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BostonFNP Guide 46,540 Views

Joined Apr 4, '11 - from 'Northshore, MA'. BostonFNP is a Primary Care NP. Posts: 5,005 (63% Liked) Likes: 12,430

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  • Dec 13

    Is quality even a factor in your equation or are you really just looking for the fastest route? Not saying Vanderbilt would not be quality education. My point as a current FNP student is I want to make sure I am prepared not rushed through then head out winging it....

  • Dec 11

    Quote from Workitinurfava
    One day we might be choosing between dying from the flu or dying from the ingredients in the flu-shot. Stay woke. Either way you are dying but the shot holds a 100 percent guarantee.
    Are you even a nurse? Can you provide any peer reviewed scientific evidence that vaccines are more dangerous than stated in official vaccine literature?

    The flu vaccine has been in widespread use for 80 years and average lifespans have steadily increased, IQs, have steadily increased, and deaths from infectious diseases have steadily decreased.

  • Dec 10

    Quote from KatieMI
    Look for big names. John Hopkins and University of Michigan/Ann Arbor are still mostly in-class, for one example.

    Just keep in mind that such programs cost accordingly and that many of them still do not provide preceptors (although they might offer more help in finding them). Where they do it, NP students often placed in locations which medical schools refuse, such as inner city community clinics and even prisons, which severely limits the value of expirience.
    I fail to see how inner city clinics and prisons are not valuable experience. Where do you think schools like Hopkins and Yale have clinicals? The Johns Hopkins Hospital is in a very bad and dangerous area and so is Yale, although New Haven has really worked to clean up their downtown. IMHO, the BEST experience is working for underserved populations, as the student will see a wide variety of problems. Medical professionals have enormous respect for providers who have such experience.

  • Dec 7

    Quote from tulipsupontulips
    3 weeks ago, one of the guys in my cohort shot me a facebook message. He asked me where I bought my stethoscope.

    He sent me his number so I could text him.

    "We can study together as long as you don't distract me"

    On Thanksgiving Day he texts me "Happy Thanksgiving!!" "Oh sorry that was for someone else"

    He texted me a few days later to discuss some things about school. I made some small talk

    Every now and then he talks about himself, but he likes to boast a lot.

    "Yeah I live across the Maserati dealership"

    "I don't know what I want to do when I graduate... I just want to make tons of money"

    He also sends me photos/videos of random things he does daily... like pictures of his lunch, unboxing videos, pictures of his calendar, pictures of him driving home.

    "Hi"
    "Hey do you have the paper that is needed for the school badge?"
    I HATE it when people try to be my friend.

    I feel like ADNs flirt overtly immaturely as well. They make me feel icky with all of their awkward conversation.

  • Nov 27

    Quote from Lil Nel
    According to my NM (you cut out the rest of my comment), they are. You should probably check with your facility.
    It's not facility dependent. It would be dependent upon the state BON. I know of no states that allow for a licensed RN to work under another RN's license. Your nurse manager is wrong, if that's what she said.

  • Nov 27

    Quote from Lil Nel
    Yes, an orientee has their own license. But during orientation, the orientee is operating under the license of the preceptor.
    No, she's not.

  • Nov 26

    Quote from WestCoastSunRN
    Actually we agree on that first point, as I also said Provider (NP) contributions are important but that nursing ALSO needs contributors with more practical knowledge regarding the work of the average RN in whatever specialty is the subject matter of said contribution.

    On the second point, I think it would be great to have more RNs at the primary care level-- but that's not what we typically see happening is it? In my experience it is the rare primary care setting that is employing RNs over MAs or LPNs. I do see RNs present more in pediatrics or some specialty clinics, but not usually family practice. Are they used more in your area?
    I think it all comes down to money. Practices don't want to pay an RN. I would love to have an RN in my practice to do patient education. MAs are great and do a good job, but I often think how nice it would be to have someone sit down with patients and go over in detail what they need to do, what resources they can avail themselves of, how they can best manage their conditions, etc. We, as providers, do the best we can but are always crunched for time. I have a lot of the educational materials as hard copies and on our practice website, but I think it would be beneficial to have a nurse go over the materials with them. Unfortunately, my practice and many others are not going to take on this expense.

