Latest Comments by BostonFNP

BostonFNP Guide 44,777 Views

Joined Apr 4, '11 - from 'Northshore, MA'. BostonFNP is a Primary Care NP. Posts: 4,801 (62% Liked) Likes: 11,672

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  • 0

    I don't regret it at all, but I can say with absolute confidence, it is not for everyone. Have you shadowed some FNPs to see if the role is something that makes a worthwhile investment for you?

    There is considerably more stress as a provider, and while you learn to compartmentalize it with time, it is a role in which the buck stops with you, and that responsibility can be stressful.

    I work 3.5-4.5 days a week and I am off weekends and holidays. I do share call responsibility with my partners twice a month for a weekday night and four times a year weekend.

  • 0

    Quote from Miffy
    I hate knowing that I don't know as much as a I should know to take care of patients properly. It gives me intense anxiety and keeps me up at night. Knowing that lives are in my hands when I feel inadequate is tough.
    It may sound strange to hear, but this is a good thing. Knowing what you don't know and self-reflective practice is an important component of practicing safely. There is not a provider out there that knows everything, and if you are aware of where that line is for you, then you should be able to safely practice.

    This job comes with a level of anxiety, and you need to compartmentalize it as you enter practice. It fades a little with time, but many providers find themselves waking up in the middle of the night at times in a panic about a patient. You absolutely have lives in your hands and that responsibility comes with a degree of anxiety.


    Quote from Miffy
    My courses don't have textbooks and my professors are unapproachable, which makes me feel even more like I don't have any clue what I am doing. Unfortunately, I feel very alone in my experience, and like no one understands. I haven't really connected with my classmates, which also makes it hard since I feel I lack support.
    It sounds like your program is really letting you down; it may help to try and find someone at your school to talk to about this.

    Quote from Miffy
    I really hope it gets better when graduating, but without the support of preceptors in the real world, I think I may have even more anxiety than I do now.
    It gets better with time. Once you are out in the real world you will have demonstrated basic competency by passing the board exams, and as you move to practice you never practice alone. Identify mentors and work closely with them. If you have questions, ask.

  • 1
    AJJKRN likes this.

    Quote from gcupid
    which is a shame....there need's to be a stop to ridiculousness. Do they believe a new grad bsn overrides there years of experience? Leave them nurses alone. That is a time in life you should be relaxing or doing things you want to do or helping your own kids pay for school. They should offer classes/continued education in their hospital if they really believe it's about safety.

    I'm so disgusted with this profession at times.
    They did (at least superficially) base their requirements on outcomes data. I am sure it was also convenient to the bottom line to get some of the higher paid nurses a help out the door. I do believe if they require it they should contribute to the cost of it.

  • 4

    From strictly a financial position: if nursing changed to a BSN or MSN entry right now it would create a shortage which would increase demand and give nurses some leverage to have some of these demands met.

  • 2
    CKPM2RN and KatieMI like this.

    There are 3 million active RNs in this country, the fact these problems exist is evidence that nurses are doing a crappy job advocating for themselves.

  • 6

    Quote from decembergrad2011
    I am talking about the nurses that I personally work with on my floor that I have seen go through graduate school. I work with them and see the things that they miss and the gaps in their critical thinking. They are where I would expect 2-3 year experience RN's to be at, and I am not saying I was any further along at that point in my career. However, you do not even know what you do not know until around two years, and that's if you stay within the same specialty.
    Are you saying that they are not ready to be bedside RNs or ready for advanced practice when you said that they are not ready to be "independent practitioners"? If you work with them on the floor, are you judging their competency in the APN role?

    I think we all agree that you don't know what you don't know until you have some experience in the role.

    Quote from NuGuyNurse2b
    With less years of experience, I'm willing to bet those BSN's probably haven't seen it all, or are not 100% proficient in their practice. Case in point: I had a patient whose port kept occluding. Flushed with Heparin, flushed with clot busters, still didn't have good blood return. Looked on the Xray...the damn needle was right up against the side of the port wall. And you know who inserted it? One of our nurses who's in an NP program.
    Do you feel 100% proficient in your practice? In my experience it's the people that think they are 100% that are the most dangerous. It has also been my experiene that anyone, regardless of their experience and education, can make errors on technical skills at times. I really don't feel that one (relatively) small technical error as a bedside nurse negates the ability for that nurse to be a competent APN.

  • 2

    Quote from decembergrad2011
    They are not ready, in my opinion, to be independent practitioners at that point, but it is not their fault that programs will accept new graduate BSN students into the next semester's course.
    Where are you in your program? How do you know these other students aren't ready? What makes you think that?

  • 4
    gcupid, Dodongo, KatieMI, and 1 other like this.

