nomadcrna

I love this answer.

Your IMAGINATION is not the same as reality. Just because you "imagine" students graduating today can't place a spinal, epidural or central line does not make it true. But you stay in your little bubble and keep putting out information from your "imagination". smh

You may want to read my post again. Nowhere did I even remotely say that students are competent after meeting the "minimum standards". Do you have to make things up? You call this an adult conversation?

They are separate now. NBCRNA has hindered and hurt our profession.

You can't graduate unless you have the minimum spinals, epidurals and central lines. You are way wrong assuming physician education is somehow better, it's not. In any case, I'm done with you. Hopefully readers will see through your blather.

Your comments are telling. You "HAD to work alone out of school"? You were graduated without knowing how to do central lines and spinals? Seriously? A spinal is such a basic part of our practice that I fail to see how your program to fail you so hard. I assume you also did not do PNBs as well. Your retort is pretty much word salad. It makes little sense. My "ego" has nothing to do with my post. My anesthesia care is absolutely no different than an MD anesthesiologist. My ER care of patients is no different than an FP physician. In fact, I find it much better due to also being a Nurse Anesthesiologist (CRNA).

Agreed. No reason for PAs to not have independent practice as well. We need to get over the NP vs PA crap. There is no functional difference. I've found the FP physicians, NPs and PAs are pretty much interchangeable for the most part. It's not the initials but the person.

I have no words. We a truly our own worst enemy. You realize that the AANA has also come out with a statement about how derogatory the term mid level is? I'm sorry your program was subpar but mine and many others were not. I'm sorry you felt you practiced beneath or less than physicians. I and many others practice at the same level and are judged at the same level. I'm sorry your care was "mid level" and less than our physician counterparts. I'm sorry you feel RNs are low level. I feel they are part of the team and bring knowledge and perspective that may differer from mine.

In 1965, one of these leaders, Loretta Ford, partnered with a physician, Henry Silver, to create the very first training program for Nurse Practitioners. Their program, offered at the University of Colorado, focused on family health, disease prevention, and the promotion of health. If you include CRNAs then it was 1909. ?

You are right. My bad.

All the NP organizations came out literally YEARS ago against the term "midlevel"? I push back every time I hear it. I don't agree that PAs are mid levels either. They do function independently, they just need xx number of chart reviews.

You may want to read my post again. Are you trying to put words in my mouth? Did anywhere in my post I even remotely say that ACNP can be in the ED? 1. ACNP can't cover ED SOLO 2. ACNP can't take the ENP board certification exam. Any other comments?

That map is not entirely accurate. Take Texas for instance, very restrictive. You need a physician to "delegate" providing anesthesia before you can do it. Have fun getting prescriptive authority. Same with MS, AL and GA. So while you may not need to be "supervised", it's not independent practice/full practice.

Nice insult. This is where the problem lays. Calling us "midlevel".

There are quite a few EM residency programs or even ENP programs for FNPs. You will be eligible to take the ENP boards.

You cannot cover ED solo as I do (FNP/ENP) because you can't see kids. You also can't become board certified in emergency medicine. Only FNPs can do this. Juan, You can't take the ENP boards unless you are an FNP

Yet you have no clue about the education. ALL NP programs have clinical requirements. There are NO all online schools. In the real world, initials mean nothing. FP physicians, NPs and PAs. All interchangeable. Good and bad in all of them.

Competition is good. Keep all the bodies. Just look at the huge amount of strife in the CRNA world. CRNAs only have one body and it's not good.

Which part of the country makes a big difference. I do 24 hour solo rural ED shifts. I get $75/hr I also cover the inpatients/swing patients when I'm on.

You do realize that NPs have a choice with credentialing bodies? Competition is good.

BTW, not all PCP clinics get stable walk in. Many rural clinics get fractures, I&Ds, wounds etc. Don't project your small part of the world to FNPs all over.

You treat patients based on "guidelines and protocols"? We are professionals and should be treating patients based on current evidence. You are a provider not a technician.

FNPs can work inpatient. In fact, many rural ERs are solo FNP. No physician etc. There is even a board certification for FNPs that grants the ENP (Emergency Nurse practitioner). Some states and many educators are confused about the consensus model. It is slowly changing but if you are interested, read up on the AAENP and ENP websites. The board certifications are through ANCC and AANP-CP

Sam, You get get education and training above your basic education as long has it's in the population/role. So FNPs in the ER are fine. Many rural ERs are staff by solo FNPs. NOTE: Many states don't need a collaborating physician. Here in Montana we are totally independent. There are even board certifications for FNPs to become ENPs. Look at ANCC and AANP-CP or AAENP. The same with first assisting. Done by NPs all over especially in rural areas. Remember, just because your hospital/state does it one way does not mean all states do it that way.

FNPs admit and manage patients all over rural america. If you remember, there is a Emergency Nurse Practitioner board certification through both ANCC and AANP (AAENP). FNPs are the only ones allowed to take the AANP version. Many rural ERs are staffed solo by FNPs who admit and manage as well. Much depends on your state laws, of course. Thankfully, hopefully, we are moving away from set roles. I think it's ridiculous that a ACNP is not allowed to do peds or some states want to keep FNPs in the clinic. This type of thinking only hurts the profession.