blusueNP

I am primarily a locums FNP and was recently presented to Zoomcare (in Portland OR) for an assignment . Anyone out there have experience with this company?

I live in Muskegon Grand Have area

Having some difficulty finding a job as FNP in Michigan - seeing many jobs that do not offer benefits! Numerous ways to work around the law such as 7days on, 7 off so that you would only be working 20hrs/week and not qualified for offer of benefits. Looks like I will need to take a job that I'm not in love with - so does any NP out there have experience with in-home Medicare assessments?

Well... I guess everyone experiences it differently. Things have changed since the pandemic started in 2020. Many places got rid of departments or cut staffing and didn't see fit to rehire these people when things returned to "normal". So instead of 2-3 weeks to credential, it now takes 3months. Make sure they pay you top hourly wage and it is not all-inclusive (you pay for lodging/mileage or rental car/gas). Getting a hotel room that has a kitchenette sounds good, but in reality, these are not quality living arrangements. Think extended stay hotels - lots of truckers and section 8 government housing. Better to ask for Air B&B. You WANT a W/D..believe me. Staffcare, Consilium, ICON, Barton Associates Currently with Consilium and working IHS in MT. Takes 45 days initially through any IHS if you've never worked at a reservation before because you are being screened through federal and IHS. You better have money put aside or have a job because it will take 90 days before you start. Many IHS facilities are 200 miles from NOWHERE and you will have to drive in from wherever they put you. That also goes for rural clinics. Many IHS clinics are in areas that have high poverty/drug/ETOH. Rez (reservation) dogs are a problem. Starving, neglected dogs that don't belong to anyone, roam in packs on the reservation and bite/maul people. Just say no - go work somewhere else - certainly not worth the insane amount of time to get approval or the job itself. Was with Staffcare the longest (9 years) they are the NP branch of AMN and I was a travel RN for them also. Got consistent work through them. But that stopped 2/2020. I just finished working as WHNP for Keiser in Napa CA (nightmare job -nobody that works for Keiser FT is a happy employee). I was already to get next assignment and they pulled all the contracts because of COVID - no more full waiting rooms and no work. I did online welcome to medicare assessments for 3 months. I did a pop-up COVID testing clinic in Seattle for 2 months. Barton Associates are like dealing with a high-pressured salesman, so ardent are they in getting you to sign a contract but be careful with them.

Howdy all! Long time no write:) So I am moving to the west side of Michigan to live with a cousin and have never practiced there but I see it is a restrictive practice state. I had some experience with this when I did perm and locums work in CA. What I remember unfortunately was being treated very poorly as a provider by the physicians. The fact that I won't be able to write for chronic pain meds is actually music to my ears! Been there, done that in OR and WA . Although we all know that I can take care of a patient from birth to death and never need to write an RX that requires said DEA number, not having it.. somehow decreases my chances of landing a job. I would appreciate some advice on job hunting (perm) and really - what is it like practicing in Michigan? Please, the good, the bad and the ugly - don't be shy:)

That's quite a jump from not have prescriptive authority for schedule 2 drugs. It has to pass the senate too. In CA - it was passed by the senate but not the house, so there it sits. Don't hold your breath.

Tell them to kiss your ass in Macy's window.

I work in research - no Rx here

Residency Programs for Nurse Practitioners

He is ignorant and makes inflammatory remarks - hallmarks of his base audience

Many many moons ago a conservative right-wing republican senator presented a bill that would have given Florida ARNP's prescriptive authority for scheduled drugs - and it still has not passed. No surprise there. I started my RN career in that state in 1996 and began my NP degree there too, but soon left - screw Florida (they are stuck in the "Dark Ages") and the FMA - they can have it.

Megan5183, who is your post directed at?

"Ummm, wouldn't it be a better idea to eliminate the substandard NP programs, instead of trying to "fix" people after they graduate from those programs?" Ummm, you state the obvious.., but I don't see that happening..Too much easy money to be made from student loans. Until somebody throws the hammer down and shuts these "schools" down, there should be something in place that safeguards public safety. NP students need solid educations, not shortcuts, and that education should extend out to residencies.

