toasterboy85

I have worked 2 years on CV/neuro team in OR as RN while going to school for my masters. After those 2 years I transferred to another hospital and worked surgical ICU at the trauma hospital full time for 2 years until I finished my masters and sat for boards. I am a board certified FNP and work with a neurosurgeon as his RNFA as well. There are certain skills that are lost while working in the OR but many new and unique skills you pick up. I would recommend looking in to transferring to an icu environment. Might talk with some of the surgeons you enjoy being around, they might be looking for an extender in the near future.

I work as a FNP-BC for a neurosurgeon. I am close to competing my RNFA so that I will be able to bill for intra-operative time. I work in Texas. My wife, who is also a nurse practitioner, practices with pediatrics and adults in a rural clinic. We have been nps for about 1.5 years. Good luck.

When I started working at a neurosurgery private practice, I was employed at 65k (as an RN, my board certification was pending testing). Within a year I am up to 80k base. I also get a monthly commission of 10% of my total collections. It is all about negotiations, I have an excellent benefit package w,paid health, 401k, ect. Also take into effect that you may not have a lot of experience in your specific field. Best advice I have, negotiate, negotiate, negotiate. Also, look at the financials of the practice. I am able to know what my charges, collections, and accounts receivable are. Throughout all my clinical NONE of my preceptorship were able to obtain this information. It is much easier to ask for a raise when you bring 400k to the practice each year. Be humble, know you are early in your career. Good luck.

I took ANCC fnp exam last October and passed first time. I studies Leik Review, Fitzgerald Review, APEA Review. As far as labs go, I don't remember seeing any, but for the most part thru your schooling you should be confident with labs. Know anemia and what CBC diff. is associated w each. As far as theory goes, I had a few, mostly what type of research/theory the question is asking. The vast majority of the questions you can narrow down to 2 possible answers. Search the all nurses.com website, there is a TON of excellent information and recommendations. The physician I work with gave me this advice "Study... and test, leave emotion out of it, you have studied for the past years, performed procedures, patient encounters, research projects, and presentations. Study... And test; you will do great. " Hope this helps, keep us posted!

The length of course is not the only factor. Remember quality of the program. There have been some recent programs that have come out whom in the professional world are not well respected and/or have a low certification pass rate (ANCC/AANP). My program took 3 year, I competed it as a part time student since I was a new RN. I worked full time nights until my last semester and had to step down to part time secondary to clinical. It is important to get a good education and foundation to build upon. Study hard and good luck.

I work at a neurosurgery practice as a nurse practitioner. We commonly prescribe norco for pain management (mostly post surgery). Recently we have gotten quite a number of patients who are abusing their norco. I have discussed with them the narcotic contract and strict control of medications like this. In addition I also prescribe robaxin, flexeril, tramadol, neurontin, and NSAIDS. although this combination is not for everyone, I am not simply prescribing norco by itself. We commonly send people to main management for additional and management of more powerful narcotics, ect. My main question though is how many APRNs are tired of patients calling one or two days early for refills, going out of town, continued pain, or whatever excuse to refill early (which I do not do). I want to help people, I hate patients whom hurt, but there comes a point that we have to look at the situation as a whole. Just looking for advice and a rant as well I guess. I work in Texas where I am able to prescribe up to class 3. Although my physician can write for class 2, we very very rarely do this (thus the pain management referral).

Good to see that there is some good interest with Texas Tech! My wife and I have both graduated in 2012 with our FNP. If anyone needs help feel free to ask.

I am a newly graduate (tested 10/2013) as a FNP-BC. I work in a busy neurosurgery practice in Texas. I have had not problems with obtaining hospital, insurance, or contract concerns because of my credentials. I have OR as well as SICU/Trauma experience. I am certified neuroscience registered nurse. If you specialize I think it is best to join an organization that supports that speciality and go to their conference. Since we have no formal training in specialities a lot of education is after graduation experience. My recommendation is start a log and have your physician sign it. Keep it updated with task, diagnostic studies, new/infrequent medical diagnosis. This can help with additional hospital privileges if needed. Hope this helps.

I know it is "looked down" to prescribe for friends or family. If you MUST, I would write up a HPI, PE, ect and have the patient sign it as well with included therapy options. This would somewhat legally protect you. Although the best scenario would be to not prescribe anything. As far as out of speciality, depends on your BON, to my knowledge as long as you have EBP rational behind your clinical decision you should be good. However do not turn your patients into lab rats. Remember... Do no harm.

I would encourage you to try the ANCC. Try not to let emotion get in your way. Study and test... That is all you can do. That was the phrase my physician told me prior to examination. I took APEA, Fitzgerald, and studied Leik. Look at the questions as a single piece of information. I continually want to add more into the questions than is provided. I think elderly may include COPD, anemia, depression, PVD, CHF, ect. You MUST not included these non-included criteria. Also know your basic nursing theory 101 vocabulary. AANP from my research is more clinical based while ANCC is more theory based. My wife and I tested thru ANCC last September and passed. I hope this helps.

Moody JB. Congratulations. I am glad that you passed it is such a relief to know that you are now a board certified family nurse practitioner. What are your plans from here?

We passed. Hope you do we'll. sounds like you have prepared well. Good luck. (ANCC orAANP?)

I am a FNP who works with a neurosurgeon. We are on call this weekend and I have spent multiple hours in the ICUs. This does not seem to be a problem at any hospitals so far. I have has precious icu experience as an RN and I am also a CNRN. I do not insert central lines, arterial line, or intubate. I am working in gaining privileges to insert icp monitors. This is established by documentation, research, and direct observation. In our Nurse Practice Act, buy providing this information AND being observed once a year by physician, nurse practitioners can increase their skill set legally.

I too am a FNP whom works in office, rounding on hospital patients and currently obtaining my RNFA. Sounds like you have an awesome job. Don't become greedy. Understand that you will build into the future. I did take a lower salary for my initial contract. However, the accounting company that we (MD and I) use have made a template for myself separate from the doctor. This will include any consultant work, follow up, office visits, and initially assisting fees (after obtaining my RNFA). I have a base salary, we are soon to have a meeting in which I will negotiate for a percentage of my overall percentage. It is such and advantage that I am able to see ALL charges and collections. I recommend you do the same. As time goes on, it will be easier to say (for example) "my collections for 2014 were 180K, my assets to the business are substantial. I think _______ is what I should make" Good luck!

Finally after 7 months I have received all my numbers, insurance contracts, and hospital privileges. Our practice has an excellent billing practice that thankfully was there for all the dealing, I only needed to sign about 400 pages of "stuff." Good luck.