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Joined Apr 4, '11 - from 'Northshore, MA'. BostonFNP is a Primary Care NP. Posts: 4,686 (61% Liked) Likes: 11,323

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  • Apr 25

    This should be an interesting discussion

    If we are speculating on the shift mine is that this represents a blend of employer preference in a low-demand market, gentrification, and the exponential increase in APN programs.

    The article mentions Magnet and IOM recommendations but steers away from the growing body of research on patient outcomes, whether it factors into this or not, it not clear.

  • Apr 25

    Quote from Happymango
    I helped a nurse prepare an immunization for a child and administered the vaccine. It wasn't till after I administered the vaccine did I realize my nurse pulled up the wrong vaccine and the infant got a double dose of a vaccine that was given previously. I had to fill out an incidence report with my instructor today and I can't help but feel like this is my fault because I shouldn't have trusted that nurse and I should have reconfirmed what I was giving. I'm scared that this mistake might cost me my seat in the nursing program. Has this ever happened to anyone as a student?
    Never, under any circumstances outside of life/death, give a med that you did not draw up yourself.

  • Apr 23

    This should be an interesting discussion

    If we are speculating on the shift mine is that this represents a blend of employer preference in a low-demand market, gentrification, and the exponential increase in APN programs.

    The article mentions Magnet and IOM recommendations but steers away from the growing body of research on patient outcomes, whether it factors into this or not, it not clear.

  • Apr 23

    I will say for better or worse (and perhaps I am one of those people are happy to see not post as much), I post less because I miss the app.

  • Apr 23

    This should be an interesting discussion

    If we are speculating on the shift mine is that this represents a blend of employer preference in a low-demand market, gentrification, and the exponential increase in APN programs.

    The article mentions Magnet and IOM recommendations but steers away from the growing body of research on patient outcomes, whether it factors into this or not, it not clear.

  • Apr 22

    Quote from quazar
    I wholeheartedly apologize for taking your head off.
    It's ok, we all have misfires, context is often difficult on the internet.

    I do agree with you on the issue of novice NPs working in specialty roles, I posted previously on an experience of referring one of my primary care patients to a specialist because I felt I lacked the experience to treat the patient and the patient saw the specialist's brand new NP right out of school. After talking to the NP on the phone it was clear that I knew far more than she did about the diagnosis; it highlights the importance of having fellowship trained and/or experienced specialists available to see referrals.

  • Apr 22

    I had a similar situation one time but it was while I was working as an NP.

    We attend our own patients at a local community hospital that is not a teaching hospital but at times our specialists have residents rotating. All the providers work together very well and everyone is on first name terms, regardless of their education credentials.

    So the specialist comes to chat with me as I sat at the orders station about mutual patient. Introduces his first year resident as "Jane". We discuss the patient and "Jane" comes with me to visit the patient. We get back and start to talk to the nurse about the plan. I mention that "Jane feels that pt should have XZY" but I feel that we need to do Y first and move from there. "Jane" buts in as says "actually its Dr. Doe and this really isn't up for debate". So I just nod at the nurse and pull "Jane" aside, and "Dr. Doe" proceeds to reiterate that she is a physician and her expertise has been requested on this patient and the plan should be followed as discussed, so she got a little perturbed and agitated at my audacity when I told her that as the attending provider we would no longer need the consultation and I would be removing the order that I placed for the consult.

    I guess she went and told her attending because shortly afterwards I was leaving the floor and the attending was dressing her down in front of the entire nursing station like I had never seen I almost felt bad for her. The very next morning I saw "Dr. Doe" tell a RN to "give her the room immediately" while doing an admission because her "time was valuable and nursing can wait". Some people never learn.

  • Apr 22

    I will say for better or worse (and perhaps I am one of those people are happy to see not post as much), I post less because I miss the app.

  • Apr 22

    I had a similar situation one time but it was while I was working as an NP.

    We attend our own patients at a local community hospital that is not a teaching hospital but at times our specialists have residents rotating. All the providers work together very well and everyone is on first name terms, regardless of their education credentials.

    So the specialist comes to chat with me as I sat at the orders station about mutual patient. Introduces his first year resident as "Jane". We discuss the patient and "Jane" comes with me to visit the patient. We get back and start to talk to the nurse about the plan. I mention that "Jane feels that pt should have XZY" but I feel that we need to do Y first and move from there. "Jane" buts in as says "actually its Dr. Doe and this really isn't up for debate". So I just nod at the nurse and pull "Jane" aside, and "Dr. Doe" proceeds to reiterate that she is a physician and her expertise has been requested on this patient and the plan should be followed as discussed, so she got a little perturbed and agitated at my audacity when I told her that as the attending provider we would no longer need the consultation and I would be removing the order that I placed for the consult.

