Latest Comments by ivanh3

ivanh3 10,456 Views

Joined: Dec 14, '07; Posts: 479 (54% Liked) ; Likes: 705
ER Nurse Practitioner; from US
Specialty: ER and family advanced nursing practice

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  • 1
    shibaowner likes this.

    No offense to the OP, but I think "broken" is a strong term. I do not feel that NP education is broken. Any program can be improved, and most quality programs (of any kind) constantly self evaluate to improve their product. I have to agree with the responder who stresses the importance of research and the avoidance of anecdotal experiences that may erroneously guide decision making. I have seen new grad NPs with plentiful nursing experience fail, and I have seen new grads with limited RN experiences excel. I have also seen the opposite occur. I have not stepped out of my fishbowl to research which is the norm. Instead I judge each NP by their actions. I learn from both. I "steal" techniques and knowledge from those I think are sharp and use this to develop my own style, and I learn what not to do from others. New NPs often bring new and fresh approaches and they keep me on my toes.

    In terms of NP vs PA education I can say this. I didn't want to go to PA school. I may admire the rigor of their programs, but I don't see a better or worse final product. In my region all job postings are "NP/PA" or "PA/NP" but never one or the other alone. I work with PAs and man are they sharp, but so are the NPs where I work. We have to be. It is a high acuity, high volume setting, and we all turn to each for help. I was full time in school, but I was able to work. I was able to be part of my newborn son's life. My wife went part time to NP school which was a bonus for our family. BTW she totally kicks ass in her "nurse practishery" skills.

    Let's continue to improve our programs and our practice, but strong language like "broken" is not helpful or accurate.
    My .02

  • 4
    rnICU303, Double Dunker, ICUman, and 1 other like this.

    To the OP, yes, there is high degree of probability that RNs going into advance practice contribute to the personnel shortage in some units. Here advanced practice broadly refers to NPs, education, and leadership. While there may or may not be a "national" shortage, certain areas of nursing seem to find a harder time recruiting and/or keeping staff. I have seen several units where 10-20 RNs at a time were pursuing graduate education or training that would eventually take them from the bedside. When those people left there would be new-hires, and then inevitably, a number of current/seasoned staff would enroll in school.

    I read several posts here that seem to use absolutist terminology: Units are understaffed due to management. Period. Low pay. period. Undue hardship/poor working conditions. Period. I don't find that language accurate or helpful. I think the etiology has a multitude of factors. Some jobs are just plain hard no matter how much support staff gets from their organizations. This is often patient population dependent. I am fortunate enough to work for a great hospital, but our market is tough. I leave my shift exhausted sometimes, and I don't blame any of it on my employer.

    I think there is a significant fluctuation of unit staffing because RNs can make a variety of lateral transfers within the same organization. This allows them to try something new yet not change employers. This looks good on a resume.

    Bottom line, our flexibility/portability can be both gift and curse.

    Just my .02

  • 0

    I have recently transitioned to the emergency room from primary care as an NP. It has been awesome. Prior to my move I have focused on Fitzgerald for my CE. Her programs were perfect for what I was doing. The still have plenty of info that pertains to what I do, but I am wondering if there are any better options out there. I particularly am interested in 2-5 day seminars. Online options would be fine, too.

    Any recommendations for or against CE providers that focus on ED advanced practice?

    Thanks in advance,

  • 0

    What are you doing outside of work to prevent burnout? I see so many folks who take their work home or don't pursue other interests/hobbies. Also, do you take your vacation time? I see tons of RNs and NPs that have rolled over their vacation time. This is not good.

    Just my .02

  • 0

    I completed the the associates to masters bridge program at Graceland. It was a great experience. I felt like everything went very smoothly. If I had one complaint it was that the program moves more slowly compared to others. I had to petition the board to double up on some classes so I could finish earlier. They have since changed the format some so I am not sure how long their program lasts. I was also a student at the University of South Alabama (USA) but that was a looooong time ago for some undergrad classes. USA is in my hometown, but I did not live there when I was in NP school.

    If it were me I would consider the following in this order: accreditation (I believe they are both fully accredited), cost (Graceland is private, and USA is a state school, but some states schools offer in state tuition+web fee for students that live out of state), program length, and required time on campus. I believe both schools require some on campus time. Graceland had 2-3 one week focus sessions. I'm not sure about USA, but this will require travel. A challenge for both schools would be finding clinical sites. This is a very challenging part of distance NP programs. Anyway, hope that helps.


