CatskillNP

that wasn't isn't the worry. No turf wars here :) Was actually much more interested in the process. How it came to be. What was the impetis? what is the gain? If CRNA's can petition and become NP's, what do CNS's have to do to be the same...just interesting informatinon as I said. I'm learning mroea bout it everyday. Smogatt, you staying in NY???? CNP

I believe they were in the same title category as CNS's. Certified Nurse Specialists. Their specialty being anesthesia. I have further learned today that not all CRNA's will be NP's. It will require additional education within an approved/accredited program. Very muddy indeed, but very interesting all the same. CNP

Nitecap. as smogmatt says, CRNA's were not APRN's in NY. Only NP's were APRN's in NYS. All specialties of NP's are NP's. CRNA's were not APRN's. They were not NP's. Now they are. Smogmatt....what and who's feathers do you feel will be ruffled. Will you be working in NY?? NP's in NY cannot get paid by the state employees. they train us, certify us and license us, but NYS in it's wisdom does not pay us. Stil a major battle. CNP

You're right, they didn't change the name of the profession, they made them nurse practitioners. In NYS only Nurse practitioners are APRN's. Still looking for NY CRNA's. Prior to this summer, a CRNA was not an APRN in NYS

You're absolutely right. So sorry to all the CRNA's out there. My bad. Anyone out there???? CRNA's have been reclassified as NP's in NYS

LPN geriatrics...LPN progressive care...RN progressive care..RN ED...Nurse practitioner family care...NP Peds...NP Geriatrics...now back t NP in family care.

Sorry, title should be CRNA's Tell me what you know/knew about the move to NP status in NY. Was looking through SED laws recently and saw CRNA's listed as an NP in NYS. That is new, very new. Did you know this was happening? How do you feel about it? what is the real situation for work/reimbursement. Is the battle with Anesthesiologists all it is said to be? Are people losing jobs and careers? Come on, inquiring minds want to know. CatskillNP

Hey Linda, where are you??? NP's are great. But I'll never say that physicians don't have a place. I bring many years of nursing to my role as healthcare provider and feel this allows me to better connect to patients, to guide them in their healthcare choices and that makes me feel better to many patients. NP

FNP/DNP I don't disagree, we have seen most of the other professions go to a Doctorate level of preparation, but I think we are in a unique position. First, we're nursing, and nursing has always had a specific role in medicine, and the last 35 years has really started to expand that role. I also believe the other professions represent an area of medicine not already "owned" by someone. What do I mean...there aren't already physicians in the role of PT or audiology and the like. So I belive the "upgrade" of education can take place easily, quickly, (in fact I've known several audiologists that upgraded online for a minimal amont of time and moneies), and with little risk to the reimbursement mechanisms in place. My concern is that there are many variables unaccounted for. In addition there are several large NP organization in this country which had no input to this document. What are NP's in states where they have no prescritptive privileges going to do? Run right out to get a doctorate that they still won't be able to presribe with. What about states with reimbursment battles going on. HMO "XYZ" decides that they will reimburse the MS NP at a rate of 65%, but DNP at 85%? That'll make the MSNP undesirable on many levels. Where are the educational institutions to provide this education in a reasonably expedient manner that allows the practicing NP a way to gain the degree while continuing to practice? I certainly am not blaming you, I'm glad you posted. I just think that in nursing we tend to be so scattered, non-directional and half thought out in process. In NY, the State Ed Department(SED) has mandated the BSN as entry level for Nursing. We were asked and we agreed, because there was scientific evidence to support the Four year nurse as less error producing than the two year nurse. There were evidence based studies that supported that role. There is also a huge grandmothering clause in there for current RN's. While no SED has to adopt the recommendation for DNP to level of practice. I believe many will look at it very closely. As NP's in practice we need to be sure to present a unified voice about how to progress with this. We need to see some form of grandmothering in this recommendation. I've heard the "well you have so many credits with your Masters...." but I want to see it in writing. I do believe there is certainly a component of this proposal by educators that mandate education to fil seats in schools that are runing our of pupils. why didn't the practitioners say they neeed more education rather than the acadamia mandating it????? We are in the infancy of ths proposal but if we are not diligent, we will be ram-rodded again by our own "parents" perpetuating the fact that nurses eat their young. We are a profession that is currently very dependent on the Physicians in most states. Signs of confusion, disorganization, in-fighting can be seen as weakness and then the ugliness could happen. We could be the victims of our own goal at furthering ourselves and end up with no role in health care. Not probably, but we have to understand that everyday around this country there are medical communities that see us as threats to their practices. If they didn't we would be providing health care across the country without all the battles. The positive outcome could be we all end up with dctorates doing exactly what we are doing right now. Why not focus all this energy at rehabbing the health system of this country, maybe this role has a place in a newer health care delivery model as a role of Practitioner, and all disciplines adequate education could be titles as one. Ahhhhh but to dream Let's here further discussion on this topic. Catskill NP

