lselvio

I am confused about "treat the SVR directly". CO and SVR are inversely related. If CO is down, then SVR has to be high....correct? It is my understanding that the SVR is a calculated number, not a measured number.

I recently exchanged emails with someone at the organization behind the consensus model. We were discussing certifications, like the one you mentioned regarding the ER. She stated that certifications, according to the model, do not change the patient population allowed by the NP's certification. For example, an FNP in the ER should only be seeing the patients with primary care/walk in clinic issues. A patient having an acute event (MI, CVA, etc) would require an ACNP. I asked about an FNP with an ER certification and she said they are still limited, by the model, to the primary care patients. That certifications do not carry the same educational requirements like the FNP or ACNP or ped NP programs do through a credentialing body with a standardized test for license.

I asked about it, but both recruiters said something along the line of "if grad school is your goal, the reserves don't really have good programs to help with that".

Good thought. The last part of what you said is my reasoning as well. Serving, even if I hate it, could be a meaningful experience. I'm thinking Navy because it's a 4 year deal and not 8, if it does suck then I'm out sooner.

That is definitely good insight. Yes, prior to this thread, in my head there was this impression that everyone was grateful and compliant because they're military, lol. Obviously that was naive. From a personal standpoint I still feel that serving in the military, even if I end up hating it, is an experience I feel I should have. But am still having the internal debate as to whether or not it is worth the stress and strain I would place on my family especially my daughter whom I share custody with. I recently precepted a student who is former Army medic, and he explained it as "for your career it is the best thing you could do. For your family it is the worst thing you could do".

Recruiter stated one tour before eligible. As it is now, I have to wait 5 years before being able to obtain grad PLUS loans (meaning I can't pay for it now). So, worse case scenario, I join, decide it's not for me, get out after 4 years, and use GI bill. I would still be 1 year ahead of my current situation. And will have contributed 4 years to the country. And not joining military to experience that IS something I regret never doing....never mind all the talk about money and school.

I was thinking mostly deployments, I guess.

That is food for thought. May I ask how old your step daughter was? My daughter is 7 at the moment, and i have a good relationship with her.

While I disagree with most of the language of the OP, I understand where they are coming from. Advanced practice nurses, as a whole, strive for the same independent rights as physicians, particularly in primary care. And yes, while the studies show that the care provided is the same or better, from a scholarly standpoint APRN's will always be looked down upon by the rest of the medical community. But I also think we did this to ourselves. There are NP schools everywhere, online, part time, convenient. In my area alone there are at least 3 nurse practitioner schools within 100 miles, and this does not count the entirely online existing schools. So we dilute our providers and reduce the value of the education, because it always be done cheaper and easier at another school. Add to this, that at least in my area, nurse practitioners are allowed to work where ever they want. Meaning there are FNP working in acute care settings (ICU and other inpatient areas), there are ACNP providiing office based care. This, arguably, could be the fault of the hiring entities, but it is nonetheless a reduction in the value of each nurse practitioner. Enter the Consensus Model. That model is attemting to streamline the titles, programs, and work environments for each education track. So that the FNP, a specialist in primary care, stays in that lane. And the Acute Care folks stay in the acute care lane. This will add value back to each provider, as they practice in the area in which they are educated and credentialed.

Thanks! Sometimes it's just cathartic to put some things in writing. Makes one think about it a little more than just tossing it around in your head, ya know?

Right, and I think I understand that pretty well. But you for example (hopefully not too personal), were you excited to go between homes? I envision my daughter being excited to see places I won't get to show her otherwise, and to come spend time with us at those new places. But I also know reality can be drastically different than the rose colored glasses. Which is why I'm leaning towards Navy. If for some reason she didn't adjust well, in 4 years I'm done and go to a local CRNA program. If she adjusts well, I stay, apply to USUHS, and make it a career. I have a feeling that this is really one of those things that I just have to decide on, and live with.

And that is what I'm hoping. Yes the money and having school paid is certainly appealing. But for the last 12 years it's been "work, home, work, home" and I don't really fee I've done anything. I see the military as a way to....add prestige?....to my career. My concern as I said before, is what happens to my daughter who most likely can't come with me?

I envisioned the guys being grateful and compliant since their job relies on them being healthy. Or that they have just been injured fighting. Something other than the same non compliance I see now. Correct, I have to wait until May 2018 to submit, but I also have 2 classes to take before qualifying for the USAGPAN. But the navy recruiter said they may give me aome time towards rank since I've been a nurse for so long.

I have talked to both recruiters and both have said as long as the foreclosure is finalized, they do not see it as an issue. Getting school paid for is obviously a big incentive, but that is not the primary reason for joining. I initially contacted a recruiter because I am burned out taking care of the civillian population (non compliant, abusing the healthcare system,) and am interested in providing care for a population that actually wants it. He then lead me down the line of what my career goals are. About it sucking, I meant if it sucks as in my daughter who is used to seeing me half of the time, only sees me about 88 days a year (not counting deployments). The family issues have come to light the more research I do, and am just trying to make sure I am making an informed decision and not just based on the monetary value of comissioning. I talked to my lawyer, and we have a gameplan as far as filing for custody changes. I was really hoping for someone who is or has been active duty and dealt with shared custody that could give some insight maybe as to how the children handled the big change in custody. My wife is on board with the military, so from that standpoint I do not think it will be an issue. The concern is for my seven year old and how she will handle the change.

I realize I never posed a question. For those of you, navy and/or army, I am just looking for thoughts. Specifically as it pertains to a shared custody situation with my daughter from the first marriage. The navy is a shorter route if she doesn't adjust well. But I would still have to go to school when I got out.