Jump to content

Riburn3

Internal Medicine
Member Member Nurse
  • Joined:
  • Last Visited:
  • 548

    Content

  • 3

    Articles

  • 14,388

    Visitors

  • 0

    Followers

  • 0

    Points

Riburn3 has 10 years experience and specializes in Internal Medicine.

I have been an RN since 2007, where I worked for almost 8 years in CVICU as a charge nurse. I graduated with my MSN-FNP in late 2014, my AGACNP in 2017, and work as a hospitalist.

Riburn3's Latest Activity

  1. Riburn3

    ANCC AGACNP Exam Tips

    Both of you sound like you’re putting in the effort and are on the right track. I scored all over the place on practice exams. The Barkley practice tests are in my opinion much harder than the real deal. Keep doing what youre doing and maintain a positive positive mental attitude and you’ll succeed.
  2. Riburn3

    NP Wikipedia Article

    Meh, our group did fire a physician because they were a giant dumpster fire and couldn’t punch their way out of a paper bag. They were a hangover of the previous hospitalist service. They never quit, but at least the NPs knew it wasn’t the right fit for them and didn’t need to be fired.
  3. Riburn3

    NP Wikipedia Article

    I think the issue is the person that edited the article is a preferred editor, sooverriding him/her is more difficult. The article also has a soft lock until November.
  4. Riburn3

    NP Wikipedia Article

    There are tons of discussions about this over the years on here. Youll see posters say that experience matters. You’ll have some that didn’t have any experience and say it didn’t hurt them. My personal belief is that its helpful in many ways. I felt very prepared in my program because I had 6 years of ICU/CCU when I started, and didn’t struggle in the program like some folks with less experience That experience also left me with better connections for employment, and my first job out of school was a direct result of having experience. Many in my class likewise.
  5. Riburn3

    NP Wikipedia Article

    To be honest I don’t know. It’s still not a very large sample size and it’s just now only being tried in other places I also mentioned earlier it was really tough finding the right NPs to fill the role. In the first year, 3 NPs essentially left only a few months in because they didn’t feel comfortable operating so independently in a state that already has had independent practice for a long time. As proud as I am, you don’t really experience that from physicians freaking out and quitting. Not that these NPs were bad, and some were already hospitalists before, they just weren’t quite ready.
  6. Riburn3

    NP Wikipedia Article

    Well it is True True, but I admit one of the program struggles initially was getting the right kind of NPs into the job as it requires a very high level of autonomy and critical thinking (we cover ICU as well). Once we found our core, it’s been smooth sailing, but we did burn through a couple folks quickly that weren’t ready for it. I also dont disagree with your comment about precepting. There are certain schools I won’t precept from, and I usually now only agree to take student that I know.
  7. Riburn3

    NP Wikipedia Article

    Hmmm you sure like to just make up a lot of bologna. My comment on consults was in regard to you saying they would run away at an NP run hospital. My point is lots of NPs isn’t scaring anyone away, we live in an underserved area so many consultants come here to finish their visas, then end up staying. You seem to live in the world and have a mentality that if you haven’t heard of something happening or seen it , then it must not be true. What’s it like being so omnitient?
  8. Riburn3

    NP Wikipedia Article

    It’s sort of funny you mention “an NP run hospital”. I work as a hospitalist in a group that is 50/50 physician and NP hospitalists. We are part of a pilot program by our company to determine if a larger pool of NPs in a group is effective and safe. Effectively our company wants to know if they can get away with this model because we are paid a lot less than the physicians, so it’s a big cost saver. We split the assignments, admissions, acuity, hours worked, committee memberships, and everything else evenly. It’s an independent practice state so there’s no co-signing. After two years, the NPs as a whole have a better satisfaction rating, lower readmission rate, equal length of stay, equal consultation frequency, fewer adverse outcomes, and fewer core metric fallouts. As a result, several of our sister hospitals are eliminating physician positions in favor of more NPs in the practice group. Since our group started this we surprisingly have more consultants that have moved to the area. No one has fled!
  9. Riburn3

    NP Wikipedia Article

    So because those are the only studies you’ve seen makes it definitive I guess? Many states have had independent practice for over 20 years. You’d think it would be all fire and brimstone there with how terrible NPs are. Look at a map of states that have independent practice, and they coincide with some of the healthiest states in the country. Look at the most restrictive practice states ( the south), and you have some of the most unhealthy states in the country. I’m not saying NPs are the cause of that either way, but it’s clearly not a detriment, and just perhaps patients that have greater access to more providers is a good thing, and a net positive. Lets not beat around the bush. Physicians against independent practice are worried about their bottom line. Plain and simple.
  10. Riburn3

