ANPFNPGNP

If there's a need for NPs in the area, then it won't matter - they'll hire anyone if they're desperate. Otherwise, it can matter a great deal. Many physicians (and the public) are turned off by online NP programs. How many physicians do you know who attended medical school online? When searching for an online program, look at the acceptance rate (red flag if the acceptance rate is high)...do they require a decent score on the GRE (red flag if no GRE is required)...do you have to find your own preceptors (red flag if you must find your own preceptors). Many factors to consider. It shouldn't be easy or convenient to attend NP school, just as it isn't convenient to attend medical or PA school. The bottom line is...we have patients lives in our hands, so get the best training possible!

I've been a NP for 8 years and I've owned a very busy practice for 3 years. I precept students from various NP programs. I've had students from brick and mortar schools and online schools. The ones from the "brick and mortar" schools were FAR better prepared than the other ones. One of the online programs even let students take their tests at home (!) before they got into trouble with the Board of Nursing. That school just started having proctored tests last August and 50% of the students failed the first Health Assessment Test. They had a 100% pass rate on their tests before they were proctored. Does that tell you anything? I've had some good students from online programs, but even they said other students were getting away with murder. I've heard of NP students paying people to verify they did clinicals with them, even though they never set foot into their clinic. I've heard of NPs having other people take their tests or took them in groups. I've been absolutely floored at what some students didn't know - those students attended online programs. I've had physicians refuse to precept NP students attending online programs after working with a few. A physician told me that he had a student do a PAP and after she inserted the speculum, she turned to the medical assistant and asked, "Is that the cervix?" Oh my goodness, the examples I could give you! Don't think that experienced RNs are all "up to snuff" either. I had a couple with 25 years of ICU, Med-Surg, ER, etc experience and they had absolutely no business being in a graduate program. I also precepted a NP from a brick and mortar school and she only had 2 years of psych experience. I almost didn't take her, but she turned out to be the best student I've ever precepted. So, you honestly never know. Any graduate program that has a 98% acceptance rate is probably a diploma mill, as is any graduate program that doesn't even require the GRE, interviews, time on campus or proctored exams. As far as the number of clinical hours and the board exams - WHAT A JOKE! Go ahead, flame me all you want, but I've precepted over 30 students, so I know what I'm talking about. Furthermore, ask yourself, what would you think about a physician who completed their medical school online?

These are medical weight loss clinics - there is one close to my office. They prescribe phentermine and you can buy their meal replacements/supplements if you want. They also provide weekly B12 shots.

Make no mistake, doctors oppose our independence because they are afraid of losing MONEY. We've all seen where a physician controlled health care system has gotten us - it's time for a change! Physicians love NPs when we're working for THEM and making THEM money. God forbid when the NPs compete directly with the physicians. If doctors are so good at what they do, they shouldn't have to worry about competition.

Honestly, you need to work as a nurse practitioner for several years before even contemplating going out on your own. Get a job with a busy internist who specializes in complicated patients, so you will be exposed to a wide range of diseases/illnesses/injuries. I can't emphasize enough how important this type of experience is, because you never know what you will see out there on your own.

No matter how many years of nursing experience one has, NPs need several years of NURSE PRACTITIONER experience before going out on their own. I made sure I had 5 full years of experience with most of that time spent working side by side with physicians (who knew what they were doing) before I even considered opening my clinic. You never know what's going to walk through that door.

Why don't you just take the ANCC instead?

You are the one who takes everything personally. Considering the fact that you work at a Children's Hospital, you are obviously encountering children who are very ill. Therefore, you really don't have the educational background or training which is appropriate for those situations. However, that is NOT the case with NPs working in primary care. So, just because you're in a situation that requires oversight, don't assume that applies to all of us.

Guess what VIRAL NP, those patients will more than likely see a NP/PA in the ER too! NPs/PAs work in the "fast track" at ERs and see the majority of patients who come there. I know that FOR A FACT because I used to work in the ER as a NP!

