ERNP

What were you eating before. You can make 75K at the bedside in the terribly paying Southeast. So at these pitiful low rates for NPs you can at least eat and pay the mortgage as well as you ever have if you just wait for the offer to go up. And when someone is really in need, the offers most certainly WILL go up.

I intend to use it

BS!!! There are jobs out there and if all of you (PAs included) would walk off laughing from those conversations, the salary will go up. Why, no supply increases demand. More demand equal more money. The just take any job mentality keeps the chains on for all involved. Went rural right out of school and laughed at 80K, they needed me more than I needed them and voila! a better offer appeared. Some MLPs aren't even negotiating at all. An example of this was a girl I knew just took a job with a company that I also perform services for. She took the initial offer and I told them it wasn't even close to enough money for my services. I threw out a number even I thought was asurd and viola! I got the money. The Little Clinic is one of those box clinics hailed as the second coming for NPs. But a little inside information would show you too that they hated having an NP in corporate and dissolved the position. They complained that we had the gall to try to negotiate our salary. I believe the quote was, "Just who do these nurses think they are." The general public doesn't get it. The people recruiting and hiring dont get it. These people won't ever get it unless we show it to them. I would go back to bedside nursing before I would work a second for less than 100K, with the only exception being if I was starting my own adventure. Which is on my list for the next year. In short..... Just walk away. Next in line walk away. Just keep walking away until they get it.

While we are at it.... let's just allow this supervisory role for a couple of years out of school... then let's cut the poor doctors loose and show 'em what we got.

dunno. i guess he feels that's all a mid-level is good for. he certainly doesn't want them practicing independently. he's had this np student for a few months, and she's the one he's planning on hiring to do his scut work, as long as he can "train her" to not believe she can think for herself. :angryfire i implore you to warn any potential candidate of this idiots intentions. then buy him a monkey to train.

If there is anyone at the scene (meaning the last 6 cars that have stopped and are clogging up the works) I keep driving. I have no tools to do much that would be useful anyway. I don't carry around the emergency bag. Now if you need a bandaid and I am on my bicycle, I can manage a bandaid and antiseptic. Roadside miracles with nothing but a tire iron and a few CDs are not possible. If there is absolutely no one else to witness the event, I will stop, call 911, walk around and report whatever injuries I see then attempt a little crowd control. I agree with the others that dead on the side of the road is dead (doesn't usually matter what the cause is -trauma vs. medical). When the appropriate authorities feel like I have given enough contact information and details of what I saw, I hit the road. By then I am late to where I was going anyway. Usually this happens to me on the way to work.

I think FNP is the better ER option. If I was an ACNP I would go for the FNP as a second. As an FNP working in ER, I am thinking of getting ACNP for potential move into a hospital service kind of role. Just thinking about it right now. Might not even be necessary. But I do love being a perpetual student.

I use my first name. Introduce myself like this... "Hi I'm (first name), the nurse practitioner. What can I do for you today?" Then we move on, the cell phone rings, they answer and say that they can't talk right now because the doctor is in the room. Go figure.

It has been quite a while.... whew!! I work ER... FNP certified. What is expected is widely variable from place to place. I work a rural ER and am the double coverage. I am expected to be able to see you if you have a chest wall deformity or a runny nose and whatever lies between. That doesn't mean consultation isn't readily available, it is. But I can't just punt and run when the going gets tough. There are days however when punting would make for a much easier day. I chose this ER specifically because there is no fast track. I didn't want to get shoved into that small of a box.

Well if they were waiting for me to use the alcohol foam hanging on the wall they would be waiting a long time. I hate that stuff. My hands are dry enough without continuously putting alcohol on them. I use the soap and water method. However, the alcohol foam and a soft cloth is excellent for cleaning my glasses. My favorite soap was the foam soap with hibiclens in it. We don't get to have that soap anymore.

Sometimes life just ain't fair. The End.

I am not sure what would be happening in an environment where one was being mobbed. I know just about everyone has been picked on before for something insignificant. Sometimes, it turns into a pattern (sometimes swirling the drain) of behavior. What I am not sure about is how it never gets stopped. Sometimes you have to bully the bullies. Take your power back and stand your ground. Then keep your eyes open and use whatever you can find to your favor. Part of the reason it looks like they are winning is that they have you so busy watching yourself that you have no time for watching them. I assure you there are many offensives committed by the mobbers everyday that could be used by you and against your mobbers. So I guess, mob back. Others who have been mobbed WILL jump on board, they are just looking for a leader. Once you have begun your offensive, NEVER write anything down. But give them cause to start chronicling you. Now they are on the run. When they run down to HR and you have no idea what they are talking about, because of course what you were saying was something else, they start looking like the idiots. It takes a lot of time and energy to break up these little brat packs, but once done is fabulous. It is passive agressive warfare and I don't think it ever gets finished. Just keep your own nose clean while you bugger up their nose a little. I think I can't conceive of mobbing because dealing with these people is what I do all the time. Since they have always backed off rather easily, I must be ok at it. So the next time someone tells you that your bed is untidy say, "Really?? My bed is untidy?? Well at least that is all. For a minute this morning I was afraid you were colorblind, then I realized you intended to wear those clothes together to form some sort of schizophrenic outfit. " or... you haven't cleaned up your trash.... "Haven't I? It appears that everything I used is neatly packed into the appropriate receptacle. It appears that it is you who has been reluctant to clean up after yourself today." Too slow to start the IV?? "Well why don't you get over here and give it a try. (Hovering around asking questions) Are you sure that is the best vein you can find? It looks a little small and knotty. You are going to use that size IV catheter? Don't you think it is a little small for any potential emergency. Don't you think she looks a little pale? The IV will have to be bigger to accomodate blood transfusion.... then... Maybe I should get someone else to try this, you don't seem to be doing it as well as I thought you would. Just stop and I will get a real pro." Don't forget to do whatever you can to divide and conquer. These people alone are small simple minded folks just waiting to learn how really small and insignificant they are. Together these people are a mob, seperate they are just whiners. And if you think they aren't talking amongst themselves as much as they are talking about you they are crazy. Let them have a few secrets as possible and spill them as often as possible. Say you overheard A talking about B to C... they were all so very sad that B has been having marriage trouble ..... in a public place to B you say "A and C were telling me what a hard time you are having in your marriage. It sounds like you are headed for divorce. Then throw in some elaborate crap, "Is he really having an affair." In several sentences you have B concerned that her husband is having an affair and someone she doens't like knows about it. Also she is concerned now about why A and C are talking to you about her. She begins to question alliance with A and C.

