the4ofus

Are we talking about medicine or nursing...two different professions? ...and there is lies many of the problems. The other part of the problem is not knowing the differences between holistic nursing practice and integrative nursing practice. There's no reason for a holistic nurse to make less money than one who is not specialized in Holistic Nursing not even if the person practices integrative modalities. I certainly wouldn't work for less money when I have more education. If discussing holistic medicine there's no reason that a holistic physician would be paid any differently than an allopathic physician. I pay just as much to my holistic docs as I do to an allopathic doctor. I prefer a Holistic MD because I'm treated better. Naturopathic physicians are recognized in17 states. Nurses are obviously recognized in every state and yes a naturopathic physician will not make as much as an APRN. I haven't done the research to support my theory on the difference in salaries between an ND and an APRN so I will not write it because that is way too much speculation on my part.

...and the only reason that APRN are deemed advanced practice is that advanced status is measured on medical practice--not nursing practice--so saying that someone is not advancing their nursing practice is not accurate. What they are doing is learning to perscribing, and provide medical diagnosis. Many nurses don't know nursing process. If nurses don't use nursing process to chart nursing as a profession becomes invisible. The two professions, nursing and medicine are two different professions. If one wants to practice medicine why not just go to medical school?

The hospital where I work "solved" the interruptions by giving all the nurses a in hospital phone to hang on their scrubs so no matter where you were if the phone rang you were expected to answer it. If you were in the room with a patient in the midst of an assessment, giving meds, teaching, or at the drug machine pulling drugs you were expected to stop what you were doing and answer the phone. I don't know what the solution is but it was impossable to take care of any patient while carrying a phone. Call bells all went to the nurses phone.

My point of contention is that when the Consensus Model was approved they knowingly disenfranchised nurse

I agree that there is an overlap of medicine and nursing. There must be an overlap if the two professions are to collaborate effectively with each other for the benefit of the patient. My point of contention is that when the Consensus Model was approved they knowingly disenfranchised nurse that did not chose to be APRN based on prescribing and making a medical diagnosis. They lifted one form of nursing above the other. The Consensus Model lifted the medicalized version of nursing above others. How can one nurse with a master degree be advanced practice and another not be? How can an APRN be an educator with no educational pedagogy? I realize this is an overly zelous interpretation that some states chose. That is also part of what I'm trying to bring to the forefront. The Conscensus Model is myopic and considers only what was important to one set of professionals at the expense of others who do not follow their beliefes. Why the divide? Shouldn't we all be working together for the benefit of those who need care? I would understand if all nurses with MSN, PhD, or DNP were advanced practice but that is not the case. When I use the word disenfranchise I mean those who have been disenfranchised can not support themselves…as in they can’t work unless they take a demotion. That is counterproductive. The profession needs diversity of thought and ways of caring for others that shows respect to all ways of caring and being with each other.

Neuro Guy NP, DNP, PhD, APRN thank you for your comments. I'd be happy to engage if you would like. What are your points of contention? I recognized that what I said would ruffle some feathers of some people on this board. Advanced practice is based on whether one provides medical diagnosis and prescribes. It is also interesting that an APRN can teach but a Nurse Educator cannot. APRNs have no educational pedagogy so how are they qualified to teach? I realize not all states have legislated all RN and APRN roles equally.

I believe what the senator said is that it would be a financial problem for the hospitals. But that was also debunked by an article elsewhere that the critical access hospitals in WA were doing very well financially. I don't understand why 1) we would need a union to protect ... isn't it just human decency to allow people to have their lunch uninterrupted and to have rest brakes?

Anyone wanting information on how to complete a degree that is focused in Holistic Nursing including the APHN (Advanced Practice Holistic Nurse) or if you are already an APRN and want to practice as and APHN follow up with the AHNCC.org to find the schools that are endorsed in Holistic Nursing and or the certification exams for all different categories as a holistic nurse or as a Nurse Coach. All are categories are title protected. Nurse Coaches can only call themselves NC if they are certified as such--same thing as we are already aware of as RNs or APRNs. All of them are title protected.

Or better yet, become a Nurse Coach(r). Nurses can take the Nurse Coach exam administered by the American Holistic Nurses Credentialing Corporation and become a Nurse Coach. Have a look at AHNCC.org to learn the criteria that you need to follow to qualify for the board exam. Nurse Coach is a protected title just as an RN or an APRN is a protected title.

A large part of this problem is that is it difficult for nurses to define their practice. We keep allowing people that have NO idea what nursing is to define who and what we are and are not. The Senator was only restating what she has heard or what she thinks she knows. She also does not understand the ramifications of what she is saying. I have a few articles for her to read. The cavities that if she doesn't want to read them she won't and she will keep making the misinformed decisions that she made when she spoke. If a nurse does not have the appropriate nursing theory as part of their education they will not know the difference between nursing and medical professions. Nurses are collaborators with the medical profession but we are a separate profession. When a nurse charts how do they chart? If the nurse charts on an EMR or some call it EHR but it is still reflecting the medical format. The document that the nurse signed off on is NOT reflecting nursing care it is reflecting medical care given by a nurse. This is one of the many reasons that we are still part of the room charge. A nurse does not chart on a SOAP note at least not accurately. A Nurse charts using a nursing diagnosis and with the nursing process. That is part of what has been removed from our nursing education. Nurses are missing nursing education, instead, we are being trained to be a handmaiden to the physician or whomever else is functioning in the medical practitioners' shadow.

