I've been going over the older posts and I am alarmed at how many times issues such as poor pay/benefits and long hours arise for many of the NPs out there.
There is no way I am spending the next 2-3 years in school to make just a little more then I do now as an experienced critical care RN, never mind the same old two weeks vacation and lousy or non-existent retirement.
Please tell me this is not the 'norm' for NPs!!! If it is then I am definitely going the CRNA route. At least they are well paid, have good benefits and fair vacation.
I'm not sure where exactly you live in TN, but I know for a fact that NP jobs in Nashville are notoriously low paying, because there is an over-abundance of NP programs in that city. I graduated from Vandy a few years ago (I live in TX) and I specifically remember hearing stories about NP's being offered $20 bucks per hour, etc. In S. TX, I've seen anywhere from $28/hr (pedes) to $65/hr (ER) with full benefits.
Unfortunately, there are a record number of new grad NP's that are flooding the market, so it will be interesting to see the outcome of this. Those online programs are pumping out the NP's like nobodies business and it is going to hurt our profession all the way around. I can see a lot of NP's going back to nursing and then the domino effect begins...hospitals will want the NP's in nursing positions and the "less educated" RN's will be out of a job. Personally, I think the standards should be raised for entry into NP programs. I've seen several programs that don't even require the GRE or any nursing experience. All this does is give our profession a bad name, b/c just about any Tom, Dick or Harry can get in!
although I acknowledge your scenario could play out, there are other possibilities
1...with the successful completion of the NCSBN vision of a national scope of practice as well as earning more equality in the world of reimbursement/hospital priveleges, APRNs could assume the role of primary care provider and MDs could assume specialized roles in health care
2...if the DNP ever becomes the entry level for an APRN, IMHO the entry into advanced practice will become greatly reduced, considering it'd take around 6 years of education (not including real life practice) to complete your education; of course the tragic consequence of this would be for educational institutions to shorten the path
as for standards...I don't know that I can disagree, but why is this occurring? do schools get more financial assistance with graduate programs than with undergrad programs? the difference between my first trip through college in the early '90s and the more recent one, it's so much more challenging to get less than an Al these days, much less fail; maybe my opinion is skewed by the schools or maybe I've become more intelligent (which defies the physiology of the human brain); or maybe this is the difference between the grad vs. undergrad environment
With the number of family practice physicians declining and/or getting ready to nosedive, I wonder if this will create more demand for FNPs? It seems like it would... or will there be a massive effort to import doctors from other countries? I did a search recently on the residency match website, and family practice residencies are just about always the ones that go unfilled (if indeed any at a particular institution go unfilled).
Funny you mention this, because just yesterday I learned how to do a male GU exam that included a rectal exam; I felt soo bad for the standardized patient. I'm scarred for life
I hope they taught you how to do the prostate exam with the patient lying down! My husband has to have frequent DREs, and his main beef with male urologists is that they do the exam with him standing up. NPs do it with him lying on his side or on his back. He says it can be pretty painful standing up, but laying down is much more comfortable (as comfortable as that exam can be, that is!). Probably because the pelvic floor muscles don't have to work so hard to keep you upright at the same time that someone is doing THAT to you! :uhoh21:
I hope they taught you how to do the prostate exam with the patient lying down! My husband has to have frequent DREs, and his main beef with male urologists is that they do the exam with him standing up. NPs do it with him lying on his side or on his back. He says it can be pretty painful standing up, but laying down is much more comfortable (as comfortable as that exam can be, that is!). Probably because the pelvic floor muscles don't have to work so hard to keep you upright at the same time that someone is doing THAT to you! :uhoh21:
this class is taught by a MD and he taught us to do it with them on their feet and bent over with the elbows resting on the exam bench (or whatever it's called); he also taught us to put a box of kleenex further up the bench so the pt. can wipe himself when done; I think it's more so the pt. can wipe his tears off...
I'll have to ask why not with the pt. lying; thanks
this class is taught by a MD and he taught us to do it with them on their feet and bent over with the elbows resting on the exam bench (or whatever it's called); he also taught us to put a box of kleenex further up the bench so the pt. can wipe himself when done; I think it's more so the pt. can wipe his tears off...
I'll have to ask why not with the pt. lying; thanks
I work in a urology practice. One of the (young! probably never had a DRE in his life) male urologists insisted to one of the female NPs that standing up and laying down, it made no difference to the patients. So she did a little survey of her male patients, and they ALL said it was more comfortable laying on their side. :) She also told me it's easier on HER to do that way. If the men stand up, their pelvic muscles and anal sphincter get so tight and rock hard, it makes it harder for her to get where she needs to be. :icon_roll
Also, I've noticed, having been in the room when my husband had exams, that male doctors tend to say something like, "OK, drop your pants." And then they stand there while the poor guy drops his drawers and waits. No dignity involved there!! Every NP I've ever seen leaves the room while my husband gets ready. As ready as a person can be for a DRE, that is!
Just so you're prepared, if you ever do a DRE on a guy that has prostatitis, be prepared for him to jump! I've been (ahem) told that it's extremely painful. And if the guy has a prostatic infection, the prostate will actually feel "boiling hot". I've heard that phrase from 2 different NPs.
Now, don't you want to concentrate on women's health? LOL But seriously, you (being male) might find yourself very popular among the men who need prostate exams if you take the "kinder, gentler" approach. What a specialty!
