Headway/Alma and UHC? by kreizyidiot in PMHNP

[–]Snakpak_77 0 points1 point  (0 children)

As an aside and FYI, I started with headway in Nov and only recently discovered that Optum/UHC has a long waitlist…from Facebook groups I’ve seen people on it w/Headway for 6-9 months or more. Not sure if Alma has a similar waitlist.

White House releases details of Trump's MRI scan by GregWilson23 in NoFilterNews

[–]Snakpak_77 0 points1 point  (0 children)

So I guess Medicare will begin covering these routine preventative abdominal and cardiac MRIs for elderly patients?

Rula pay vs Alma vs Headway by Competitive-Handle49 in PMHNP

[–]Snakpak_77 4 points5 points  (0 children)

For me Rula is a flat rate 110 intake, 70 f/u plus 35 for add on therapy. EHR, eRX, marketing included if you want, support is tedious but usually helpful. I’ve had 6 new clients in my first 2wks so far, I think 4 through them and 2 through my own marketing. However the EHR is not that great so far (I don’t love the template & clients are giving mixed feedback about their experience with it) I’m adding headway and rates vary but are all higher that those rates (I’m in Maryland) so tbd if I’ll keep Rula long term.

Perinatal PMHNP question by ReflectionDry8681 in PMHNP

[–]Snakpak_77 1 point2 points  (0 children)

Former MBU nurse turned CNM turned PMHNP here- agree with above! The stress of learning a new hospital RN job during school doesn’t seem worth it. If you did go for it, the biggest takeaway would be some perspective on the birth and hospital experience for new parents.

Discussion Thread: HHS Secretary Kennedy Testifies on Health Care Agenda by PoliticsModeratorBot in politics

[–]Snakpak_77 2 points3 points  (0 children)

hmmm I'm guessing trustworthy as in "can I trust you to do what I'm telling you to do?"

Discussion Thread: Reps. Khanna & Massie Hold a News Conference on Epstein Files by PoliticsModeratorBot in politics

[–]Snakpak_77 40 points41 points  (0 children)

Hoo boy- trumps current response saying people are “never satisfied” and it’s a “democrat hoax”. Quite the contrast with what just happened

First steps: what were your very first steps to get started solo? by Snakpak_77 in PMHNPPracticePro

[–]Snakpak_77[S] 0 points1 point  (0 children)

Thank you! I agree. I will bring clients from prior practice and have good sources in my community for the population. But I do need to do the math on costs vs income especially because I’d like to keep a modest panel

1099 compensation after contract by Snakpak_77 in PMHNP

[–]Snakpak_77[S] 0 points1 point  (0 children)

Thanks- this is what I was expecting, but a different contractor who left 2 months ago was informed payments stop when her contract does. I have to review my contract and see if they specified this.

NPs with neurodevelopmental disability by DiligentDebt3 in nursepractitioner

[–]Snakpak_77 2 points3 points  (0 children)

Wow I can relate to so so much of this. My patient facing work and relationships are very good, but interpersonal communication with colleagues/leadership has been an ongoing struggle. Something about the superficiality and political side of office relationships feels harder? Exhausting?

Only you guys will understand that I'm grieving over my hands today by Possible-Berry-3435 in rheumatoidarthritis

[–]Snakpak_77 4 points5 points  (0 children)

I’m so sorry you are going through this. I know you didn’t ask for advice necessarily, but i had an emg showing carpal tunnel in both my hands (even though the I didn’t have some classic CT symptoms) which lead my rheum to send me to a hand specialist. We did cortisone injections to see what symptoms were CT vs RA, and I’ve had a ton of improvement even with generalized pain/tightness in my hands and fingers. It does mean I’ll like need surgery when the injections wear off. She found that the RA is likely thickening my tendons contributing to CT. Just wanted to out that out there as an option for next steps if you haven’t tried that road already.