I am new to the PCP game, (Graduated 1/22 with FNP post-master's cert. WHNP-BC in 2010) what I am referring to however, is the comfort level of the new NP upon graduation and certification as a clinician. I am appalled that NP residencies are not routinely offered. Of course NP's have been doing without them for years. But with the influx of substandard NP programs out there - it should be mandatory. The second statement was something I witnessed at the clinical site (as a student) before graduation. The NP was flustered and did not know how to interact with the pt (who was scared out of her wits!) The woman had been to UC the day before for the same complaint, and was told to f/u with PCP - I don't know what went on at the UC, but the woman told us that she had chest pain and heavy pressure and that it had increased from the day before. There was nitro at the clinic, but not readily available.

Yes, I am absolutely appalled that residencies are not mandatory. There are approximately 24 sites around the country - each with 2- 6 slots for applicants and everyone and their mother is applying for them. A good number are associated with universities and the associated hospital/clinics. They have so many people applying that they have their choice of candidate. Many of the FNP residencies want you to be bilingual.

Hello, Congratulations on your graduation. Please spell out your words on this post . This is not texting - we like full sentences and correct syntax. My advice is to go to work at least part-time and start getting your pt care experience. Regardless of the path you choose, it will take time. You mentioned that you lack the pre-requisite classes, and these you must have in order to be accepted into a nursing program. You are young - you have the time. Do not be in such a hurry. You will gain much from a good education. Practitioners are entrusted with peoples lives​ - they need a solid education, not shortcuts. 1) If are worried about "wasting time", don't bother with the "2yr" ADN degree if the NP is your goal. Why? You still need all of the prerequisite classes (2yrs). This is in addition to the 2 yrs of nursing school for a grand total of 4 yrs. So it is really a BSN, only without title! 2) Save yourself the time/money and get into a good 3-4 year BSN program, and then apply to grad school. If you do the bridge program (RN to MSN) and skip the BSN - you will not be able to teach in some states without a BSN somewhere in your educational history, so if this is the case where you live, and you want to teach nursing at some point in your career, then go for the BSN and then apply to a good MSN/NP program with a solid program - preferably one associated with a major university. I say this because they are in turn associated with major medical facilities and offer substantial clinical experiences for NP students. 3) There are many things that you will not be exposed to if you go through a bridge program. Bridge programs are typically condensed and students are under a great amount of pressure academically. You should choose a program that is rigorous and has high expectations of its students. Don' t sell yourself short- do the work and get into a good school- there are far too many substandard schools that are only too willing to take your money and give you a lousy "education" in return - you will lose in the end.

MD's do quite well because they have at the very minimum a 3 year residency. NP's are thrown to the wolves upon graduation with 6 months to a year of clinical exposure - which doesn't come within a 100 miles of what med students get. Give me a major break! I would never in a million years think my medical know-how is equal to that of a physician. Make no mistake - NP's are practicing medicine, and while my 17 years as a bedside/home health/case manager RN experience will enhance my practice - it is the physician's mindset I now embrace. I personally do not believe that someone who graduates, passes the NCLEX and never provides pt care deserves to be called a nurse. Here is an example of how nursing experience comes into the clinical picture: a graduate NP from Georgetown University started her first job at a busy clinic. A pt came in, f/u from an UC visit the day before for CP - she was still having it. The NP came into the MD's office and said the pt was scaring her. The only thing she could think of was getting an ECG. An experienced hospital RN would have the presence of mind to think: MONA and call 911. She/he would also assure the pt that help was on the way. I firmly believe that patient care - and PLEASE do not sum up this care to mean cleaning up the mess - this is only a small part of it- it includes patient education, technical dexterity, knowing how to interact and cooperate with the medical team - this is what makes a nurse a N.U.R.S.E. If you never are exposed to this- what are you bringing to the table? You have no skills. Go the PA route - please.