What privileged universe are you living in? It's apparent that you have absolutely NO IDEA what goes on in the REAL WORLD! There are not enough primary care physicians NOW...are you totally out of touch with reality? As far as people taking their kids to the ER, well MAYBE those parents don't have insurance and can't afford to pay an outrageous amount of money for a visit to a pediatrician's office! One of the pediatric urgent care clinics in my area charges a MINIMUM of $165 for a visit. There are pediatricians, NPs and PAs working there. However, I charge $48 for a child's visit. I'm trying to keep those kids out of the ER for minor emergencies. I'm also charging $20 for school physicals - you wouldn't believe how busy I've been lately. This is working out for ALL OF US! I've only had to refer one child to the pediatrician across the street. Guess what...SHE REFERS HER OVERFLOW TO ME!

Since when is medical school the ONLY way to go? In NM, psychologists and optometrists can prescribe medication and they never attended medical school. The studies have shown they provide excellent patient care in comparison to physicians. In OK, optometrists can perform LASIX surgery and they've been doing it for years - it's helping to bring the cost of the procedure DOWN. These were turf battles the AMA tried to fight and lost. I'm preventing major health problems by offering low cost care to patients who are uninsured and underinsured. Several of my patients can't afford expensive visits at either a physician's office or urgent care clinic, so they come to me. They are getting excellent and cost effective care. The reason I opened a practice in a medically underserved area is because patients needed health care and physicians weren't interested in providing it. Get used to it, physicians will never be in control of health care again. Those days are long gone - thank GOD for that!

I don't think I'm equal to a physician. However, I know that I can take care of the majority of healthcare problems that present on a day to day basis and I know when I can't. I refer to a "higher level of care" for complex issues that I'm unable to treat. I've been doing it for 5 years now. I "shared" an internal medicine practice with a physician - I saw the patients 3 days a week and she saw them the other 2 days. This arrangement worked out well for both of us. Doctors have monopolized the health care field long enough - we can all see how that has turned out. In NM, psychologists and optometrists are able to prescribe medication within their scope of education/training - you can bet THAT ruffled some feathers. In OK, optometrists are able to perform LASIX surgery and that has brought down the cost of that procedure so more people can afford it. In fact, the TMA and TX Medical Board have filed a lawsuit against the TX Chiropractic Board over yet another "turf" issue. Make NO mistake about it, this is all about money! If physicians were so concerned about patient care, then why did they try to get legislation passed in 2009 that would have enabled them to supervise up to 8 midlevels in TX? Now, just how on earth is that humanly possible? As long as the doctor is on site, they can bill at the DOCTOR RATE for those midlevel visits, even though they never see the patient nor review the chart. You don't think this is about money??

What I have a problem with is when someone comments that independent NPs are a danger to patients. If you make that comment about me, then you better be able to prove it.

Wowza, where do you live? Are you not aware that NPs in several states have been completely independent of physician oversight for years now? This is NOT a new phenomenon. Make NO mistake about it, this is a $$$ issue. If physicians TRULY thought NPs needed to be fully supervised, then they would check out each patient that was seen by the NP before the patient walked out of the door. I pay a doctor $$$ to review 10% of my charts every 30 days, because I'm forced to, since NPs aren't independent in my state. This has to be the most ridiculous law ever...those patients are LONG GONE by the time he reviews their chart. So, you call that supervision? If a patient presents in my clinic with health issues that are clearly outside my scope of practice, I refer them to the doctor! What's really hilarious is that the docs in TX wanted to be able to supervise up to 8 NPs/PAs - how is that possible? That was shot down by the legislature. Doesn't that sound like a money making plan to you?? Now remember, as long as that doctor is on site, they get to bill at the DOCTOR rate for those NPs/PAs, even though they never see the patient. Wow, if I was a money minded doctor I wouldn't want that cash cow to go away either! TOO BAD IT ISN'T ABOUT PATIENT CARE! Furthermore, I'm seeing comments made about my profession that are nothing short of libelous. If a physician (or anyone) ever made some of these comments about me and I got wind of it, I would most definitely sue him/her for slander. We do NOT have to tolerate this folks.

It is ALL about the money, make no mistake about that. CRNA's ARE replacing anesthesiologists and will continue to do so. Here's the latest study that was just released comparing outcomes. http://www.medscape.com/viewarticle/726427?src=emailthis I know a couple of physicians, one is an anesthesiologist and the other an internist, and they both encouraged their sons to become CRNAs. The internist told me that CRNAs make more $$$ than him and he's been practicing for over 25 years! These doctors are well aware of what lies ahead in health care. Interesting they would encourage their children to become advanced practice nurses instead of doctors, huh?