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Sorry for the errata in number 2 Meant to write AI ... So while I support our increased education and growth there will be competitors. Who do I mean for instance : --Family Practitioners if they show better aggregate indices like enhanced MLE scores --Cognitive Psychologists who prescribe basic antidepressants --RPh teams, who with nine specialty board certifications, are looking to prescribe, plus proponents of CAM- functional med. I am noting that because head to head comparisons on cost and clinical utility are coming. So if any particular discipline is found lacking in outcomes with a comparator who is better, then legislation is likely to reduce the effect of that discipline. Nursing -either clinical or advanced practice will not have ability to rest on any historical significance. Rather it will be the individual professional who will need to see if they can impact better than average with less cost. It will also be harder to not be compared to larger data sets of other professionals, even if they are not in our own state. This is because groups like CMS, Medicaid, ACO's etc are there to benefit their clients, not one profession. So they have accountants and data base managers looking over comparator data within our society and from others to enhance coverage and reduce outlay. All the best

That is a great question. My husband is an MD and we have seven other MDs in the family. You may want to address this with both HR, the AANC and the AANP. There are challenges with running your own business, chiefly liability. In addition liability is different in different states. Still if you felt that you could modify that risk somewhat based on geography and job type, this may be useful. Please understand that I am sympathetic yet concerned about the following 1- Given certain lobby & research forces, we may need to work on different licensure for much of our working career. If you doubt this look at the AMA or PPP agenda or the following--- > See the paragraph about us. It is not all positive https://clearhealthcosts.com/blog/2023/08/this-doctor-says-corporate-medicine-is-a-threat-to-public-health/ 2- AI will be coming soon & will be able to evaluate local and global practice. So while our support our increased education and growth there will be competitors. Who for instance Family Practitioners if they show better MLE scores, Cognitive Psychologists who prescribe. RPh team who with nine specialty board certifications are looking to prescribe, plus proponents of functional med. To approach this with an even tempered goal, I might consider the following a- Practice many jobs--- Most talented clinical nurses can do this b- Be a life long learner c- *** Adapt to market demands. So if that means doing telemed to help rural settings or working with MUSAs or SNIFs, the whole team benefits. d- Never assume that other clinical partners won't have their PACs trying to reduce our autonomy but we can be good clinicians even when we work indirectly. e- Be happy that you contribute because the 21st century of nursing is growing worldwide as evident by the ICN conference in Scotland this year. f- Innovate in both the public and the private sector. I am proud of nursing and the work we do plus I look forward to other's insights.

In all technical fields, including NP work, I believe that they might look at our age. This may not be due to individual strength but rather HR experience with mild fluid/crystalized intelligence changes that occur with age. This is also true in engineering and highlighted by a work called " The Death March" plus cited below https://www.psychreg.org/ageism-engineering-technology/ Still there has been work on incorporating different work programs called the glass ceiling project. It is my understanding that several things help workers with limited minority voice, like those of us in the 6th decade> 1- Diversify work 2- Be ready to tackle other projects (RN and FNP) 3- Be consistent 4- Keep your project list in writing. So for instance, can you work as an educator, research associate, CDE or navigator. 5- When certain industry leaders are extremely young consider whether that work team will or will not create harmony.

I was in ancillary care, then RN, & then FNP age 49 yo. Worked in several states after decades of tertiary care, found interviews are varied and my husband is an MD. Here is what I learned from my interviews and speaking with medical administrators- CMO's off record 1- Try to keep a few skills intact. For instance CDCES ( DM educator), research coordinator- Sub Investigator, ACLS-PALS-ENPC, first Assist; & and keep abreast of top 5 EMRs. 2-You can work both as an RN and FNP. So try to keep emphasizing the 3 P's the ANCC emphasizes (Pathology, Physiology & Pharmacology--> **Consider the ApHA pharmacy review text. Also learn 150 most common RX & 30 common IV infusions. Once in practice, this emphasis will keep your practical with time constraints we face. 3- Others may disagree but if you find the leadership is very young, then don't be overly dismayed if you are a minority, Keep plugging away at the networks and keep consistent with good work. There is data that many patients like NPs with lived experience too. 4- If you get a DNP too, be careful regarding titles. Please know that that I understand the rationale for changes but the administrative groups can be iffy. This is consistent either with DNPs or with new verbiage for "Physician Associates". What they have essentially told me is they need good clinical insights and less "visionaries". Sorry for a few typos in last posting and good luck !

https://www.bridgeport.edu/news/nutrition-certifications/ https://dietitiansondemand.com/breaking-down-the-masters-degree-mandate-for-dietitians/ Hi, I am a retired RD who became an FNP. Certainly, we can all attain additional nutritional knowledge. One challenge is that in 2024 becoming an RD will require graduate degrees too. In addition, I don't know who now can provide subsidized MNT – Medical Nutritional Therapy. In general, I found that it takes a minimum of five years dedicated training plus an internship so it might make sense to evaluate other options too. For instance, an NP with health coaching certifications, training from the American College of Lifestyle Med or Diabetes Education may do well. If you would prefer to stay in an academic setting, it might be useful to get a PhD in Nutrition or Epidemiology. In addition, I might recommend you look for a large R1 institution due to the magnitude of grants. Furthermore, I believe that if you want to publish in nutrition it might take that type of training. Medical schools, Pharmacy schools and Nursing schools are all adding nutrition coursework to improve our general understanding. Why that is very useful, if you really want to counsel patients separately plus be reimbursed, you may have to consider a full RD program. Please understand though that these programs are quite competitive too and that pay scales are lower too. Due to the internet, nutrition aptitude is improved in all health disciplines though and you can help clients by getting them to nutrition experts on the web. This is a great service to patients and I appreciate all staff that do that for patients.

This is a great question. You should interview persons from both professions. I am a career changer that was licensed in all three areas of your interest. That is I was an RD, got an MPH. Then I returned in a nursing grad entry program completing an MSN and finally an FNP training track. RDs have more responsibility with better salaries now but many do cross train. You would have to ask them why as individuals. If you would like to correspond more, I am at [email protected]. As my career comes to a close, I want to wish all persons like you good luck. Health care needs many types of professionals and they are all productive... Good Luck.

I am an FNP who was also a dietitian with an MPH. I feel broken hearted for you because FTT is frequently a problem with social neglect on the part of the mother.. While you cannot breach confidentiality, I do understand why reporting now seems to be imminent. Wierd as it may sound, would a male visitor help or a visitor with an older woman that the mother may feel more intimidated by. I don't want to hurt her but utilize every bit of social policing we can muster Moreover would you consider colored water in a pitcher with the 600 cc marked off. she can pour the total volume of feed in a second clean pitcher and compare the volume..