djmatte

Leadership is definitely a thing for the military, but not something you will be expected to focus on early on as a NP. In the civilian works, your leadership will reflect in how well you work with your team and foster relationships therein. That's assuming that you're even set up in a team like environment. In the military, you will have leadership expectations, commensurate with your rank. You'll be expected to demonstrate leadership in both the clinic as well as while interacting with the soldiers and or staff that you out rank. Leadership qualities and styles vary with individuals. In general, the best qualities I've faced were individuals that were straightforward about their concerns and or observations, but also had the capacity to not overreact. An easy trap some providers fall into is feeling overwhelmed or overreacting to your patients, their staff, or a number of other things that they can't control. these issues often will lose the confidence of your team and only undermines your ability to advance in leadership roles.

For one, I'd make sure with the practice manager in the owner that that's the new expectation. If so, I would follow it up with a demand for more compensation or a reduced patient load to accommodate. You're looking at over an hour and a half of extra time spent on patient care daily(based on an average 20 patient day at five minutes to room the patient). If they won't reduce the patient load, demand an additional $15,000 a year to make up the difference of what it would cost them to pay for an MA.

Part of the reason I used to only precept students from Frontier. I knew they vetted their locations and observed their students in clinic multiple times through their rotations. Unfortunately I can't anymore now that I'm in the military. I will say though the military IPAP and US armed services university NP programs are producing since stellar PAs and NPs. At the end of the day, diploma mills are pushing forward profoundly bad NPs with no oversight of their clinical progression or real world outcomes. They don't willingly produce their graduation rates and are worse about posting their board pass rates. Complicate that by our boards being an abysmal display of an entry level exam for a provider who could essentially walk right into a full empanelment and you have a recipe for disaster. We do need to hold our governing bodies and school credentialing organizations to a higher standard.

Howdy! This is a little bit of a shot in the dark, but I'm wondering if I could get some feedback from others who have gone through the program at the school? Clearly, I am already licensed so I'm not going back to school. But I have a task to check into the school regarding their output and quality of training. If anybody who went to that school could provide me some insight I would appreciate it. You can do it publicly here or direct message me. I appreciate any help in this. It's a short turnaround so I probably won't need anything after Friday. Thanks in advance.

There are lots of garbage "accredited" schools. Most often, it's Walden or similar online program graduates who walk out feeling the most unprepared with historically the worst outcomes in board or even practice readiness. So having clarity on where you went to school gives us perspective on why you fell the way you do.

What kind of NP Program did you go through? Something reputable I hope.

The characterization of the discipline may matter.

The fact that you're in Kentucky is HUGE. FNU has an awesome campus with a rich history of nursing service through hazard county. Look into that. Stay away from the chamberlain and other for profits. Many places won't even consider hiring them.

To add on, becoming a provider isn't gonna improve the dynamic of your child's health needs. Your benefits will likely be worse and the extra hours you will put in as a NP will be much more. Many nurses going into this field are quickly finding their work life balance in a hospital was much better and the pay more time appropriate. I went to frontier myself and while mostly online, there are in person requirements and expectations that you complete/ pass in person physical exams and lofty checks on clinical sites. They still aren't perfect, but they are a far cry better than the for profit centers. They have higher expectations in passing their tests and don't take in anywhere near the amount of students as other schools. But as I said earlier, given the totality of what you've indicated earlier, I'm not entirely sold that becoming a provider is in your best interest.

Definitely a questionable thread as a whole.

Family medicine is a specialty. Much like FNPs. It requires its own board certifications in its own right. So let's not argue over who commands more in what capacity. A psych NP isn't any more qualified to treat hypertension than a psychiatrist. The only reason psych NPs are paid more is because the overhead is less. They are still reimbursed at the same rate for an office visit as any other medical provider. They don't have the "luxury" of an MA or office equipment needed to run a clinic. There's essentially more flexibility in the value of RVUs. Your anecdote doesn't speak for all PCPs and your superiority complex is perplexing as many of those in family health are simply trying to keep up with the demand because of lack of mental health access. Most of the medications we have access to are old and we don't have the time to go through the complex prior auths to get them on newer medications while we address 5 other problems. As you treat the "most complex" organ, you're dismissive to those have to deal with every other organ system, chronic pain, diabetes management, hyperlipemia, and by the way ensure all of our HEDIS measures are up to date.

If you have any intent of gaining any remote proficiency in this career path or any remote respect from your colleagues, then I recommend any number of more reputable schools than the hot garbage that is Walden. Find a school that has in person requirements before you start clinicals, actual clinical site evaluation, and clinical placement. Walden checks none of those boxes.

I'm a hard send someone to psychology for mental health evaluation regarding ADHD. A referral should never be " cost prohibiting" if they can see me in clinic to ask the question. If they have the diagnosis in the past, I have no problem verifying them on it and restarting meds. I have no doubt there are many adults who likely have ADD/HD who either never got tested or had parents who refused to chase that diagnosis. But in family health, that diagnosis is not my specialty.

From an admin perspective, many ADNs work in a range of capacities because their clinical experience warrants that. My wife for instance makes more than in do as an ADN because she's developed a solid foundation in senior living over 20 years and has worked the visits side of some of the latest companies. She's in charge of people with degrees/licenses from LPNS,BSNs, to PHDs. Depending on the clinical environment, an ADN can just s as well not endorse an NP order just as well as any doctor. If they feel there is a safety concern to the patient or others, they can bring that up to the powers that be. RNs are charged with both the safety of their patients and ensuring the patient has a functional plan to recovery. She can't change your orders as others have pointed out however. At the end of the day, there is a clear conflict here. Might be advisable to find out who these things are happening. Have you done anything to make her question your medical decisions? Is there a personal tiff?

