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What state do you live in?! It sounds like they came down really hard on you. And I will NEVER practice in a state where a board puts so much action behind somthing that wasn't involved in a sentinal event. And I'm a little confused are you working under a re-instated license while the BON does it's investigtaion, and they've found enough harm done or concern of harm done so aggregious that you have been allowed to work 3 years and now post haste you have two options of revocation or surrender?! I definitely agree with others. Contact an attorney, do not surrender your license, and contact an attorney.

So you're in Florida. I was thinking of moving from Washington which is fully autonomous to Florida. Previously I lived in NM also a FPA state. So, I've never worked in a state which required any kind of oversight or colaborative aggreement. So, it makes me a little nervous to move to a highly restritive state. I'm trying to gain some insight from those that live there that might be able to help me by answering some questions, and sharing some info. Part of my motivation is the sun, and a swimmable ocean. Lcation, location, location. I would be moving to the St Pete area, or Tampa area. My brohter and mother live there, so I have family there. Yes, it seems pay here is higher, but not 300% higher and the cost of living between NM and WA is about 300% greater. So, although I'm making well into six figures, it all disapears cost of living. But I've heard jobs are hard to come by in FL. Is this just a new grad issue? I am not a new grad and my previous practice has been FP, UC, and aesthetics primarily. I'm applying for license now, prior to applying to any jobs because it seems nobody wants to talk to you without a florida license already. So, I guess my questions are how do you find working in a state where you have to have a supervising physician? Is it really that hard to find a job? Is there any other info or tips that might make this decision easier, or bring some clarity to mind?

Are you in Washington? Just a guess by your name and the picture of the Orca. I work in Seatte, live in Bothell. And I have NEVER encoutered cost of living as high as it is here!

Thank you. That information is helpful and makes a lot of sense. What I was hearing was from exactly what you said a new grad, who was living in the Miami area. He may have issues due to that. Like I said, I've submitted my application, I have noticed unlike other states, without a Florida license already in hand nobody is quick to call me back, except for pain centers since ARNP's were just given DEA numbers this year. Not my cup of tea however.

Retirement.

Hi, I'm looking for a little advice, experience, thoughts, networking, what not.... I am a seasoned family nurse practitioner and have practiced in two states, both were completely autnomous states for ARNP's. So, no collaboration agreement, or overseeing MD required. If I was inclined to do so I could open my own practice, which isn't totally out of my thoughts (just a scary thought most days). Anyway, I have recently thought about moving to Florida. I always said I would NEVER practice in a state where NP's were not atonomous, never say never I guess. Now, i'm considering moving to one of the more restricted states as I understand it. Also one of the most poorly paid states. Again, I'm hearing this from some pretty biased people. I currently practice in Seattle where yes, I make well into 6 figures, the cost of living here is so high 6 figures barely pays rent in a crappy appartment. It's like living in NYC and only getting worse. My brother lives in St Peterburg and my mother also recently moved there. I visited last summer and LOVED, LOVED, LOVED Florida, and this was in the summer! Returning to seatlle has been tough. I still have dreams of sunshine and florida and the gulf. Maybe I could put my damn ego on the backburner and move to florida. But people have cautioned me. What I have been told is that the pay is awful, jobs are hard to come by, and the pay is awful, even considering how much lower cost of living is. My specialty has been family practice, urgent care, and asethetics primarily. I'd love to hear/read any thoughts Florida ARNP's can share with me. I have two kids, they also loved Florida, however to move again, I hate to do unless I'm really, really certain. I have just applied for my Florida state license and once that comes through I thought I'd test the waters and see about applying for jobs. But I'd like to know what it's really like to work in state where you are not autonomous. Are jobs really that hard to find? What about schools, kids, family life? Work/Family life ratio. Right now it's terrible, I'm still having to work three jobs to keep us aloat. Thanks so much!! Sarah

Hi, I'm looking for a little advice, experience, thoughts, networking, what not.... I am a seasoned family nurse practitioner and have practiced in two states, both were completely autnomous states for ARNP's. So, no collaboration agreement, or overseeing MD required. If I was inclined to do so I could open my own practice, which isn't totally out of my thoughts (just a scary thought most days). Anyway, I have recently thought about moving to Florida. I always said I would NEVER practice in a state where NP's were not atonomous, never say never I guess. Now, i'm considering moving to one of the more restricted states as I understand it. Also one of the most poorly paid states. Again, I'm hearing this from some pretty biased people. I currently practice in Seattle where yes, I make well into 6 figures, the cost of living here is so high 6 figures barely pays rent in a crappy appartment. It's like living in NYC and only getting worse. My brother lives in St Peterburg and my mother also recently moved there. I visited last summer and LOVED, LOVED, LOVED Florida, and this was in the summer! Returning to seatlle has been tough. I still have dreams of sunshine and florida and the gulf. Maybe I could put my damn ego on the backburner and move to florida. But people have cautioned me. What I have been told is that the pay is awful, jobs are hard to come by, and the pay is awful, even considering how much lower cost of living is. My specialty has been family practice, urgent care, and asethetics primarily. I'd love to hear/read any thoughts Florida ARNP's can share with me. I have two kids, they also loved Florida, however to move again, I hate to do unless I'm really, really certain. I have just applied for my Florida state license and once that comes through I thought I'd test the waters and see about applying for jobs. But I'd like to know what it's really like to work in state where you are not autonomous. Are jobs really that hard to find? What about schools, kids, family life? Work/Family life ratio. Right now it's terrible, I'm still having to work three jobs to keep us aloat. Thanks so much!! Sarah

What state do you live in?! That's awful since addiction is accepted by the federal government, the AMA, WHO, NIH, etc as a disability and a disease. It would be tantamount to telling a diabetic, or hyperthyroid nurse they cannot work because of their diagnosis.

