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Hi DC2RN, I totally hear you...but it's what I want, what IV'e always wanted for myself in the end. I also feel as i have stated before, that there are some doors closed to me in terms of my professional goals because I am only masters prepared that an MD would open. The assuption that I would be "giving up 8 years of my youth" is totally incorrect. I wouldn't be giving up anything, only gaining/attaining what I want. In 8 years I will still be me, it's where I want to be-that's what I want to affect. As I stated in an earlier post...I have been in the military now for over 10 years and they are certainly willing to pay for school and pay me as well, obviously not without a "price". I will owe 4 years of service, I get to choose if it will be on active duty or reserve status, amongst other things. APRN

Hi Sistermike... Thank you for your words of encouragement and infact, some of what you said about why one might want to pursue an MD was on the money for me. I always wanted to be a psychiatrist but life happened, I got married, joined the militay, (who, by the way is willing to pay for medical school and pay me monthly at the same time), and I had children. I didn't want to sacrifice my time when my children were smaller for the rigors of medical school so I instead chose nursing school (as a stepping stone) to my ultimate goal. I eventually want to conduct research in psychopathy/sociopathy. I want to work in the field of forensics with the "criminally insane". I am a behaviorist at heart and want to know why people do what they do, you know, the nature v nurture issue. I have yet to find a way in as an NP but I know for sure I have a way in as an MD. As much as I and others would love to believe that MD's and NP's are "equal" we are not and in alot of forums (mostly by colleagues, sometimes by patients) we are not. That's a fact. Hi Yellow finch, in this forum you stated....."If you choose Family NP and sometimes Acute Care NP programs then your knowledge base is larger and the time in school is generally longer". Where is this program at because all of the individuals I went to school with all went the same length of time as me. We all started off in general course work, then specialized our last year of school and all graduated together. I was in class with soon to be psych NP's, pedi NP's, FNP's, etc and no one got anymore schooling than anyone else. I noticed a trend throughout your postings, you try very hard to make a pitch for MD's and NP's as "being the same", but we aren't on so many levels. In the end, if someone wants to pursue medical school, then why not?... APRN

Sounds good to me. In your earlier post, i felt like I was being attacked....so keeping the focus on what it should be on is wonderful Thank you..

First of all, My opinion is my own and I am entitled to it and whether you agree or not is of no importance to me. Secondly, bedside manner and therapeutic touch can definately be intertwined. When I see a patient and they are havind a particularly difficult time.....understanding, comforting, a reassuring voice, and the power of a hand on the shoulder can go along way, so I don't follow what your talking about "As far as being under a Doc and over a CNA"....It's not about that, however, no matter what you do there is always a heirarchy. I don't think that i'm any better than any one else or visa versa. I want to be an MD because for me it puts me at the "top of my game" and opens doors that are closed to me as an NP no matter how idealistic you are about what goes on in the healthcare profession in terms of equality "in the patient's eyes". What about equality between practitioners? I don't know where you live or practice, but there is most certainly not "equality" amongst alot of healthcare practitioners for one reason or another. Opening up a private practice is an option I want to pursue at the MD level mostly because of less hassel in terms of supervision and insurancr reimbursement This conversation was never about a patient and what kind of care they receive so please don't attempt to turn it into that!

Hi all, I posted twice before I had a chance to read everyone's posts. So, with that being said, I need to apologize for my very "forward" thinking and comments. This is my second time using this forum so I don't know how to use it very well. I'm still learning how and were to post. In any case, because of the second post I just read from the originator, forget anything i said because with abuse involved, on any level, if you do anything to greatly anger your husband, with no resources, friends, or otherwise, you may be in "big trouble". Some of the other posters mentioned battered women's shelters, etc...all good ideas...what about "sneaking alittle money here and there and putting away for a rainy day? I had a G.F. whose husband all out beat her at the slightest thought of her being anything less than obedient and she slowly put money away like if he gave her x amountof $ for groceries, she would "skim" alittle off the top, or take alittle out of his wallet when he wasn't looking. I know you must be afraid but the bottom line is that as long as you "allow" this treatment, then that's what you will get. I don't know how difficult it must be for you or even to get the nerve to stand up to your husband and risk physical injury but you must do something for you and your kids. Your kids are learning that it's ok for men to hit women and for women to take it. Please be safe, APRN....

