mursedylan

Hello all! I am planning to take AANP in about a month. I have gone through Hollier's APEA, and some select chapters of Fitzgerald's question book for my weaker areas. I proceeded to buy the APEA 150-question predictor two-pack of exams. Exam 1, I scored a 77 (the exam shows 70 or greater to be "high likelihood of passing cert. exam). I am now doing a lightning round of the Leik book cover-to-cover for a couple weeks, then I will take my second APEA exam, as well as the AANP 75 question practice exam. I know there is no such thing as 'over-kill' because every little pearl I learn is just more that contributes to my clinical practice when I start my job, but I also don't want to study myself silly and overload. How accurate is the concept of scoring greater than 70 on APEA correlating to passing AANP cert? I do tend to have none-to-mild test anxiety and have always been a good test-taker in terms of having a clear head. Anyone do very well on APEA predictor and fail the certification?

To SHGR: This sounds very similar to the practice of the physician I met with that is opening up his own direct primary care practice. Just him, no MA, no receptionist, no nurse, and like the one you described, the patients get his cell number with complete 24/7 access. Yes, it sounds crazy to sell yourself over to your patients, but this provider told me that he is confident that the professional boundaries will be maintained and the patients will respect the practice and not abuse it. He said he drafts a contract for him and the client to sign which states that if the client abuses the practice unnecessarily, he has the right to discharge the client from his services with a 30 day (i think) notice. Also, this guy is a DO. So yes! This practice is very DO friendly. This particular physician finished a residency in a class of 8 I believe, in which there was a pretty even mix of MD and DO. Thanks!

To juan de la cruz : Interesting! Sounds like a higher-end practice in terms of luxury! I value the provider-patient encounter as well and the time that this model may allow for more thorough and quality care. I also think that is neat to have an acupuncturist and dietitian on site. When I envision the possibility of opening a direct primary care practice, I think less along the lines of luxury and more along the lines of affordability, ease of access, and quality of care and provider-patient relationship. Thanks for your reply!

To FutureeastcoastNP: Thanks for your reply! This was along the lines of how I was thinking. My personal opinion (and everyone is entitled to their own opinions and I will not condemn or belittle anyone else for having their own opinions as well) is that our government is very inefficient economically and practically at "providing" health care to those who cannot afford it. This is why I am interested in this model, but I understand that there may be some details that are difficult to work out when drawing up a business model to accommodate for those who cannot normally afford health care, but may be able to afford it with a direct PCP model such as this. Not only do I think our government doesn't do a good job with this, but the recipients of this "affordable care" often do not know how to appropriately utilize their access to health care. With this model, hopefully there is a platform to motivate, encourage, and educate the lower-income health care consumers so that they utilize the system correctly (stay out of the ER for non-emergencies, get the recommended health screenings, etc.) and begin to take pride in their own health and well-being. The majority of providers do not have time to listen to and adequately teach their patients, and it is often (but not necessarily always) very difficult to get a PCP appointment withing a reasonable amount of time, which this model also can accommodate for with same-day visits or even house calls if need be. The under-privilaged, low-income, low health literacy population are humans just like everyone on this forum, and NPs working in this model might be able to help the big picture of health care in this way. Just my thoughts and opinions- I'm quick to admit to being wrong on political issues, and I'm always open to discussion! Thanks! :)

To Pilot2RN: Good luck with your endeavors! I am interested in this model as well, but like you, I also hope to gain some experience and networking for a few years as an FNP before establishing a direct primary care practice, or even considering it. Keep in touch with me for anything you hear or see regarding NPs practicing this way, and I'll be sure to do the same. How long until you are done with FNP program, and what school are you at? Thanks for your reply!

Good luck with your endeavors! I am interested in this model as well, but like you, I also hope to gain some experience and networking for a few years as an FNP before establishing a direct primary care practice, or even considering it. Keep in touch with me for anything you hear or see regarding NPs practicing this way, and I'll be sure to do the same. How long until you are done with FNP program, and what school are you at? Thanks for your reply!

I recently spoke with a few family medicine residents who when finished with residency are starting "direct primary care practices." This is where patients pay a monthly 'membership-like' fee for a broad range of primary care services including physicals, minor procedures, office visits, house calls, and access to your physician via phone, text, and e-mail- sometimes even advertised as 24/7 access. Also, these physicians work out deals to get medications at-cost (no markup... example: bottle of 30 lisinopril for $0.25), and lab tests for steep discounts (such as a CBC for $5). They cap off their practice at between 500-600 patient members, and they enumerate the details of services in a contract between the patient and physician. This works well with insurance plans that are dropping primary care services (which results in them cutting premiums by as much as 50% I have heard). My question to any nurse practitioners or other readers is whether or not you have heard of nurse practitioners operating with the same or similar practice, with or without a collaborating physician (depending on which state). Anyone who does operate this way? Any thoughts and discussion about this direct primary care model?