If they are able to understand the procedure and have had an opportunity to have all their questions answered by the surgeon (that is the part that I get hung up on) then they can sign for themselves. That being said it is never a bad idea to have an unmedicated family member sign when available. IMHO, involuntary psychs don't have to sign consent for transfer. Are you gonna not send them because they say no? So, it really is just potentially another battle to take up valuable time. It doesn't change the outcome.

I attended an in person program and still had to find my own preceptors. The ER docs I worked with were more than willing to help, but I had to find office placement for 8 hours each week and it wasn't easy. Lots don't wish to perform this service to the next group coming up.

I love and could not live without the credentialing specialist that works with me. I don't know what they would do at an insurance company, but if I had to keep up with all my own stuff.... I don't know if I would have time for anything else.

Drives me nuts too!!

I was talking about nurses and nursing faculty too. I won't move on to the general populace until we can come up with a semblance of a collective thought. Besides, my interactions with the public would leave me to think many of them have a higher opinion of NPs than the OP

Oh come on... I know you know the drill. They see NPs and all kinds of healthcare providers for colds looking an instant fix for the ailment. They are never happy to find out there is "no magic bullet". There are days when I feel like using a magic bullet, but that wouldn't help the patient and I would be arrested, so I can only mention the lack of a magic bullet during my time with these persons. It doesn't seems to me that aspiring to be the best has been ingrained into many of the programs of higher learning. I remember when I was in undergrad we had an assessment competition with med students. We won hands down with flying colors. Having had that experience I really don't feel like they are getting any more out of an encounter than I am getting. Maybe if the schools teaching advanced practice nursing weren't so interested in everyone knowing where the walls of the box are and the inherent danger of passing beyond the scope of the walls, but were more interested in looking at what an NP has to offer outside the box, the attitudes of many would change. NPs have just gotten started exploring outside the box, I would encourage all to find at least one thing that is outside the box someone else wants you to be in, and incorporate into your day. Just one idea a week adds fifty new avenues per year per NP. THAT is a lot of new ways of thinking about NP practice.

I'll say... would you have a knee jerk suspicion of measles in a 50 year old woman?? I sent her home telling her I was having a hard time getting my head around it, but that was the thing it looked most like. Confirmed by lab.

One of the reasons employment with the state was unattractive. I have great benefits too, but don't want to top out at that wage or start so low.

You mean you have never offered just to give someone that 50 cents so they will quit looking for the coupon or just said, "Look just keep the 37 cents, I have to go." ??? To the OP, I agree. RN, whether it be ADN or BSN seems more easily marketable these days.

Right, in the OR it wouldn't be the patients driving you nuts. Worse, it is the prima donna surgeons (in my experience anyway). And THAT is a problem that will NEVER be solved in your favor. I will take the whiney patients over the arrogant prima donna surgeons any day, any time.

Trauma, I am like you... I never spent 3-4 hours per credit studying for anything. And being the highly competitive beast I am, I did want to get as close to the 4.0 as possible. Only made it to 3.96. I don't even think I ever spent 3 - 4 hours studying for a test. The worst classes for me were those little 2 credit courses that took up way more time writing papers than the 3 credit courses that I was truly interested in. That used to irritate me more than anything. As a matter of fact, for the actual classes and tests during the last year, I was able to rely greatly on my experience. I took only 1 day off per week during the last year. All the other days I was in clinicals, working, or in class. For me, I used to go to class and clinical all in the same day just to get the hours. Plus, I was doing the majority of mine in the ER and I didn't want to miss out on any opportunity that might occur in my absence. I saw my family again after graduation and on planned vacations. Once in a while I would steal the covers from my husband while we were sleeping, I knew he was still there because he stole them back. Sometimes, insomnia is a good thing.

Oh... and when it comes down to it, no one is doing any job for free. All jobs are about cash flow.

Corrections might be good. But I wouldn't cross the ER off the list entirely. It isn't so much about hiney puffing, although occasionally a hiney might require attention. There are whiners, some days a lot of whiners, but the ER needs people also who can say, "Well maybe you shouldn't buy a pack of cigarettes today and use that money to buy your child some tylenol." Or "If you can't afford Robitussin, you can't afford a cell phone, yet you have been on yours for an hour."