I work in a urology practice. One of the (young! probably never had a DRE in his life) male urologists insisted to one of the female NPs that standing up and laying down, it made no difference to the patients. So she did a little survey of her male patients, and they ALL said it was more comfortable laying on their side. :) She also told me it's easier on HER to do that way. If the men stand up, their pelvic muscles and anal sphincter get so tight and rock hard, it makes it harder for her to get where she needs to be. :icon_roll
Also, I've noticed, having been in the room when my husband had exams, that male doctors tend to say something like, "OK, drop your pants." And then they stand there while the poor guy drops his drawers and waits. No dignity involved there!! Every NP I've ever seen leaves the room while my husband gets ready. As ready as a person can be for a DRE, that is!
Just so you're prepared, if you ever do a DRE on a guy that has prostatitis, be prepared for him to jump! I've been (ahem) told that it's extremely painful. And if the guy has a prostatic infection, the prostate will actually feel "boiling hot". I've heard that phrase from 2 different NPs.
Now, don't you want to concentrate on women's health? LOL But seriously, you (being male) might find yourself very popular among the men who need prostate exams if you take the "kinder, gentler" approach. What a specialty!
we provided a drape for the pt. and tried to maintain dignity as much as possible up until the exam itself; as I watched the professor demonstrate the exam to me I kept looking at the guy's face; his eyes were closed and he was taking slow deep breaths; I assume he was praying or something
I definitely understand what you are saying about muscles tightening up; I guess the only argument for standing is that when you are pushing your finger up there, the pt. can maintain his position better against the pressure of us trying to get in far enough to feel the prostate; I say this because our SP was a big boy and I really wasn't 10000% sure I was far enough in and I was really pushing; fortunately I don't have tree trunk fingers
women's breast and gu is next week yipee :stone
since I am a psych nurse, I honestly don't see myself examining many bipolar or schizo hineys, but of course it's good to know in case
we provided a drape for the pt. and tried to maintain dignity as much as possible up until the exam itself; as I watched the professor demonstrate the exam to me I kept looking at the guy's face; his eyes were closed and he was taking slow deep breaths; I assume he was praying or something
I definitely understand what you are saying about muscles tightening up; I guess the only argument for standing is that when you are pushing your finger up there, the pt. can maintain his position better against the pressure of us trying to get in far enough to feel the prostate; I say this because our SP was a big boy and I really wasn't 10000% sure I was far enough in and I was really pushing; fortunately I don't have tree trunk fingers
women's breast and gu is next week yipee :stone
since I am a psych nurse, I honestly don't see myself examining many bipolar or schizo hineys, but of course it's good to know in case
LOL!
Good luck with the female exam next week!
In case you haven't seen the Family Guy clip where Peter gets a prostate exam:
Specializes in Still a medic at heart but ICU, M/S, SVU.
Just a little curious. How can most of you say "only 30 dollars an hour"? Do you know how many people would kill to be making 20 dollars an hour? Shoot...that would make my life a lot easier right now. Please keep in mind that nurses, overall, make very decent wages in comparision to other jobs. And as an NP, it's not about money, but about the autonomy and educating and treating your patients.
Specializes in Still a medic at heart but ICU, M/S, SVU.
I agree. Off course we all have to pay our bills but I just find how funny it is that people focus on salaries on these boards. Maybe one day, after I have a few more years of experience under my belt, I too will mention it. Maybe because I'm new I'm content with what I'm getting.
Just a little curious. How can most of you say "only 30 dollars an hour"? Do you know how many people would kill to be making 20 dollars an hour? Shoot...that would make my life a lot easier right now. Please keep in mind that nurses, overall, make very decent wages in comparision to other jobs. And as an NP, it's not about money, but about the autonomy and educating and treating your patients.
How many of those people you speak of who would "kill to be making 20 dollars an hour" have put in the time, money, and effort to earn an MSN? NP is a career choice - of course money is a factor. NPs are worth far more than 30 dollars an hour.
Just a little curious. How can most of you say "only 30 dollars an hour"? Do you know how many people would kill to be making 20 dollars an hour? Shoot...that would make my life a lot easier right now. Please keep in mind that nurses, overall, make very decent wages in comparision to other jobs. And as an NP, it's not about money, but about the autonomy and educating and treating your patients.
I can assure you that I expect to make more money than I did as a RN. I'm taking on a lot of liability/responsibility plus I spent a lot of time and money going through NP programs. I know what physicians are making for doing the exact same thing I'm doing and I'm not happy that it's almost twice as much! Do you think that's fair? Did the people who would "kill to be making 20 dollars an hour" spend 6-7 years in college? Do they make life and death decisions every day?
PMHNP10
1,041 Posts
although I acknowledge your scenario could play out, there are other possibilities
1...with the successful completion of the NCSBN vision of a national scope of practice as well as earning more equality in the world of reimbursement/hospital priveleges, APRNs could assume the role of primary care provider and MDs could assume specialized roles in health care
2...if the DNP ever becomes the entry level for an APRN, IMHO the entry into advanced practice will become greatly reduced, considering it'd take around 6 years of education (not including real life practice) to complete your education; of course the tragic consequence of this would be for educational institutions to shorten the path
as for standards...I don't know that I can disagree, but why is this occurring? do schools get more financial assistance with graduate programs than with undergrad programs? the difference between my first trip through college in the early '90s and the more recent one, it's so much more challenging to get less than an Al these days, much less fail; maybe my opinion is skewed by the schools or maybe I've become more intelligent (which defies the physiology of the human brain); or maybe this is the difference between the grad vs. undergrad environment