What's more disgusting is the actual acceptance to graduation ratio.

To be fair, these schools often weed them out through either scholastic attrition, financial attrition, or simple inability to pass boards after the fact. This is how their for profit model is sustainable. You can take and retake a class ad nauseam until you pass out give up and they still get that money. The problem is they are preying on people with grandiose promises of a sub par education and a low likelihood of success. That's the problem with these schools. They feed on underserved or desperate populations.

Beside manner doesn't even register in these schools. They have no minimum of nursing experience required. Many can move straight from their RN degree without showing any form of patient competence outside the bare minimum NCLEX pass.

For a select few that is the case. But problem is these schools churn out crap on the regular. Many hiring organizations have caught on and won't entertain the idea of hiring them. These schools also entrap many into student loans they may never get a degree for because they are unable to work and keep up with the education. If we don't openly talk about these issues, more students make that poor choice.

Let's try arguing my points rather than throwing around diagnoses you aren't prepared to make. (BTW this is actually against forum rules, but since you have the reactionary maturity of a child I won't opt for moderation). 1. They don't publish their stats like other reputable schools do. 2. They don't adequately vet their clinical rotations. 3. They provide minimal support in placing clinical rotations (a standard that even their accreditation body is mandating). 4. They don't properly ensure their students are checked off in ability physically on sight before that student begins clinical rotations. 5. They take on thousands of applications knowing that many won't make it through or ultimately will be saddled with far more debt than other schools. 6. Their practices prey on a range of ethnic and social classes dragging them into debt with grandiose promises of what they could be without giving them the real expectations of graduation. These are facts and observations I and many have concluded about our many interactions with this school and their students for close to a decade. They raise suspicion of the schools ability and by proxy anyone who chooses to go there.

Many do. But many struggle to pass boards or even finish at these schools. There is an understanding that these for profits operate on the likelihood many won't make it through it will not b made it through in a timely manner. They take in thousands of students a year. They don't support them in things like clinicals. And when their bare minimum curriculum fails to prep them for boards, they still say "we still game you a degree". But even for thousands of failures, there's still a percentage of people who got a subpar education who happened to pass boards (still a poor measure of ability), who likely got a subpar clinical experience because the schools only care that you showed up somewhere. They have poor clinic vetting practices and don't have rigorous standards. It's current NPs who need to hold the line on schools we're willing to entertain when interviewing. You can be the best NP from your school, but if you came from one of those schools you won't get an interview with any clinic I have the capacity to influence because I refuse to let those schools or anyone stupid enough to entertain that option a margin of opportunity.

At the end of the day, the quality of the for profit schools is demonstrably poor and the fact that they exist only suggests their accrediting bodies are either poor in their standards or complicit in pushing out crap NP education. They also know if they shut down the Walden's and Phoenix's, a lot of NP licenses will be at risk or in limbo.

As evidenced by the quality produced by the Walden's et al, it's clear those accrediting institutions aren't as rigorous as you purport. Even ACEN recently enacted a requirement for providing preceptors. None of the for profits are hitting that metric from the number of people I still see begging for a preceptor for those schools. Quality has a range of metrics. Percentage of graduates to totals accepted. First time pass rate on boards. And even observed performance compared to peers at similar level. The first two, the for profits won't even report because they know their numbers are abysmal.

Any time spent working outside business hours is money lost unless actively seeing patients. No additional work or tasks performed past the allotted time is accounted for or made up. If you own the business, then maybe you are doing well to ensure patient satisfaction and maintaining them as a solid source of income, but that's in your interest and extra efforts are expected as that business owner. But nobody's paying for that ancillary staff to stay late or for that nurse practitioner to continue to write extra letters. Suggesting nurse practitioners "do more" do make up for the pay shortfalls fails to account that they are by and large doing the same amount and billing for the same complexity as their colleagues work more "advanced" training. Doing more will simply equate to lower quality care while giving clinics a means to squeeze more from already overworked clinicians. A PA I used to work with came in an hour early every day and stayed an hour late every day so she could get more patient access in and accommodate their schedules. She was praised up and down for all that she was doing for her patients and the money that she was bringing into the clinic. She did make a not more in bonuses. But during that time, I watched her literally burn out because she tried so hard to maintain a high accessibility to her patients at times that took away from her own personal life. And for all that extra effort, she still didn't make anywhere near with the lowest paid Dr was paid at that clinic system.

Some of that comes down to what you want and what you believe you can be best prepared for. When I got my FNP, I wanted to with in preventative medicine. I never worked with mental health before and couldn't see myself working in that environment. The money is better in a lot of specialized nursing fields. CRNA to name one. But I didn't have the background or really the interest to pursue those areas.

Not all places or groups use the same terminology. I grew into my own where mid level was a standard acceptable term. APP. MLP. They're standard catch all phrases that people truly need to stop losing sleep over. It's different terminology, utilize to characterize a group of people in an effort to differentiate doctors from those other staff. Yet it seems mostly NPs that lose their proverbial excrement over such an innocuous term.