WEBVTT 00:00:00.000 --> 00:00:02.580 There was an email that went out about a company 00:00:02.580 --> 00:00:04.900 that one of the therapists have worked with us 00:00:04.900 --> 00:00:06.799 a lot at ASU. There was an email that went out 00:00:06.799 --> 00:00:08.980 and said, hey, this company's hiring. They are 00:00:08.980 --> 00:00:11.179 more than welcome for new grads. They qualify 00:00:11.179 --> 00:00:13.759 for federal loan repayment, all of these things. 00:00:13.919 --> 00:00:15.699 And I was like, oh, I want all of these. And 00:00:15.699 --> 00:00:17.420 I knew that there was a clinic near my house. 00:00:17.579 --> 00:00:20.000 And I did decide I was going to open it to NPs 00:00:20.000 --> 00:00:23.140 and PAs, only advanced practice providers. No 00:00:23.140 --> 00:00:25.820 physicians allowed. Sorry, not sorry. Y 'all 00:00:25.820 --> 00:00:27.879 get your own stuff all the time. So there are 00:00:27.879 --> 00:00:30.539 times where I am adjusting. know a sliding scale 00:00:30.539 --> 00:00:32.859 or i'm adjusting blood pressure meds but i do 00:00:32.859 --> 00:00:35.020 it under the discussion with a person who does 00:00:35.020 --> 00:00:37.640 hold a dual certification so that i can document 00:00:37.640 --> 00:00:40.960 that people forget that you are a nurse like 00:00:40.960 --> 00:00:43.740 you have all of this nursing knowledge and the 00:00:43.740 --> 00:00:46.000 ability to assess the ability to question the 00:00:46.000 --> 00:00:48.780 ability to like de -escalate those are nursing 00:00:48.780 --> 00:00:51.939 skills i had a sister of a patient who threatened 00:00:51.939 --> 00:00:54.439 to slap me and then this big human stood in front 00:00:54.439 --> 00:00:57.539 of me and i was like oh who's that and so that's 00:00:57.539 --> 00:01:00.909 how that started This week on No Prior Off, I'm 00:01:00.909 --> 00:01:03.630 very excited to have Andrea Kemp. Andrea and 00:01:03.630 --> 00:01:06.150 I went to school together at Arizona State University, 00:01:06.430 --> 00:01:09.489 so we've both been psych NPs for 11 years. She 00:01:09.489 --> 00:01:12.409 has a wide array of clinical experience working 00:01:12.409 --> 00:01:16.150 with pediatrics, inpatient, and she's going to 00:01:16.150 --> 00:01:19.730 share so many tips with us today. She also precepts 00:01:19.730 --> 00:01:23.129 and mentors tons of psych NP students and is 00:01:23.129 --> 00:01:25.480 getting ready to launch a community. focused 00:01:25.480 --> 00:01:28.519 on helping to support psych NPs who are especially 00:01:28.519 --> 00:01:31.980 interested in working with inpatient psych. So 00:01:31.980 --> 00:01:35.560 very excited about that. And she also teaches 00:01:35.560 --> 00:01:39.140 at Northern Arizona University in their psych 00:01:39.140 --> 00:01:41.620 NP program. So she has a really interesting perspective. 00:01:41.939 --> 00:01:44.379 She's wicked smart, and I can't wait for you 00:01:44.379 --> 00:01:46.319 guys to get to know her. So thanks for being 00:01:46.319 --> 00:01:48.799 here, Andrea. Of course. Thanks for having me. 00:01:49.099 --> 00:01:54.230 Yeah. How did you even decide you wanted to be 00:01:54.230 --> 00:01:56.709 a psych NP? Like, just tell us a little bit about 00:01:56.709 --> 00:02:00.629 yourself and who you are and how you so happened 00:02:00.629 --> 00:02:03.510 upon it. I think psych was kind of an easy choice 00:02:03.510 --> 00:02:06.049 for me. So I was not a psych nurse before I became 00:02:06.049 --> 00:02:09.810 a psych NP. I worked in the ER mostly. I started 00:02:09.810 --> 00:02:13.289 my nursing career 17 years ago on a PCU tele 00:02:13.289 --> 00:02:15.689 unit. And then after about a year of that, I 00:02:15.689 --> 00:02:18.509 was like, I need some things that. Gets me moving 00:02:18.509 --> 00:02:21.129 a little bit more. And so I asked for a transfer 00:02:21.129 --> 00:02:23.270 to the ER. They approved it. And then that's 00:02:23.270 --> 00:02:25.169 where I went. And that was much better for me. 00:02:25.270 --> 00:02:28.150 And so I think in that respect, that taught me 00:02:28.150 --> 00:02:31.270 crisis is crisis, right? You're going to get 00:02:31.270 --> 00:02:33.629 it. You're going to see everything. And not only 00:02:33.629 --> 00:02:35.750 psychiatric crises that I saw in the ER, but 00:02:35.750 --> 00:02:37.789 medical crises. And while I liked the medical 00:02:37.789 --> 00:02:39.949 component, that wasn't really where I saw my 00:02:39.949 --> 00:02:42.770 career going. I had actually always planned to 00:02:42.770 --> 00:02:46.259 become a lawyer. And so even while I was finishing 00:02:46.259 --> 00:02:49.219 up my bachelor's degree, taking the LSAT and 00:02:49.219 --> 00:02:51.539 going to law school was my plan. And then I just 00:02:51.539 --> 00:02:54.659 kind of last minute decided to change it. And 00:02:54.659 --> 00:02:58.400 psych is what called me. The idea of being a 00:02:58.400 --> 00:03:00.580 medical NP just wasn't where I thought I was 00:03:00.580 --> 00:03:02.479 going to. My brain was going to be challenged 00:03:02.479 --> 00:03:05.360 enough just for who I am as a person. And psych 00:03:05.360 --> 00:03:08.180 is a puzzle. And that's what I like. And so. 00:03:08.960 --> 00:03:10.819 That's just where my transition happened. And 00:03:10.819 --> 00:03:13.039 then I stayed in the ER while I was in NP school. 00:03:13.120 --> 00:03:16.280 I worked full time. I did work at Phoenix Children's 00:03:16.280 --> 00:03:19.120 for a little bit in the ER there and saw a lot 00:03:19.120 --> 00:03:21.199 of pediatric psych holds and how difficult it 00:03:21.199 --> 00:03:23.900 is to place pediatric patients, let alone adults. 00:03:24.439 --> 00:03:27.199 And that's kind of where I just saw where the 00:03:27.199 --> 00:03:28.740 where the need was. And I knew that that's where 00:03:28.740 --> 00:03:31.460 I wanted to be. Yeah, that's awesome. That's 00:03:31.460 --> 00:03:34.840 really cool. What would you say has been the 00:03:34.840 --> 00:03:37.879 most challenging part of your psych NP career? 00:03:39.400 --> 00:03:42.780 I think it's learning at the beginning and even 00:03:42.780 --> 00:03:45.740 when you transition to new jobs where your boundaries 00:03:45.740 --> 00:03:49.060 are. And because it's very easy to get overworked. 