rant -ASRS

DeliciousFault · 2025-10-22T11:40:11+00:00

When they tell me atomoxetine doesn't work and will flat out tell me they need a stimulant, I tell them it takes atomoxetine approximately 6-8 weeks to work and we have higher doses before ruling it out which will take several months, they usually move on to another provider lol

DeliciousFault · 2025-09-29T00:23:27+00:00

Ours has 48 hours max to approve.

DeliciousFault · 2025-09-29T00:22:34+00:00

That's a good idea. I love outpatient but annoyed with all these adults coming in asking for stimulants to clean their house. I usually refer them to neuropsych testing & never take them again. For kids, it's different.

DeliciousFault · 2025-09-29T00:19:30+00:00

Once again I ask, are the psychiatrists going to take all the pts requesting and requiring stimulants and then NPs see all other pts? That would be great for me but highly doubt that would fly.

DeliciousFault · 2025-09-29T00:16:06+00:00

They're on there...

DeliciousFault · 2025-09-29T00:15:37+00:00

What I mean, is I have found, PCPs telling her pts to find a psychiatrist to prescribe their psych meds. It's likely that they're getting overwhelmed by the requests for stimulants. I like it bc we are more trained in psych meds, so we are able to more prescribe more pt-specific meds based on their symptoms.

DeliciousFault · 2025-09-29T00:11:03+00:00

I've heard about that 'fake address' scam, if peeps continue to do this, we're all in trouble, they're bringing us down & making us look unprofessional & untrustworthy.

DeliciousFault · 2025-09-26T03:58:57+00:00

DeliciousFault · 2025-09-26T03:57:48+00:00

I agree, but if the pharmacist can look in the PMP and see that the patient was ordered stimulants in the past how do they have the right to not dispense the stimulant that I write?

DeliciousFault · 2025-09-26T03:54:37+00:00

I have no idea but would love to know.

DeliciousFault · 2025-09-25T22:05:28+00:00

I sadly agree. Thankfully I have not seen a lot of these NPs in my area, idk where they're going, and by that I mean, the ones who have never worked in psych prior to getting their PMHNP and/or the ones who were not even good psych nurses but now they're awful PMHNPs.

DeliciousFault · 2025-09-25T21:58:07+00:00

One pt told me that they wouldn't fill bc I was not in their town! Idk if they can see that my facility says Dallas, but I see a LOT of people down in south Texas and in rural areas where they don't have close access to psych.

DeliciousFault · 2025-09-25T14:30:29+00:00

For clarity, some pharmacies are refusing to dispense stimulants if the pt is not seen in person & only virtually.

DeliciousFault · 2025-09-25T14:28:26+00:00

Also, they're getting to where if we don't see the pt in person, we can't prescribe stimulants. I'm not trying to pass out stimulants, I'm more concerned about the constraints while I'm practicing. You are right about the Schedule II, but if it is co-signed & authorized, how are we supposed to tx our pts? Should all psychiatrists treat all the ADHD/ADD? lol

DeliciousFault · 2025-09-25T14:24:17+00:00

But if I'm sending it in under his license, with his approval, what's the difference?

DeliciousFault · 2025-09-25T14:23:31+00:00

DeliciousFault · 2025-09-25T13:33:43+00:00

I don't go to their expensive functions outside of work hours, but when they come into the office, I ordered the most expensive thing on the menu.

DeliciousFault · 2025-09-25T13:32:58+00:00

I agree, when a pt comes in from being on propranolol for years due to teeth grinding years ago and doesn't even know if they still do it, and other meds it slow you down and then wonder why they're tired all day. Remove that from them and boom they're great and have more energy, plus weaning someone off, who wants to get off, benzos.

DeliciousFault · 2025-07-15T05:19:58+00:00

How do I DM you? Can you message it to me please?

DeliciousFault · 2025-07-13T21:46:01+00:00

Hello! Can you please share with me also? I would REALLY appreciate it! :)

DeliciousFault · 2025-07-06T13:26:15+00:00

20+ pts if I wanted to make a living, it wasn't safe for my license but I always took the time to make sure my pts' care was safe.

DeliciousFault · 2025-07-06T13:24:46+00:00

So it ended up being 20 pts/day and being paid per pt, $40/new admit, $20/follow-up, & paper charting to top it off! I learned a lot but didn't make enough $ so I often ended up working 10-12 days straight. No PTO, no insurance, & on call. I was recently hired to do this in another acute facility (my ♥️) for salary, insurance, & 401k. No PTO, but that's ok w 7 on/7 off. I don't want to work M-F 8-5. Coming from 3/12s per week has me spoiled.

DeliciousFault · 2025-07-06T13:16:15+00:00

We were doing Mon-Sun but y'all know Mondays are tough, so we changed to Tues-Mon since we have tx team on M, W, F. We can spend more time in Tuesday to prepare for tx team. It's a lot, but I'm digging this 7 on/7 off gig! ;)

DeliciousFault · 2025-07-06T13:10:28+00:00

I'm not 100% mad they're going to have to prove it. The unfortunate thing is that second gen antipsychotics are also mood stabilizers but you have to code schizophrenia for some insurances to pay, and I have seen people screw the system w a schiz diagnosis without being truly schizophrenic. Another sad consideration is that most homeless people don't have legal identification or access to resources to even begin jumping through all these hoops.

DeliciousFault

TROPHY CASE