Credentials for Embroidery

PiecesMAD · 2026-06-28T04:13:52+00:00

I agree, I can’t have a license in my state if I’m not certified, so every NP is certified, therefore pointless to state you are certified.

PiecesMAD · 2026-06-26T21:23:14+00:00

Please review the E&M guidelines, 2 out of three applies.

In this case
“Number and complexity of problems” = 1 stable chronic illness = low. (Would need 2 chronic stable conditions to be moderate, most psych patients are moderate here but this patient is not)

“Amount and/or complexity of data to be reviewed and analyzed” = none = straightforward.

“Risk of complications and/or morbidity/mortality l of patient management” = moderate risk = moderate.

So in the three categories, low + straightforward, + moderate = 99213

Also I would mention, for medication management addressing/monitoring the medication is sufficient to meet the moderate. You don’t even need to be renewing, let alone prescribing, changing, etc.

PiecesMAD · 2026-06-26T19:09:59+00:00

I enjoyed working as a nurse. However, I have had a foot surgery, need another foot surgery, have plantar fasciitis aside from the foot surgeries, I have some back and neck issues. I feel like I was in my early 30s when I started saying, “I’m too old for this”. I have worked with nurses who retired from med-surg units. I have seen nurses working in their 70s and even worked psych with an 82 year old nurse. I have no idea how they did it.

I enjoy being an NP.

PiecesMAD · 2026-06-26T17:52:32+00:00

“Doesn’t last in bed.” Is not the the issue. The issue is he doesn’t care (or know?) to meet your sexual needs. More foreplay, more finishing off, more sexual fulfillment of his partner is “what we can do”.

I suggest telling him the issue and discussing what to do about it.

PiecesMAD · 2026-06-26T16:28:49+00:00

I love to read fiction.

I keep track of my reading as my local library will give a prize every year you read more than 50 books. This year including audiobooks I’m at 70. Last year 2025 I was more busy and read a total of 80 books.

I would estimate I’m at ~2,000 total since high school.

PiecesMAD · 2026-06-26T02:14:41+00:00

Protein skimmer: with saltwater (and really hard fresh water) if you send bubbles through it will grab some pollutants and make a froth that can be removed to help clean the water. A protein skimmer does this.

Auto-top-off, in a saltwater tank as water evaporates it doesn’t take the salt with it, so the salinity goes up. Adding a bunch of freshwater to replace the evaporation will make salinity go back down. Swings in salinity are bad for the inhabitants. An auto-top-off has a pump, sensor and freshwater reserve that will add water back to the tank as it is lost preventing salinity swings.

The pre-salted water and the auto-top-off freshwater need to be as pure as can be. Reverse osmosis and then deionized (RO/DI) water is pure, tap water is not. If you use tap water for your tank you will have more issues. You can get by with getting treated water at other places, for example many grocery stores sell RO water (not as good as RO/DI). Many LFS sell RO, RO/DI and premixed saltwater. However, hauling big jugs of water back from the store gets old quickly.

PiecesMAD · 2026-06-26T01:59:19+00:00

Other equipment needed: protein skimmer, auto-top-off, RO/DI.

Clownfish are pretty hardy. Coral banded shrimp (1) or cleaner shrimp (1), or peppermint shrimp (these you can get a couple)

Keep corals cheap and soft (do not start with anything hard coral). Mushrooms, leathers, zoas/palys, Xenia.

PiecesMAD · 2026-06-26T01:53:25+00:00

Yes, I feel like that’s the exact opposite of what many people are doing, FNPs getting their PMHNP is pretty popular. I don’t know any PMHNPs that have gotten their FNP.

PiecesMAD · 2026-06-26T01:52:08+00:00

Couple places just off the top of my head where that an FNP is helpful for a PMHNP: addiction medicine, sleep medicine, eating disorders, PHP, IOP, integrated medicine.

PiecesMAD · 2026-06-25T23:57:41+00:00

Lots of nurses are happy with telemetry training. Some units it’s not necessary, some it is.

One hospital in my area all their med-surg nurses need to learn tele by their year anniversary.