00:03:49.060 --> 00:03:51.500 It's easy to pick up that extra shift. It's easy 00:03:51.500 --> 00:03:53.780 to say, yeah, add on that patient that, you know, 00:03:53.780 --> 00:03:56.120 showed up and really needs to be seen. Can't 00:03:56.120 --> 00:03:59.099 come in for another two weeks. And so and I think 00:03:59.099 --> 00:04:01.819 as nurses, we're taught to hold a lot like you 00:04:01.819 --> 00:04:03.759 can take one more patient. You can do that extra 00:04:03.759 --> 00:04:06.159 step. And it's hard sometimes when you transition 00:04:06.159 --> 00:04:08.550 roles. to be able to step back and say, hold 00:04:08.550 --> 00:04:10.870 on, I have to protect myself a little bit because 00:04:10.870 --> 00:04:14.139 I'm getting. tired. My brain is fatigued at this 00:04:14.139 --> 00:04:18.100 point. And we want to help. It's a natural ability 00:04:18.100 --> 00:04:20.660 that nurses have. And all of us are, not all 00:04:20.660 --> 00:04:22.800 of us are born with it, but a lot of us grow 00:04:22.800 --> 00:04:26.000 it. And it's hard to say no and protect yourself. 00:04:26.120 --> 00:04:27.959 So I think learning your boundaries and learning 00:04:27.959 --> 00:04:30.100 how to advocate for yourself and what you know 00:04:30.100 --> 00:04:32.699 that you should or should not be doing is kind 00:04:32.699 --> 00:04:34.899 of the hardest part. But then once you get that 00:04:34.899 --> 00:04:38.160 down, any new transition is much easier. Yeah, 00:04:38.240 --> 00:04:40.560 that's a good point. That's a good point. Okay, 00:04:40.600 --> 00:04:44.189 let's talk about your kind of your first job 00:04:44.189 --> 00:04:48.209 that you got as a psych NP and how was that for 00:04:48.209 --> 00:04:50.769 you like how did you find that first job how 00:04:50.769 --> 00:04:54.689 has compensation been I got hired for my first 00:04:54.689 --> 00:04:58.379 NP job five months before we graduated There 00:04:58.379 --> 00:05:01.279 was an email that went out about a company that 00:05:01.279 --> 00:05:03.420 one of the therapists had worked with us a lot 00:05:03.420 --> 00:05:05.160 at ASU. There was an email that went out and 00:05:05.160 --> 00:05:07.560 said, hey, this company is hiring. They are more 00:05:07.560 --> 00:05:09.740 than welcome for new grads. They qualify for 00:05:09.740 --> 00:05:12.000 federal loan repayment, all of these things. 00:05:12.319 --> 00:05:13.959 And I was like, oh, I want all of these. And 00:05:13.959 --> 00:05:15.660 I knew that there was a clinic near my house. 00:05:15.920 --> 00:05:19.759 So I was like, OK, this will be good. And I sent 00:05:19.759 --> 00:05:22.399 an email back. I was interested. They called 00:05:22.399 --> 00:05:25.019 me in. I did a formal interview. And then what 00:05:25.019 --> 00:05:29.759 I really liked is they. brought me to the clinic 00:05:29.759 --> 00:05:32.819 that I would be at. And they were having like 00:05:32.819 --> 00:05:36.339 a big staff meeting. And so I got to, they actually 00:05:36.339 --> 00:05:38.500 gave me two tips and tricks for working there 00:05:38.500 --> 00:05:40.579 before they even hired me. We did this whole 00:05:40.579 --> 00:05:43.560 thing and I just felt immediately welcomed. And 00:05:43.560 --> 00:05:46.519 so I did tell them, I have two interviews. I 00:05:46.519 --> 00:05:48.699 had an inpatient job interview that was lined 00:05:48.699 --> 00:05:51.060 up and I had another outpatient job interview 00:05:51.060 --> 00:05:52.860 that was lined up. And so I said, before I sign 00:05:52.860 --> 00:05:55.050 anything, I'm going to do those. Because I've 00:05:55.050 --> 00:05:57.069 never been offered an NP salary before. I've 00:05:57.069 --> 00:05:59.069 never been offered a compensation package. I 00:05:59.069 --> 00:06:01.810 don't know what is going on out there. And I 00:06:01.810 --> 00:06:03.550 want to see what everybody has so that I can 00:06:03.550 --> 00:06:06.129 piecemeal or say this one feels the most comfortable, 00:06:06.209 --> 00:06:09.649 but I like this from this one. And so I did that. 00:06:10.069 --> 00:06:13.370 I signed a letter of intent with them. And then 00:06:13.370 --> 00:06:16.230 when I did those other interviews, the salary 00:06:16.230 --> 00:06:18.610 for the other outpatient job was higher, but 00:06:18.610 --> 00:06:20.589 they didn't qualify for the student loan repayment. 00:06:20.829 --> 00:06:23.209 So I went back and I asked if they would meet 00:06:23.209 --> 00:06:26.860 me in the middle. And they did. And so I said, 00:06:26.879 --> 00:06:30.379 OK. And so I actually signed that job for four 00:06:30.379 --> 00:06:32.160 to five months before we graduated. So I knew 00:06:32.160 --> 00:06:34.339 I was good to go. And they knew the day that 00:06:34.339 --> 00:06:36.439 I wanted because I told them I'm applying for 00:06:36.439 --> 00:06:38.439 the National Health Service Corps Loan Repayment 00:06:38.439 --> 00:06:41.019 Program. I have to be working by this date. And 00:06:41.019 --> 00:06:43.019 they did everything for me to make sure I was 00:06:43.019 --> 00:06:46.459 in person working by that date. I don't think 00:06:46.459 --> 00:06:48.680 I realized that or I don't remember that. So 00:06:48.680 --> 00:06:50.540 that's pretty cool. You know what I mean? It 00:06:50.540 --> 00:06:53.209 was good. And I mean, that company has been my 00:06:53.209 --> 00:06:55.209 home the whole time. While I've had other jobs, 00:06:55.290 --> 00:06:57.089 I've transitioned in and out of different places. 00:06:57.290 --> 00:06:59.990 I'm still with that company. Gotcha. Gotcha. 00:07:00.129 --> 00:07:02.230 What was that salary that you negotiated for 00:07:02.230 --> 00:07:08.649 starting out? So at the time, it was $130 ,000. 00:07:08.889 --> 00:07:12.269 So they offered me $120 ,000. This was 11 years 00:07:12.269 --> 00:07:15.170 ago. So they offered me $120 ,000 with only $1 00:07:15.170 --> 00:07:22.430 ,000 for CME. Then the other company offered 00:07:22.430 --> 00:07:25.730 me $150. They were also a 45 -minute drive from 00:07:25.730 --> 00:07:28.370 my house. So I wasn't even going to take that 00:07:28.370 --> 00:07:31.550 job, honestly. But they gave me a good salary 00:07:31.550 --> 00:07:34.750 negotiation standpoint. And so then I went back. 00:07:34.790 --> 00:07:38.709 And so we negotiated up to the $130. And it was 00:07:38.709 --> 00:07:41.069 great. I could pick my own schedule. And then 00:07:41.069 --> 00:07:44.689 what also helped me is I asked them, I told them, 00:07:45.069 --> 00:07:46.110 They're like, you're going to have a six month 00:07:46.110 --> 00:07:47.769 probation period. I said, OK, I want to retalk 00:07:47.769 --> 00:07:50.009 about my salary at six months. And they said, 00:07:50.050 --> 00:07:52.170 then you'll do a year evaluation. I said, OK, 00:07:52.189 --> 00:07:53.769 I want to talk about my salary at both of those 00:07:53.769 --> 00:07:56.670 points. I made that very clear up front because 00:07:56.670 --> 00:07:57.930 you don't know what you're going to be asked. 