Hi Angie, I'll try not to flame you but get real...does it really matter if her husband thinks she should work or not? Or more what she feels would fulfill her and make her happy? And his lack of support of that? She has a right to pursue her dreams just as her husband did when he opened his business and she supported him. Is it too much for her to ask that he return the favor? I don't think so. Women all over the country work and still care for their families too...I do. I have 6 children and a wonderful, "helping" husband. I am an NP and work in an out patient psych facility. On average, I work 80 hours a week between on call, in the hospitals overnight doing admit paperwork, and the daytime at the facility itself. We have family evening every Friday, we eat together every night and even if we can't for some unknown emergency, I still cook every night and they eat together in my absence. My husband and I both help the kids with their homework, etc...So see, it can be done,because I'm doing it...Like the woman whose husband is in the military said, "where there's a will, there's a way" Listen, I can certainly understanding compromising what you want to do to meet everyone's needs, but not for the sake of pacifying her husband who in my mind is totally wrong!! Because you know what...when it's all said and done, he has exactly what he wants, what about her? APRN....

Hi, Sorry about the issues your having...It will get better i'm sure. Ever thought about before school/after school programs? They usually take the kids at about 7am and then they keep them until like 5pm? or a part time nanny to drop the kids off, fully dressed, lunches packed ready to rock? Maybe drop them off at 6:30 so you can make it to work then pick them up as soon as you get out? She can walk then to school and pick them up if it's within walking distance. A neighbor who doesn't work looking for alittle extra money might be willing to do this, or even a college student with a late morning class, a car, and the need for some extra cash. Not much, like $50.00 a week ($10.00 daily) I would "kill" my husband if he acted that way, but your situation is unique to you. Alot of this may be your husbands way of making sure you always "need" him. I swear some men are so afraid of their wives having their own lives and careers and becoming independent. Of course your career is just as important as your husbands and if you allow him to get away with this then he will and you will never have what you really want and will regret it later and after being married nealy 16 years, I can tell you that unseated regret can and will ruin a relationship, especially when there is blame placed. Either stand up and "force" him to help or swallow it and find another workable way. What about asking one of the mom's your kids go to school with that don't live too far away? You would be surprised who would say yes...I would if I lived in TX and new your family and ya'll were nice and law abiding. Think about it.....Dropping the kids off 1/2 hour before school all ready to go wouldn't be a big deal for a mom who is already up getting her own house in order. Just some suggestions, let me know how you make out...GOOD LUCK!!!! APRN:nuke:

Hi Chick pea, I'm sorry you had such a bad time. There's comfort in knowing that all of us nurses are not half bad. We don't all eat you guys and then spit you out. It will get better as you learn the ropes and become more confident about yourself and your capabilities. Don't let this "nasty" nurse ruin it for you. Ask as many questions as you can and when you mess up, report yourself to the manager before anyone else can, in the guise of asking for help/guidance, and understanding. Your new at this, cut yourself some slack your going to mess up, SOOO what.........even seasoned nurses like myself have had not so good days. I remember years ago when I first became a nurse, I was always so scared about forgeting things and as a practice (even now, though now I am a nurse practitioner) I still make a check list of all of the things I need to do for a patient. For example: I'm caring for Joe Smoe who is fresh post-op abd surgery....my check list would go something like this.....BP..P..R..T lung sounds, check for edema, check for bleeding at the site, monitor the wound, etc-Q4hours (rationale is that since the patient is fresh, if he develops a fever or the vs are grossly different than they were 4 hours ago that is indicative of infection or internal bleeding, and even acute pain and I want to be on top of that)...next is urine output. On my paper, I write UO and put a line next to it then yellow it so I can know that it needs to be done (indication is less than 30cc or no uo for a shift is indicative of fluid retention, amongst other acute issues being fresh post-op....next, I want to monitor pain and to do this I write down the type and amount and frequency of the pain med I am expected to administer and I ask the patient about pain at the times I wrote on my paper and again I yellow this out to distinguish what I still need to do ( I write my report from the off-going shift in black and the things I need to do in red, then yellow the blank area next to it, the I write what I actually did in blue or green so that I know it's done)....anyway I hope you get the point. Assess by patient true, but there are things your going to do for each patient that are constant (VS, lung sounds, etc...pain management, edema check, UO) then things that are specific to the patient based on your assessment, patient needs, and pateint diagnosis. If you find that you are having issues remembering to not leave meds at the bedside then put that on your list and put a little box next to it, yellow it out and when you give the med and have thrown everything in the trash, then put a red check mark next to it to indicate that it was done. I hope this helps... APRN:nuke:

