TradHunterRN

I was glad to find this thread as I am finishing my AGNP certification in a few weeks but was offered an interview at a large medical center for their hospitalist team. Apparently I am in the final pickings! This issue has now been running through my mind a lot. All but ONE of the providers in this team are AGNP or FNP, only ONE actually has their ACNP! Apparently they don't take an issue with it yet, though they said they may make ACNP a requirement in the future. Despite the good arguments on both sides of this issue presented in the above comments, I have yet to seen any conclusive assessment of the legal risks to the provider. Has there ever been a published case of successful litigation against an AGNP or FNP who was providing care in the hospital setting where the type of their certification was the major issue? If not legal action then BON action? The job is a wonderful opportunity for me and my family. It is not what I was originally looking for (was planning on outpatient) but the opportunity kind of fell into my lap. (For any of you who would simply say "why didn't you do acute care then?") Now, there is a state university just down the road that offers post-master's ACNP so that is an option for me to cover myself and improve my skills. I am just worried about taking a job that will put me at increased legal risk because of the letters behind my name.

Hi all! I am writing to you today as a graduate student soon to be AGNP! I graduate in December, hope to take boards by end of January and so am looking for my first job. I currently live in the Cleveland, OH area but my wife and I have considered moving out west for a long time and have decided that getting my first job in a new state may be the best way to get us out there; now or never sort of thing! We have settled on Colorado, and are thinking about moving to either Denver or Colorado Springs. Planning on flying out there in the next month or two to scope some things out. So I am mainly asking any nurses/nurse practitioners in those areas if you know of any health systems that do NP residency/fellowship/externship programs. I did a Google search and so far was only able to come up with a program affiliated with the University of Colorado, Denver, that requires your ACNP. I saw Peak Healthcare had a primary care residency in 2015 but couldn't find any information for current programs. I know these type of programs usually start opening up around this time of year for start dates in June or July so that is why I am asking for some help. Also, any advice on getting your first NP job and all your licenses in a completely new state would be much appreciated. Or, any info about practicing in Colorado that you think a new grad may want to know (Colorado has more full practice authority compared with OH for example). Thanks in advance for your help, this community is a great source of help and information!

Thanks for the answers! Dranger, that is a bummer that transitioning is difficult. Recruiter didn't mention it being an issue but then again he may just be sugar coating things. Was hoping to get started soon to build up benefits time and tuition assistance. Is there any way for a civilian to see numbers, like how many of a specific AOC they are trying to get at any given time?

Hey all. BSN, RN working full-time in the state of Ohio. Currently working on my FNP. Looking to maybe join Army Reserve. Briefly talked to AMEDD recruiter and he said the only training I had to go through was 28 days of BOLC. I saw there is a long course BOLC as well that is 7 weeks long. Am I definitely only going to need the short course? I have no prior military service. Also any other general input on the subject of being an RN/NP in the Reserves would be appreciated. Thanks

I know this is why, but that doesn't make it right. Nurses make up the bulk of a healthcare workforce. Angry underappreciated/overworked nurses make for poor patient care = low patient satisfaction = HCAPS drop and so does reimbursement. I just feel like that is where we are heading. The other issue is the dropping large sums of money on flatscreen TVs for patient rooms in my critical care area where most patients are too sick to watch TV, a pointless cafeteria overhaul, etc.

Where do you people make these kinds of figures??? I Just double checked my 2013 tax returns after reading the crazy high salaries on this thread. I GROSSED $45,239 working full time. GROSS! The shift diff here is $1/hr, charge nursing is only like $0.75; they would rather understaff us (in an ICU) than pay overtime or call in staffing resource nurses; they got rid of the weekender pay bonus and we only received a %1.5 raise this year. And I will say where I work because I am not afraid to mention like so many nurses are, I work for Cleveland Clinic, the number 4 hospital system in the nation.... Where are you high rollers so I can jump ship!

I feel there are bigger problems in nursing education than just the preceptor issue.