00:07:58.069 --> 00:08:00.069 You might think you get into a job and then you 00:08:00.069 --> 00:08:02.870 realize, wait, there's a lot more here than I 00:08:02.870 --> 00:08:05.129 realized. I'm being asked to do a lot more. And 00:08:05.129 --> 00:08:06.769 so you don't want to pigeonhole yourself into 00:08:06.769 --> 00:08:09.670 a salary right at the beginning. But I'm also 00:08:09.670 --> 00:08:12.290 a firm believer that your first job is for learning 00:08:12.290 --> 00:08:15.910 and not earning. Like your job, that job is going 00:08:15.910 --> 00:08:17.490 to get you in there. That job is going to show 00:08:17.490 --> 00:08:20.050 you how to actually do it on your own. And you 00:08:20.050 --> 00:08:21.230 should have a job where you're going to have 00:08:21.230 --> 00:08:23.269 a lot of help or a lot of people that are behind 00:08:23.269 --> 00:08:26.329 you. Right. Yeah. No, that's a great point. That's 00:08:26.329 --> 00:08:28.269 a great point. But so you've been with that company 00:08:28.269 --> 00:08:31.449 ever since. That's like unusual. It is unusual. 00:08:31.550 --> 00:08:33.389 But I felt very I feel very comfortable with 00:08:33.389 --> 00:08:36.820 my company. I trust my leadership. I know that 00:08:36.820 --> 00:08:39.320 they listen to me and they've given me lots of 00:08:39.320 --> 00:08:41.940 growth opportunities. They let me when we first 00:08:41.940 --> 00:08:44.259 opened our unit in Kingman, Arizona, that's an 00:08:44.259 --> 00:08:45.940 inpatient and observation unit. They offered 00:08:45.940 --> 00:08:48.519 me the medical director position. So I did that 00:08:48.519 --> 00:08:51.159 for about the first year, a little more than 00:08:51.159 --> 00:08:53.779 a year that that unit was opened. And that was 00:08:53.779 --> 00:08:55.720 a good time. I mean, that's something that a 00:08:55.720 --> 00:08:57.740 lot of NPs at the time weren't being offered 00:08:57.740 --> 00:09:00.700 were those higher level positions. And that was 00:09:00.700 --> 00:09:02.840 a good learning experience for me. Yeah, absolutely. 00:09:03.019 --> 00:09:06.769 So did you go to Kingman? I didn't have to. So 00:09:06.769 --> 00:09:09.370 I went a couple times when we were walking the 00:09:09.370 --> 00:09:12.789 unit, when it was still getting approved for 00:09:12.789 --> 00:09:14.889 everything, when we were trying to figure out 00:09:14.889 --> 00:09:17.490 the workflow. Because for me, if I can walk through 00:09:17.490 --> 00:09:19.889 it, I can figure it out. It's harder for me to 00:09:19.889 --> 00:09:22.269 try to hold it in my brain. So I'm like, I need 00:09:22.269 --> 00:09:24.470 to be, patients are going to walk in here. Who 00:09:24.470 --> 00:09:26.110 are they going to see first? What door are they 00:09:26.110 --> 00:09:28.429 going through? Does this seem safe? Is this corner 00:09:28.429 --> 00:09:31.409 weird? Because I had a lot of inpatient experience 00:09:31.409 --> 00:09:34.169 at that point. And so I did go up a couple of 00:09:34.169 --> 00:09:35.830 times when we were trying to work on our patient 00:09:35.830 --> 00:09:39.570 flows and admission process. What's your schedule 00:09:39.570 --> 00:09:43.389 now? So my schedule is a seven day on, seven 00:09:43.389 --> 00:09:46.960 day off. We switch on Wednesdays. So I work Wednesday 00:09:46.960 --> 00:09:49.259 to Tuesday. And I asked for that specifically. 00:09:49.460 --> 00:09:51.620 So when I started with the company, I worked 00:09:51.620 --> 00:09:53.919 outpatient primarily. And then I would cover 00:09:53.919 --> 00:09:55.700 like within the first couple of months, they 00:09:55.700 --> 00:09:57.259 sent out an email and they were like, hey, does 00:09:57.259 --> 00:09:59.580 anybody want to cross train and be able to pick 00:09:59.580 --> 00:10:01.539 up like weekends or holidays on the inpatient 00:10:01.539 --> 00:10:03.159 unit? I was like, yes, because I was missing 00:10:03.159 --> 00:10:05.440 the ER. I loved outpatient because I saw kids, 00:10:05.500 --> 00:10:08.320 but I was really missing like that movement. 00:10:08.980 --> 00:10:12.200 And so I was like, yeah, I want to do that. And 00:10:12.200 --> 00:10:14.240 so that's what I did across train. So I would 00:10:14.240 --> 00:10:15.980 pick up, they would have providers go on vacation. 00:10:16.019 --> 00:10:20.200 I would go, it was great. And then in 2019, a 00:10:20.200 --> 00:10:23.340 full -time position opened up and I was still 00:10:23.340 --> 00:10:25.779 doing one year of the loan repayment. And so 00:10:25.779 --> 00:10:28.840 I was like, Hey, I want this job. I want this 00:10:28.840 --> 00:10:31.139 job. Don't get rid of it. Let me transfer to 00:10:31.139 --> 00:10:33.899 it. And I'll work both for the next like seven 00:10:33.899 --> 00:10:36.960 months. So what I did is I would go into the, 00:10:36.960 --> 00:10:40.679 uh, onto the unit in the morning. And I'd be 00:10:40.679 --> 00:10:42.179 there for a couple hours. And then I'd go to 00:10:42.179 --> 00:10:44.279 the outpatient clinic and I'd work six hours, 00:10:44.460 --> 00:10:46.879 six or seven hours at the outpatient clinic until 00:10:46.879 --> 00:10:48.600 I was done with that loan repayment. And then 00:10:48.600 --> 00:10:50.720 I transferred fully over. And that's when I said, 00:10:50.779 --> 00:10:53.820 I want a seven on seven off schedule. And we're 00:10:53.820 --> 00:10:58.559 on call every other week that we work. And so 00:10:58.559 --> 00:11:01.519 there's that. Interesting. So you and I both 00:11:01.519 --> 00:11:03.600 did the student loan repayment through the National 00:11:03.600 --> 00:11:05.940 Health Service Corps. But it sounds like it was 00:11:05.940 --> 00:11:07.639 a little bit like different because yours was 00:11:07.639 --> 00:11:10.549 for five years. I did multiple. So I did the 00:11:10.549 --> 00:11:12.990 first two years and then I re -upped it. Oh, 00:11:13.009 --> 00:11:15.129 okay. Okay. Gotcha. Gotcha. And you got all your 00:11:15.129 --> 00:11:18.610 loans paid off that way? No. So I waited because 00:11:18.610 --> 00:11:22.830 I almost, I just applied for buyback, student 00:11:22.830 --> 00:11:25.889 loan buyback. So at the end of it, the government 00:11:25.889 --> 00:11:29.029 will forgive a hefty chunk of the amount that 00:11:29.029 --> 00:11:31.710 they, I mean, they've already paid like $80 ,000 00:11:31.710 --> 00:11:34.389 towards my loans, but they will forgive probably 00:11:34.389 --> 00:11:38.080 another 95, which the majority is interest. That's 00:11:38.080 --> 00:11:41.139 just been sitting in accruing. But that's another 00:11:41.139 --> 00:11:43.259 thing is like figuring out who can pay your loans 00:11:43.259 --> 00:11:46.519 for you work there because my my job is a nonprofit. 