FNP/DNP

I agree. We don't have very specific guidelines in my ED on what we need to involve the docs in, but I always try to for the same reasons that you mentioned. We are not physicians and it would not look good in a lawsuit that we were taking care of critical patients without involving our MD's.

I agree 100 % with what you are saying here about the insanity of the concerns that NP's will misrepresent themselves as physicians. I have never introduced myself as "Dr...". The only time I use my title is in the academic setting. I am often confused as a physician and I sometimes correct patients several times and spent quite a bit of time explaining what an NP is. I have absolutely no desire to be thought of as a physician and I think I can say the same for most of my colleagues. The NP's in my ED continue to have the best patient satisfaction scores in all aspects of care.

So what you are suggesting is that I, with my 5 years of independent rural health experience and 2 years of emergency department experience, should be only doing preventive visits and URIs, UTI's? You are suggesting that I am incapable of differentiating serious illness from minor complaints? Interestingly I had a 35 year old who came in for "food poisoning" with complaints of diarrhea and vomiting and some abdominal cramping and chest wall tenderness from the persistent vomiting. Although he had absolutely no cardiac risk factors, my instinct and experience told me that there was more to this story and the "chest wall" pain ended up as an acute MI. The patient was cathed in a timely fashion and all was well. I can guarantee you that had the physician on that day seen the patient he would have been discharged with no cardiac workup. The moral of my story is, I think NP's are more than capable of differentiating the serious illness from the run of the mill complaint and our talents would be wasted by what you are suggesting.

Caldje, We beat this topic to death on the PA forum, remember? I don't know why this has to be a competition. I think it's time to end this pointless discussion as no points are being made on the clinical differences of PA's or NP's. Those interested in finding that out can feel free to private message me for some information on NP's.

jeremy, i agree 100% with everything you say here. as a student it is probably disillusioning to envision 4 years of graduate school to become a nurse practitioner. once you are practicing you only wish you had learned more. i would have loved to have had a longer residency. as an aside, i work in the emergency department and the nurse practitioners always exceed the md's in patient satisfaction on press ganey scores. do the physicians like it- no. interestingly, one of them asked to shadow the np's sometime to see what we do that makes patients so satisfied! thanks for your comments. it is nice to see some support for the dnp.

I have to disagree with you. I have my DNP and have been a practicing FNP for 6 years. The full time NP's where I work make 100,000 per year. I am quite certain that my doctorate has advanced me professionally in terms of salary and aquiring NP positions. The DNP is not intended for NP's to have independent practice. That is a state legislated issue. The DNP is to recognize that Master's level programs are inadequate to prepare one to practice at a novice level once graduating from the NP program. I felt very confident when I graduated that I was competent and ready for a busy practice. The clinical doctorate brings credibility to our profession, and don't kid yourself into thinking it isn't necessary. It isn't easy being a nurse practitioner, it is a constant fight and the more credentials we have and the more competent we are, the more we will be respected by our physician colleagues.

I agree 100% with that. Unfortunately, my university requires a PhD for a full time position. I only have a DNP and I am a nurse practitioner with no desire to go back for the research doctorate. I left my position in great frustration that the students really have no one clinically up to date to teach them. I make triple the salary as a nurse practitioner than I do as an educator. Maybe someday I'll go back when practice is more appreciated at that institution, or I'll most likely go elsewhere. I really loved teaching and was very disappointed by this experience.

for me it was also about 10 years. all of the faculty were still there. it wasn't really a problem because i got my doctorate somewhere else and had a lot of different experiences from the time i went to school there.

Here in Indiana I think the going rate is 3,000 per clinical (5 hours per week). This includes going the night before to pick patients and grading papers and meeting with students. I am discouraged by the amount of work- probably better for the tenure track people,

What is it you like better about pepid. I'm just curious- I saw that they have an ED version and was considering trying it out too. The only bad thing I have found about epocrates is that it can be difficult to install for the first time.

I agree with all of the above. If you purchase the epocrates upgrade you can get labs, drugs, diseases and an antibiotic guide. I have religiously used epocrates for 3-4 years and have never been disappointed, It is well worth the money and you really can keep up with all new drugs as they come to the market.

Right foot was a little numb for two months- just decided to have it checked out that night. Same patient comes in twice a week every week for a plethora of aches and pains.

I think that is a very GOOD reason to go the the ER!

Having a business degree and some sales experience prior to nursing and many friends in pharmaceuticals, I think I can speak to this career choice. I think the field used to be very lucrative and enjoyable back in the day, but now it has become cut throat and the daily details are more boring. The product lines that reps are carrying are smaller with most companies. My rep friends speak often of the instability as one company is being bought by another. On the pro side, I think the flexibility is great, you get a company car and freedom to make your schedule (although they have to account for all of their time). My office was very nice to reps because we were an indigent clinic that relied on the samples and they treated us well. Some offices are downright rude to them. You have to have a very thick skin. Personally, I think the job would be incredibly boring. Now a friend of mine worked for J & J in their medical equipment sales and that was great. She sold joint replacement products and actually went to surgery with the orthopods. I think that would be much more interesting and challenging. There are alot of options and they LOVE nurses, pharmacists, etc. Good luck with your career choice.

I am an NP, but having spent some time on the PA forum have gotten some good education about their profession. First of all-not anyone can be a PA- those are very competitive programs to enter, harder to get into than NP programs. PA's have excellent training and many PA's work independently, with physcians cosigning charts just like we do. This debate is senseless. We have more similarities than differences.