LunaticFringe, I'd consider it a good sign that she didn't change up a bunch of things. More of a chance to get to know you and what's going on etc. Gathering enough information and getting a feel for things in order to make better decisions than someone who might just jump in and throw a bunch of stuff at you, you know? It's but one of the many things I love about my psych NP -- I'm not just some number or just another BP case, pull out the "recipe book" x, y, and z. Next!

Skywalking -- some of it will depend on what state you're in (as in the 50, not as in mental. ) There are differing levels of what they call "prescriptive authority". Like, not allowed, allowed with Dr. signature, etc., right on up to full prescriptive authority (ie., autonomous), which is how it is where I live.
As for finding, just totally lucked out. We had moved, so had to set something new up. I was running in circles trying to find somewhere that would take me, and getting desperate. Then I suddenly remembered a former neighbor that had raved about how much an NP had helped his brother (who was paranoid schizophrenic). So I called around and was able to get in with one in about a month. At the time, it was a bit of a drive (we live closer now), but it turned out to be very worthwhile.