brownrice

Hi! I have been to your website and tried to call but couldn't get through on the number....to comment on your post here, I think this is a novel idea because I do believe there are many services being "held captive" by traditional providers. Not that others are not qualified to perform the service, just that no one has really pioneered the idea to do this outside this traditional arena. I can think of pros and cons...pro is that they sell the stuff in the grocery aisle, so it must be pretty darn safe for the FDA to deem that a consumer can apply it. The substance you use may be a bit different from the store, however, I'm sure the agency insuring you has examined the risk of this new service every which way from Sunday, and again, if they gave it the nod, you would think that's pretty safe. Playing devil's advocate, I could say that the service may be applied to teeth that are too fragile to undergo the procedure, etc., and this could be putting your client's teeth at risk. However, you must have an informed consent sheet to cover you for this. I would really welcome a personal email if you would send one. I have some questions you may be able to answer. Thank you, and I wish you continued success with your practice!

The best and only way I know of to get the information regarding the laws in any state is to call the state, department of nursing, and speak with someone about the laws. Ask them to direct you to their website, which will list their respective laws in writing. Just ask them directly "I am a nurse, can I perform aesthetic procedures in this state without a physician? If so, which procedures? Then, find it in writing. You wouldn't want to trust one person's verbal advice this much! Some states allow for an NP to practice aesthetic medicine independently (among them Washington, Arizona, New Mexico). Some states allow RN's to perform aesthetic procedures only if a physician is present--these procedures are usually limited in scope. Other facilities will allow an RN to perform extremely limited procedures if they have a medical director physician who is not ever or seldom present at the facility. So, you see, it can really vary. Finally, an insurance agency working with people all over the US to insure aesthetic procedures will also be well versed in what can/can't happen in the various states.

Hi: Regarding fixing up your place....with some creativity, you can end up with a much cozier, neater feel than the newer, glitzy strip malls!! You need not spend a lot of money, just like Periwinkles is saying--be creative! Now, for your sink: There is a product out there to refinish chipped bathtubs and sinks. You can find it at Home Depot. Just ask them! You basically spray on a new coating of glaze. A friend of mine did it to a bathtub, and you'd never know this now white tub used to be pink!! Get some books from the library on decorated cottage style or "shabby chic", for ideas on how to bring out the unique features of your place. Use live plants!! They bring an ambience and energy to a room that cannot be duplicated with any other material. Nature makes everyone feel good and connected. A small salon I go to (in an old rundown shopping mall) is fixed up really cute. She ripped the formica and other old junk off the wall, and got some plaster at Home Depot. She then used a trowel and put it on sorta unevenly. Then she painted it a soothing, canary yellow. It has a nItalian fresco feel with its uneven, hand crafted appearance. The black picture frames she hung seem to "pop" against this warm yellow color. Best of all, plaster is cheap!! Have fun! Let us know how you're project is going! Tracey

Hi Tanya: I'd love to hear more about your conference, business goals, etc. Didn't see a way to pm you though! Thanks.

I would also move away from the area. Statistics reveal that the midwest is the "armpit" of the nation if you will, for NP salaries/respect. Conversely, both coasts offer much high salaries for NP's/PA's. Perhaps the fact the AMA is centered is Chicago is from where this stench emmanates? If so, I wouldn't expect the air to clear anytime soon. Stay in the area and accept it, or move on.

Was having the MPH degree not marketable in you geographical area? This, ultimately is one of the reasons I have chosen the NP track, which I am currently in. I love epidemiology, prevention, etc. However, unless I was prepared to move to the capitol city of our state, and work with the State Department of Health, or to Atlanta to work for the CDC, it looked like my job prospects were very very slim indeed. So, to the OP, does this help at all? Do a search and look to see where the MPH jobs are located. If you don't mind moving, no problem. For me, it is VERY important to get to choose exactly where I will live. Small towns, clean air, clean water, no traffic or commuting are a priority for me.

Notice the wording is medical doctors. Not just doctors. They are opposing nursing doctorates or "doctors of nursing". The AMA is not just now setting out to quash the scope and rights of midlevels. It's a little late for that.

