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Dr. Tammy, FNP/GNP-C

Dr. Tammy, FNP/GNP-C

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Dr. Tammy, FNP/GNP-C specializes in ER; CCT.

Dr. Tammy, FNP/GNP-C's Latest Activity

  1. Dr. Tammy, FNP/GNP-C

    FNP - Their Own Clinic - California

    That is correct, hence the need for a supervising physician.
  2. Dr. Tammy, FNP/GNP-C

    Med assistant for NP

    Only so many characters will fit so I had to triage out a few and use the short version. Here's the long one: Dr. Tammy, DNP, MSN, BSN, FNP-C, GNP-C, PHN, RN, EMT-P Does that work for you?
  3. Dr. Tammy, FNP/GNP-C

    520 supervised furnishing hours in CA

    Yes and No. Yes, as a NP, you can write for schedule II's (If you have BRN NP/furnishing cert/Schedule II CE course and DEA registration). No, if your MD supervisor will not allow you to do so. Remember, in California NP's have no scope of practice beyond a RN. Because of our medical assistant status, our technical function is dictated by the supervising physician. Only when NP's get it together and reject the "mid level" name and status quo and recognize themselves as nursing professionals versus second-rate physician extenders, will we have full authority as other states operating in the 21st century.
  4. Dr. Tammy, FNP/GNP-C

    FNP - Their Own Clinic - California

    Yes. There are no restrictions for opening a clinic like there are for PA's. There are several challenges, though. First, to be able to practice, you need to be covered under standardized procedures. Check the California BRN website as there is much information regarding this in position statements under advanced practice. Second problem is being able to get paid. Medi-Cal and Medi Care: no problem. Everything else: huge barriers. Most third parties will not contact with you--only your supervising physician. This, of course, is a huge impediment because now they are not only on the hook for supervising your practice, but also in how you bill. Third, referrals will not deal with you--they will report to your supervising physician for the most part. This causes many delays from radiology/lab to specialty physicians.
  5. Dr. Tammy, FNP/GNP-C

    520 supervised furnishing hours in CA

    The intelligence of California regulations coupled with the lack of California NP leadership always leaves me scratching my head. AMA/CMA fought hard to specifically remove "prescribing" from the scope for NP's. Since the vast majority of NP's here consider themselves mid level, physician extending medical assistants coupled with the lack of leadership in our state's NP association, there's little outcry. So it goes--we "furnish" or "make medications available. Kind of like a crack dealer, I suppose except they are pretty much autonomous. The only State in the US where NP's can't "prescribe". The logic for obtaining a furnishing certificate is breathtaking. You need 24 weeks and 520 hours of experience "furnishing" under a physician under SP's. There are no regulations that define any difference between furnishing with a furnishing certificate and furnishing for the 520 hours needed for the furnishing certificate. Both deals require SP's and some level of physician supervision. Here's the best part: You are not permitted to "furnish" unless you have a "furnishing certificate" yet without the "furnishing experience" you can't obtain a "furnishing certificate" Only in the Peoples Republic of California. For me, it took over a year, because I could only work part time, as I was going through a DNP program. I used both my civilian, police and military NP hours to equal the 520. Also, make sure you take that mickey mouse Schedule II course that CANP offers via CD and submit with your BRN application. Otherwise you won't be able to write for Schedule II's. Although the BRN cashed my check with 48 hours, it somehow took them an additional 5 weeks to review the three forms I sent with my application before they issued my cert. At least I feel warm knowing my fees help keep people off of unemployment.
  6. Dr. Tammy, FNP/GNP-C

    States restricting FNPs rounding on inpatients

    Check out the Pearson report. Here in California, there is no difference. NP's are certified by the board as NP's--not with any specialization or practice location restriction (outpatient versus inpatient).
  7. Dr. Tammy, FNP/GNP-C

    Med assistant for NP

    Perhaps it might be time to reevaluate your position as a NP with the organization and to reflect on which profession you are in and which level you are at (see below). If you consider yourself a midlevel provider in the profession of medicine, then you are relegated as a dependent technician staff member and consequently, should have little, if any, input on the direction of any component of the practice more than just an advisory opinion. As an example, and as a technical mid level provider, it might be decided that you start calling patients back from the waiting room, performing vital signs, then providing a technical assessment on patients followed by cleaning up the room afterwards and perhaps making sure the physicians have coffee. If however, you view yourself as a top-tier member of the nursing profession, then this is a different story. In this case, you are not a mid level provider but a professional nurse at the top of the nursing-practice pyramid. Consequently, you—as a top-tier provider of nursing must set professional boundaries to ensure the best possible outcomes for your patients. This includes, making sure the practice—which is generating money from your professional services as a NP—not as a technican-- provides for those resources requisite in caring for your patients. Perhaps if they are not willing to do this, then they really don’t need you, but the services of a mid level provider. That’s OK, though, because there are plenty of mid levels around as well as places that really do need professional top-tier nurses. Profession of Nursing Practice Levels NP/CRNA/CNS/CNM RN LVN CNA Profession of Medicine Practice Levels (not exhaustive) Physician Physician Assistant Respiratory Therapist Scrub Tech EMT-Paramedic Medical Assistant EMT-Basic Profession of Pharmacy Practice Levels Pharmacist Pharmacy Technician Profession of Dental Practice Levels Dentist Dental Hygienist Dental Assistant Profession of Physical Therapy Practice Levels Physical Therapist Physical Therapist Assistant Physical Therapist Aide
  8. Dr. Tammy, FNP/GNP-C