00:11:46.779 --> 00:11:49.299 And so I qualify for public student loan forgiveness. 00:11:49.639 --> 00:11:51.559 And I knew that that was going to happen. So 00:11:51.559 --> 00:11:53.940 there was no reason for me to like quickly pay 00:11:53.940 --> 00:11:56.019 off my loans or have to pay out of my own pocket 00:11:56.019 --> 00:12:01.340 as little as possible. Now, I don't think I know 00:12:01.340 --> 00:12:03.080 I'm like being repetitive, but I don't think 00:12:03.080 --> 00:12:06.720 I realized that you like had this job lined up. 00:12:07.159 --> 00:12:10.220 four months before graduation were you because 00:12:10.220 --> 00:12:12.679 people are very much all over the forums like 00:12:12.679 --> 00:12:15.720 when when should I start applying like for jobs 00:12:15.720 --> 00:12:18.059 you know what I mean like were you insecure about 00:12:18.059 --> 00:12:20.059 that like well I won't have my life I won't have 00:12:20.059 --> 00:12:24.379 my DEA like no I I think if anything it was like 00:12:24.379 --> 00:12:28.559 I have to finish this like I have a job now I 00:12:28.559 --> 00:12:31.100 have a job waiting for me. And to me, that was 00:12:31.100 --> 00:12:32.940 because I didn't take, you know, we could take 00:12:32.940 --> 00:12:35.960 our boards early. Like we could take them after 00:12:35.960 --> 00:12:39.039 the second year because we met all of our clinicals. 00:12:39.039 --> 00:12:42.000 I didn't take them immediately. I took mine in 00:12:42.000 --> 00:12:44.820 like April of the year we graduated. Like I think 00:12:44.820 --> 00:12:46.419 some people took them that summer, like while 00:12:46.419 --> 00:12:48.559 we were all applying for like IRB. Some people 00:12:48.559 --> 00:12:50.899 also took their boards. I didn't do that. I waited. 00:12:51.549 --> 00:12:54.450 I took them in April. But it just kind of gave 00:12:54.450 --> 00:12:57.309 me that oomph to be like, I'm finishing this 00:12:57.309 --> 00:13:00.230 program. Nothing is getting in my way. I know 00:13:00.230 --> 00:13:03.509 what's waiting for me. And I didn't want to be 00:13:03.509 --> 00:13:06.690 six, eight months after graduation trying to 00:13:06.690 --> 00:13:08.570 find a job. So if someone was going to give me 00:13:08.570 --> 00:13:11.289 a job, I was going. Even if I didn't like it, 00:13:11.370 --> 00:13:13.070 I'm going to be there for a bit. And I'm going 00:13:13.070 --> 00:13:15.549 to learn. And that's the best thing. And honestly, 00:13:15.669 --> 00:13:17.610 I think that that happens a lot. It was the same 00:13:17.610 --> 00:13:20.169 way I felt with nursing. I got a nursing degree 00:13:20.169 --> 00:13:27.129 in a loan repayment thing. So I got a nursing 00:13:27.129 --> 00:13:29.149 degree for free, and I had to work for the hospital 00:13:29.149 --> 00:13:32.330 system for three years after I graduated. And 00:13:32.330 --> 00:13:34.169 they gave me a job. I worked on one of the hardest 00:13:34.169 --> 00:13:37.230 PCU units in the city, where at another time, 00:13:37.269 --> 00:13:38.649 I had somebody tell me, if you can work on that 00:13:38.649 --> 00:13:40.909 unit, you can work anywhere. So that's just how 00:13:40.909 --> 00:13:43.389 I've looked at every job. Whether it's good or 00:13:43.389 --> 00:13:46.519 bad, it's going to teach me something. Yeah, 00:13:46.559 --> 00:13:49.059 for sure. And I mean, you've learned a lot clearly. 00:13:49.720 --> 00:13:53.240 Tell us more about like this community that you're 00:13:53.240 --> 00:13:55.340 launching or is it a community? What is it exactly 00:13:55.340 --> 00:13:59.399 that will be this resource for psych NPs who 00:13:59.399 --> 00:14:01.860 are really interested in inpatient psych? Because 00:14:01.860 --> 00:14:03.899 we definitely need more resources for people 00:14:03.899 --> 00:14:08.019 who are like committed to that. Yeah. So once 00:14:08.019 --> 00:14:11.480 I started posting on TikTok when I did your little 00:14:11.480 --> 00:14:13.840 program that we did, which was great, the kind 00:14:13.840 --> 00:14:17.279 of. our the brand sprint it was fun and it kind 00:14:17.279 --> 00:14:20.240 of just got me to post things that I tell everybody 00:14:20.240 --> 00:14:22.240 about that are probably tired of hearing me repeat 00:14:22.240 --> 00:14:25.000 myself so now I just tell it to the masses um 00:14:25.000 --> 00:14:28.559 but I think that uh when it came time to like 00:14:28.559 --> 00:14:30.519 looking at a lot of people got no one's talking 00:14:30.519 --> 00:14:32.519 about this I haven't heard any other inpatient 00:14:32.519 --> 00:14:34.399 providers you told me that and so I was like 00:14:34.399 --> 00:14:36.820 okay I'm just going to build a general like school 00:14:36.820 --> 00:14:40.179 community and We'll do like a monthly meeting. 00:14:40.240 --> 00:14:42.559 We'll have weekly like case studies. Hey, drop 00:14:42.559 --> 00:14:44.159 something you learned. How is your schedule? 00:14:44.500 --> 00:14:47.519 Also, like, what are you being asked to do? What's 00:14:47.519 --> 00:14:49.179 your role? Do you feel like you're being given 00:14:49.179 --> 00:14:51.960 too much? And like kind of a little bit of a 00:14:51.960 --> 00:14:53.899 not complaining, but where you need to go with 00:14:53.899 --> 00:14:56.120 people who understand who are going to be like, 00:14:56.179 --> 00:14:58.279 yeah, that's not right or that doesn't seem right. 