Content That lhflanurseNP Likes

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lhflanurseNP, MSN, NP 9,547 Views

Joined Jan 6, '13. Posts: 580 (41% Liked) Likes: 439

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  • Jun 28

    Get a lawyer who is WELL-EXPERIENCED in worker comp/disability related injuries. Seriously!!!

    You need someone who truly, truly knows the LEGAL ins & outs of this issue. I would not be relying on random info (albeit well-meaning) from family, friends and anonymous posters here.

    Your employer is NOT out to watch for your best interests - your lawyer will.

  • Jun 28

    RN experience will be IMPERATIVE to your career as an NP! Being a nurse, while it certainly does involve getting your hands dirty with tasks yot seem to feel you're above, is about so much assessment and evaluation. RNs spend a good chunk of time giving medications and watching how they effect the patient, and can recommend dosage changes or notice if the patient is having adverse effects. Their assessments are also invaluable in determining what comorbidities, psychiatric or otherwise, a patient is experiencing, because treatments for a variety of disorders can be tricky when considering medication interactions and the like. Being an RN is absolutely fundamental to becoming an NP, as it hones your observation skills, your communication skills, and your familiarity with the treatments and therapies available to your patients. Also, RNs spend a ton of time educating and reinforcing the teaching done by other professionals with their patients, which is another piece of your job as an NP.

    I'm sure you didn't intend this, but your post comes off as rather condescending, like you find the work of an RN to be futile and boring. I'd like to recommend that you volunteer at a mental health facility and shadow both an RN and NP if possible. I think that would give you a wealth of insight into the tasks involved in both roles, and help you make am informed decision about your career path. I genuinely wish you the best of luck in finding a career that suits you.

  • Jun 25

    Quote from psu_213
    The student replies to me "well, how about a real report."


    Wow. WOW. When I was in school, I had to go to the unit the night before and research my patient and was expected to know all about them, including their scheduled meds, by the time I arrived bright and early 1 hour before shift change. The *only* exception to this was L&D.

    Interesting. Things sure have changed.

  • Jun 25

    First, I have never witness a nurse being mean (patronizing, etc.) to a nursing student--even if said student was not up to standard.

    It does go both ways. I got to work, got report on my patients. Started the routine of assessing/medicating my patients. A group of students strolled onto the unit at 0755. One came up to me and said "I have Mrs. Smith in room 2" (name changed to protect the innocent). I replied "OK, well she has a history of A fib. She is here after cardioversion." The student replies to me "well, how about a real report." I wanted to tell her "well, that happened an hour ago," but I held my tongue and did give her more of a report. (I don't know about anyone else, but when I was in school, we always arrived before shift change and listened to report...that does not seem to be the standard now.)

    Yes, it's a shame that nurses aren't always appropriate in their treatment of students; however, it can be a stressful experience for an overworked nurse to have a student come to him/her and demand that the nurse stop everything to "explain stuff" when other things need to be completed ASAP.

  • Jun 25

    Quote from OnOn2RN
    Hahah. I give my husband one of 2 things depending on my mood - a smartass answer or I start a super technical science answer and he gives up. [emoji23]
    When people ask me why their elbow hurts or what that weird rash is, I always answer that it's the hallmark sign of a brain tumor. Most of my family and friends have quit asking me to diagnose them. Except DH. He wants a diagnosis and advice, but then he never takes the advice given. Nothing changes.

  • Jun 2

    Quote from RockMay
    How many hours of EKG or xray does this online NP program include?
    Enough that I know bad when I see it, and my program is a hybrid. Thanks for playing.

    Taking a page from the Jewish playbook of answering a question with a question:
    How much NST/fetal monitoring does your program provide?
    What are you trying to prove?

    Take your ax and grind it somewhere else. Your posts remind me of my 11-year-old who can't let an argument go even when his assertions are so patently ridiculous as to be funny.

    I'm not in favor of low-quality education on any front, whether NP or PA or MD but nor will you come to a nursing board and paint all of us with the same brush because you apparently have an issue.

  • Jun 2

    Quote from RockMay
    NP independence came about as a result of aggressive legislative lobbying, not actual medical knowledge.
    Yes the all-powerful nursing lobby? As compared to the meek AMA lobby.

    Attachment 22346

  • Jun 2

    Personally, I would let it slide, cont to do my best, learn from your mistakes and go on.

    I respectfully disagree with above poster who (if you read his/her posting history) is extremely unhappy in general with their chosen career path.

    You can't always be in a warm and fuzzy environment - being an NP is not always a supportive role. However, sometimes we just have to roll up our sleeves and wade right in. I've been an APN for 10 years now and my practice is big (21 MDs now) and many varied personalities. And yes...they gossip sometimes. Here's some tips I've learned when I've goofed:

    1. Admit my mistake up front. No crying, no hysterics, just the facts.
    2 Come up with a plan to remedy it. In my worst mistake, I made a prescribing error which was exceedingly costly. I enrolled in an extra pharm course, took an additional 30 hours CME in pharm, sought additional advice from some trusted NPs I know (thank you Siri) and moved on.
    3. Don't participate in gossip. Be known as someone who might be aware of mistakes other providers' make but who doesn't repeat them.
    4. Sit in on exams of the MDs who are questioning you - even if it means you have to do so on your own time. This shows a commitment to the job and profession.
    5. Find a mentor - another NP who you admire and trust who can help you navigate the ropes of the practice. Consider joining your states' APRN organization.

