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djmatte ADN, MSN, RN, NP

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  1. djmatte

    Realistic Facts About FNP in Northeast Ohio

    Lol crap aside from talking people off the ledge of benzos and Norco, advocating for fewer processed foods and exercise is the majority of my patients.
  2. djmatte

    For ER: FNP or ACNP (Texas)

    Acute care and emergency medicine are typically vastly different in training and necessity. An ACNP imo is no more qualified to work in emergency than an fnp and arguably less if they have any form of pediatric population. There is an ENP certification that anyone who works in that arena should attain imo.
  3. djmatte

    Why don't more NPs advocate for better training?

    While I don't disagree that involvement in our local organization is important, I don't find they (mine specifically) are particularly interested in the quality of NP education programs. Certainly not enough to potentially hold back the profession on the stage of legislation and improving NP autonomy. If they ever suggested that NP education was lacking, the AMA would be all over that and two decades of progress would be a wash (appropriate or not). IMO improving education starts at the either the school accreditation or the two organizations that certify NPs. The problem with both is there are too many organizations in the pot. There are multiple school accrediting agencies ranging from national to regional and all are generally accepted by certifying bodies. And as evidence by some of those schools with accreditation, many of the "low performing" schools still maintain high level accreditation. AANP and AACN specifically are in competition (especially since they don't allow cross certifications anymore) and their bread and butter is adding new members and ensuring those members continue to pay dues. They sure as F aren't going to risk a steady increase of members by adding additional restrictions. A good area they could start is by certification bodies forcing new nurse practitioner graduates to complete residencies prior to certification. This could at least slow down the flood of new NPs and provide a more structured hands on education that those bodies control and have a vested interest in. But as previously mentioned, it slows down numbers (money) and increases their work (cost) by adding more programs to manage.
  4. djmatte

    How did your program teach physical assessment?

    Our physical assessment class was online. But my school (Frontier) had school house sessions that had in person check offs for head to toe examinations for adult, infant, and male/female GU. We also had specialized workshops in various other assessments such as musculoskeletal areas. These weren't simple checks where someone guided us through the process. They were blind exams where we drew three random cards and had to go through the motions of those specific areas on the fly in under 10 minutes. The infant though was head to toe with all reflex tests for everyone. We were not allowed to proceed with clinical without these passed. IMO in person demonstration (not previously recorded) should be a base standard for any school.
  5. djmatte

    Oversupply of Nurse Practitioners

    I generally look at places like San Francisco from a different perspective. Most of the time the pay reflects cost of living. It's only * hard* for people in service industries. Professional jobs tend to hold up better. You can get by in those cities with no car and probably technically afford a house in the right situation. Comparing what you get in the Midwest compared to major cities is where people get tripped up. But I remember living in Stuttgart Germany. 1600 euros a month for housing, but a train stop two blocks away and impeccable bus system and I didn't own a car for two years. Only had my Harley. Wife and I could easily live in San Fran or NYC comfortably.
  6. djmatte

    FNPagnpFNPFNP....no it's AGNP

    Quoting for auto-correct type-o's.
  7. djmatte

    FNPagnpFNPFNP....no it's AGNP

    Seriously?! Pediatric, adult/Geri and women's health primary care are all thoroughly covered in training. There's nothing those areas do that aren't touched on or thoroughly covered in fnp school. While ganted every school has a broad latitude in training and frontier certainly went balls out on our clinical experiences, the same can be said for all np areas. Some are good, Dionne mediocre, some just bad. Too many points of entry, too few controls. You work in acute care of memory serves and if that's your area for debate of FNP training, clearly my post was not focused on acute care or hospitalist jobs.
  8. djmatte

    Ok TEXAS NP's, wake up and smell the coffee!!!

    Looks good, but I would proof read some of it for grammar before sending.
  9. djmatte

    Head hunters be like...

    Pretty much nails the bulk of emails I get from a range of websites.
  10. djmatte

    Can I work with specialist as FNP or should I pursue AGNP

    No. But it might beat out an agnp in primary care or urgent care that needs someone who covers the life span. I could be mistaken, but I'm under the impression they were wondering about more specific specialties that aren't covered by a specific np path. Things like derm, urology, endocrine, cardiac, etc. Though I agree the versatility is a facade. Imo if you go fnp, you go because you want to provide primary care to the broadest range of patients you can impact. Nothing more frustrating than working with an fnp who sets limits on their patient panel. I worked with one recently who saw a B.C. frequent flier. He refused to do a gyn check for bv because it was against his religion, but wouldn't treat her based on symptoms or history without current cultures. He handed her the swab to culture herself.
  11. djmatte

    Need help deciding between job offers

    As a new grad, I wouldn't want to float. I would want to be in a position where I can develop steadily and get a solid patient panel. 2 per hour is a dream by most primary care standards. But someone more driven might be better with a busier schedule.
  12. djmatte

    FY 19 Navy Nursing

    Found out the other day my credentialing cleared. One more interview and the package should be done. Then we wait to see if and when new fnp billets drop. Meantime, I have contract discussions upcoming on my current job. Will probably renew for a year on the premise that fnp jobs truly are wiped out for fy19.
  13. djmatte

    Admin Day

    I wouldn't characterize it as common, but some places do have blocks set up like this. So you might have a few hours to do these things. That's the more common setup I've seen.
  14. djmatte

    Insurance coverage for ER visit

    When I got home I looked it over. It was just a statement and said at the bottom it was not a bill yet...still pending insurance coverage. Will wait and see on that. Thanks for the input though!
  15. djmatte

    Insurance coverage for ER visit

    Or lack there of? My girlfriend and I are both RN's. I work in a hospital and her in a memory care facility. About a month ago she visited an ER due to some severe abdominal pain she had for approximately 4 days straight and after seeing some unexpected vaginal discharge. A tad bit afraid there was some sort of miscariage. She made sure that this specific hospital was covered by her insurance before she went because there are about 3 hospitals in our area. She was there for about 6 hours, went through an intravaginal ultrasound, ct scan, and had labs drawn. In the end they found nothing and sent her on her way. Within a couple days the symptoms cleared and she was fine. Today she got slapped with a $10,000 ER bill! Does an ER's lack of finding anything exempt an insurance company from paying anything?