traumaRUs

Uh, I politely disagree. As a very experienced APRN, I will not be clinically supervised by an RN. Nor would I put myself in that position. As I stated above, an RN could supervise an APRN for employment issues (ie schedules, HR matters). However, clinically, I have full practice authority in my state. Of course, I do have a supervisor.

I have to add that TikTok has a recent "phase" of people posting the most ridiculous stuff and its just a trend. For instance, one of the people I follow (an NP) all of sudden posted that they now operate independently, managing anesthesia during the operation as well and then the patient gets up off the table and makes the comments, "oh and I didn't even have to see a doctor." So, it was just like an exaggeration of their usual duties.

Maybe I'm not understanding - are you saying an RN is supervising and advanced practice provider? Maybe for employment issues? Surely not for clinical issues, correct?

Psychiatric NPs make bank. If I was you I would go for it. It puts you in the drivers seat for your career vs your one and only hospital. They aren't treating you fairly

I'm 66 and an NP but I worked nights for 15 years as an RN when I was in my 30-40's and I think it took time off my life. I know some people can do but I found that my own internal clock made me a better day shift person. If you found it hard in your 30's are you sure you want to attempt it in your 60's? Just another perspective....

RubyVee - so sorry you had to live thru this but I'm glad you did. Hope your life is happy now and free from domestic violence

Hmmm Fresenius has newer machines - is there a reason you are using an older model? This one doesn't have chairside charting for instance. In looking at your earlier posts, I gather you are not in the US? Can I ask what country you are in? Here is a YouTube video for machine set up: How to set up a Dialysis Machine part I (Hemodialysis Training)

I have profound hearing loss in my left ear and mild to moderate hearing loss in my right ear. I wear hearing aids in my left ear 100% of the time and only occasionally in my right ear. For myself in my job (nephrology APRN) I use an EKO core stethoscope that I wirelessly connect to my Apple airpods 2. I only use the right earpod. I can hear very well with this arrangement - for both heart and lung sounds

Dialysis is very recovery friendly and they usually need nurses

I committed a med error as a new APRN that ultimately led to death. That was many years ago but I still tell the story to new APRNs in the hopes they can avoid my awful mistake. I do not profit from this experience but I'm also fortunate to retain my job. Perhaps this is what she hopes to do as well?

I've been a member since 1999. Lots of memories

I agree with Hppy! Get some in-person help to debrief from this traumatizing event. I was a new APRN (only on the job 6 months) and I made a potentially fatal prescribing error. The pt was harmed and I went thru 7 years of a lawsuit. The only thing that kept me going was being able to talk with someone. You can get thru this but please, please get some counseling

Oh Marla - your spirit is inspiring. I know how much you have suffered in the last few years. You gave your heart and soul to AN and helped so many here. You will certainly be missed. Give our thanks to your husband for sharing you with us

Dialysis companies like Fresenius and Davita are very friendly for those in recovery. There are no narcotics and since providers now have to eprescribe ALL controlled substances you don't even handle scripts. Best wishe

Probably due to obstructive uropathy or neurogenic bladder. Some renal transplant pts can still develop obstructive uropathy and not be able to void on their own. However, its very important that they stay well hydrated and so of course they need to urinate.

I'm on a volunteer Fire/EMS dept. I run ALS calls and tonight I had to restock narcs. We do use ketamine for chemical restraint. That said, this is a rural dept that covers a lot of area and we do NOT transport. We have a protocol for chemical restraint. I'm also an APRN and feel comfortable with ketamine but would definitely error on the side of the low end of the amount given

I don't work in a hospital, but rather for a large private practice nephrology group. Does the hospital or practice unit measure the NP's productivity? Yes, very closely. We bill for office visits under our names. We code the visits manually. We also see hemodialysis pts in hemodialysis units and this is a bundled payment determined by CMS. How are these calculated CPTs, billable collections, and RVUs? We don't use RVUs but rather the number of pts seen. Does the NP work in a group? How is the work distributed, calculated, or monitored? We are a large practice and have a director of APRNs. Work is distributed loosely on who lives where (we cover approx half the state), the number of pts seen and the experience of the provider How is the compensation determinED? Basic cost of living raise each year, then productivity bonus as well Is the NP a hidden provider? Nope

My nursing salary is very generous and we would be able to easily survive on it alone. However, I went back to school at 48 and while working full time got an advanced degree. My RN salary was a great second income but we would have had to cut back on many things if it was our only income. RNs nowadays, from what I see are extremely over-worked and underpaid. And yes, the state of military pay is deplorable. Signed a USN vet

Well, I'm 65 and still working. Unsure about retirement at the moment - probably, maybe, not sure, really up in the air... I do think I would like to cont to work part-time only because when I was young and foolish somehow I thought I wasn't going to age. I didn't contribute to my retirement as I should so I'm still catching up. However, I salute those that planned better and were wiser then I

I'd contact a lawyer about getting out of that contract. Reeks of fraud with unnecessary and BILLED tests. Yike!

Ill try to help you out: 1. What is nursing for you? Nursing is a wonderful career. I've been a nurse for 30+ years. I enjoy helping people and as I'm very experienced, I enjoy it much more. 2. What are the roles of nurses based on your experience? I started out in med-surg for a couple of years, then did medical ICU and some urology clinic work. Then we moved to another state and I did level one ER for 10 years (my most favorite position). I became an advanced practice nurse in 2006 and I've been a nephrology APRN since then (my best-paying position) 3. What could you advise for future nurses? Realize that when you get out of nursing school, you won't know everything. It's important to ask before you do if you don't understand the task. Be humble and kind. Best of luck

@txrnblue - what type of role are you in???

Yes, exactly - I get 18% of my base salary given to me for retirement which I can managed as I see fit. I also have free healthcare for myself and there is a bonus structure which adds another 5% to my salary

Depends on what the nephrology practice wants you to do. I'm a nephrology APRN x17+ years. I work for a very large midwest practice. Productivity is the key. When I first started, our practice did require us to see hospitalized pts. However, as reimbursement and managed care programs have advanced, it is more profitable for us (APRNs) to see dialysis pts and office pts where we can bill to the fullest. Although I'm credentialed at the hospitals it makes sense to use us to the best advantage. As to adults vs peds nephrology, do the practices have peds nephrology? Our practice is very large and we have two peds nephrologists. I think it just depends on the way the practice aligns itself with care

Oh my goodness! 65 is NOT retirement age. I'm 65 and going strong. I've interviewed and been offered positions as recently as two years ago. Few of us can retire at 65 anymore. I'm personally disappointed in the above responses - ageism exists I guess.... To the OP (original poster) I do advise you to tread lightly as you now know the culture of the hospital. I would wait till I was retired to bring it up. Best wishes