Hi, In terms of seeing, diagnosing, and treating patients MD's and NP's are equal. However, as a background,nurses are taught to care for a patient in a holistic sort of way, we look at the entire patient, not just what is wrong for that particular visit. MD's on the other hand are taught to treat the immediate illness and move on to the next. Nurses are taught the value of therapeudic touch and I have personally only worked with a handful of physicians who even have "ok" bedside manner. Although we can both open private practice, I still must have an MD over me, as if I don't know what i'm doing and need a chaperone to be able to care for my patients effectively. Also, in terms of reimbursement, it's not 100% unless an MD signature is there (at least in Ma) We get somewhere between 70-90% without the MD sig. For me, I want to be at the top of my game so to speak and right now (again soley my opinion of myself) i'm at the bottom of the food chain relative to practitioners. In medical care there is a heirarcy it goes from the bottom to the top........CNA, medical assistant, LPN, RN, RN-specialty, RN-specialty, certified, NP/PA, MD........I personally feel that MD's are still "over me" if that makes any sense. In a hospital setting, like when I worked in telemetry as a nurse, I was typically in charge of the unit and delegated responsibilities to the other staff (CNA's, LPN's, etc). Even though i'm not in the same practice forum now, I still feel like I don't want to have to "answer" to someone who because I am an NP (sometimes) doesn't treat me like a peer because he/she is an MD, like we aren't on the same playing field. Can anyone relate? APRN

Hi all, I work in an out patient setting, I am the only prescriber in the practice. The MD is at another location so I handle everything concerning meds, refills, MD calls, etc. I make my annual salary of 90,000, the facility maintains (pays) for my lic renewal and all CEU's, I make my own schedule, I have 3 weeks paid vacation per year, I don't do any on-call, nor do I wear a beeper, the facility pays tuition for any classes I take that relate to my job, raises are assessed yearly, and it's 20 minutes from my house. It has been my experience after searching around that the Eastcoast pays well, and the Westcoast pays well, even Arizona pays well. The southern states don,t pay all that great but I also noticed that the internet is not quite as accurate as one may think. It is a blanket statement to say that the average pay for an NP is capped at about 85,000 (from what the internet says). What the internet doesn't say is that experience, specialty, rural area versus subs/city area, patient population, and one's negotiating skills are are key in salary. For example, before I started working for my current employer, a private out patient counseling service run by a PhD was looking for a prescriber and offered me 50,000 to start with a raise to 60,000 within 6 months. Of course he was out of his mind and I told him so. Point....alot depends on what type of business you work for. Now, I work for a large (nationwide) out patient provider, they have offices in Arizona, Goergia, Tennessee, and Rhode Island. They get the majority of DOC contracts in the states listed above. This other facility that I interviewed with way back when was privately owned by a practicing PhD, it was a small business with few LICSW's and MHC's, so he was not able to offer as much as my current employer, though he could have offered more. You can also consider going into private practice. Go to the website npcentral.org or .com and take a look around, that site is strictly for NP's and it gives all kinds of info on going into private practice. Right now, i contract my services privately to lawyers who need mental health assessments of their clients in child custody cases, criminal matters, and other legal issues. What I really want to do is go into private practice with an FNP. Since I am a psych NP, I think it would be both lucrative for the NP's and offer more continuity of care for clients if their mental health provider and their PCP were in the same office, same practice, kill two birds with one stone so to speak. The practice could bill insurance for everything right there in the office such as lab work, routine or non-complicated x-rays (with the equiptment and maybe a medical assistant or x-ray tech), casting, eye exams (unless ref is needed for a specialist).....anyway, you get my point? Sorry, I went off on a tangent, thanks for bearing with me...... APRN

Hi everyone, Thanks so much for all of yall's advice. I will be persuing a traditional medical degree. I had always planned on doing so I just wanted an easier way to do it because I feel a masters degree (psychiatric and mental health nurse practitioner, practicing in an out patient clinic) should matter. But....it does not. I have to take some other core courses first to meet the med school pre req's of which I will start in September then I plan on applying to schools in Massachusetts. It;s unfortunate that there are no programs for those of us who already practice in the provider sector of healthcare. It's almost as if we are unrecognized by our peers. Anyway, thank you all... APRN;)

Hi all, I'm new to this site but I'm also interested in becoming an MD. I am a psych NP for 2 years now and have always wanted to become an MD but as someone else stated, I have a family, etc. What im finding is that an advanced degree doesn't mean anything these days. You still need to take all of the chemistries, physics, biologies, and calculus's. If anyone is like me, i obtained my degree through the traditional nurse setting and core corriculum which means I didn't take the 2cd year or chemistry, no physics, no calculus, and the bio and micro bio I took for the nursing program are really no good in terms of preparing for the MCAT. I did apply to and got accepted at Oceana but they require alot. #1 you must find a supervising Doc and with bias towards online MD programs, how hard will that be #2 you need $6,000 up front to attend a 6 week "transitional" course at a college near you and I don't have that with all of my children in private school, etc. They offer financial aid for 1/2 the cost of the total tuition which is $100,000 but not for that 6 wek course and #3 you work at your own pace, so what does that mean? I didn't persue it, and now I don't know what to do...any suggestions???

Hi all, I live is Massachusetts and I am a psych np. I make 90,000 a year, salaried. I have been an np for approx. 2 years. Should i be asking for a productivity bonus? What exactly is that and who is entitled?