya motorgrrl,

Well, I've worked with several.

One of their advantages is they are paid on a salary, instead of piecework like MDs.  So, the NP gets the same amount per day whether they see 1 patient or 40.

Whereas MDs have to pack them in or can't pay the bills.

(Depending on the MD's greed level, too, of course.)

NPs are caring and compassionate by trade, and most of them have learned a *lot* of medicine in their education (here in Canada, anyway, they need a BSc. to qualify).

In general, they specialize in preventive care, counselling, and management of chronic conditions.

If the NP feels the need for new meds or a change in meds, or the med you need renewed is not on the list of things they're allowed to Rx, or the test they want to order is not something they're allowed to order, the NP will consult with the "supervising" doc and get a cosign. 

Also, the NP might ask the doc to see a patient in consultation if they need a second opinion or confirmation of a Dx.

Feedback I've seen from patients has been very positive.  And as the sometimes-"supervising" doc, I've been pretty impressed on the whole.

I'd also be interested to hear about your -- and others' -- experience as NP patients.

--ncc--

Link to comment
Share on other sites

My tdoc is a NP (she doesn't do meds, only therapy) and she works closely with my pdoc. I think my tdoc is great. She is very kind and interested in knowing about physical symptoms of MI. I really feel that she listens and has true empathy. She's a nurse, after all. She is very perceptive about the effects of the meds that the pdoc tries. My pdoc is great as well, but we don't talk issues or touchy feely stuff. He mostly wants to understand my mood state and reaction to meds. Once he's got that info then he kicks me out of his office ;) But whatever, he thinks of himself as a psychopharmacologist, an alchemist, or such. Fine with me if he gets it right.

Now, if the NP turns out to be Nurse Crachett from One Flew over the Cuckoo's Nest, that is another story.

--Weasel

Link to comment
Share on other sites

One of their advantages is they are paid on a salary, instead of piecework like MDs.  So, the NP gets the same amount per day whether they see 1 patient or 40.
Not true here, ncc!

I went to a Nurse Practitioner in my family doc's office to "save money."  She charges more for for the appt. than my doctor!  She jacks up the time by using her palm pilot to check for interactions among my meds, when it's not necessary.  She also yacks on and on to run up the time.  I finally caught on to her because NP was charging me $85 for an appt, and when I saw my doc next, she charged me $58! 

Link to comment
Share on other sites

I *love* nurse practitioners. The ones I've had - in general practice, not psychiatric - have been very thorough, relaxed, taking their time. They still care. They ask lots of questions, and want experience. If I have a choice, I'll specifically make an appt with one.

Link to comment
Share on other sites

Frankly I prefer a nurse practitioner for most health problems.  In my experience they're more thorough, thoughtful, and have better bedside manners than most MDs.  My hormone specialist is a NP who specializes in girlie hormones and she's terrific.  She refers me out to an MD when necessary.  She does prescribe antidepressants at times, but won't try to treat anything but simple depression; she refers to a pdoc for that.

I'd definitely stick with a psychiatric NP for psychmeds.  But if you get stuck with her, a pdoc might be necessary.

Link to comment
Share on other sites

Now I have a pdoc through my HMO. I used to go to one at a local psych clinic. At times when I needed to see him and he wasn't available, I saw a NP. The NP was great and nice, and made sure to consult with my pdoc to make sure things were ok when he wrote a script or something. Usually it was maintaining my meds.

I want to become a psychiatric NP, so it is great to hear what good experiences everyone has had with them.

Link to comment
Share on other sites

One of their advantages is they are paid on a salary, instead of piecework like MDs.  So, the NP gets the same amount per day whether they see 1 patient or 40.

Uh, not mine. Her practice is private, she isn't working for anyone, and is quite talented. I asked her once why she hasn't gone for full p-doc and she said it was a matter of schooling.

I know she calls p-docs she trusts to discuss certain things, (I have had some weird med reactions) but I wouldn't trade her for anyone else.

ON THE OTHER HAND, we have a NP in our community that is such a moron, I wouldn't send my enemy to her. Poor judgment, and isn't allowed to see kids after some bad calls.

It's just like anyone else. Go and see what you think, and then take it from there. I see no huge difference in her or her associate, who is my husband's p-doc. They are friends before the p-doc is "overseeing her".

That's my experience anyway.

Breeze

Link to comment
Share on other sites

I've seen both pMDs and pNPs and hands down, I'll take the nurse practitioner any day of the week.  My current pdoc is a psychiatric NP, and I've seen her for almost 3 years now.  She's done a great job managing my me, and my medication.  She never spends less than 30 minutes with me.  When I call to speak with her, she returns my calls within the hour.  If it's out of her realm, she would consult her supervising MD, who I was required to have an appt with as part of beginning to work with her.  At least I know the guy.  She's wonderful.

My former pdoc (MD) managed me in the hospital on a crisis basis.  He diagnosed me correctly (thank God) and got me straightened out and on the appropriate medication.  However, after that he only saw me for about 7-10 minutes at each appointment.  Based on this short amount of time, he attempted to managed my complex meds.  I didn't feel very stable, and I sought help elsewhere.

Enter nurse practitioner.

Bottom line?  If you need crisis management on an inpatient level, you probably need an MD.  Out of the hospital?  I'm going for an NP, everytime.

Link to comment
Share on other sites

This year I have seen both a PNP and an MD.

PNP: Very kind lady, seemed like she genuinely cared about me and my experiences. When I was having weight issues, she walked with me over to the nutritional center and made sure everything was set up.

As for the actual appointments with her- they seemed very "standard?" - it was always the same questions- on a scale from 1 to 10 rate your: sleep, anxiety, mood, irritability..etc. I found that to be very annoying by the 3rd time seeing her because I would eventually be spouting out random numbers... its just hard for me to put my feelings in numbers from 1 to 10.

Eventually when my issues weren't being solved by any of the meds she gave me, I was transferred to the MD.

MD: Not as nice as PNP, but I like seeing her better because the conversation is more free-form... she'll just say: tell me about how you've been feeling the past couple weeks... and I can just say what I feel.. not hmm I feel a 4 right now.  Its hard to tell if MD is genuine or not, she acts like she cares, and will often ask random questions about other aspects of my life.. but then again there are times that she laughs at me ... ;)

MD also is into trying a wider variety of meds.. not just ssri after ssri.. but I think that may be the point at this center- that PNP works with you first, and then if you are somewhat treatment-resistant or have larger issues, then you see MD.

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...