:) LOL I think the record was something like 837 in a 6 week period Keep em coming!!!

If you haven't already looked at it, go out to the AACN web site and review the DNP proposition paper. This effects everyone of us working as an ANP. I;d like to hear comments on it. I have some of my own but will hold back to see if this generates any concern or interest. In a nut shell, the AACN has decided that we need a Doctorate of Nursing Practice. CNP PS, no grand "mothering" clauses in there

They work "under he direct supervision of the MD" we work on collabotion, huge difference of responsibility and role. Also they go througha miniature medical model f a full time 40 hour plus week of education with much more clinical than NP's. that's why experience is important, there isn;t enough clinical in the NP programs. S

If you're not from a nursing background, go the PA route, they'll teach you how to be little doctors. NP's are not little doctors. They are nurses with advanced education in assessment, diagnosis and treatment of all ages of patients. We bring to this career not the opportunity to make money, but the opportunity to bring nursing values to more patients. Become a PA. Scott, NP

Congrats on a huge accomplishment YRNS. I graduated at 19 with my LPN,a nd was pretty sure I was headed for a masters in nursing anesthesia some day. Oh well, times and ideas change. This wasn't a "don't become an NP" rant. It's great that yo want to become an NP, I'd be hard presses to have found another career I would have anjoyed more. This was more of a don't take the easy road, or don't let NP's give the career away for nothing rant. Hard work and experience will prove successful and good luck in your endeavors. Scott

Ufortunately, alot of the impetus behind the fast tracking came from scholastic need to fill seats. Additionally, NP's didn't put their foot down and say NO, WE won't treat this profession like this. Also unfortunately is that the reality is jobs are getting tighter, at least here in NY. I'm very involved with the NP organization for NY, The NPANYS. It's amazing how we as a profession see ourselves in two distinct lights. We are practicing at one of the highest levels of Nursing, yet we fold like cheap suitcases when we need to be organized to stand up to medical organizations that want us gone. An example: 10,000 NP registrations in NYS. 10K!!!! only 2300 have joined and support the only voice for NP's inthe state. Where is everybody??? Why isn't everybody out their at least supporting thier profession. I beg you, if you are in a state with a state wide NP organization, run, don't walk, to the computer/phone, call them and join. If you don't want/have the time to participate, still join, the monies are needed to provide every NP the opportunity to sit at the legislative table and deal with organiztions that want us gone!!!! WE are the profession, WE need to say we want better admission requirements, WE need to support eachother and move this profession on an ever increasing role in the health care of Americans. Hope your day goes well tomorrow. S

Nurse Practitioner Association New York State...the lone voice for NP's in this empire state. Congratulatins on your new RN status. Now get out there and make a differnce on someones life :)

