penniv

Update: August 1st will my first day seeing patients in my new practice. I am opening an integrated medicine clinic. I have hired a chiropractor I know well as an independent contractor. I will be doing cognitive behavioral therapy, injections, physical rehab, PRP & stem cell therapy and more. My background is ortho so that has helped a lot. I am very anxious for this new venture to begin.

1. I think the requirement for a DNP is a long shot. As someone who will have a DNO in2 months, I personally don't feel it is necessary. For me, it was about a promise to myself to take my education as far as I could. 2. As one of the only orthopedic nurse practitioners in my area I often precept NP students. When those students finish and becoming working NPs I often get calls or text messages asking about the various ortho issues they are seeing. 3. I think comparing a NP to an MD is just ridiculous. We are too different to consider. NPs are trained in the nursing model (holistic) versus the medical model (problem-focused).

No, I am an adult NP. If you were to actually look at my licensing it says "Primary Care Adult Nurse Practitioner." I knew I never wanted primary care and since my RN background is 100% ortho that's where I have stayed.

I have been an ortho NP for 6 years. I doubt you will find literature supporting the salary. If possible, find out what the PAs are making since unfortunately they usually get higher pay. I think you'll just have to come up with a number and know that it's your bottom line.

As an ortho NP I would not settle for less than $120/year. They will likely offer you something significantly lower so be prepared to defend your rate. The surgeons are making close to, if not over one million annually!

I have been an Adult Nurse Practitioner with a specialty in ortho for 6 years. My RN background was 100% ortho as well. I have my own clinic time and have been a surgical first assist in 100's of surgeries. I absolutely love ortho! Now, with that being said, ortho is hard work. You will need to have an immediate and vast knowledge of the musculoskeletal system. Depending on your specific role, you may have a surgical requirement where you will need to get certified as a RNFA (RN First Assist) in order to bill the insurance companies. I have reduced 100's of fractures, injected thousands of joints and tendon sheaths/origins. I write Rx meds as needed and refer patients to therapy. I also interpret my own x-rays and order advanced imaging as needed. It is a great field to work in. Good luck!!

My background as a nurse practitioner is hand and shouldersurgery. Shame on any provider who did not splint what sounds like a Colles' fracture! I would inquire about an Exos wrist splint if your fracture is stable and does not need to be reduced. They are low profile and waterproof. If it the radial head is within the standard deviation of approximately 30 degrees we don't typically operate. Sometimes we will plate those that are less than 30 degrees to speed recovery time. IF you need surgery, the simple answer is that excluding unforeseen complications you should absolutely be ready to return next year. You are so close to the end. If it were me and my fracture was stable and non-surgical I would do everything in my power to stay put. Now, of course surgery complicates things so that must betaken into consideration. Ask the orthopedist about how much displacement there is and if it is within acceptable limits. I will forewarn that you do lose some range of motion regardless of surgical intervention or closed healing. Explain your situation and ask for their opinion. You should have routine x-rays to monitor the fracture progression.

Jeremy, I have spent the 5 years in Orthopaedic Surgery. Prior to that I tried my hand at the Chiro/Medical model. I found out very quickly that it was all about making the DC money and not about helping my medical patients. My DC was insisting that I perform US guided arthrocentesis at least 5x/day. When I pushed back and said there was no way that my patients needed that he insisted that it was necessary to cover my salary. I threatened to report him to CMS for fraudulent billing and that settled him down! You will not find proof about the need to see patients every 30 days because it doesn't exist. It is a billing tactic used to create income. I caution NPs to avoid getting into this type of system unless it is run by a MD and not a DC. Penni

I am getting ready to start my own House Calls practice in South Carolina. It will be a fee-for-service, so no insurance to deal with.

You need more information on his billing before you can make a decision. You also need to find out what the laws are in your state regarding billing of a RNFA. In South Carolina I am paid 85% of the eligible reimbursement rate of the first assist payment. There are states that do not allow billing for certain insurances. Find out his most common surgeries and then you can determine if they pay a first assist. From there you can determine if the finances make sense based on your malpractice insurance and you covering your own benefits and taxes. Also remember, that it sounds like you will be self-employed so no opportunity for worker's comp either.

I personally catch myself saying "statistically speaking, you're more likely to..." to my patients. In that sense I am referring to how they compare to the larger volume of patients I see with same condition.

As previously stated, I am an orthopedic NP. I split my time between clinic (90%) & OR (10%). Most of the PA's in my department split 60/40 though. Salary is very variable. I will just say that I make a base that is in the low 100k plus a productivity bonus quarterly. Hope this helps some. Penni

You'll want a VERY reliable internet. Broadband is typically preferred especially during exams. You may want to take exams somewhere you have a reliable access. I graduated from UAB in 2010 and found that my broadband was the best. Hope this helps.

I have a couple of things in mind. The first is a RNFA. This would allow you to work more advanced role in the operating room which it sounds like you want to do. The other option is to go ahead and get your NP and find a surgical group to work with. I am an orthopedic nurse practitioner and I split my time between the operating room and the clinic.

I think as preceptors we have a responsibility to our patients, peers and the public to produce the best students we can. That being said, we are dealt the hands we are dealt. I'm an Ortho NP and so it is a rare day that I get a student with Ortho experience. I do expect them to have a basic working knowledge of nursing though. I had a student a few years ago that took the fast track RN-MSN and I told her that I didn't think she was ready to practice as an advanced practitioner until she had better critical thinking skills. She understood and discussed it with her advisor. She cut back to part-time and started working part-time at a local hospital to help gain some experience. Hope this helps! Penni