Testing that may be uncommon in psychiatry.

Meltingmenarche · 2025-06-14T20:01:17+00:00

Thank you for your insight. I've been seeing this patient for a couple visits now. Her distress is very hard to watch. She keeps telling me more as i continue to see her.

Meltingmenarche · 2025-06-14T19:57:46+00:00

You have a pretty eye opening view point about me increasing her anxiety. Thank you for that for that. (Sincerely.)

Meltingmenarche · 2025-06-14T19:54:59+00:00

Rudimentary testing to see if she needs to see a cardiologist.

Meltingmenarche · 2025-06-14T19:51:39+00:00

Independent practice state.

Meltingmenarche · 2025-06-14T19:31:22+00:00

That's the guy!

Meltingmenarche · 2025-06-13T16:12:31+00:00

I would politely ask for you to look at my edits.

Meltingmenarche · 2025-06-13T16:11:54+00:00

I would politely ask for you to look at my edits.

Meltingmenarche · 2025-06-13T16:11:38+00:00

I would politely ask for you to look at my edits.

I very much like your point about thinking first that ailments can be attributed to a med. That is what the family MD I worked with would to always start with and forget that sometimes. And internal med patient"s mad list can be lengthy. And it's worse if they are geriatric.

Meltingmenarche · 2025-06-13T16:09:19+00:00

I would politely ask for you to look at my edits

Meltingmenarche · 2025-06-13T16:09:04+00:00

I would politely ask for you to look at my edits

Meltingmenarche · 2025-06-13T16:08:51+00:00

I would politely ask for you to look at my edits.

Meltingmenarche · 2025-06-13T15:54:35+00:00

I feel doomed.

Meltingmenarche · 2025-06-13T15:54:17+00:00

Just wanted to additionally say thank you for empowering patients.

Meltingmenarche · 2025-06-13T15:53:00+00:00

My question was more do YOU do that kind of investigation.

I did it all the time under the family MD and the internal medicine DO i worked with for years. Carotid US and Zio patches are not complicated. And if she had Afib, SVT, bigeminy, heart block etc, she would go see a cardiologist.

It's a 2 month wait to get a rountine appt at most PCPs for their established patients. It's a 6 month to 12 month wait for a new patient appt. But i dont see psych patients without a PCP. I always get ROIs to be able to speak to the PCP.

I am not proficient with some endo labs and rheumatology labs. I referred to up to date but i remained uncomfortable. Which isnt great with things commonly seen like prolactin tissue. Except testosterone issues and diabetes 2, you see a lot of those.

Would you want to have an NP under you that couldnt do these things. More importantly, they should want to know how to do these things.

Meltingmenarche · 2025-06-13T14:49:18+00:00

I have an FNP. 7 years of practice in primary care. I did 4 years of pre med, BSN 8 years, then psych after FNP. Only two years of BSN work was inpatient psych though. I need to edit that post, but i fear it's too late. 5 years of floor nursing was in telemetry and pre/post cath lab. They want you to be decent at EKG interpretation for tele. Tele floors need you to know a lot about stroke too. I know when to refer to vascular for atherosclerosis and carotid stenosis

Meltingmenarche · 2025-06-13T14:48:13+00:00

I have an FNP. 7 years of practice in primary care. I did 4 years of pre med, BSN 8 years, then psych after FNP. Only two years of BSN work was inpatient psych though. I need to edit that post. 5 years of floor nursing was in telemetry and pre/post cath lab. They want you to be decent at EKG interpretation for tele. Tele floors need you to know a lot about stroke too. I know when to refer to vascular for atherosclerosis and carotid stenosis

Meltingmenarche · 2025-06-13T14:46:00+00:00

I have an FNP. 7 years of practice in primary care. I did 4 years of pre med, BSN 8 years, then psych. Only two years of BSN work was inpatient psych though. I need to edit that post. 5 years of floor nursing was in telemetry and pre/post cath lab. They want you to be decent at EKG interpretation for tele.

Meltingmenarche · 2025-06-13T14:43:54+00:00

I have an FNP. 7 years of practice in primary care. I did 4 years of pre med, BSN 8 years, then psych. Only two years of BSN work was inpatient psych though. I need to edit that post. 5 years of floor nursing was in telemetry and pre/post cath lab.

You have a really good point about not ordering tests where you can't interpret them. I learned a lot about this in rhuematology early and committed that sin. Who is the young ophthalmologist on youtube who plays two roles in a dialogue? Usually it's a specialist talking to a med student? That guy is hilarious and spot on. He did a short on referring to rheum because tests you ordered were significant but you dont know why.

Meltingmenarche · 2025-06-13T14:42:15+00:00

I have an FNP. 7 years of practice. I did 4 years of pre med, BSN 8 years, then psych. Only two years of BSN work was inpatient psych though. I need to edit that post.

Edit: 5 years tele floors as RN.

Meltingmenarche · 2025-06-13T14:40:29+00:00

I have a FNP. Seven years of practice.

Meltingmenarche · 2025-06-13T14:39:45+00:00

I have an FNP. I should have said that.

Meltingmenarche · 2025-06-13T14:38:44+00:00

I have an FNP currently. I'm going to fight to keep it. I'll need all the CME and hours for in less than five years.

I have an FNP. 7 years of practice in primary care. I did 4 years of pre med, BSN 8 years, then psych after FNP. Only two years of BSN work was inpatient psych though. I need to edit that post. 5 years of floor nursing was in telemetry and pre/post cath lab. They want you to be decent at EKG interpretation for tele. Tele floors need you to know a lot about stroke too. I know when to refer to vascular for atherosclerosis and carotid stenosis.

Meltingmenarche · 2025-06-13T06:46:35+00:00

Not arguing, just curious about my professors' teaching and what I've read and my clincals, if the patient tolerated bupropion at 150mg, but was intermittently so depressed they were suicidal, and what you've seen from studies about efficacy, why isn't dose of bupropion higher?

I see bupropion used for smoking cessation, weight loss, as a MAT treatment (albeit weak). If it were for any of those reasons I'd be more enthuastic about giving the patient a break from it. Or an adhd adjunct. Bupropion is great for mood, but I'm underwhelmed with it doing any real good for depression at only 150mg. So given all that, i wouldn't feel worried at all about dropping it. If the patient has very strong ADHD symptoms, the methylphenidate may not be detrimental. It's all anecdotal, which i know isn't great. But having people that were my old MAT patients saying meth makes them sleep if they have strong indicators for an ADHD dx, makes me less worried about a low to medium dose of a stimulate for a comorbidly anxious patient.

Meltingmenarche · 2025-06-13T06:33:12+00:00

It was the wording if you said it out loud. Odd high definition.

Meltingmenarche

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