I'm a FNP and in the NPDB for suspension/probation of my RN license years ago. I also have a DEA license. It hasn't been difficult to get jobs, but when you go through credentialing you have to disclose any previous disciplinary actions. Remember addiction (if that's your story) qualifies you for ADA protection against discrimination. All I ever have to do is turn over a short two paragraph synopsis of what happened, and the BON diversion program discharge letter showing successful completion. I've never been denied.

I agree with what others have said as well. I have been a SANE-A and SANE-P for the past 6 years. I'm not sure if you've completed the training course yet, but you cannot take the certification exams without completing the training course. If you log onto the IAFN website they have all the requirements listed. I would contact your local SANE programs and ask to shadow or take call with a nurse for a shift. You might want to see a couple of cases prior to jumping in. We actually require that potential candidates see at least one case before an official offer to hire is presented. Training is expensive and costly and nurses really need to understand what they're getting into. It's also a drain on SANEs who have been there for years to train new nurses only to have them leave a short time later. Our unit also requires that our nurses obtain the TNCC certification within the first year of employment. Not all of our SANEs are ER nurses but like others have said you need to know how to describe with a fair amount of confidence and authority the difference between abrasions, and lacerations or bruises and ecchymosis in front of judge and jury. After all you are qualified as an expert witness in most cases. Our unit is a freestanding unit. We are not ER based, which I like a great deal. Truthfully I wish they were all like that. We will do exams in the hospital if we need to, that is the patient is admitted, or it needs to be done in the OR. However the majority of our 40-50 cases a month we do in the office. But, that means we need to function safely and comfortably with a fair amount of autonomy. We need to know what the risks are post strangulation and what S/S to be watchful for. What to do with a patient who maybe withdrawing, overdosing, bleeding, cutting her wrists in the bathroom, or passes out during a blood draw. Do you just keep swabbing or send her out? The ER is a stressful job, but I don't think it's anymore stressful than SANE can be. There are days where you're up for more then 48 hours, you've had exam after exam and you can't remember who's tear belonged to whom, and you're praying your pager doesn't go off again because you feel like you head may explode if it dose. Attorneys that land baste you the stand, hired "expert witnesses" who are brought in to slam your testimony, despite the fact that you've already said you're objective and don't have any allegiance to either side or outcome. But at the end of the day, I do love it. It's been a great learning experience and has made me an overall stronger provider. That being said though I'm on call tonight and crossing ALL my fingers hoping I don't get paged!

If you're looking for a proof reading writing service I've used:http://www.coolitworks.comI've used it for papers, resumes, and soon my thesis. I'm getting ready to graduate from the FNP program and them I'm going to Frontier to do the CNM so I'll have both. I'm not the worst writer in the world but hate APA and editing your own papers is hard because it's in your own voice. They're not too pricey and I saw huge improvement in my grades.

Actually, and I know this is old but I teach nursing and hate to see information that's incorrect, but Protamine is used to neutralize Lovenox. Always check your sources and information. Including your sources sources if needed. It doesn't matter if they're a doctor from the US, another country, or another planet, you need to be sure because it's your practice and not theirs. Think if it this way, you're sitting in court, your patient bled to death and the attorney says you didn't know protamine sulfate was the antidote? You say, "well I thought I did but this dr. from another country online told me it wasn't". I'm sure since this post is so old you've come a long way in your practice. I still wanted to put it out there so other new nurses may benefit.SarahPer the Cleaveland clinic it's 1mg of Protamine SIVP for 1 mg of Lovenox. For treatment of overdose:Protamine (either the sulphate or hydrochloride salt) should be administered in more serious cases. The anticoagulant effect of the drug is inhibited by protamine. A slow i.v. injection of protamine will almost completely neutralize the anticoagulant activity of enoxaparin (i.e., the anti-IIa activity); however, the anti-Xa activity is only partially neutralized (maximum about 60%). The dose of protamine should be identical to the dose of enoxaparin injected, that is, 1 mg or 100 units of protamine to neutralize the anti-IIa activity generated by 1 mg enoxaparin. Particular care should be taken to avoid overdosage with protamine. The half-life of enoxaparin should be taken into account when calculating the neutralizing dose of protamine to avoid overdosage. The rate of administration of protamine should not exceed 50 mg in any 10-minute period since administration that is too rapid can cause severe hypotensive and anaphylactoid-like reactions.

The thing that's scary about that is triaging these people. Was this an elderly person? Often in the elderly we see no signs just "I don't feel well" or more commonly shortness of breath is their only symptom. Then you have to try and figure out over phone triage whether the 300 calls of SOB is cardiac. We missed one not that long ago. It was awful.

WHy are you no longer using terbutaline?

Hi all. I am in the NP program and getting ready to move as a new NP. I currently live in an independent practice state and would like to move to another state that allows NPs independent practice. I have looked for a definitive list of which states are independent, heavily regulated, moderately regulated, and minimally regulated. I found one list but it was published in 2007 and I'm wondering if there have been any changes. Does anybody have a complete list of states? Thanks, Sarah