Okay, this is pretty clear to me. It is saying that if you are not an MD, OD, or DDental med/Dental surgery, that you cannot imply, advertise or connote to the unsuspecting public that you are a doctor ready to practice to heal someone under the guise of being a "doctor". They are looking for a legal provision here....a legal right to put the hurt on anyone who might be doing this. It is obviously directed as a precautionary strike against DNP's.

Cyndee MSN RN: What is a "top tier" university doing hiring NP instructors who were "never RN's?" And what does this say about the quality of education you received from this "top tier" university?

Just wondering, did any of you consider an online program? I'm now in a grad program (FNP)...switched from WSU in a hurry--just did it initially because it was here in the state and didn't think there would be that much difference in programs, boy was I wrong. Anyway, just a warning to give it some thought if it's not too late, or if you find yourself frustrated later on. There are BSN online options out there!

Ch123 Hello! I'm cruising the website and came across your question. I'm an FNP student with a year to go (43yrs old, if that matters at all)...but I couldn't resist offering my 2 cents. If this is what you want to do, of course you need to go for it!! Here is a point to consider as well. Since the average age of the population out there is older rather than younger, you automatically have an advantage when building rapport with patients. If I were 40, 50, 60 >, I want you treating me. I can relate to you and the life skills and wisdom you bring, as opposed to a 23 yr old. It is comforting to have someone near your own age attending to your care. And "comfort" is a HUGE part of the nursing paradigm. I hope you will follow this if it is your dream to do so.

Dear Catch33er: I empathize with your plight. I will be an FNP in a year, and could just as well be facing this issue. As you remember from the pm I sent, I'm about an hour away from you geographically. I emailed one of my favorite NP professors PhD/ARNP to pick her brain about your issue. She is very active politically in Washington state and knows legislation pertaining to nurses, healthcare, insurance, extremely well. She works in a small practice for underserved part-time, and teaches part-time. She is a very intelligent, nice person. This is her message: Unfortuantely, as limited as mental health care is for insured people it is almost non-existent for the uninsured unless there is a volunteer staffed clinic. I am not familiar with the resources in Walla Walla and suspect this NP knows better than I. One thing she may want to do is set up a mechanism for consulting on cases and do some CE on psych issues. Also, people who have severe mental health issues may be directed to apply for disability on the basis on their psych problems which then can gain them access to mental health services if they qualify for Medicaid or Medicare. If there is anything I can do to help her - even just talking through ideas about how to approach the problem - she should feel free to contact me. So, If you would like her email address, just pm me, and I'm happy to pass it on.

If nurses continue to refuse to unite and organize, demanding better pay/respect commensurate with the level of education and responsibility they shoulder, they will only continue to work crappy hours, holidays, nights and weekends, passing out meds like a bandit as they max nurse/patient ratio.

CGFNP: Amen! You are RIGHT ON with your message. Some may not like the direct approach, but yes, XXXXXXXXXXX. Those that can't stand the heat need to get outta the kitchen. There is something to be said for those with the courage to say it like it is, rather than back stab or complain behind someone's back about issues that can be dealt with head on. Perhaps this is why men seem to have better luck rising to the top? As for Theory, APA papers and the like, it's a ridiculous waste of time.

"People with true mental illness need to be managed by a psychiatrist and manage is the key word here." Germanicus, regarding your statement above regarding psychiatrists: Please don't forget about Psych NP's!!!!!!!!!!!!! They can manage this patient load just as well, and are doing so as we speak. If you look at the number of psychiatrists available per density of population, it's abyssmal. Psych NP's have been and will continue to fill this gap. ESPECIALLY for the rural areas. The state university here has been given a large grant by the state/federal government to expand/give tuition grant assistance to psych NP students here. This NP specialty is doing a beautiful job supplying NP's to fill in where the Psychiatrist either doesn't exist, or doesn't have time to handle. Any psych NP's out there want to add a word or two?

Check out Indiana State University. They have BSN to MSN, and may have RN to MSN, but I'm not sure. 100% online, very organized, friendly, low cost per credit, no GRE! Best of luck to you.

