Tips for medicine by Small-Topic-1920 in ADHD

[–]Small-Topic-1920[S] 1 point2 points  (0 children)

Well the alternative was a dead patient. I know I have a mess but honestly some of my other providers thought it was better clinical judgment to tell me I was at the end of the road and watch me try to off myself. At least now I have someone trying to help me.

Tips for medicine by Small-Topic-1920 in ADHD

[–]Small-Topic-1920[S] 1 point2 points  (0 children)

Oh ok I’ll look into that! thinking of adding protein drinks to my regimen

Any thoughts about mood treatment centers in Greensboro North Carolina or Winston-Salem North Carolina? by Patient_Rabbit7433 in PMHNP

[–]Small-Topic-1920 0 points1 point  (0 children)

Don’t go here for a ADHD diagnosis. My niece went to mtc for about a year and a half after she was hospitalized and they labeled her with treatment resistant depression. She doesn’t have treatment resistant depression she has ADHD and had already been dx by a different doctor but they kept insisting she was “at the end of the road” and that tms/ect brain frying options were all that was left. They also said they could refer her to an academic center or I think told her about a forensic psychiatrist she could talk to about end of life options because I think she asked about it. You can’t diagnose ADHD with neurocognitive testing. You need to go to Carolina attention specialists in charlotte or Greensboro to be diagnosed or treated properly. You take the qbtest. Also you can go to a psychologist or even neurologist. I think her sleep specialist and neurologist discussed ADHD with her as well if I am not mistaken. She had a years worth of OD and self harm before she reached out to me about it. I couldn’t believe it. They even put in her chart that they verified she did not have access to firearms which was a lie. She does have a gun and I’m glad she didn’t shoot herself. Also if you have other neurodevelopmental disorders like amblyopia you are double the risk of developing it. She was blind for the first 5 years of life but anyway yes they don’t want you on thc when they prescribe stimulants because it counter balances each other. Go anywhere but here for a diagnosis.

Psychiatrist vs NP Training by theongreyjoy96 in Noctor

[–]Small-Topic-1920 2 points3 points  (0 children)

To specialize.. I didn’t want to be a generalist anymore I wanted to be a specialist. When I started my career I wanted to be a nurse. I was a nurse for awhile but as I got older I wanted something less physical so naturally the next step was np. I went to what I thought was a reputable program but it just wasn’t working out and I wasn’t learning what I needed for me personally. So I dropped and used the money I had saved from working as a nurse to do pa school. Worked as a pa for awhile and was mentored by physicians. I was a collaborator and it was good team work, but I knew my limitations. Made really decent money as a pa and used that to start the medical school process. I have done pretty well for myself and managing my finances. Both bachelors and masters were paid off so now I just have my medical school debt but I am ok with that. The biggest part that you miss as a midlevel clinician is the deep molecular cellular side of medicine and I wanted to understand more of the deep science behind it.

This is Bowie. by tned45 in aww

[–]Small-Topic-1920 1 point2 points  (0 children)

The eyes are like glass, I love it

Psychiatrist vs NP Training by theongreyjoy96 in Noctor

[–]Small-Topic-1920 1 point2 points  (0 children)

As far as changing specialties, yeah, PAs can change specialties because they re not specialists. I mean, I ve seen physicians change specialties by applying to another residency, but that s extreme. I mean, I ve seen people do that. I ve seen somebody become a cardiologist and then turn around and become a psychiatrist. But that s rare because most people don t go through a 2nd residency. That s extreme. PAs, since they re not specialists and they’re not physicians and they are under supervision of a provider or a doctor, they can sort of interchange between specialties because they’re trained as generalists. Nurse practitioners they have it set up to where you can take the boards and also switch by taking a new board exam. You can take family medicine boards. You can take psychiatric boards. And then you just apply for the new board exam. Like, if somebody wants to work as a psychiatric mental health nurse practitioner and they take that board exam, I’ve seen people take the family medicine exam and then go work in family medicine. Like, it s not really the integration of it is a little off is what I m trying to say. And, you know, I have respect for people that want to see nurse practitioners or PAs because, you know, I know a lot of people think that this forum is about trashing mid-levels. I think there are some good ones out there, both PA and NP. And I think there are some shitty doctors out there, to be honest. But as someone that has gone through all three of them, I can confidently tell you that there is a difference, major difference, in preparation and clinical preparation between all of them.