    NP Wikipedia Article

    I agree most surgeons are adequate. Most I’ve met are fantastic. When you took a generalized shot at the NP profession and our personality not understanding shortcomings (which had you actually ever been on this site would know there’s literally hundreds of pages worth of NPs discussing the profession and our shortcomings), I decided to make a joke about surgeons. Surgeons are experts at deflecting their own mistakes and shortcomings onto others. Clearly not all of them are, but there’s a reason for the profession being associated with the term “God Complex”. At the end end of the day, comparing education has done nothing to enhance the physician lobby, and more and more states are granting NPs their independence, not the other way around. When I sat in a recent hearing where the government of New Mexico passed a law allowing all APRNs the ability to admit their own patients in a hospital without a physician, the senators asked point blank, if the physicians there fighting the bill had any proof that nurse practitioners, particularly in independent states like New Mexico, provided inferior care or their patients suffered worse outcomes, and they straight up said no proof exists, and spouted on again about education. They were promptly silenced. The bill passed easily and was signed by the governor just this month.
  11. Riburn3

    NP Wikipedia Article

    Clearly never met a surgeon.
  12. Riburn3

    NP Wikipedia Article

    I'll also add after doing some digging, that it appears since the end of march, an entity has taken over the page, and started making numerous edits, and now the page is semi locked. While some comments are fairly accurate, others are blatantly false or misleading, indeed fake news. Anyone with half a brain can read the edit history, check the IPs, and actually read the references cited and realize this is a hit job. The person editing it apparently knows a great deal about Pakistani cricket and Nurse Practitioners, no other medical articles. "NP training covers basic disease prevention, coordination of care, and health promotion, but does not provide the depth of expertise needed to recognize more complex cases in which multiple symptoms suggest more serious conditions" which is just blatantly false and cites nothing to back this up "Increased utilization of nurse practitioners is leading to increased cost of care through increased use of resources and unnecessary referrals". Check the references, they make absolutely no claim that we are leading to increased cost in healthcare and the difference in ordering practices in very small sample settings is 0.1%, not really statistically significant. Considering we bill at 85%, we are cheaper. "Nurse practitioners are more likely to prescribe antibiotics when they are not indicated". Only assessed providers in ambulatory care and the overall conclusion of the reference was that all providers over-prescribe and the study did not separate NP's or PA's, and even mentions in the studies limitations that the finding might no be representive of NP/PA practice because of the sampling methods used. "Although a few studies have shown that NPs provide similar quality care when compared physicians, these studies were found to have a medium to high potential for bias and had low to insufficient strength of evidence" This is my favorite as the article referenced so supposedly back this up states explicitly "The studies we reviewed did not demonstrate a difference between APRN care and physician care in primary and urgent care settings with regard to health status, quality of life, mortality, or hospitalizations" I think we can all agree there are ways to improve our profession and standards of entry, but this article is a biased pile of garbage and I can't believe it's allowed to exist.
  13. Riburn3

    NP Wikipedia Article

    Never said it was inaccurate in regard to what you just took the time to post, and even mentioned the part about clinical hours and education in my OP as being accurate. My larger issue is whoever edited it (foreign IP address), especially with regard to quality, presented a very narrow view of references and some of the “citations” are very poor quality. Their wording in general was also poorly done. It also failed to cite the many articles that do exist out there that prove our strengths. The intent was clearly biased in nature.
  14. Riburn3

    NP Wikipedia Article

    https://en.m.wikipedia.org/wiki/Nurse_practitioner
  15. Riburn3

    NP Wikipedia Article

    Has anyone taken a gander at this recently? Looks like someone with a pro-physician lobby has gotten ahold of the page and it really casts NPs in a very negative light. Some of the statements like contact hours and education aren’t inaccurate, but they definately go out of their way to make us look bad and it’s very one sided. Many of the “articles” cited are actually just surveys conducted by physicians. Kind of funny. Theres a whole section on “quality of care” that is basically bogus and doesn’t care to reference or mention any articles that are based on systemic reviews that say we actually have better ourcomes than physicians in many regards.
  16. Riburn3

    What's a Nurse Practitioner?!

    I think this is a pretty reasonable question and I respect it more than "what is a nurse practitioner". Depending on state, the roles and regulation can be nearly identical. The reality is, a provider is a provider, and for the most part we all do a very similar job, whether you're an NP, a physician, or a PA. The difference really is we all get there with a unique educational experience.
×

By using the site you agree to our Privacy, Cookies, and Terms of Service Policies.

OK