Hey all, starting Patho this fall so I know this class will be a lot of work as we all are realizing. I would just say this: Focus on what you are asked to focus on to help you get through the class...BUT read the chapters as much as you have time for. You are not going to school to pass a test. You are going to be given the responsibility to diagnose and treat clients so your clients will expect you to know your stuff! Good luck everyone :)

Not to mention the fact that RNs constantly prevent or catch fall-outs that would prevent insurance from paying for the entire hospitalization! (i.e. Q2H turns, making sure physicians write orders for the things they are asking us to do; etc. etc.) I have lost count of all the things that they are "Auditing" at my facility. Also, a response to the OP in general. I agree with the other posters about "kill 'em with kindness, bite your tongue, etc." BUT, you cannot let people treat you like trash. My unit had tons of bullies and eat-their-young "veterans" when I started two years ago. Our manager had just started and had zero tolerance for catty BS. Those problem starters have either been let go, or found work elsewhere because they knew they were being watched. If management is not supportive it may be time to talk with that manager and express your concerns and look for work elsewhere. Anyways I am not condoning aggressive behavior on your part, but there comes a point where it is fair to say "I am here to listen to what you have to say when you can show a little respect for me"

Thanks Boston that response gave me a lot of insight. The thing about "everything at your fingertips" is something I have thought about too, and actually that challenge in PC of having to rely on your assessment skills and history taking is really exciting to me. I love performing assessments so I think that would be ok for me :)

I start my program in the fall so can't speak from NP perspective but I felt this way about my undergraduate. There was often a very large amount of good info that has helped me tremendously in practice as an RN now but at the time I had to glaze over because it wasn't going to be on the exam. Could see where this could be more of an issue when that knowledge really has to stick because I will be the one making diagnostic and prescriptive deisions. And to answer the broader question I am going full time because I am a little impatient, BUT I do have two children and a wife finishing grad school so if the first semester or two is awful I will drop to part time no problem with no regrets.

Thanks for the response. 2 years ICU, and I do understand there are vast differences. However, here is my logic. Where I work, most NPs working inpatient don't have a whole lot of autonomy and honestly some of the groups the NPs just feel like fluff. I would HATE IT if I went and got my ACNP and essentially did the same things I do now; alerting the doctor and taking orders. I feel like in a more primary setting I would have more responsibility for each patient's case. It is THAT difference, the need for in depth knowledge and critical thinking, that I think may be stimulating enough to replace losing the "rush" of the ICU. Just wondering if my speculation matches up with people's real experience :). Also I mainly think I would get bored with CRNA. P.S. Please, if you are an ACNP or other inpatient NP do not take my post as a dig. I am not saying you don't critically think or have responsibilities. I am simply saying this is how the system seems to work where I am at.

Hey all, just got accepted to an FNP program, will be starting in the fall. Having ICU experience up to this point and loving it, I am concerned that I will be dissatisfied and might miss the ICU experience. Have any FNP or AGNPs on here come from an ICU experience to an outpatient or specialty setting and been dissatisfied with their job? Or do you find that the major change in roles and the increased responsibility/critical thinking make up for the difference in pace? Thanks for your responses!

Whether you want the perception to change or not it doesn't change the fact that the lifestyles are very different. I am not saying NPs do not work hard, I am simply saying that in my field, the physicians have to attend to patients and their problems (as well as all the extra stuff) for many more hours than the NPs that work for them. No where did I say that NPs were lacking in knowledge or that they were incompetent. What I am trying to get across is that a lot of posters seem to feel that physicians are irrelevant. That a few didactic courses are all that NP schools are missing. I am simply stating that those core sciences are NOT the reason why physicians get respect.

I don't understand the anger and frustration occuring in some of these posts. Also, I don't understand why there is such a culture being fostered in this thread of "NPs could replace physicians if we had more training, they would be perfect providers". If you want to be a physician, pursue medicine. If you want to stay in Nursing, be an NP. There is no replacing physicians outright in my opinion. Take two equally intelligent persons, one a physician and the other an NP. Now assume they have the same scientific background because of advancing education as proposed here. What do you have? Typically, (and I am saying typically so please don't take this personally if this is not you) you have the NP that works a set schedule of around 40 hours a week, has good vacation, no on call time and rarely if ever gets paged. Many physicians I work with work 80+ hours a week, might get one weekend off a month, take call in the middle of the night after working 12+ hours straight, and must maintain continuing education and research on top of this. That level of immersion in their career is what makes many physicians so sharp and knowledgeable, not the background in the sciences, but the constant daily grind. Two very separate lifestyles. This is why I chose to enter the NP profession (just got accepted to an FNP program for the fall btw) rather than going into medicine as I was debating on doing. I have a family and time consuming hobbies. I did not want the life of the surgeons and intensivists I work with.