    Being an APN is different than being an RN - the role is similar but the expectations and responsibilities are far greater.

  • Jun 1

    Quote from RockMay
    You forgot about the part of doing 2-3 years of pre-reqs and having on average 10,000 hours of health care experience.

    Contrast that to "direct entry NP" programs of which many are laughably online.
    Your not worth entertaining but if by some change someone reading this post thinks for a moment your statement as truthful, '10,000 hours & 2 to 3 years of pre-requisites' and not misleading outright lies. One can read for themselves the curriculum of what it takes to be a PA from Duke University and their program. Going online to the site it is plan to see the lies your asserting as truth. I find it doubtful that even 1,000 hours are attained. So stop it with your garbage.

    Physician Assistant Curriculum

    Below: Copy of Duke University PA Curriculum without carts

    Physician Assistant Curriculum Duke University*
    preclinical studies•clinical experiences
    The first 12 months of the program are devoted to preclinical studies, and the remaining 12 months to clinical experiences in primary care and the medical and surgical specialties.* All courses are required, no transfer credit is accepted, and no credit is awarded for pre-admission experiential learning.* Only full-time students are admitted to the curriculum.

    During the second year of the PA Program, students complete 10 rotations.* These clinical experiences are composed of eight required and two elective rotations, and a final senior seminar course.*At least one of these rotations is required to take place in a medically underserved area.* Students must successfully complete the end of rotation exam at the conclusion of all required rotations as well as other clinical evaluations throughout the year.* Clinical year students will return to campus throughout the second year to participate in Call Back days and evaluation

    Go to the site to see the 2 year curriculum cart.

  • Jun 1

    RockMay is a troll on these forums. Just wastes time here picking at the NP profession.

    At least NP's have independence (which PA's do not thankfully), and are required to be an actual healthcare professional beforehand, unlike PA's who will admit any blow schmoe with barely any healthcare background and some random degree.

  • May 31

    Actually I started in informatics-but decided I didn't want to be sitting in front of a computer all day or trying to train other nurses to use systems. I wanted to be with patients on the clinical side of things. I also knew I'd take a pay cut-at least to begin with. You should try and shadow an informatics APN and an NP and go from there..

  • May 29

    People are successful without experience, but I do feel nursing experience is invaluable. I'm glad that I waited. I feel like you learn a LOT in the "real world" of nursing that you don't learn in nursing school. Doing over, I would do the exact same thing.

    From one previous honors BSN student to another

  • May 29

    On the other hand, I think this is a legitimate question unlike the one the OP posted before in another thread.

    Consider the following scenario:

    A family practice physician sees a new patient to establish routine care of a healthy middle aged male with no prior histories. He performs a physical exam, checks vital signs, orders labs, and determines that screening diagnostic tests are required. He writes up a note on the patient and bills the insurance company for $100.

    An FNP sees another middle aged male with the exact same profile as the one the physician saw and performs the exact same procedure as the physician but can only charge the insurance company $85 or 85% of what a physician can charge because that's what the CMS rules state.

    If you look at it, both providers did the exact same thing. The argument against making reimbursement equal between physicians and NP's is that NP's offer a more cost-effective alternative to the care physicians offer by charging insurance companies less. That disparity, however, is also preventing NP's from having a level playing field with physicians.

    In some institutions and practice settings, physicians insist on billing services alone and not having the NP's on their team bill in order to capture the 100% reimbursement. This devalues the NP in states where a collaborative practice is required. There are good arguments on both ends of the debate.

    This is not about NP's asking to be allowed to perform the full scope of physician and surgeon practice. What it is is asking if NP's should be paid the same as physicians if they bill for the exact same CPT code. I'm also not excluding PA's in this argument.

  • May 29

    Quote from sailornurse
    As a new graduate NP you need to be in the supportive environment.
    But why? Why shouldn't we come out of school prepared to practice independently to the full scope of our license? Although a supportive environment would be ideal I don't think it should be expected. I have concerns the unreasonable expectations of extended orientations for new NPs hurts our credibility with physicians who expect us to be ready to practice. We have one, not even new just new to our specialty, who calls the physician before ordering a multi vitamin its embarrassing.

    To the OP please reconsider accepting poor wages or working conditions due to an obligation to your patients. Very few men or physicians fall into this codependent trap. Make your requirements known before you start a new job and handle your business like what it is, a business.

  • May 26

    I have been a nurse for almost 40 years. I would love to say I have never made a mistake, but that would be a lie. I have made more than my share. The fact of the matter is that you are human. Many things contribute to making errors, but the bottom line is that you are human. We make mistakes, and sometimes they can be big ones.
    First of all, nobody was injured. You took accountability for your actions. You did all the right things. Since I do not know what the error was, I have no idea why you were fired from your position.
    I am a Nurse Manager now, and an educator. My job is to support my nurses, even when they make mistakes. Unless they keep doing the same thing over and over, and unless it is something they could lose their license over (violation of the Nurse Practice Act), making a mistake, no matter how large, that did not result in injury to the patient would probably not lead to termination.
    Your nurse manager CANNOT divulge to a prospective employer what you did. In most states that is illegal. If that happened, you could and should file a lawsuit.
    Get some counseling, but above all FORGIVE YOURSELF AND MOVE ON! Don't give up your career for this. Early on in my career I was fired from a job. Yes, it really hurt, and yes, I seriously thought about quitting. I am glad I chose the right course, which was to move on.
    I hope you will move on and find a job where you can be the very best nurse you can.


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