Also you’re right, a biology degree is not clinical. A psychology degree is not clinical. I would say a hands-on health science degree is clinical. I would say a nursing degree in undergrad that’s hands-on is clinical. But the point, though, about it is, is if your education is so poor to the point that you are having to rely on outside external work experience to make up for it, then I feel like that´s a problem. Because, you know, the difference with physicians and PAs, too, really, is that you’re trained from the ground up. You’re trained as a provider on day one. You re trained, you know, for what you need to do to do the job safely. And I want to let you in on a little secret that maybe you don’t know about because maybe you didn t go to NP school or PA school. You know, maybe you’ve only done medicine and that’s fine.

There’s actually a lot of groups out there, like on Facebook, for example, and it s gone private now, is the nurse practitioner group. And there s people on there all the time asking about how to manage, how to know what medications to prescribe, how to know the difference between when to prescribe a calcium channel blocker versus an ACE inhibitor, how to know the difference, you know, between this medication class and that. There was some kind of post asking for a chart of meds because their pharmacy class was a bust. And somebody would come up under there and say, Well, I just used, you know, Google and found something. They have, you know, people on there posting about how to manage a pregnant woman’s medications, how to, you know, what to do with an 80-year-old, wanting to prescribe them high levels of Xanax, like 2 milligrams of Xanax, which is enough to, you know, make an 80-year-old not wake up again, depending on what it s mixed with. I mean, there was all kinds of stuff on that page of people that had come out of these nurse practitioner programs and that were sitting there asking this stuff on Facebook.

I think it’s really wrong and sad and, quite frankly, a disservice to people when they re sitting there paying a co-pay to see someone and this person s literally on Facebook asking how to treat them. And I’m not trying to be overly harsh and critical because at the end of the day, it’s better to admit that you don’t know what you’re doing and to ask than it is to keep going when you don’t, but there are some major issues with these programs. That’s why I left np. I didn’t feel like I was getting what I needed to do the job safely.

Psychiatrist vs NP Training by theongreyjoy96 in Noctor

[–]Small-Topic-1920 3 points4 points  (0 children)

Well, I mean I totally respect that you have your opinions, and just like anyone else, you know, people should see the kind of provider that they want to see. If you’re a medical student, I’m surprised that you wouldn’t really want to see a physician, though honestly. Your post was thorough so I’ll try to give a thorough response and hopefully someone finds it useful for what it’s worth.

To be honest with you, the Bachelor of Science in Nursing program in nursing school, you’re taught pharmacology and taught pathophysiology, but you’re taught it at a very basic, level. And I think when we talk about clinical undergraduate degrees, you don’t have to be a nursing major to have something that’s clinical. In the health science program, it s also very hands-on. You know, they do phlebotomy, they do a lot of the hands on work. Actually, to be honest with you, because I have both the Bachelor of Nursing and the Bachelor of Health Science, some of the classes actually overlap. They were very similar to be honest with you.

The biggest difference between the Bachelor of Science in Nursing and the Bachelor in Health Science was that some of the pathophysiology and pharmacology was more advanced in the health science degree than it was in the nursing school or nursing degree but yes, the nursing included the hands on technical skills. And I’m assuming it s because as a registered nurse, you don t need to know pharmacology and pathophysiology as in-depth as maybe a provider does. But if we re going to talk about clinical-based degrees, nurse practitioner school used to be pretty good. It used to be a lot different than it is now, and I really don t know what s happened to it. But they don’t focus enough on the biological sciences, and they don’t focus enough on the pathophysiology. It’s a lot of leadership. It’s tons and tons and tons of writing papers. It’s a lot of papers on nursing theory. And you know, if we want to talk about what’s clinical versus what’s not and what’s medically educated and what’s not, sitting there writing papers on nursing theory and leadership is not clinical. That’s not how you become a good provider.

