Mijourney

Lifelong learning is important to keep you motivated and stimulated. Congratulations on your achievements thus far! I think you are doing plenty to impact a community. Whether it is one person at a time or a group of people, what you are doing is making a difference in somebody's life. My belief tells me that when God makes His final judgment on you, it won't be on the quantity, it will be on quality. However, if you are feeling a pull towards a population of people, I say work it out with your family and see what happens. Best wishes.

I too was informed that the reason for the discontinuance of the APHN-BC credential was due to low numbers of applications. I wonder, however, if that will change in the future as population health is growing in popularity. At some point, the public health specialty may change over to population health.

I personally would stick with UF. I do not believe American Sentinel and UF are in the same league. American Sentinel is not accredited by gold standard regional authorities as UF is. American Sentinel has only been around since 2006 having been originally a conglomeration of three separate entities. Check out their websites and review their histories including the accreditations. Just my opinion.

I understand the need to admit fully qualified people to a program. You want nurses that will do well in studies and pass any applicable certification tests the first time around. But, if your BSN is over ten years old, I don't think a program should hold a low GPA against you especially if you have remained in nursing and have grown in your practice. This is evidenced by supportive managers, supervisors, and directors as well as the ability to obtain certifications.

The problem with a single payer program in real time is that it will still emphasize sick care. In the U.S., our coding system for diagnoses and procedures is all about sick care. I envision a single payer program as being focused on prevention, promotion, and primary care with the continuation of third party auditors to maintain vigilance on fraud, waste, and abuse practices. I envision increasing use of telephonic patient encounters and telehealth in a single payer system. I envision more meaningful partnerships between practitioners, clinicians, patients and their families to establish health education practices that would place more of the onus of health status on the patient and caregiver. Hopefully, emphasis on prevention, promotion, and primary care will hold the line on substantial increases in our taxes or outgo under a single payer system. Right now, with emphasis on sickness care and extreme profit and consumers low level of health literacy and indifference toward their health status, healthcare is out of control. If single payer is done right, it may work. However, I wonder if we just should not have a hybrid system whereby prevention, promotion, and primary care is sponsored by a single payer entity and the catastrophic is paid for by a combination of the patient and other entities. I feel that in the case of most chronic diseases and certain injuries, the patient should be on the hook when the condition perhaps could have been avoided. For instance, if my primary care provider advised me to avoid engaging in high risk activities such as overeating, eating unhealthy foods, avoiding exercise, or driving dangerously then there should be some liability on my part particularly if I demonstrate high risk activity under the primary care provider's watch for some time and it's documented in my record.

Avid, you make great points. But believe it or not, my concern is not just with who is in the white house (he is just a microcosym of society), it is with the people within this country that seemingly vote their emotions and jaded values. Because what is right is confused with "our" rights due to relativity, we are once again in a win or lose situation with healthcare. I feel that nurses, who make up the bulk of healthcare workers, have an opportunity to really impact things for the better not only by how we care for our constituents, but by how we conduct ourselves personally and what we stand for. Alas, there are a good number of nurses who have no true regard, no love for people. This is evidenced in a number of ways including how we as nurses relate to one anther on the job. Additionally, how we as U.S. citizens truly feel for one another has been manifested in a number of ways and has been witnessed or dramatized through the 24-hour media.

So, if noted authorities in our great U.S.A. says that we were "founded" on Judeo-Christian principles, where did this mentality go when it came to executing healthcare? Was it ever there? Both the ACA and ACHA are based on extreme thought processes, IMHO. True prinicples of the Bible could have been ideally used to settle the score but alas, everything has become relative including morality and ethics.

So Avid, just to put things in a perspective, do you see health care as a priviledge, right, or necessity? I get a bit flustered when someone talks about their rights because that is different then being right, IMHO. Also, are we our "brothers" keeper or should healthcare be an each person for him/herself? The point is, should the healthcare "system" be designed in the extreme or can middle ground be found?

There are reportedly reputable sources that offer some information on health spending and health status. The World Health Organization (WHO) is one entity. Below is a link to another entity. U.S. Health Care from a Global Perspective - The Commonwealth Fund Spending on US Health Care, 1996-213 | Health Care Economics, Insurance, Payment | JAMA | The JAMA Network

Oh and if anyone responds to my topic, please consider the ACHA that was announced today, which is supposed to be the answer to the ACA. The media accounts I reviewed, did not indicate where nurses and APRNs stood on the subject. We need to make our voices heard.

Capitalism seemingly started off as a good ideal but has gone awry in the U.S. according to my readings. Capitalism has impacted healthcare for a long time. Now greed, or extreme capitalism, seems to be the prevailing force. Health and medical care is now an industry and not a ministry. Should we nurses accept the direction of the industry which is in crisis mode and may crash our economy or should we become proactive workers toward seeing healthcare turn back into a ministry of sorts. What is nursing's responsibility in truly improving access and the provision of healthcare and preventing healthcare from completely crashing from the weight of greed? How has nursing been part of the problem? What are steps that we can take to turn the ship around and be the solution? Keep in mind that research indicates the U.S. forks out the most amount of money for health and medical care but yet our country's health status does not reflect this.