00:14:58.759 --> 00:15:01.340 And I did decide I was going to open it to NPs 00:15:01.340 --> 00:15:05.179 and PAs, only advanced practice providers. No, 00:15:05.299 --> 00:15:08.460 no physicians allowed. Sorry, not sorry. Y 'all 00:15:08.460 --> 00:15:10.720 get your own stuff all the time. So you don't 00:15:10.720 --> 00:15:13.080 get to come. But I just thought that because 00:15:13.080 --> 00:15:16.200 I have a lot of psych PAs who comment on my stuff 00:15:16.200 --> 00:15:18.299 and send me messages. And so I thought that that 00:15:18.299 --> 00:15:22.700 was important to include them. And because there's 00:15:22.700 --> 00:15:24.440 just not a lot out there. And there's a lot of 00:15:24.440 --> 00:15:27.679 people commenting here or there, but not not 00:15:27.679 --> 00:15:29.700 a lot of this is what happens. This is what it 00:15:29.700 --> 00:15:30.980 looks like. And that's what people don't really 00:15:30.980 --> 00:15:33.379 understand. And the public doesn't understand 00:15:33.379 --> 00:15:35.919 what an inpatient unit does. I think everybody 00:15:35.919 --> 00:15:39.539 thinks. This is what TV tells me. This is what 00:15:39.539 --> 00:15:42.399 movies tell me. And then they just think that 00:15:42.399 --> 00:15:44.860 that's what it is. And sometimes it is. You know, 00:15:44.879 --> 00:15:47.120 that's one of the myths is that that just is 00:15:47.120 --> 00:15:49.659 what it is, but it's not. And I think a lot of 00:15:49.659 --> 00:15:51.879 people think that the locked door scares them 00:15:51.879 --> 00:15:53.980 and they don't really realize that the locked 00:15:53.980 --> 00:15:57.259 door is more to protect the patient than it is. 00:15:57.820 --> 00:16:00.620 The public, because the locked door is there 00:16:00.620 --> 00:16:03.120 because the patient is not safe to be outside. 00:16:03.279 --> 00:16:06.120 The public is unsafe to them at that point. It's 00:16:06.120 --> 00:16:09.039 not there really to protect other people most 00:16:09.039 --> 00:16:11.879 of the time. It's because somebody has been deemed 00:16:11.879 --> 00:16:14.419 unsafe towards themselves and they have to be 00:16:14.419 --> 00:16:17.539 protected at that moment. Right. Yeah, that makes 00:16:17.539 --> 00:16:19.519 sense. What do you love the most about working 00:16:19.519 --> 00:16:25.259 in patient psych? So I like I view every patient 00:16:25.259 --> 00:16:28.750 as a puzzle. I like. being able to sit down and 00:16:28.750 --> 00:16:31.690 try to see what treatment this patient has had, 00:16:31.769 --> 00:16:34.529 what hasn't worked, what could work. And I'm 00:16:34.529 --> 00:16:37.470 in a little bit of a lucky perspective now that 00:16:37.470 --> 00:16:39.669 my unit has transitioned to a step -down unit. 00:16:39.830 --> 00:16:42.250 So I'm getting patients who have been hospitalized 00:16:42.250 --> 00:16:45.210 at least a week at another facility before they 00:16:45.210 --> 00:16:48.529 come to me. And so I get to do more fine -tuning 00:16:48.529 --> 00:16:51.669 that outpatient providers would love to do, but 00:16:51.669 --> 00:16:54.100 they don't get the follow -up all the time. So 00:16:54.100 --> 00:16:55.860 I might have patients who are with me for a few 00:16:55.860 --> 00:16:57.759 weeks to even a few months if they're waiting 00:16:57.759 --> 00:16:59.879 for a very specific type of community placement. 00:17:00.519 --> 00:17:03.220 So I really get to see their mood, how it adjusts, 00:17:03.220 --> 00:17:05.819 how it changes to admissions and discharges on 00:17:05.819 --> 00:17:07.440 the unit, how they deal with staff, how they're 00:17:07.440 --> 00:17:08.740 going to deal with staff when they're at a group 00:17:08.740 --> 00:17:10.759 home. How are we going to get your medication 00:17:10.759 --> 00:17:13.119 regimen to where you are literally the most stable 00:17:13.119 --> 00:17:16.079 I can get you before you leave this facility? 00:17:16.809 --> 00:17:19.049 And so I like being able to try to put those 00:17:19.049 --> 00:17:21.049 pieces together. I like being able to sit down, 00:17:21.170 --> 00:17:23.730 ask as many questions as I can, be as nosy as 00:17:23.730 --> 00:17:26.730 I can when it's clinically appropriate, put my 00:17:26.730 --> 00:17:28.569 puzzle together, and then try to figure out all 00:17:28.569 --> 00:17:30.529 the pieces that are the glue that keep my puzzle 00:17:30.529 --> 00:17:33.230 together. Yeah, that makes sense. That makes 00:17:33.230 --> 00:17:36.130 sense. What are your top three resources that 00:17:36.130 --> 00:17:41.089 you would recommend for inpatient psych? So I 00:17:41.089 --> 00:17:44.029 obviously use Carlot a lot. Um, because it's 00:17:44.029 --> 00:17:46.650 just easy, like it's quick reference. Um, and 00:17:46.650 --> 00:17:49.269 it's just easy to get to the information. Everybody 00:17:49.269 --> 00:17:51.390 uses stall cause it's just kind of the go -to, 00:17:51.470 --> 00:17:53.269 right? That's for like, if I'm looking for more 00:17:53.269 --> 00:17:54.970 detailed information, am I looking for renal 00:17:54.970 --> 00:17:56.990 impairment, liver impairment, like more details 00:17:56.990 --> 00:18:00.410 specifically, then I go there. And my third is 00:18:00.410 --> 00:18:03.430 literally my other providers. We are a very close 00:18:03.430 --> 00:18:05.930 knit group. We are, uh, we've all worked together 00:18:05.930 --> 00:18:09.450 a very long time. I think. Two of my other providers 00:18:09.450 --> 00:18:12.130 are also dual certified FNPs. So we get the medical 00:18:12.130 --> 00:18:14.589 component, which is nice because I do prescribe 00:18:14.589 --> 00:18:16.230 medical meds. I know a lot of people think that's 00:18:16.230 --> 00:18:18.289 outside scope, but there is no medical provider 00:18:18.289 --> 00:18:20.390 that comes to our facility. It's a subacute unit. 00:18:20.529 --> 00:18:23.549 It is psych NPs and that's it. So there are times 00:18:23.549 --> 00:18:25.990 where I am adjusting, you know, a sliding scale 00:18:25.990 --> 00:18:28.309 or I'm adjusting blood pressure meds, but I do 00:18:28.309 --> 00:18:30.430 it under the discussion with a person who does 00:18:30.430 --> 00:18:33.650 hold a dual certification so that I can document 00:18:33.650 --> 00:18:36.970 that. but they are a breadth of knowledge and 00:18:36.970 --> 00:18:39.269 we can usually figure out anything. So even though 00:18:39.269 --> 00:18:41.890 we are like seven days on, seven days off, we 00:18:41.890 --> 00:18:44.349 are case consulting a lot. Like, hey, I'm admitting 00:18:44.349 --> 00:18:45.970 this person. I know you're not back for a couple 00:18:45.970 --> 00:18:47.730 of days, but this is what I'm thinking. And we 00:18:47.730 --> 00:18:52.029 do a really good handoff. We do a written handoff. 