    Quote from txmurse69
    I tell our new grad employees that our professions are different, MD's diagnose and prescribe treatment, nurses implement that treatment and care for patients. We need more nurses that want to care for patients and less that want to compare themselves to MD's.
    You can tell them that but you are 100% wrong.

  • 4

    Quote from llg
    Even when we treat such people well, it doesn't change their underlying motivation and plans. As a profession, we need to map out different career paths for such people to avoid wasting the resources they consume during that mandatory 1-2 years of hospital experience.
    I think Katie's point is (maybe not, but I've seen this happen many times) is that often times novice RNs that do have plants for APRN roles don't get treated well on the floor. I understand why the experienced RNs on floors are pissed, it's a bad situation, but I don't think that's a reason to treat people poorly.

  • 3

    Quote from Ruby Vee
    Not only is this likely to be problematic for the future of nursing AND Advance Practice Nursing, it's a problem NOW. All of these future NPs and CRNAs aren't really interested in the job they've been hired to do right now, and the patients get short shrift.
    This is a huge problem.

    These novice RNs are trying to learn an RN role without their complete attention while also trying to go to didactic graduate classes and learn the NP role in clinic without complete attention. It is not a good model for the novice nurse, the employer, or patients.

    Quote from Ruby Vee
    Believe me, it has nothing to do with treating new grads better. These folks are boasting that they're applying to an NP program or only looking for ICU experience to get into anesthesia school before they've spent even a single day on the unit.
    But that is not a blanket excuse to be treated poorly, or worse, unsafely. I am not saying you personally, just in general.

  • 2
    Rocknurse and SurfCA40 like this.

    One way to look at this is to consider the numbers:

    By graduates/education:
    The number of NP graduates between 2010-2013 is about 52,000.
    The number of RN graduates between 2010-2013 is about 144,000.
    The number of NP graduates in 2010 was 11,000 and in 2015 it was 20,000.

    By workforce data:
    In 2011 there were about 100,000 NPs and that increased to 128,000 in 2014, a 28% increase over 4 years.
    Between 2003 and 2014 the total number of nurses in the workforce increased from 2.44million to 3.04million, a 24% increase over 12 years.

    It shows that the number of NPs is increasing exponentially but the number of NPs compared to the number of RNs remains a small fraction of the total RN workforce.

  • 2
    ilovensg and Dodongo like this.

    How long would you expect the symptoms of bronchitis to last?

  • 0

    You may want to talk to a lawyer about this before you do anything.

    Per my read/knowledge (I am not a lawyer or legal expert, just reading the documents):

    "Individuals who answer “yes” to the GMC-related licensure or APRN authorization application questions and who are not excluded from licensure or authorization as set forth in Licensure Policy 00-01 must submit all relevant documentation as required for the Board to determine his/hercompliance with the GMC licensure requirement.".

    If you have to answer "yes"to any questions you would then fall under obligation for documentation relating to and 12-step programs or drug/alcohol rehabilitation programs. If you don't have to answer "yes" then it does not apply.

    Questions are:
    "• 1. Has any disciplinary action ever been taken against you by a professional and/or trade licensing/certification board located in the United States or any country/foreign jurisdiction, including removal from a long-term care nurse aide registry program?
    • 2. Are you the subject of pending disciplinary action by a professional and/or trade licensing/certification board located in the United States or any country/foreign jurisdiction?
    • 3. Have you ever applied for, and been denied, a professional and/or trade license/certification in the United States or any other country/foreign jurisdiction?
    • 4. Have you ever surrendered or resigned a professional and/or trade license/certificate in the United States or any other country/foreign jurisdiction?
    • 5. Have you ever been convicted of a felony or misdemeanor in the United States or any other country/foreign jurisdiction?
    • 6. Are you the subject of any pending or open criminal case (s) or investigation (s), (including for any felony or misdemeanor) in a jurisdiction in the United States or any country/foreign jurisdiction?"

  • 2

    Quote from WestCoastSunRN
    Is FNP cert sufficient for most generalist hospitalist roles?
    Your board certification doesn't dictate where you can work: your state practice act, your own ethics, and your employers policy does. The real question is do you feel you have the experience and training to fill that role both professionally and ethically.

    If you are going to dual cert the logical progression in FNP then ACNP.

  • 2
    traumaRUs and ilovensg like this.

    Quote from Dodongo

    From what I can tell from a quick google search, if you're concerned, make sure you know the patient's baseline INR and then you can re-draw the INR in ~3 days. OR, you don't even have to worry about it. Haha.

    Would be interested in hearing from experienced providers.
    Don't just "google" it (and don't just blindly take advice from posters here either, myself included and perhaps least of all..)!

    You should have access to experienced providers/mentors, guidelines/p&p, and point of care resources that should inform your clinical practice. You do not want to be telling a lawyer that you checked google to make your decision.


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