ACNPCOLO

Brief Hx: I come from a strong applied science background, got into nursing specifically as a spring board for NP. Now I’m BC in both ACNP and FNP. I love my job as a hospitalist the pt population is primarily internal meds patients. My problem is other NPs not the MD’s as one would expect. There are a number of really sharp dedicated practitioners; however we are constantly being lessoned by the remainder. I feel that a number of the NPs out there are either poorly trained or can’t break the floor nurse mold. I feel that I’m constantly having to defend the profession. I just wonder if it is just me? The other issue is that there are some NPs that think they are MD’s! Finally, what is the point of specialty degrees if any NP will do (FNP in ER, FNPs in Hospital med, etc.)? Thank for allowing me to vent, I just need to know if this is a global problem.

The real questions are lungs for life or variety. Granted as a LPN the options are limited but as a RN there are 1000’s of options. Career growth is limited in the RT field. If you are young go for the LPN. That’s my 2 cents.

I'm a card nurse, TAKE THE DAY SHIFT! lots more happens, it fast paced. Just remember be confident and ASK FOR HELP! good luck, remember troponin is the key :)

All Nurse to Aid, do you sup. LPN's, accuity, PTO, Scheduling, etc

1. NP’s can have private independent practices in some state, please refer to the pearsons report which is pub. every year. It contains the entire practice requirement, etc for each and every state. Here in Colorado, I personally know of 4 private practice owned and operated by Np’s. In our state we are required to have a collaborative agreement (see CO scope of practice doc) not and supervisory agreement. Which is completely different! As a result of the collaborative agreement, the Np functions completely independent in all aspect unless a consult deemed necessary by the NP. Both PA and NP’s can only bill 80% of the MD fee in most cases. Further I would like to say that the above mentioned private practices are not planned parenthood, or a women’s clinic, 3 are Fp and 1 is county sponsored first emergent contact clinic (talk about independence). NP do not make “nursing diagnosis”, we have to function under the allopathic modal just as PA, MD and DO’s. we do incorporate the holistic view point. there are PA schools which are certificate not just BS, MS. Both professions have moved away from this programs because Medicare require ALL mid-level providers to have MS and National Certs. Further ALL accredited NP program REQUIRE BSN most have a min. of 2 years in “critical care areas” do the math, 3744 hours of previous exp. + 600- 1000hrs in NP rotation + 600-1000hrs in RN rotation = approx 5744 hours. I’m a ACNP (Acute care) if you did not know thus stating that we ACNP spent our time in just fp, peds, ob/woman health. Apparently your not getting the correct info. We focus on systems, thus we had to do clinical rot in cards, neuro, neph, GI, internal, etc. unlike PA’s – NP come in may different “colors” FNP, ACNP, ANP, ENP, Onco-NP, CRNA, Midwife, etc. These are specialties, and yes some of us are in peds and women’s health. AS for being on the medical boards, we are not licensed under the board of medicine, why would we be on there board?There is not clinical difference in functionality of PA and NP other then above mentioned. To assume one is superior to the other is false. I would like to make a final statement as the MD preference. As mentioned above, NP have independent license, thus we can function without direct supervision (collaborator) in 21ish states. This means that unlike PA’s, the MD is not required to be on premises. This further limits liability of the MD because unless consulted he/she had no involvement in the pt. WE ARE INDEPENDENTLY LICENSED sole responsible in most cases.

Daisey, I graduate from a ACNP program in less then 6 months, the NP's as hospitalists function with in the Established scope of practice. thus a ACNP Function very similar to that of the MD's with the exception that the plan of care must be establish first (MD domain). in the following years you will see the functionality of NP limited to the speciality. hope this helps