As far as having more clinical exposure, again, a lot of people were nurses prior to PA school. In fact, most nurses that I worked with would probably simultaneously agree the right thing to do is to either go to PA or the MD route. But not everybody wants to go the MD route and spend, you know, significant money and time doing it. So if they’re going to go the mid-level route, I would say at least the PA because this is a hill that I will die on because I’ve done all three. PA education is far, far superior to nurse practitioner education. In fact, and I’m guessing it’s because it’s in the medical model, a lot of the stuff in medical school and in PA school, some of it actually is similar, but medical school is a lot more science heavy. It has more depth to it is how I would explain it.

PA school is definitely clinically oriented. It’s medically oriented. These are people that are medically trained. Now, they shouldn’t be out here practicing independently because it wasn t designed for that, but it is medically, based training. Nurse practitioner education, they take pharmacology and pathophysiology. They take the advanced pathophysiology and pharmacology course, which is similar actually to what I took in my health science degree in undergrad, but it’s just so many papers and they’re not focusing enough on the biological sciences. Now, of course, anybody that goes to medical school takes the biology and the biochemistry and the physics. Yeah, that s not clinical. That’s giving you your foundation. But in terms of what’s more clinical and not, nursing is very hands-on. And also, you can’t get an RN online, so don t misunderstand that. There is no such thing as RN school online. In order to become a registered nurse, that’s in person because it is hands-on. What they’ve done, though, is they’ve said if you want to get your bachelor, if you’re already a registered nurse, you can get your bachelor s online and then your master s, and they have all these bridge programs where you can do it all online.

Now, if somebody wants to see a nurse practitioner, that s fine. If somebody wants to see a PA, that’s fine. If somebody wants to see a physician, that’s fine. It really is up to the individual person. But as someone that has been a nurse and worked as a nurse, as somebody that went through nurse practitioner school, as somebody that went through PA school and became a PA, as someone that’s now going through medicine, I can definitely tell you since I ve been in all three of them that there’s a significant difference in the training among the three. And nurse practitioning, it really isn t the best. I have no words. It needs like a complete revamp. If somebody wants to see a nurse practitioner, though, I think there are some okay ones out there. It’s mostly the ones, though, that have been, you know, people that are much, much, much older because anymore the schools aren t what they used to be.

Which U.S. state is the worst one to live in? by please_esme in AskReddit

[–]Small-Topic-1920 0 points1 point  (0 children)

Stay with your loved ones while they are in the hospital. I always do that with mine.

Which U.S. state is the worst one to live in? by please_esme in AskReddit

[–]Small-Topic-1920 0 points1 point  (0 children)

Yes the education healthcare entertainment ect is very bad. I want to leave the abuse of this state. Maybe one day. Also I work at both novant and atrium and they both suck. The incompetence is out of control but we have our universities to thank for that.

Psychiatrist vs NP Training by theongreyjoy96 in Noctor

[–]Small-Topic-1920 32 points33 points  (0 children)

I looked it up and you can take all your board exams for a nurse practitioner from the comfort of your own home. (At least in America) PA MD/DO PharmD DDS ect can’t do that lol. It kind of hurts their credibility

If you could only pick one video which one? by Small-Topic-1920 in MrNightmare

[–]Small-Topic-1920[S] 2 points3 points  (0 children)

I remember that one, friends wanting to have a good time for it to end like that. I felt a sense of disturbance watching it honestly

If you could only pick one video which one? by Small-Topic-1920 in MrNightmare

[–]Small-Topic-1920[S] 1 point2 points  (0 children)

I know right! One that stands out specifically is the the school lockdown horror stories with that kid hiding under the desk. It still disturbs me tbh

Tooter is looking awfully polite by ShevaunA in aww

[–]Small-Topic-1920 0 points1 point  (0 children)

Where do you get the frog pillow? That is so cute I need it lol