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  1. FullGlass

    Why don't more NPs advocate for better training?

    I don't understand your statement. Didactic content is the same no matter whether it is taught at Hopkins or Acme U. For clinicals, it is the rotations that are key. A student who can get decent rotations with decent preceptors will be ok. There are people who go to for-profit schools who work hard and become good NPs. This is why I discussed organizations having good hiring practices in a previous post.
  2. FullGlass

    For ER: FNP or ACNP (Texas)

    There is no "ENP MSN" program that I am aware of. The OP was asking about which programs to apply to. You're talking about a post-master's certification in EM. One still has to get the NP MSN first.
  3. FullGlass

    For ER: FNP or ACNP (Texas)

    The Consensus Model is moving away from FNPs in the ER. NPs currently have to choose Adult or Peds Acute Care.
  4. FullGlass

    1st NP Job: Pain Management, bad move?

    Pain management is a fine choice if it is a reputable clinic. If their website shows they offer multiple types of treatment, and does not emphasize narcotics, then that is a good sign. There are many interventional pain management clinics that do not prescribe any opioids, or only do so as a last resort. Ask around and do internet research on the clinic and its providers to get a sense of their reputation and practices. Depending on where you are located, $100K for first year is not bad, especially since you are going to get a lot of valuable training. You could negotiate a healthy increase for the 2nd year, once you have solid skills under your belt. Not everyone can find a good general primary care job right out of school. Pain is still the #1 reason people go to see their provider and pain management will give you valuable skills should you decide to move into general primary care later on. I see a lot of pain patients in our general primary care clinic. Should you stick with pain management, specialty NPs make more money than general NPs.
  5. FullGlass

    For ER: FNP or ACNP (Texas)

    The ACNP program covers ER. I have not heard of an MSN NP program that is only geared towards EM. The trend is away from FNP for the ER and to ACNP. Another option is to become a PA. An FNP program will not include any acute care didactics or clinical rotations.
  6. FullGlass

    Why don't more NPs advocate for better training?

    Thank you. I am curious as to how many subpar for-profit schools are out there. When I reviewed the list of accredited NP programs in California, there were only a few for-profit schools listed. I think there is a place for for-profit schools, but am in favor of reasonable accreditation requirements. Some of these schools are decent, such as National University in California. They do help students who have to work full-time and need more flexible schedules. A student who goes to a crappy school, but puts in the work, can still get a decent education.
  7. FullGlass

    Can I work during an ABSN program?

    For the 15 month ABSN program - working part time is possible, but no more than 15 hours per week and only if you have excellent time-management skills and are confident you can still have adequate study time. I am a classic over-achiever and the ABSN was the hardest academic program I have ever done; it was harder than my MSN. Some of my classmates worked part-time, but only for the first 1 or 2 semesters. It was strongly advised that students not work. For 12 month ABSN program, no way should you work unless you are confident nursing school material is going to be really easy for you. You will have classroom and clinic hours. And in addition, the rule of thumb is 3 hours of studying for every 1 hour in class. Most people in my 15 month ABSN program were studying about 40 hours per week, on top of lectures and clinical time. Clinical time is going to be 16 to 24 hours per week and don't forget to add commuting time. That doesn't leave much time for anything else. If you plan to continue your education beyond the ABSN in order to become an NP, CRNA, or educator, then you will need to get good grades and unless you are superwoman, then that is not going to be easy.
  8. FullGlass

    Why don't more NPs advocate for better training?

    Philosophically, I believe it is up to the individual to get a good education - plenty of good schools are out there. It is then up to the free market to decide who gets hired. Personally, I felt my school did a good job (Johns Hopkins). Schools vary in quality and it is up to prospective students to research schools. Employers do have some idea of which schools are good and which are not. A new grad NP who went to a reputable school is going to find it easier to get a good job than a new grad NP who went to a crappy school. Honestly, do the many complainers on this forum think that hiring managers of NPs, who are likely to be MDs or NPs, are completely clueless as to which schools are decent? I currently work in a Northern California rural FQHC and we precept NP and PA students from UC Davis and actively try to recruit from there because we know that is a good school. My mentor is a brilliant MD (Georgetown Med, Mayo Clinic residency) and he told me he didn't expect me to know anything as a new grad NP and he wanted me to ask a lot of questions. He is happy with my progress as a first year direct-entry NP (with no RN experience) and so is our Medical Director. Are we supposed to believe that employers are unable to read a resume, assess experience, and unable to conduct an interview and monitor shadowing time adequately? If employers are unable to do these things, then the fault is with their hiring process. Actually, I do think hiring is not done very well in healthcare in general. Since my previous career was in business, I can say with certainty that the hiring process is much more rigorous in the best corporations than I have seen in healthcare. Here are some of the things that would be standard in corporate America: - extensive interviews with both management and one's prospective peers - one-on-one and panel interviews - often, some sort of written exam to test basic knowledge, writing, and analytical skills - some sort of evaluation of one's ability to do the job in the form of a case study or simulation. I was surprised that not one of my shadowing days included evaluation of my ability to take a basic H&P and do a basic PE. Employers could easily increase the rigor of their hiring process to weed out the chaff. Finally, I think there are some unrealistic expectations out there of a new grad NP. It is expected the first year will be a steep ramp up period. That is because NP residencies are few and far between. Smart employers know that and plan accordingly. Here's what I would expect of a new grad NP: - how to do a basic H&P and document appropriately on an EHR; ability to learn EHR in a reasonable period of time - basics of a PE and what type of focused PE to do for common issues like URIs, UTIs, etc. - fundamentals of pharmacology; most common meds for common diseases, when to give antibiotics or not - how to research and find information when one does not know something, like using Uptodate and Epocrates, etc. - basic labs/tests to order for common conditions - ability to demonstrate critical thinking and reasonable knowledge to develop differential diagnoses - ability to give a good report when asking questions or requesting consultation by a more experienced provider All of the above could be reasonably assessed with a rigorous hiring process. We have a serious shortage of primary care providers in many areas of the USA. This is both a supply and distribution problem. The last thing we need is to reduce the supply of PCPs. As for increasing the length of school and mandating NP residencies, that has to be balanced against cost issues. Yes, MDs have 4 years of school and then internship and residency, but the average MD emerges with 200K to 300K of debt! Do any new or prospective NPs out there think it would be ok to increase the student debt of NPs? Those who think PA education is superior are free to go to PA school. Those who want to be MDs can do the work and go to med school. Personally, I am satisfied with my NP education. Are there some things I wish had been covered in more detail? Absolutely. That doesn't mean the whole system sucks.
  9. I'm not sure what you mean by full-time. Full-time is 40 hours per week. If you mean how many hours you have to work to receive benefits, that varies by employer from 32 to 36 hours per week minimum to get benefits. There are very few professional jobs that allow one to work 40 hours per week and no more in any industry. I get paid a straight salary, with an on-time charting bonus. At my clinic 40 hours is considered full-time, with a max patient load of average 18 patients per day. I get 1.5 hours every 8 hour day for admin time and I also work through lunch. If I am efficient, I can usually finish all my charting by 5 pm or at most with 1 extra hour in the evening. I usually spend 2-3 hours on the weekend catching up on stuff.
  10. FullGlass

    Pros and Cons of Direct Entry NP Programs?

    I think this should be moved to Student NP, that is where discussions of various schools usually take place.
  11. FullGlass

    Geropsych NP... what to do

    If you truly want to do psych, then go directly for an MSN or DNP as a PMHNP. Also, do a general psych program so you have more flexibility and aren't stuck only treating geriatric patients in case you change your mind or have trouble getting job doing only geriatric psych.