A large part of this problem is that is it difficult for nurses to define their practice. We keep allowing people that have NO idea what nursing is to define who and what we are and are not. The Senator was only restating what she has heard or what she thinks she knows. She also does not understand the ramifications of what she is saying. I have a few articles for her to read. The cavities that if she doesn't want to read them she won't and she will keep making the misinformed decisions that she made when she spoke.

Trauma RU and other's Something you all may not know is that the APRN role came about through manipulation. Those that chose not to practice medicine have been disenfranchized. RNs in at least some states are synonymous the role of an LPN. They can only work at the bedside no matter what their level of education. Nice, right? I'm close to finished with my Ph.D. I do NOT want to medicine, I want to practice nursing. Who is going to hire a Ph.D. at the bedside? Do you know that advanced practice nursing (APRN) is based on your medical education? It is not based on your nursing education? The way that the APRN came about is that anyone who did not agree with the proposal was uninvited or "overlooked." Their vote was not considered in the ratification process, so the proposal for the Consensus Model was ratified on the basis of a full consensus of those in attendance. I have that referenced appropriately but am not including it intentionally. Some states have now recognized the CNS role as an APRN role but it depends on which of the roles each state chooses to recognize. Most universities in FL no longer offer the CNS b/c FL is only interested in nurses that practice as medical providers. The CNS role is still advertised on their websites. When someone calls about it they are told no they have the APRN and nurse are not educated about their profession enough to realize there is a difference. For the reward of doing what one has been manipulated into doing. they will be used to provide medical services and will be paid less. That is a bargain for whom? Not the nurse that is paying higher insurance premiums, and that has much more responsibility. The APRN position is much more demanding, The APRN now is rewarded with an 80 hour per week. So that lovely raise they got by being an APRN if calculated is now far less money than one could have earned if they worked a few hours of overtime in the ICU. Calculate it out if you don't believe me. I've helped more than one APRN that was running KP service for the MDs they work for and they figure out that they were making less doing physicals and paperwork--not seeing patients and providing nursing care. You become a bargain to the system that pays you a reduced rate b/c you are a nurse providing medical services.

Yes, I understand that CNS have medical and nursing education. If I am understanding you properly...my point was that CNS have only recently been re-included in the APRN role. FL only approved the CNS role in 2017 or 2018. I served on the committee that facilitatied that recognition for a short time. Only some of the Foci of CNS are approved and it depends on which state one lives and practices in and if the foci is approved by the state where one practices. For instance if one lives in Kansas the public/community health foci is recognized as APRN, In FL public/community health is NOT approved for the APRN recognition.

I would not chose that NIWH program eventhough AHNA endorses it. I have tried to talk to those people several times based on their ads--No just NO. I have friends who have gone to it and their education--well education is never a waste, but do you really get what you are paying for is the question. If you want to be a certified holistic nurse--I support that endevor--I also support the Nurse Coach(r) and in the spirit of transparancy I am certified in one of the advance certifications. I would personally choose one of the programs like the HSMI (Luke Seward) or the IHAP (now sponsored by AHNA) for general credit hours. I went to the original when the program was with the women who developed it at BirchTree. It changed my life...as did the HSM-I. I'm now studying for the NC exam. Its new in comparison to the other certifications. The other night I returned to the HSM-I documents and recordings that were in one of my sessions to reset--to come back to myself. The work is beautiful and very applicable. Buy the Scope and Standards and read it ingest it, live it for two years. Once you know the Scope and Standards and can apply it then take the exam. HN has nothing to do with the modalities one practices though most of us do practice a few modalities--integrative practice. The other option is to do a program that is endorsed by AHNCC in one of the universities and then you'll be able to sit for boards straight out of school--nursing and the nurse coaching. If the nurse coaching you will need the The Art and Science of Nurse Coaching in addition to the ANA/AHNA Holistic Nursing Scope and Standards of Practice

If it would be of any help. When the Consensus Model was ratified it was done knowing that many nurses were being disenfranchized and they literally did not care. The people that did not support the role as those who voted in the NP were disinvited...so yes it was stacked. Its in writing and documented but try to find that documentation--good luck. If you are a nurse and want to be a nurse you are of NO value. ANA or ANCC in this case wants people who have medical training. They don't know the difference between nursing and medicine. We've lost nursing as a profession. When a nurse is judged superior to other nurses based on medical education we have a real problem. The NPs keep protesting no we are still nurses. Well maybe but not really. It has only been recent history that some CNS have been reinstated into and advanced practice role. This has been brewing since the early 1900. Not all states approved all CNS roles. I've been quiet for some time and it has not served me so I'm speaking out based on the facts as they are written. I was totally disenfranchized in the state where I live as in I can't practice at my level of education. I can practice as a BSN at the bedside and eventhoug I loved my patients the system is so difficult that you cannot work in it because it jepordizes your well being and postentially the patients b/c systems just look at nurses as task doers and not as people that takecare of others. We don't build cars we are not Toyota.