Well, this has happened to me. I graduated with a post master's FNP on 1/22 and got this job in research. They advertised for an FNP to do physicals, interpret and sign off on labs and EKG's. I looked at the position and thought "here is a position with very little pressure". I have been working here for almost a month and am looking for another position. Why? I have done approximately 20 exams. Although the position was advertised to include both clinical and administrative duties, research is such that clinical duties are sporadic at best - the rest, (and I'm finding out) most of my time has been spent typing up doctors resumes for various pharm. sponsors and mind-numbing paper shuffling. When labs and other reports come in, the MD is called and he comes in to sign them off. I was told the other day that when he was on site, they would rather have him do the physicals. Ok, so those are two items in the job description that have been taken away. I shadowed him for about 3-4 days and he was almost apologetic to the pts in needing to give them a physical - and I use the word loosely. I didn't know you could exam the abdomen with the pt standing! There are no oto/opthalmoscopes in the exam rooms either, although the check list clearly lists "ears, eyes,throat" to be included in the exam. This physician is a lovely person, but he is a retired ob/gyn and he let me know that he was never certified in family practice. So my plan is to keep this position and study for the ANCC exam in May. I have been on some interesting interviews (one "working" interview, I did a GYN exam w/pap, but the plastic speculum had no teeth to click to keep it open and the other NP said they ordered them that way because it was cheaper!) I am board certified as a WHNP but only worked for a few months before going back to get my FNP.

you can dispense with the ***** the term "pussyfoot" refers to treading lightly around something - as something a cat or "puss" (another name for cat as in Puss n Boots) would do.

Oh, please, give me a MAJOR break! Most nurses start out eager and kind - a few months or years on the floor takes care of THAT. Come on now! A person can only be dumped on by management so many times before it starts to show. Most abusive job I ever had. I'm an NP now, but QUIT 16 yr RN job a l-o-n-g time ago.

I was only a semester into my FNP program and after realizing how hostile the FMA is to ARNP's that I would never in a million years practice in FL. So after living there since the early 1990's - left. I now live in California. So - if there is nothing keeping you there, go west!

I suspect you are giving voice to something that many feel, but are afraid to admit even to themselves, even for a minute..for most high achievers, quitting is not an option...but it is apparent that advanced practice nursing is not for you..do not pursue it any longer - take the general education courses and funnel your energy into a different avenue. The last thing the world needs is a nurse with an advanced degree influencing healthcare who has no heart for it.

I don't know if this is the right place to find out about med techs in an ALF, but here goes. I am a home health RN who sees pts in an ALF in Tracy. I have never seen a nurse there. They say there is one that is "on call", but I have never seen this person and I have been there on different days and at different times. The med techs do not take blood pressures on pts who are receiving BP meds Yesterday, I went to re-certify a pt who is getting B12 shots monthly, when I took her VS, BP was 218/94 on her left arm and 198/92 on her right arm, I called the MD and got an order for an extra dose of her Coreg 12.5mg po now. The med tech stated she could not f/u with a BP later on in the evening. This woman is on multiple BP meds, and takes some of them TID. What is the risk to my license as an RN going in to a facility that allows their med techs to dispense cardiac meds without first obtaining VS.

Hi Dixie Cup - I did not take your test, I took the NCC WHNP exam and passed yesterday - but let me tell you something - I thought for sure that I failed - I was all ready to fail - I had a plan to study harder, quit my teaching job and go work for an ob/gyn, etc.. - but when I saw the proctor hold up the paper with the letters p-a-s-s, I almost passed out! I still cannot quite believe it. My test did not "shut off" like the academy's does. I had to answer all 175 questions, and it was torture, because, again, I thought for sure I failed - I even went back and changed about 5 of my answers (something I tell my students never to do). In fact I tell them that failure is always an option - negative thinking is contingent thinking - it allows one to have a back-up plan. I feel for you - because I expected to be where you are - waiting to take the test again, and this time, to get it right - and you probably will. Don't despair, we're pulling for you.

You cannot teach at a secondary school of nursing if you don't have your BSN first