00:18:52.049 --> 00:18:53.890 We have a board that has all these things. We 00:18:53.890 --> 00:18:56.130 highlight it based off what we still need. And 00:18:56.130 --> 00:18:58.250 then we do a verbal handoff the Tuesday before 00:18:58.250 --> 00:19:00.799 we switch so that it's just like, hey. I put 00:19:00.799 --> 00:19:02.440 this in the report, but I need you to verbally 00:19:02.440 --> 00:19:04.380 know I need you to follow up on it so that we 00:19:04.380 --> 00:19:07.180 don't miss things. Yeah. So there's like a whole 00:19:07.180 --> 00:19:11.220 system for it. Yeah. How did you get into teaching 00:19:11.220 --> 00:19:16.079 at NAU? And yeah, tell us about that. Because 00:19:16.079 --> 00:19:19.180 I think a lot of us psych NPs are like, oh, would 00:19:19.180 --> 00:19:22.740 that be a cool like side gig that we do? Like, 00:19:22.740 --> 00:19:26.299 so just curious, like. Yeah. So teaching for 00:19:26.299 --> 00:19:30.490 me came. By accident, actually. So I was talking 00:19:30.490 --> 00:19:32.730 to one of the NPs that works at one of our other 00:19:32.730 --> 00:19:35.769 facilities. She was like, hey, an NAU nursing 00:19:35.769 --> 00:19:37.490 instructor came. They want to bring students 00:19:37.490 --> 00:19:40.069 like just like bachelor's degree nurses. They 00:19:40.069 --> 00:19:42.430 want to bring nursing students. They were wondering 00:19:42.430 --> 00:19:45.769 if any of us wanted to teach clinicals. And my 00:19:45.769 --> 00:19:47.349 daughter was getting ready to graduate high school. 00:19:47.369 --> 00:19:49.390 And I'm like, well, this will pay for her tuition. 00:19:49.650 --> 00:19:52.069 So I'm going to look into it. So I looked into 00:19:52.069 --> 00:19:54.589 it. And at the time, it was just like a pay by 00:19:54.589 --> 00:19:56.910 credit. And so I did undergrad the first semester. 00:19:57.410 --> 00:20:01.029 And then after that, everybody was like, oh, 00:20:01.230 --> 00:20:04.369 you have a doctorate and you're a psych MP? You 00:20:04.369 --> 00:20:05.930 want to teach? Like, do you want to teach teach 00:20:05.930 --> 00:20:07.950 instead of just doing clinicals? And I was like, 00:20:07.990 --> 00:20:10.650 I'll take a course. So it was actually the psych 00:20:10.650 --> 00:20:14.210 MP, the PMHEP program at NAU is still new. It's 00:20:14.210 --> 00:20:16.369 only a couple of years old. And so it was the 00:20:16.369 --> 00:20:18.009 first time that they were going to be teaching 00:20:18.009 --> 00:20:22.210 the PEDS course. So Miriam, who is my counterpart 00:20:22.210 --> 00:20:24.390 in the program, she developed the whole program, 00:20:24.529 --> 00:20:26.190 got it accredited, all that stuff. She's like, 00:20:26.289 --> 00:20:28.210 hey, do you want to teach the PEDS course this 00:20:28.210 --> 00:20:30.529 summer? I was like, I guess if it's the first 00:20:30.529 --> 00:20:32.210 time, I guess I can't mess it up. There's no 00:20:32.210 --> 00:20:35.509 standard. So let's do it. And then a full time 00:20:35.509 --> 00:20:38.569 position came available and I applied. And it's 00:20:38.569 --> 00:20:41.289 a it's a long process to get hired, even if you're 00:20:41.289 --> 00:20:42.809 already working at a university. There's a lot 00:20:42.809 --> 00:20:44.930 of interviews. There's board interviews. You 00:20:44.930 --> 00:20:49.039 have to, like, do a presentation. And so I did 00:20:49.039 --> 00:20:51.779 it. I applied and it all worked out and it's 00:20:51.779 --> 00:20:54.440 been it's been great. And so I teach now I'm 00:20:54.440 --> 00:20:56.579 kind of on the same flow where I teach the same 00:20:56.579 --> 00:20:59.299 courses, just different times of the year, because 00:20:59.299 --> 00:21:01.700 we did admit people on like a rolling basis to 00:21:01.700 --> 00:21:06.470 start. And now we're just kind of getting. to 00:21:06.470 --> 00:21:08.609 where we have big cohorts of students. You and 00:21:08.609 --> 00:21:11.309 then we have another buddy we went to school 00:21:11.309 --> 00:21:13.829 with named Andrea. She is also teaching. And 00:21:13.829 --> 00:21:17.269 so she's like, you should teach, you should teach. 00:21:17.450 --> 00:21:19.509 So it just was cool that you guys kind of started 00:21:19.509 --> 00:21:21.390 doing that around the same time and that you 00:21:21.390 --> 00:21:24.569 guys both really enjoy it and love it. Yeah, 00:21:24.609 --> 00:21:26.750 I was a little bit unsure because my, honestly, 00:21:26.829 --> 00:21:30.529 my personality is not for everybody. I'm not 00:21:30.529 --> 00:21:34.359 the... I'm not the easiest to I just I have no 00:21:34.359 --> 00:21:36.099 nonsense. I don't want to hear it. I want you 00:21:36.099 --> 00:21:37.619 to know the information. I don't want to fluff 00:21:37.619 --> 00:21:40.759 it. But my students enjoy that. And I get that 00:21:40.759 --> 00:21:43.299 feedback a lot because I just tell you, like, 00:21:43.319 --> 00:21:45.680 this is how this reads. This is how it looks, 00:21:45.920 --> 00:21:48.720 which is kind of the difficult part for students 00:21:48.720 --> 00:21:51.740 is you get stuck in your book and you don't really 00:21:51.740 --> 00:21:54.799 learn the patient. And that's where I think, 00:21:54.859 --> 00:21:56.920 especially like working on an inpatient unit, 00:21:57.079 --> 00:22:00.559 people forget that you are a nurse. Like you 00:22:00.559 --> 00:22:03.500 have all of this nursing knowledge and the ability 00:22:03.500 --> 00:22:05.779 to assess, the ability to question, the ability 00:22:05.779 --> 00:22:08.720 to like de -escalate. Those are nursing skills. 