    Cheap online MSN / FNP programs

    Check out Northern Kentucky University. Around the mid $300's/unit for online.
  9. Dr. Tammy, FNP/GNP-C

    DEA# and California Furnishing license for the ED

    Odd is a kind word for what we have here. I could be wrong, but I think California is the only state where NP's can't "prescribe" but we "furnish" or "make agents available". Kind of like what drug dealers do I suppose. Also, for the OP - make sure you have a separate set of SP's in place just for you in the interim between your NP certification and the time when you get your NPF. Why? SP's require minimum credentials enumerated in the document (See CA BRN info for SP development). Most include requirement for NPF as formulary is needed. If they just add your name to this list and you are using these as the legal instrument to practice when you go outside of basic nursing, you would be outside of the scope of the SP's - technically practicing medicine without a license. I made up one when I started (without a NPF), then used those for about 7-8 months; then when my NPF came, made up a different set, now inclusive of the NPF - but not including scheduled drugs; then when my dea came, was added to mix with the rest. Rebeca Zettler sells a pretty good "fill-in the blank" type deal for this. Just make sure you keep your own copies in a safe place. I'm told that one of the first things that occurs in any lawsuit involving NP's is they try and prove that you were operating outside of your scope of practice. Not sure if this is true or not, but for new NP's not in the know with SP's without a diligent manager taking care of these things, it wouldn't be too hard to prove if new NP's are just added to the list with others.
  10. Dr. Tammy, FNP/GNP-C

    DEA# and California Furnishing license for the ED

    Not sure where you are getting your information but that is not correct. Whenever a NP orders a drug (in California) they do so under a standardized procedure and the function is furnishing. There is no authority that provides only for the need for a furnishing and DEA registration number if the NP is ordering scheduled drugs outside of the hospital setting. Moreover, there is no waiver for NPs that are ordering narcs within the hospital as not having to procure both a furnishing and a DEA number: The Boards Website provides: "The BRN issues a furnishing number to a nurse practitioner that allows him or her to "order" or furnish drugs and devices to patients using approved standardized procedures. A nurse practitioner with a furnishing number may obtain a Drug Enforcement Administration (DEA) registration number if they want to order controlled substances as needed for patient care." http://www.rn.ca.gov/applicants/ad-pract.shtml#npf CA B & P CODE: 2836.2. Furnishing of Drugs or Devices Defined Furnishing or ordering of drugs or devices by nurse practitioners is defined to mean the act of making a pharmaceutical agent or agents available to the patient in strict accordance with a standardized procedure. All nurse practitioners who are authorized pursuant to Section 2831.1 to furnish or issue drug orders for controlled substances shall register with the United States Drug Enforcement Administration.
  11. Dr. Tammy, FNP/GNP-C

    Indiana State University BSN Thread for Current Students

    What questions do you have?
  12. Dr. Tammy, FNP/GNP-C

    Any new NPs go directly for DNP?

    I wasn't able to do much in the way of any type of work during the last year, but then again, I kind of fast tracked it.
  13. Dr. Tammy, FNP/GNP-C

    It's time to collaborate-not compete-with NPs

    It The Journal of Family Practice
  14. Dr. Tammy, FNP/GNP-C

    Passed CPNE

    As the famous philosopher Borat from Kazakhstan would say, Very niceeee!
  15. Dr. Tammy, FNP/GNP-C

    Any new NPs go directly for DNP?

    Perhaps you stated in more on point, regarding non-nurse practitioner commenting on advanced nursing practice on another post.
  16. Dr. Tammy, FNP/GNP-C

    Any new NPs go directly for DNP?

    I'm not sure I'm following your logic. Please correct me if I'm wrong, but from your title, I presume you are a CRNA and you entered the DNP program as a CRNA, which means you were already certified as a clinical expert prior to going into the DNP program. Now, what you are saying is that you wish you had more clinical time and specifically clinical time outside of your area of expertise such as ER, womens health ect. within the DNP program. Were you made to believe that the DNP program was not a translation into practice program for previously established clinical experts? I'm curious. Did your DNP program purport that it would make you a clinical expert outside of your area of expertise? Did your DNP program indicate that you would have additional clinical training within your present, and certified area of clinical expertise as a CRNA? If you feel you did not have enough clinical hours for your specialize area, is this a concern for your DNP program or for your MSN-CRNA program?