OK, I have been on my computer for several hours now, sitting. That is a health risk in and of itself. Should I be punished by paying to be in a high risk insurance pool because my chronic disease(s) and risk factors are exacerbated from long sit times at work and at home? At work, I am expected to be efficient and productive (I work in a non-traditional health setting). I only get short periods of time for breaks and lunch. I also have genes that add insult to my injury. When there are only so many hours in the day to get tasks (such as reading) done along with the risk factors and chronic diseases, what is a person supposed to do? I do not consider myself as liberal in certain aspects of life, but I do believe that a person needs ready access to quality health services and meaningful education. For those of us who are gifted with the responsibility to serve as proficient health care providers for example, how do we to successfully carry out our purpose in life if we don't have the access to health care and education? I've been witnessing healthcare coming apart at the seams. It's not clear to me that any political party can save it.

It is true that nursing care should be directed holistically, but in this case there are actual graduate nursing programs that specialize in holistic nursing and that is what I was inquiring about. In fact, I have visited several practicing nurse practictioners over the years and they did not address my concerns in a holistic fashion. They more or less addressed me as a physician would, focusing on the specific reason for the visit with questioning not going beyond that. Specified holistic nurse practitioner programs are designed where one can study complementary or alternative methods of treatment and care while incorporating the traditional. This is the type of program I am looking into as far as expanding my knowledge and skills. I am most interested in getting a response regarding whether becoming a holistic nurse practitioner is worth the time, effort, and money.

Hi All, I have been an RN for a long time. I am ready to move from disease(d) or sickness care to prevention and wellness. I find that holistic nursing is an area of interest for me. Can anyone tell me the benefits of becoming a holistic nurse practitioner as opposed to pursuing holistic nursing at the undergraduate level? I presume that becoming a nurse practitioner will entail a whole different way of thinking, more investment in malpractice insurance, more time studying the trade journals, more time networking, and just basically more everything. Am I off base?

Thanks to all of you who provide direct care. You're awesome!

I agree with Esme12. More and more employers are requiring certified employees to show the accreditation agencies as well as the public that they meet quality standards and that a high level of service can be expected. Certification with experience typically will give you an edge over others who did not pursue that route.

You make a good point SummitRN about the training for physicians and the training for nurses. As the scope of nursing practice expands, nurse residencies make good sense. Patient care has become too complex for nurses to simply graduate from a nursing program and be thrown completely to the wolves.

Couldn't agree more.

In my nursing career, I have been through trials and tribulations as no doubt many of us have. I do think that attitude plays a huge part in how we approach our jobs and how we respond to the environment. Our maturity level is equally impactful. I am grateful for having a job, but at the same time I don't believe for one minute I should roll over and play dead when the rolling gets tough.

PMFB-RN, I think that it does not settle well for you to imply that four year nurses are mostly nerdy with limited life experiences. I think what is important is whether the nursing profession is producing well-qualified people for the task at hand which is providing great quality care and services. Patients and their families want the best bang for their buck. They want highly competent, skilled and knowledgeable caregivers who can lead them to optimal health in a caring, compassionate, and cost effective manner. An across the board well-established nurse residency program, in my mind, can lend itself to meet that end whether it be through a two, three, four year or graduate level program. The longevity and effectiveness of these programs are being decided by nurse researchers as we write.

What I was disappointed by was that there were no nurses, that I saw, presented as experts on health care. We still stand clearly in the shadow of physicians. I think it would have been interesting to hear from the largest group of health care providers, I believe, in the world on what's wrong with the health care industry and possible solutions.

Yes, PMFB-RN, you are correct on certain levels. But, more and more jobs are being automated and outsourced as we write and those jobs will never come back. Currently, we are faced with the health and medical industry being the predominant industry in terms of jobs. I'm not sure that will change anytime soon in light of the fact the boomer population has not reached its peak. I also believe that as long as we have two year nursing programs that we will always have people who will be looking for the fastest way to decent wages.

PMFB-RN, your points are well taken. I think a growing number of nurses are opting for graduate education, especially nurse practitioner, because these nurses have more autonomy and potential for better pay. Someone correct me if I'm wrong but I believe NP services are billed like a physician's whereas we garden variety nurses are part of room and board. If the scope of their practice changes to allow them to admit patients and write certifications for areas like home health, then NPs impact revenue, although we regular nurses impact revenue with the care we provide. You're right, though, that the economy has a great effect on people coming into and/or staying in the profession. I'm not certain that will end once the economy has improved because nurses, particularly RNs, make pretty decent wages although that is debatable in many circles. In addition, if we do see nursing residency become more wide spread, it may increase retention in the profession. On the basis of that, the question for me is what is the turnover rate of advanced practice nurses meaning how many of them give up their board certifications?

Katie, I agree with much of what you write but the nurses are in the hole not only because of external forces such as the AMA but because we refuse to get our act together. I know of several people who switched professions because nursing felt like a disenfranchised profession to them.

Correct me if I'm wrong, but the pathway to medical education seems to be more typical then the pathway to nursing education. Basic nursing education is very diverse as opposed to basic medical education. There are nearly 3.5 million licensed nurses in the U.S and there are a diversity of schools with nursing programs. There are nearly 800,000 physicians in the U.S. Available medical schools are more standard. As was pointed out earlier, the large influx of nurses with diverse basic education may be contributory to the low interest in nurse residency programs by the powers that be. However, at the graduate level, the hours required to complete an advanced practice nurse program seems pretty consistent across the board. With undergraduate nursing, in particular, being in disarray, I can't help but wonder as some of you may be wondering whether that means that graduate level nursing will finally be established as entry level. I wonder this in light of the establishment of CNL (clinical nurse leader) programs.