  • 0

    I am not sure, but it is a great program. It is very well run. Very smooth. Good luck!

  • 1
    ChrisRicci likes this.

    Quote from lildev82
    ivanh3, where did u go to np school? was it distance learning? just curious. id like to do the same. thanks devin
    I went to Graceland University for their ADN to MSN program and then obtained my DNP from the University of Alabama. In each case didactic was mostly online and of course all the clinicals were traditionally done.

  • 2
    infinity85 and ChrisRicci like this.

    Former Excelsior grad, current nurse practitioner. Dig in, dig deep, try hard, and then try harder. You can do it.

  • 4
    AmyRN303, morganvibes, zmansc, and 1 other like this.

    Freedom or free health care? What? No one said healthcare was free, but if you are talking about universal coverage, then yes you can have both. How silly to suggest other wise. Did you actually say something to the effect of get a job? You do realize that many of the people who benefit from the ACA are the WORKING poor? And no, not everyone in America thinks they are entitled to everything. Absolutist thinking like that is not productive. And wow, a 1950s rant about communism. Priceless.

    Quote from Heathermaizey
    Why should healthcare be a God given right? That's the problem with America, everyone thinks they are entitled to everything. No, your not. You need to work for what you have. People think that they are entitled to everything and only the people who are rich should pay for it. Unless you physically cannot work (which healthcare is provided for those people), get up off your butt and get a job. But it's a recession and there are no jobs, people proclaim. There are plenty of jobs out there for people who want them. It may not be your dream job, but do it until a better one comes along.

    We are being clobbered with extra taxes, now subpar healthcare, among many other things because people feel a sense of entitlement. They feel the rest of us should pay for their existence. And everything I have worked so hard for is going down the tubes.

    People who feel this way need to move to a communist nation where everything is provided for but they have no human rights. You can't have both. Ask the people in China or North Korea what they would rather have freedom or free healthcare. I bet most of them say freedom.

  • 1
    SnowShoeRN likes this.

    Yes, you can do it. Just don't go all weddingzilla, and it should go well. You can have both a memorable and meaningful ceremony within the parameters you mentioned, but you will have to work as a team. Congratulations!


  • 1
    hutch304 likes this.

    I am wondering what the demands are if someone is offering a new grad 100K. Ask about the work environment. Being too busy right out of the gate may be frustrating for both you and your patients. This can add a lot of stress. Also ask about what kind of support you are going to get as a new grad. I made sure at my interview to discuss that I was going to be perhaps a bit more "needy" because of my new grad status. The physicians were happy that I was up front about this, and we worked out how consultations with them were going to work (sometimes they were not physically on site). Another area is professional development. Will you get paid time off (above and beyond vacation) and reimbursement (or a budget) for continuing education? For example my first job offered 1 week paid time off and 2000 dollars for CE. Will they cover your liability insurance? Will you be taking call? In any case, the devil is in the details. For me the biggest issues was new grad support.
    Hope this helps,

  • 0

    The University of Alabama. This is not to be confused with the University of South Alabama. Both are good schools though.

  • 0

    I worked full time during my DNP. I was able to do my final project at my place of work and that helped quite a bit.

  • 0

    As a paramedic myself I would suggest you look into becoming a physician's assistant. I became an NP because I was already an RN, and it made made more sense for me. However, had I not been an RN, I would have gone the PA route. I have known several paramedics over the years who went the PA route, and it was good fit for them.

  • 1
    SycamoreGuy likes this.

    You say the PAs are "way" better than the NPs. Please quantify. What standards are you applying? What outcomes are you measuring? If the best articulation you have is "way", that will simply not suffice. Measure "every" variable? How about just one?

    Quote from VICEDRN
    Ivan, I don't know that we can measure every variable at play here but we can all recall our experiences and pick up on the subtlety of the market. I also work in Atlanta and frankly, the pas around here are way better than the nps. Every time I have worked with a midlevel, I have preferred the pa and the powers that hire? They seem to be catching on to that and hiring nps.Now maybe you could sell me a story about how all np programs need to increase their academic rigor but in the meantime, having taken online classes, the issue remains clear to me: it's easier to succeed in online environments and thus, fewer people are weeded out of the programs.