I came to the site today and saw lot's of posts of wonderfully excited people interested in becoming NP's. The vast majority of the tones of education were: "I have the opportunity to become and NP through an advanced MSN program" or "I'm sales person at Target with a Bachelors in sociology, and with just one year of school I can become an RN then get my NP degree!!!" Sorry about this but....Being a nurse practitioner is more than just getting the degree. The job requires experience. Not a year of med surg, not a two year Master's, but some real NURSING experience. We are NURSE PRACTITIONERS, that's nurses with additional skill to allow the diagnosis and treatment of patient problems. It requires the inate skill that makes a nurse magnified to the 'nth degree. What makes good providers as NP's is the same characteristic that made them good nurses. It's experience. I'm not on a high horse, just an NP that has seen too many "rammed through the system, get their money" NP's. This job is serious. It's serious on several levels. First and formost, you are being entrusted with the care of people that put their complete fath in you to make good decisions and provide quality care. This IS different that being a nurse. How many times have you sat back as a nurse and berrated a provider about their choice of treatment plan or pushed for the provider to make a decision and get on with it. That all changes when you're the one with the RESPONSIBILITY for the decision. Yeah, it's an ear infection, yeah amox should do the job. Are you ready to commit fully to giving someones most honored item, their child, a drug that could kill them??? It's not cook book. It requires a base of knowledge, experience, reponsibility, and a committment to furthering your skills. It's a lifestyle! The second group you matter to is the professional community. As NP's, we let the schools go freaking haywire in putting out as much crud as they wanted. They saw dollar signs and began pumping out graduates without regard to job markets or the economy of NP's. Boom, a flood of NP's. Fully half of them are transfer's in from "associated science's". Read sociology, psychology, earth sciences...all able to take their bachelors in science, convert to an RN in one year, and complete their master's in two more. These people may ultimately make good NP's, but not in three years!!!! What makes anyone think that this is the way to put NP's on the map??? What kind of fodder is given to the medical community, especially, to denounce the practice of NP's as being amateurish, poorly skilled, etc. It really opens us up to all kinds of flaming by other medical groups. If you're an RN, thinking about becoming an NP, don't do it for the salary, chances are you're going to make more as an RN in the right setting. If NP is for you, go out and work, get a job, get several and work in areas like the ER(still, in my opinion, the best experience), community health care, critical care, etc. Then after a couple of years, think about going the MSN/NP route. You will be a better provider, it gives more credence to the profession, and ultimately the little kid with the OM will thank you for your skills. I know a rant, but it makes me nuts to think that being an NP is anything less than the greatest honor innursing you can become.

PAC-DO you said: "How can an NP practice without knowing some of the more detailed pathophysiology taugth in medical schools? I am at least willing to admit that NP's probably get decent pharm and clin med courses compared to medical school, but without the detailed histo, path, embryo, immuno, how can one really feel confident that they know enough to practice alone? " A couple of responses come to mind. First, how on earth do you get into a car, turn the key and drive, safely, without knowing the detailed intricacies of the workings of an automobile??? With that said, do you really believe that all MD's and PA's understand all the intricacies in all of medicine before they go and practice? Do they remember them today? I've been in nursing for 20yrs, 10 as an NP, 6 years in Emergency medicine. Now in family care. The vast majority of medicine is routine wellcare with the minor acute's thrown in. That's the majority. Now every now and then, there is a case that doesn't go the way I'm expecting, and after further investigatin, it becomes clear that the requirements for evaluation exceed my knowledge base, then I refer to a specialist. I've worked side by side with MD's for all those years, and know a handfull that were so full of themselves, they thought they knew what you're describing as a knowledge base. They were dangerous people. They wouldn't ask, they knew it. Make a mistake? Sure they did, often, waste money in tests? Yup. I've asked questions, been given very detailed answers, went home and researched the info on my own, and the MD wasn't even close!!!! MD hostility, I personally find it rare, it's worse on the political side, and it's worse because it's about money and power. NP's are approaching practice issues as continuity of care, meeting needs of outlying communities. MD's are looking at the loss of revenue's, in areas they won't work, and how to keep control of health care. I'm the first to admit the medical model provides a gold standard of medical information volume. I do not agree that they are the only ones able to meet the needs of health care in a safe, economical, caring manner. Medicine ran the roost for decades, maybe even longer, they created a situation based on "keep the outsiders unknowing". Now that others are learning that health care isn't a mystery, the Medical profession realizes the jig is up and working like a mad man to get the horse back into the stable. It's too late, the horse is out, now it's time to sit together and create a health care system where care, skill, economics and the patient come first. There is money, enough for all to live comfortably. S