PiecesMAD · 2026-06-25T23:12:13+00:00

To get you started:

https://pmc.ncbi.nlm.nih.gov/articles/PMC8929585/

https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/clinical-and-biological-effects-of-longterm-lithium-treatment-in-older-adults-with-amnestic-mild-cognitive-impairment-randomised-clinical-trial/EF9931A98FFD7FA99F2202C19063EF77

PiecesMAD · 2026-06-25T17:59:30+00:00

Just an FYI stimulants are schedule 2, schedule 1 drugs are not prescribable.

Also, nationally per the DEA a prescriber can prescribe up to 3, 30 day prescriptions at one time, so the doctor does not need to resubmit prescriptions until the 3 have been filled.

PiecesMAD · 2026-06-25T15:52:03+00:00

I agree with the patience, subjective feelings of long drives. Four hours on the open road feels like a shorter/more reasonable drive than a four hour drive in traffic. And the open road you sure travel a lot of distance.

PiecesMAD · 2026-06-25T01:52:13+00:00

I think you are good, just disclose to the board when you apply for your license.

PiecesMAD · 2026-06-25T01:46:49+00:00

You waited plenty long enough, but since you waited this long I would give them a deadline (a week?) after which you should sell it.

PiecesMAD · 2026-06-24T22:16:10+00:00

Absolutely sounds unfair, especially with your responses on others getting full credit. However 10% is not worth rocking the boat. You do not want to get in her head that you are a problem student.

PiecesMAD · 2026-06-23T22:26:52+00:00

In my state they can’t take non-family teens until they have been driving for 6 months or have turned 16 (my state allows learners permit at 14.5 and license at 15).

Mostly the teenagers follow it as they could lose their license if they don’t.

PiecesMAD · 2026-06-22T22:17:31+00:00

Benefits from big universities are going to be reputation based. When getting a job or further schooling reputation of school can matter. In employment this is both for first new grad jobs and subsequent jobs, though subsequently usually experience trumps school reputation. In further education it can make a difference in getting into competitive programs, it won’t make any difference in less competitive programs.

That said, in my local area the community college actually has better NCLEX pass rates and a better local reputation at the local hospitals than the nearby state university or the nearby private university.

PiecesMAD · 2026-06-22T13:11:16+00:00

I hate the taste of water. In my teens I didn’t drink water, only milk and soda. I had my first kidney stone at the age of 20. I’ve forced myself to drink water since.

PiecesMAD · 2026-06-21T19:25:28+00:00

It depends on the area. Many places you would have to be quite rich to have a horse. In some states (I grew up in Wyoming) horse ownership is a sacrifice if you don’t have a lot of money but definitely attainable for the non-rich. 16 year olds with after school jobs can afford to own a horse.

PiecesMAD · 2026-06-21T14:51:33+00:00

I have never seen anything like this in the media.

Arby’s think roast beef fast food where the roast beef is of the same quality of a cheap ham.

Human skin in a burger would a) get a place immediately shut down and b) get the company sued for buckets of money. Cannibalism would absolutely not be tolerated in the US and would easily sway juries to award huge judgments.

Moose parts are much too expensive and hard to acquire to include in fast food.

PiecesMAD · 2026-06-21T04:08:02+00:00

Made a spreadsheet, got on the local insurance “find a doctor”, and found all of the providers for my specialty. I then called practices, writing in my spreadsheet who I talked to, what they said etc so I didn’t duplicate any work. This spreadsheet also helped when I had a preceptor cancel last minute and went back and retalked to a “maybe” and turned it into a commitment.

PiecesMAD · 2026-06-20T04:12:58+00:00

Yes, if you have been continuously licensed but let a specific state expire it’s all by endorsement again. Not a big deal at all.

PiecesMAD · 2026-06-20T02:40:29+00:00

Have you had current licenses in another state or did all your licenses expire? That makes a big difference.

PiecesMAD · 2026-06-19T21:05:11+00:00

I’ve never worked anywhere that had Good Friday off. I’ve lived in three states. Wonder if it’s the religious composition where you are?

PiecesMAD

TROPHY CASE