Dumb question--What do you NPs do?

[Joe NightingMale, MSN, RN]

My program attracts a lot of people interested in becoming NPs. I'm looking more towards the CNS role, as I'm looking for something more hospital-oriented and specialized. I've never wanted to do the kind of primary care my PCP does (and I'm not looking forward to yet more school).

But I really like and am good at basic physical assessment, which is something more associated with NPs (and is in fact taught by NPs for both the lab and lecture sections). So, I'm starting to wonder if I am right about the NP role.

So what is it that you all do?

[BarbaraNP]

I own my own primary care practice...so I do it all. Assessment, diagnosis and treatment. Lots of pt teaching, counseling, and coaching. I love it when I get to do treatments.

Since I no longer work inpatient, I can't really address that other than to say many NP's do all the acute care stuff (fill in where residents use to be) as well as ER/trauma.

BarbaraNP

[ILoveIceCream]

Hi, BarbaraNP.

Can you do all the things a FP doctor can do?

[n_g]

Sure, NP's can do everything a FP doc can do, at 85% reimbursement rate. It's not a bad deal considering we have lower loan debt and training is only 2 years.

[traumaRUs, MSN, APRN]

I beg to differ with you n_g - NPs can't do EVERYTHING a FP MD can do. What the NP can do is strictly controlled by the state practice act. It is best when considering advanced education, that you fully understand your state's practice act so that you don't waste time obtaining an education that will not allow you to do what you want to do.

As to Joe (like your username by the way), in IL, the nurse practice act doesn't differentiate between an NP and CNS. They are grouped together along with CNM and CRNA as APNs. The new nurse practice act just went into law a few days ago.

I am in the process of moving back to a large hospital and some of the things I can be credentialled to do include:

central line insertion

endotracheal intubation

suturing

dc'ing tunneled catheters

inserting PICC lines

(and I can't remember everything else). However, you also have to keep up your proficiency with these skills too. Just because my collaborative agreement says that I can do stuff, doesn't necessarily mean I will or should! lol

You might contact your state's advanced practice society to see what other info they can offer.

[Joe NightingMale, MSN, RN]

I beg to differ with you n_g - NPs can't do EVERYTHING a FP MD can do. What the NP can do is strictly controlled by the state practice act. It is best when considering advanced education, that you fully understand your state's practice act so that you don't waste time obtaining an education that will not allow you to do what you want to do.

As to Joe (like your username by the way), in IL, the nurse practice act doesn't differentiate between an NP and CNS. They are grouped together along with CNM and CRNA as APNs. The new nurse practice act just went into law a few days ago.

I am in the process of moving back to a large hospital and some of the things I can be credentialled to do include:

central line insertion

endotracheal intubation

suturing

dc'ing tunneled catheters

inserting PICC lines

(and I can't remember everything else). However, you also have to keep up your proficiency with these skills too. Just because my collaborative agreement says that I can do stuff, doesn't necessarily mean I will or should! lol

You might contact your state's advanced practice society to see what other info they can offer.

Thanks!

I guess what I'm trying to figure out whether I should go ahead and spend the time and money becoming an NP (as most of my classmates plan to) or spend the money and time to become a CNS (which a nursing professor thinks is a better fit for me) or skip the further education and money and just practice as a generic MS RN (which I'll be when I graduate). Definitely want to do education and research and have pt contact, just not sure of the right route/area...

[traumaRUs, MSN, APRN]

Joe - I work in Peoria, IL and here at least there is much confusion over the CNS versus NP roles. I would choose whatever would give you good employment opportunities. I did an MSN in management and leadership first, then went back for a post-MSN adult health CNS. I did the CNS solely because that was what was offered at the college of nursing affiliated with the hospital. (Not the best reason to choose an education but I'll be honest). My only concern was getting the APN behind my name. I truly identify with the NP role far more than the traditional CNS role (education, clinical expert on a particular unit, research, etc).

[Joe NightingMale, MSN, RN]

You're right, whatever will get me a job (preferably the kind I like) is what I should do...the specifics don't matter much, and anyway it's too soon to know what path I'll be taking.

[traumaRUs, MSN, APRN]

Good luck Joe!

[happydays352]

"At 85% reimburstment rate" not always true in some states it's 100% of physcian pay, it's called equal pay for equal service or something like that.

:) Just had to be picky.

[core0]

"At 85% reimburstment rate" not always true in some states it's 100% of physcian pay, it's called equal pay for equal service or something like that.

:) Just had to be picky.

To be picky this only applies to Medicare/Medicaid. The reimbursement is 85% of what medicare would pay the physician unless it is incident to. Most other payors pay a percentage (above or below) medicare and may or may not have different rates for NPPs.

David Carpenter, PA-C

[Corey Narry, MSN, RN, NP]

I am in the process of moving back to a large hospital and some of the things I can be credentialled to do include:

central line insertion

endotracheal intubation

suturing

dc'ing tunneled catheters

inserting PICC lines

Removing tunnelled catheters? that's great. I've never done that and not credentialed to do it either. Usually Vascular Surgery puts them in and removes them where I work. Have done short-term dialysis access catheters though.