  • Nov 23

    I am a direct entry NP grad. I did get some RN experience before graduating, but it was per diem. I would describe myself as quite successful. I literally have only had good feedback from the physicians and other providers I work with. I was very careful and cautious (especially when I first started) and now 2+ years into practice am really settling into the groove of my field. I also do a lot of reading, which has helped. Was my RN experience helpful? Sure. But it has been completely eclipsed by my first few years of practice as an NP and the support I've had from my provider colleagues. The reality is that what matters (IMO) to be successful as an NP is having a supportive, high quality NP position as a new grad. You want to see a variety of pathology in a supportive environment with reading on the side - this is what makes a great provider. It sounds like OP did not have that in her job and was set up to fail.

    Also, I can't help but find it frustrating to hear non-NPs comment on NP practice. The fact that they are so highly focused on RN experience indicates to me that they don't really know a lot about what it's like to be an NP and develop your way of practicing. RN experience in minuscule in comparison to working as an NP - seeing patients, working through diagnoses and tests, coming up with treatment plans, and getting guidance from more experienced providers - this is what matters. Truly every single person from my program is a successful NP or RN. Some chose to not go on to become NPs but to stay RNs. Those of us (the majority) who opted to continue on to become NPs after the accelerated RN training are practicing in this role without any issues at all.

    My biggest concern is online NP programs with low barriers to entry. These are what will damage our field. I know two terrible psych nurses. Both are attending some BS part-time online PMHNP program. One is such a terrible psych nurse that he was recently remediated and is having to go through training again. He has no business whatsoever becoming an NP. Of course his online program is happy to take his money.

  • Nov 22

    This got pretty heated. Some pretty shocking/macabre statements were made.

    I agree with Boston here... NPs are "above" RNs in the medical hierarchy. Are they our bosses? No. Neither are physicians. But physicians/NPs give the orders and RNs carry them out. I have a really great relationship with the physicians I work with (as an RN still) and they say all the time (jokingly) they are my boss, and I respond that they don't sign my paychecks so they can shove it. But, when it comes down to it, if they want something done, I'm there to do it (within the hierarchical system that is medicine). And, as an NP, I expect that the orders I place on my patients are carried out.

  • Nov 22

    Quote from mmak
    Would you still recommend that I get my own insurance if my PMHNP employer is paying for my insurance?
    In my humble opinion any nurse who is not carrying personal malpractice/liability insurance is asking for trouble. I f you make a mistake bad enough to get you sued YOUR FACILITY WILL NOT BACK YOU UP. It also kind of depends on what you have to lose. If you own a home you can lose it. Attorney retainer fees can run into the thousands. I carry a million dollar policy which is not too expensive since I have carried since I was in nursing school.

    Hppy

  • Nov 15

    Quote from LibertarianNurse
    I have always wondered at the lack of experience that people have coming out of a direct-entry program for either BSN or MSN. I would like to think that these graduates have the education and clinical experiences to guide them so that they come out of school knowing what they are getting into, but it just seems like that is not the case. More and more I hear about people such as yourself who have no nursing experience prior to the program and they often flounder, have a hard time in general, or end up quitting. The point of these direct entry programs is to allow more NPs and APNs to enter the job force in a relatively quicker manner than the traditional, but I am skeptical if they are doing the graduates or the public any favors because of these kinds of issues. Many have felt like you do and end up leaving the nursing profession altogether, which is counter to the way the educators envision it to be. I'm sorry you are having this experience. I think your inclination to return to bedside nursing is a good one. Get a year or two of experience under your belt, and perhaps be looking during that time for a suitable NP/APN position, but you will be that much more marketable for those positions with other experience at the bedside. Pediatric NP could be a great choice, if you already have some knowledge there. Best wishes!
    So, there were 40 in my graduating glass. We keep in touch. Not one felt they couldn't cut it as a NP and ended up leaving NP positions to work as a RN. After I read your post I emailed a professor I work with at a per diem job, who coordinates a Direct Entry program at a large, reputable university and asked her if she was aware of this happening with her graduates. She said she was not seeing this at all. Granted, I'm looking at a relatively small sample size in a specific geographic location, but I'm wondering where you're getting your info from. Is it purely anecdotal? I'm sure there are some DE grads who go back to RN positions, but how many is "many"? And how does that compare to experienced RNs who cannot make the transition to NP and elected to go back to the bedside? There's a thread here where several new NPs who are seasoned RNs are going back to bedside.