    I guess she went and told her attending because shortly afterwards I was leaving the floor and the attending was dressing her down in front of the entire nursing station like I had never seen I almost felt bad for her. The very next morning I saw "Dr. Doe" tell a RN to "give her the room immediately" while doing an admission because her "time was valuable and nursing can wait". Some people never learn.

  • Apr 21

    I will say for better or worse (and perhaps I am one of those people are happy to see not post as much), I post less because I miss the app.

  • Apr 21

    I will say for better or worse (and perhaps I am one of those people are happy to see not post as much), I post less because I miss the app.

  • Apr 21

    I had a similar situation one time but it was while I was working as an NP.

    We attend our own patients at a local community hospital that is not a teaching hospital but at times our specialists have residents rotating. All the providers work together very well and everyone is on first name terms, regardless of their education credentials.

    So the specialist comes to chat with me as I sat at the orders station about mutual patient. Introduces his first year resident as "Jane". We discuss the patient and "Jane" comes with me to visit the patient. We get back and start to talk to the nurse about the plan. I mention that "Jane feels that pt should have XZY" but I feel that we need to do Y first and move from there. "Jane" buts in as says "actually its Dr. Doe and this really isn't up for debate". So I just nod at the nurse and pull "Jane" aside, and "Dr. Doe" proceeds to reiterate that she is a physician and her expertise has been requested on this patient and the plan should be followed as discussed, so she got a little perturbed and agitated at my audacity when I told her that as the attending provider we would no longer need the consultation and I would be removing the order that I placed for the consult.

    I guess she went and told her attending because shortly afterwards I was leaving the floor and the attending was dressing her down in front of the entire nursing station like I had never seen I almost felt bad for her. The very next morning I saw "Dr. Doe" tell a RN to "give her the room immediately" while doing an admission because her "time was valuable and nursing can wait". Some people never learn.

  • Apr 21

    I had a similar situation one time but it was while I was working as an NP.

    We attend our own patients at a local community hospital that is not a teaching hospital but at times our specialists have residents rotating. All the providers work together very well and everyone is on first name terms, regardless of their education credentials.

    So the specialist comes to chat with me as I sat at the orders station about mutual patient. Introduces his first year resident as "Jane". We discuss the patient and "Jane" comes with me to visit the patient. We get back and start to talk to the nurse about the plan. I mention that "Jane feels that pt should have XZY" but I feel that we need to do Y first and move from there. "Jane" buts in as says "actually its Dr. Doe and this really isn't up for debate". So I just nod at the nurse and pull "Jane" aside, and "Dr. Doe" proceeds to reiterate that she is a physician and her expertise has been requested on this patient and the plan should be followed as discussed, so she got a little perturbed and agitated at my audacity when I told her that as the attending provider we would no longer need the consultation and I would be removing the order that I placed for the consult.

    I guess she went and told her attending because shortly afterwards I was leaving the floor and the attending was dressing her down in front of the entire nursing station like I had never seen I almost felt bad for her. The very next morning I saw "Dr. Doe" tell a RN to "give her the room immediately" while doing an admission because her "time was valuable and nursing can wait". Some people never learn.

  • Apr 20

    Quote from Boomer MS, RN
    My statement is based on my professional experience, entirely anecdotal, albeit enough to carry some weight. As I said, I have not read any current literature on how much RN experience is necessary or recommended for acceptance into any nursing graduate program. I have no doubt my alma mater would be able to provide that data. But I'm not interested in pursuing the information. My interests lie elsewhere....So my disclaimer is that it is only my opinion.

    It is sad that sometimes others' opinions here are attacked via disparaging responses. And I agree it damages the profession.
    You feel attacked because others have challenged your opinion which you state you have no interest in and have not done any research on?

    Rich, E. R. (2005). Does RN experience relate to NP clinical skills?. The Nurse Practitioner, 30(12), 53-56.

    Barnes, H. (2015). Exploring the factors that influence nurse practitioner role transition. The Journal for Nurse Practitioners, 11(2), 178-183.

  • Apr 19

    Quote from Happymango
    I helped a nurse prepare an immunization for a child and administered the vaccine. It wasn't till after I administered the vaccine did I realize my nurse pulled up the wrong vaccine and the infant got a double dose of a vaccine that was given previously. I had to fill out an incidence report with my instructor today and I can't help but feel like this is my fault because I shouldn't have trusted that nurse and I should have reconfirmed what I was giving. I'm scared that this mistake might cost me my seat in the nursing program. Has this ever happened to anyone as a student?
    Never, under any circumstances outside of life/death, give a med that you did not draw up yourself.


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