00:22:09.259 --> 00:22:11.839 They're not provider skills. You learned them 00:22:11.839 --> 00:22:15.079 a long time ago. Pull them back out. Yeah, that's 00:22:15.079 --> 00:22:18.740 awesome. I love that you're like doing all these 00:22:18.740 --> 00:22:21.440 different things. Like you're teaching at like 00:22:21.440 --> 00:22:24.740 a traditional institution. You're like creating 00:22:24.740 --> 00:22:28.299 innovative. digital products online like you're 00:22:28.299 --> 00:22:30.319 doing social media like you're just kind of like 00:22:30.319 --> 00:22:33.640 trying it all out like why not yeah yeah i mean 00:22:33.640 --> 00:22:35.700 nothing really scares me or bothers me i don't 00:22:35.700 --> 00:22:37.059 know how many people watch my videos sometimes 00:22:37.059 --> 00:22:39.519 a lot sometimes none it just is what it is but 00:22:39.519 --> 00:22:42.420 i think nobody knows it if you don't tell them 00:22:42.420 --> 00:22:44.740 um and that's kind of i think one of the big 00:22:44.740 --> 00:22:47.720 things about working inpatient like i said people 00:22:47.720 --> 00:22:49.819 don't know they have a preconceived notion as 00:22:49.819 --> 00:22:52.559 to what it is And there's a lot, there's a lot 00:22:52.559 --> 00:22:54.839 of facets to it. You know, my unit does a lot 00:22:54.839 --> 00:22:58.640 of involuntary treatment and that's hard. It's 00:22:58.640 --> 00:23:01.559 one of the like biggest ethical crossroads in 00:23:01.559 --> 00:23:03.619 medicine is when you're taking somebody's autonomy 00:23:03.619 --> 00:23:06.759 away and you're telling them like, sorry, but 00:23:06.759 --> 00:23:10.180 this is going to happen. And that is, it's so 00:23:10.180 --> 00:23:12.579 hard. And I'm just kind of a big believer in 00:23:12.579 --> 00:23:15.440 talking to my patients, whether they can consent 00:23:15.440 --> 00:23:18.200 or not. I try to give choices within the non 00:23:18.200 --> 00:23:21.190 -choice. I understand you don't want this long 00:23:21.190 --> 00:23:24.849 -acting injection, but you're going to receive 00:23:24.849 --> 00:23:26.609 it. This is why. You're on court -ordered treatment. 00:23:26.730 --> 00:23:29.009 It's been deemed necessary. You stabilized on 00:23:29.009 --> 00:23:31.670 it before. I know you don't want it. You're going 00:23:31.670 --> 00:23:33.990 to get it. Do you want it before snack or after 00:23:33.990 --> 00:23:36.670 snack? So I try to give them a choice within 00:23:36.670 --> 00:23:39.210 the non -choice. And sometimes that helps. You 00:23:39.210 --> 00:23:40.849 know, you might get called a couple names and 00:23:40.849 --> 00:23:43.549 they might scream the whole time. But a lot of 00:23:43.549 --> 00:23:46.089 times it at least de -escalates it in the moment. 00:23:46.230 --> 00:23:48.160 And honestly... A patient's probably not going 00:23:48.160 --> 00:23:50.819 to remember all the meds that I give them while 00:23:50.819 --> 00:23:52.460 they're with me, but they're definitely going 00:23:52.460 --> 00:23:54.619 to remember if I talk to them like a person or 00:23:54.619 --> 00:23:57.740 not. That's very true. Have you ever felt like 00:23:57.740 --> 00:24:00.000 your safety was in question? I know that's something 00:24:00.000 --> 00:24:03.400 that comes up pretty regularly and people have 00:24:03.400 --> 00:24:04.819 different feelings about it. And it probably 00:24:04.819 --> 00:24:07.700 obviously depends on the setting and whatnot. 00:24:07.859 --> 00:24:11.039 But I'm just curious. It does. So, I mean, I've 00:24:11.039 --> 00:24:14.230 had unsafe. situations in all aspects of my career, 00:24:14.309 --> 00:24:16.430 working in the ER. It's actually how my husband 00:24:16.430 --> 00:24:19.309 and I met. I had a sister of a patient who threatened 00:24:19.309 --> 00:24:21.670 to slap me. And then this big human stood in 00:24:21.670 --> 00:24:24.089 front of me and I was like, oh, who's that? And 00:24:24.089 --> 00:24:28.630 so that's how that started. But right. Yeah. 00:24:29.089 --> 00:24:31.869 But as far as like safety, it depends on the 00:24:31.869 --> 00:24:34.369 day. And I have been assaulted. I had I made 00:24:34.369 --> 00:24:37.269 a video about it on TikTok on the five year anniversary, 00:24:37.450 --> 00:24:41.710 which was last month. I. as just gotten back 00:24:41.710 --> 00:24:43.329 from maternity leave. I was on like my second 00:24:43.329 --> 00:24:45.450 or third week back. And I had a patient who just 00:24:45.450 --> 00:24:47.809 didn't want to be there anymore. He was not psychotic. 00:24:47.849 --> 00:24:50.029 It was a complete choice to assault me because 00:24:50.029 --> 00:24:51.670 he knew he was going to get removed from the 00:24:51.670 --> 00:24:55.150 unit if he assaulted me. As a provider perspective, 00:24:55.410 --> 00:24:58.230 a lot of times that will get you taken off of 00:24:58.230 --> 00:25:00.250 the unit, especially if you're deemed stable. 00:25:00.430 --> 00:25:06.109 So what we've determined with police is that 00:25:06.109 --> 00:25:09.009 if a patient is discharge ready, and they assault 00:25:09.009 --> 00:25:11.809 somebody, they can be removed from the unit because 00:25:11.809 --> 00:25:14.069 they've been deemed ready to go. They're just 00:25:14.069 --> 00:25:15.750 waiting on like one thing. And normally that's 00:25:15.750 --> 00:25:17.250 housing. So if you're just standing there waiting 00:25:17.250 --> 00:25:18.829 for housing and you decide to punch somebody 00:25:18.829 --> 00:25:22.009 in the face, you're going to go to jail. You're 00:25:22.009 --> 00:25:23.710 not going to be charged in the state of Arizona 00:25:23.710 --> 00:25:25.589 because the attorney general has their own little 00:25:25.589 --> 00:25:28.069 thought on that, but you will be removed from 00:25:28.069 --> 00:25:30.390 the unit. And so he knew he was going to get 00:25:30.390 --> 00:25:34.529 off the unit. And so he, I got hit a lot. I ended 00:25:34.529 --> 00:25:39.089 up in the ER in a neck brace. It was a day. I 00:25:39.089 --> 00:25:41.890 had a nurse get assaulted all at the same time. 00:25:42.730 --> 00:25:44.809 And it was just one of those things. And cops 00:25:44.809 --> 00:25:46.430 got there. He put his hands behind his back and 00:25:46.430 --> 00:25:51.349 said, I'm ready to go now. And so it just kind 00:25:51.349 --> 00:25:53.670 of is what it is. And I know that that sucks 00:25:53.670 --> 00:25:55.750 and it doesn't really sound right. But unfortunately, 00:25:55.869 --> 00:25:58.690 it is kind of something that we are at risk of 00:25:58.690 --> 00:26:01.549 all the time and in health care in general. Like 00:26:01.549 --> 00:26:03.630 to say that assaults don't happen on a med surge 00:26:03.630 --> 00:26:06.940 unit or by family in an ICU is not. accurate. 