I am graduating from a BSN program in 3 weeks. I have no RN experience, but I do have 5 years of CNA experience in med-surg and ICU. I was accepted to a BSN to DNP-FNP program to begin fall, 2014. I have also heard mixed opinions on whether or not this is a good idea in terms of not having experience, but I feel that as an FNP student interested in providing primary care, the sum of my CNA experience, undergrad nursing experience, and concurrent part-time employment in a med-surg unit as an RN for 2-3 years while in DNP school would be enough. I do plan on being very dedicated to hard work and open to coaching and mentorship during and after DNP-FNP school. I have also been highly supported and encouraged to do this right fresh out of the BSN program by some of my undergrad professors who have also gotten Master's FNP education because if I wait at all, it "will be hard to get back into education mode." Am I delusional, or is it possible that this is going to be just fine? I am planning on doing DNP-FNP part time for 5 years (as the program is laid out for par-time students), but I have considered upping it to full time or nearly full time in order to finish between 3-4 years. Thoughts or advice? OP, how is it going for you?

Got accepted for DNP-FNP program beginning in fall of '14! :)

To answer your question, whether or not you are able to apply to a DNP program before graduating all depends on the program you are applying to. So, yes you can, but only to the programs that allow that. You will find that programs will do one of two things: 1) allow direct admission in which you may apply before graduating from your BSN, or 2) they require 1-2 years of experience as an RN, which means you would not be able to apply before graduating from a BSN program, unless you had already gained the experience as a associates degree. Some DNP programs are built to be a completion after an MSN. There is a very wide variety of type of these programs with different focus areas and such. Before I began the application process, I emailed a list of questions to a number of schools in Wisconsin. One of my questions was whether or not direct admit student from a BSN program would actually have a shot at admission. The response from each school was that their DNP cohorts was a good mix of fresh BSN graduates and experienced nurses. Another piece of feedback I got from numerous people is that if you would like to function as an acute care nurse practitioner (in-hospital), you will certainly wish you had hospital experience as an RN, and success is difficult if you do not. However, FNPs in clinics is a different story- so I am told. You still need to have very sharp assessment skills that can be gained from a year of hospital experience, but you are playing a different game than an acute care NP. My advice: -Identify exactly what you want to do as an NP, and read/talk to people about whether you should wait a year or so before attempting DNP school. -Focus very heavily on assessment skills, pathophys, and pharmacology while you complete your BSN: ask questions, and always figure out the "why?" behind everything. -Research the admission requirements for a few schools that you would consider applying to for DNP. -Email their admissions office a list of any questions you may have. -Seek mentorship from current professors or nurse practitioners you know. I did all of those things and it definitely was very valuable. I am still waiting to hear back from the school I applied to. They interviewed 100 and admit about 25, and I should hear about in about 2 more weeks. I'm trying to not get my hopes up, but I did give it my best shot. I hope this helps!

Painful indeed!! I'm also getting married in June, and my finacee likes the idea of me keeping a neat beard for the wedding. I say its great to keep it as a permanent fixture, but just tighten it up for occasions that call for it.

Greetings! I am finishing my BSN this May and am also applying/interviewing for jobs and graduate school. I have already done a couple interviews, and I have left by beard on. Originally, my beard was about 5-6 inches long, but I trimmed it up to about 3 inches, made the edges blunt and nice, and cut down any stragglers there were. I feel it brings out my character, adds a look of confidence (if it is a good beard that it 'edged up nicely' even if its long), and for me, it adds 5 years to my age appearance (I'm only 22, but I've had patients guess that I'm as old as 32). I havent been clean shaven in years, but any time in the past that I brought it down to a shadow, I was told I look much much younger. I met with a few of my professors to prepare for my grad school interview and they supported me keeping the beard but 'shaping it up.' I will try to remember to post the results of my interviews when I hear back in April. Beards are important. Its who you are. Don't work your beard around your life. Work your life around your beard. The number of men in nursing is growing rapidly, and the beards can add an image of gentle wise strength- so keep rocking it!

I have recently applied and interviewed to a DNP program at University of Wisconsin- Oshkosh. I am graduating from a BSN program this upcoming May. I have asked a lot of people, including the school I am applying to, about the decision to go directly into a DNP program from a BSN program with no RN experience- I understand many people will tell me not to do this, but there is also a handful that tell me that it is a good idea to go straight into it as well. I weighed the choices, and decided I wanted to try to go part-time and hit it hard while working part time and gleaning as much clinical knowledge, wisdom, and mentorship that I can while in the DNP program. I interviewed already, and I feel confident with how it went, however there were about 100 interviewees, and they only accept 25 students. I should hear back in mid-April. I do really want to get in, so I am asking for advice: -Does anyone know about UW-Oshkosh and what type of applicants they accept? -Now that the interview is over, is there anything else I can do such as write a letter of intent? -Any advice for a student going straight through (I would be part time DNP student for 5 years)?