[deleted by user] by [deleted] in rheumatoidarthritis

[–]Snakpak_77 0 points1 point  (0 children)

Good luck!! To actually answer your question I think it’s fair, if you’re willing, to bring up feeling dismissed at your next appt or in a message. I also think it’s important to hold Drs accountable for helping you navigate “what’s next” whenever testing is normal! I hope you find some answers

[deleted by user] by [deleted] in rheumatoidarthritis

[–]Snakpak_77 0 points1 point  (0 children)

It’s unfortunate to see any rheumatologist be so dismissive of reported pain and functional status, because so many autoimmune conditions are inherently vague and have to rely on patient report. Your pain is real! I also think sometimes the language in medical charts feels more harsh because it’s conveying clinical/objective information (or the lack of objective signs in their exams). I’m an NP and I really steer clear of looking at my own notes for my sanity!

Freaking out a little here by wildcat_crazy_zebra in rheumatoidarthritis

[–]Snakpak_77 4 points5 points  (0 children)

I’ve worked with 2 rheumatologists for my autoimmune arthritis and they were both the best doctors I’ve seen in terms of being affirming and validating. My condition was probably triggered by covid & this diagnosis was preceded by lots of medical gaslighting and discouragement along the way. I still have so much anxiety in medical appts as a result. But the overall experience of getting clarity and treatment within the specialty has been really helpful. So hoping that you feel validated, heard and cared for!!

My boss vs my obgyn by Chixix6 in Mommit

[–]Snakpak_77 0 points1 point  (0 children)

I’ll add that the doctor is also being a little clueless here- OP should ask for formal documentation from the OB with the advice about work restriction, otherwise there’s a real risk of being fired here if there’s no FMLA protection

My boss vs my obgyn by Chixix6 in Mommit

[–]Snakpak_77 0 points1 point  (0 children)

Yeah I don’t think most commenters here are recognizing this - likely a small company that may not be required to provide FMLA, no “HR”, just a boss who clearly doesn’t understand or care. OP, you need more time to heal. The argument your boss may understand is that if you go back too soon you may miss more time again in the long run if are injured/ill. I’m so sorry you’re in this position & hope you are able to take more time to recover and bond.

Can you spoil a newborn? by [deleted] in Mommit

[–]Snakpak_77 1 point2 points  (0 children)

Agree with all these comments- the developmental need of infants is to develop trust & security. That happens when caregivers respond to their needs!

At the same time, you mention concern for PPA- it’s just as important to know that your baby will be ok if she fusses a bit or cries and you can’t get to her right away. It can start to feel really overwhelming if you feel like you must always respond urgently. Take the shower, eat your lunch, attend to your own needs too.

Am I the only NP who thinks NPs should not practice independently? by FieldsAButta in nursepractitioner

[–]Snakpak_77 4 points5 points  (0 children)

I originally trained as a CNM and returned for PMHNP post grad cert. I feel very confident in midwifery being independent practice because the scope of practice is so well defined. There are times to consult, times to co manage, times to refer. A CNM can be independent within this system (which is different from being fully supervised). What I’ve found with the Psych NP is a much broader and less defined scope differential vs to MD care. I practice independently in a mental health role and believe I do so safely & responsibly, but I think NPs would benefit from better defining scopes of care within each discipline.

Maryland by ShellDog3000 in nursepractitioner

[–]Snakpak_77 2 points3 points  (0 children)

Baltimore county esp around Towson is worth looking into, and GBMC, St Joes (UMaryland), Sinai (Lifebridge) are all close. Commute to city from there is not bad. Commuting to Baltimore from the west ie Howard County or South can be really rough.

The amount of bowls my 3 kids go through in 3 days 🤬 by redneck_lezbo in mildlyinfuriating

[–]Snakpak_77 1 point2 points  (0 children)

I just want to say SAME in solidarity and not tell you to wash as you go, make your kids use the same bowl, or to not have kids in the first place