00:26:07.299 --> 00:26:10.079 And none of it makes it okay. But it's just one 00:26:10.079 --> 00:26:12.839 of those things where it can happen. I trust 00:26:12.839 --> 00:26:16.200 my staff. You know, I ask and I make, I make 00:26:16.200 --> 00:26:18.380 slightly light of it now. Like I'll be in the, 00:26:18.380 --> 00:26:19.799 in the bubble and I'll be like, Hey, is anybody 00:26:19.799 --> 00:26:21.240 going to hit me today? And they'll be like, no, 00:26:21.380 --> 00:26:24.559 we're fine. But if somebody is squirrely, they'll 00:26:24.559 --> 00:26:27.819 tell me or, Hey, and we do that all the time. 00:26:27.839 --> 00:26:29.420 We do that with everybody. It's just part of 00:26:29.420 --> 00:26:32.559 the handoff. But safety is where some people 00:26:32.559 --> 00:26:34.799 have a big concern. But it happened outpatient 00:26:34.799 --> 00:26:38.079 too. I mean, outpatient, you're shut in an office. 00:26:38.619 --> 00:26:40.460 And a lot of times it's just you and a patient. 00:26:40.579 --> 00:26:43.700 And are you going to be able to get out? Maybe. 00:26:44.400 --> 00:26:48.720 Does your safety button work? Who knows? And 00:26:48.720 --> 00:26:51.180 so that can follow you, I think, in all aspects, 00:26:51.240 --> 00:26:54.019 unless you're telehealth, of course. But I like 00:26:54.019 --> 00:26:57.220 being with my patients. I like seeing my patients. 00:26:57.859 --> 00:26:59.839 I have a lot of patients who don't like to sit. 00:27:00.109 --> 00:27:02.490 and talk and so we walk and pace the unit we 00:27:02.490 --> 00:27:05.210 go and sit outside there's a patio I meet them 00:27:05.210 --> 00:27:06.970 you know if they're doing crafts I'll go sit 00:27:06.970 --> 00:27:09.309 in the craft room like none of that bothers me 00:27:09.309 --> 00:27:13.490 and I just you know I I haven't really felt a 00:27:13.490 --> 00:27:17.369 significant issue since that time and I like 00:27:17.369 --> 00:27:20.569 to think that this far in my career I can assess 00:27:20.569 --> 00:27:22.490 if somebody is escalating enough where I can 00:27:22.490 --> 00:27:25.799 protect myself And I've taken a lot of de -escalation 00:27:25.799 --> 00:27:27.880 programs. Like I have to do one every year as 00:27:27.880 --> 00:27:30.960 part of my regular job. And then NAU does their 00:27:30.960 --> 00:27:33.000 own program too. So I'm actually, I have like 00:27:33.000 --> 00:27:35.500 a certification in two different ones. What have 00:27:35.500 --> 00:27:38.740 you done for like to take care of yourself with 00:27:38.740 --> 00:27:42.259 this career that can be heavy and, you know, 00:27:42.259 --> 00:27:45.660 pretty intense? The toll can be a lot, right? 00:27:45.720 --> 00:27:48.599 It's a lot of, it's more like moral injury for 00:27:48.599 --> 00:27:50.700 me. Then it is like straight up burnout. And 00:27:50.700 --> 00:27:53.119 I think that is just my schedule. I have a come 00:27:53.119 --> 00:27:55.759 and go schedule. I can go in like I need to be 00:27:55.759 --> 00:27:57.539 there, obviously, like by a certain time. I can't 00:27:57.539 --> 00:28:01.440 just like wander in at 6 p .m. But I can come 00:28:01.440 --> 00:28:04.880 and go as need as I need to. And then I'm big 00:28:04.880 --> 00:28:07.299 in my family. I have three kids. I have a little 00:28:07.299 --> 00:28:10.519 guy. I try to do as much with him as I can. The 00:28:10.519 --> 00:28:12.059 older ones are adults and they're living their 00:28:12.059 --> 00:28:14.839 lives. But, you know, they're still here. We 00:28:14.839 --> 00:28:16.759 take a lot of trips and we're just together as 00:28:16.759 --> 00:28:19.980 a family a lot. And that to me is a recharge 00:28:19.980 --> 00:28:23.099 for me. I don't really need much anything else. 00:28:23.119 --> 00:28:27.000 If I'm with my family, I feel good. Yeah, that's 00:28:27.000 --> 00:28:29.079 awesome. That's good that you prioritize that. 00:28:30.000 --> 00:28:33.900 I know we're coming up on time. But one thing 00:28:33.900 --> 00:28:37.859 I ask everybody who's on the podcast is what 00:28:37.859 --> 00:28:40.720 does the term no prior auth mean to you? Am I 00:28:40.720 --> 00:28:45.150 allowed to curse? Yeah. To me, it's more of a 00:28:45.150 --> 00:28:48.309 it's like a no bullshit. I hate prior auths. 00:28:48.309 --> 00:28:51.190 They take up so much time. And I do them even 00:28:51.190 --> 00:28:53.289 as an inpatient provider. I do them for meds 00:28:53.289 --> 00:28:55.549 because we're a small unit and we fill our meds 00:28:55.549 --> 00:28:57.289 through a pharmacy. So I do prior auths all the 00:28:57.289 --> 00:28:59.910 time. And they are complete bullshit most of 00:28:59.910 --> 00:29:01.410 the time. I'm answering ridiculous questions 00:29:01.410 --> 00:29:03.670 about why a patient shouldn't have this when 00:29:03.670 --> 00:29:06.190 I decided that they should have it. And I say 00:29:06.190 --> 00:29:09.930 it and they should get it. So that's what it 00:29:09.930 --> 00:29:12.740 means to me. Okay. I love it. Also, one more 00:29:12.740 --> 00:29:14.140 thing, and we're going to have you on for another 00:29:14.140 --> 00:29:16.259 episode because there's a lot more that I know 00:29:16.259 --> 00:29:19.220 that we want to hear from you as far as like 00:29:19.220 --> 00:29:23.099 prepping for clinical and like for psych NP students, 00:29:23.299 --> 00:29:26.279 especially more practical tips that way. But 00:29:26.279 --> 00:29:28.359 you're also going to be speaking at a conference 00:29:28.359 --> 00:29:32.740 coming up. Where is that? When is that? In case 00:29:32.740 --> 00:29:35.740 anybody wants to check it out. That is the, it's 00:29:35.740 --> 00:29:39.079 the Southwest NP Symposium Conference. It's the 00:29:39.079 --> 00:29:43.019 end of July. I think it's out in Mesa. And I'm 00:29:43.019 --> 00:29:46.299 going to be speaking on NP decision fatigue and 00:29:46.299 --> 00:29:48.059 just kind of what that looks like and how that's 00:29:48.059 --> 00:29:49.599 different than burnout because a lot of people 00:29:49.599 --> 00:29:53.079 assume that they are the same thing and ways 00:29:53.079 --> 00:29:57.480 to combat it and make your day and your day in 00:29:57.480 --> 00:29:59.740 clinic or on the unit work better for you. You 00:29:59.740 --> 00:30:02.460 said that's in July? Yeah, end of July. I think 00:30:02.460 --> 00:30:05.619 July 25th. Okay, cool. Because that would be 00:30:05.619 --> 00:30:08.559 a good opportunity, at least for local Psych 00:30:08.559 --> 00:30:11.059 and Peace here in Arizona to come check it out, 00:30:11.160 --> 00:30:15.039 do some networking. So yeah, very cool. All right. 00:30:15.039 --> 00:30:18.019 Well, thank you for being here. And we'll see 00:30:18.019 --> 00:30:20.759 you for part two soon. All right. Sounds good.