    It fascinates me how people who are not NPs and have not been through a DE program are so quick to disparage them.

  • Nov 14

    Quote from blondesareeasy
    Lie.
    Tell em' you got the shot.
    Go to Walgrens, get a receipt for something, tell em' you bought the shot.
    Photoshop someone else's receipt.

    Flu shots are a pharmaceutical gold mine.
    The flu kills OLD people and the immunocompromised. It doesn't kill people that go to work for a living and are up walking around.

    So play the game until a LOT of years go by that will prove that the flu shot ain't what it's supposed to be.
    Yes, it does. I am working for a living, and I am up walking around but if I were to get the flu, I can guarantee that I would have a tube shoved down my throat to keep me alive. I am not immunocompromised.

    And if you do anything you suggested, you should be fired.

  • Nov 14

    Quote from Rnis
    Clearly the parlor comment was tongue in cheek. I certainly don't have to do any of those skills it just can take up to 30 minutes to an hour to facilitate those tasks.... which yes we do IV's and straight caths on occasion in primary care.

    I think there is just a lot of defensiveness seething from your posts. It sounds like you have a lot of great experience in your profession and I am certainly not judging you as a provider. I just commented that it's not really possible for you to make a blanket statement that previous RN experience is not relevant.

    Yes it was tongue in cheek and I'm glad you recognized it as such. FWIW, I do know how to cath and start IVs, but it's not a good use of my time when there are 20 patients waiting to be seen and we have other staff who can do those tasks. So, it really doesn't matter if I can do them or not.

    And yes, I am defensive. I've been on this site for over 10 years and get really tired of the constant bashing of DE NPs. I replied to the OP to give support, encouragement, and share my experience. Inevitably, someone or several someones have to start with the put downs. It's especially infuriating when those who are not even NPs make blanket statements that the programs are subpar and shouldn't exist. Sure, there are some bad programs and less than competent DE NPs. You can say the same for traditional NP programs and NPs with 20 years of bedside experience. I've been precepting for a while, and have found that it doesn't matter how much or little bedside experience a NP student has. It's very specific to the individual. Perhaps I should say that bedside experience is not relevant to the success of a NP, because that is what I have observed. Some of the skill learned as a bedside nurse can be relevant, depending on your practice. I can certainly see that to be true with a NP who is a hospitalist or intensivist.

    Not all of us need to take the same path to wind up at our ultimate destination.

  • Nov 12

    Quote from wtbcrna
    I don't how many coins did fall out?. It was an example to try to make you understand herd immunity, obviously it didn't work.

    If you are working as a nurse and/or not living in plastic bubble then you are still a danger to everyone around you if decide to not be vaccinated.

    The whole reason for herd immunity is to protect the population as a whole, which would mean that the flu would still have little chance of spreading even if someone didn't become immune to the flu from the flu vaccine.

    The last I heard it was still illegal to molest children and cover it up.
    Apparently you haven't heard of Roy Moore, who is getting strong support from the religious right. While he does deny having sex with a 14 year old, he doesn't deny dating teenagers- whatever that means. And, as some of his supporters point out, Mary was a teenager and Joseph was an adult.

    It is a new world.

  • Nov 9

    Quote from Farawyn
    Stomach flew.
    You can prevent it by drinking your own pee....


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