Your right, it ain't about the pay....it's about a higher level of autonomy...a higher degree of respect...engaging your mind...and unleashing your spirit~~what have you researched with a passion--now you can make educated judgements based on this research/practice and help others with this knowledge, without first running it by the authority (a doctor). The thing is, higher pay will come with this position. And guess what? If you so choose, you can work Monday-Friday, 8-5 for this pay. Shifts? Time and a half for holiday pay? Initially, NP new grad salary may be neck-in-neck with a RN who works crappy hours, shifts, nights, holidays, or has to travel to make this "great money". After a couple years, however, the NP pay will increase. IMHO, folks who can't visualize how this is so much better don't have what it takes to be the type of professional I have described above. For this, they will stay locked into a job taking orders, sharing their negative opinion with others who have a bit more ambition than they could ever dream of. Whatever your mind can conceive, you can achieve. Leave folks like this and their negative attitudes in your trail of dust.

Yes Anon, I experienced this throughout my BSN clinicals. Especially bad was one of the charge nurses who was in the process of getting her own BSN, after having worked with her 2 yr degree at the same hospital for 20 years. She was downright mean and nasty to me. She even went as far as calling my professor, making up bad things to report to her about me. Hard to believe? It happens. Fortunately, my prof saw through what she was doing; my character, grades, and work ethic were already well known. Scary that these such people are working around vulnerable patients, and spitting venom to others along the way.

Yes, If my NP program completely deleted the "theory" course I would be ecstatic!! Mumbo-jumbo....but don't forget, the mumbo jumbo doesn't end with that ugly book they wrote. They have now contributed to the pile of BS that the BSN and MSN nurses get to pull quotes from~~when writing all these lovely APA papers. Okay, back to the topic. Has anyone heard from poor Pinoy? Probably never thought that a discussion quite like this would ensue.........

Hi Mingus: I can only imagine what the training for MD's must be like. At least they recently put a limit to the number of residency hours that can be accomplished within a certain time frame. I find the current Western medical model a bit odd, and the practices that are required of it's workers even more odd. Consider that during my hospital clinical rotations, I would hear nurses say "I don't have time to go to the bathroom when I need to, or I don't drink much water/etc. because I don't know when I'll get to go to the bathroom". Well, hello, guess what a contributor to UTI's can be? Not drinking enough water OR, not "going" when you first need to. Hmmmmmmmmm. We are not taught (in nursing school or at work) that we need to respect and take care of our own mind/body/spirit first, so that we can be strong and healthy enough to attend to the needs of others. Without the strength, we are only going to cause disease within ourselves. Consider this as well: Research is reflecting that breast cancer rates are higher in women that work at night. (it is somehow interfering with hormonal cycles) In addition, working under flourescent lighting adds another dimension to this problem. And I haven't touched upon the 12 hour shift thing. Three of those in a row and you need the other four days just to recover. Is this why so many nurses are overweight? They are so exhausted, and the lack of a regular schedule prevents a regular exercise routine... Yes, someone must work at night, someone must be there when they're needed, BUT there are solutions for these issues. Unfortunately, they bite into corporate profits too much for administrators to implement them. Afterall, there is always that new round of recent community college graduates that will take the lowest pay, and work nights. Luckily, I realize these pitfalls of the profession, and know how to avoid them. Until hospitals treat nurses with the dignity they deserve, I would never consider working in one. I will not sacrifice my body long term to take care of someone else. It is sad to see this happening to nurses. They deserve the best, and get the least. But it will never stop or change if we just keep accepting it. I can absolutely see why the female MD's recommended NP/PA! I will say this: consider where (state) you will be working, and what type autonomy you desire. Your state board of nursing will be a big help in that regard. Good luck with everything!

Hi Siri: How was Hawaii? Did you learn to surf?

Hello Mingus: The female doctors are all saying "don't do it", which refers to what? Don't become an NP, or don't go the direct entry route? What is it that is horrible? And what setting are these women working in? Hospitals? I have one year of NP education left. I'm excited, I love it. You could not pay me enough money to ever think about becoming a medical doctor, however. I attended school to become a Naturopath before deciding to become an NP. I have researched my deciisons every which way, as I am very analytical. Becoming a PA was out of the question, as the autonomy could never be there. Go to the PA forum if you want to get a taste of the frustration over lack of autonomy of the part of PA's.

Please allow me to make some corrections to the misinformation that is being given here: 1. Allergan IS midlevel friendly. Provided you are licensed to perform as an NP independently in your state, you may open an account--with absolutely no problem. AND... 2. The Botox product must be shipped to a "medical facility", not a home address, for example. It need NOT be a "physician's office" or to an MD. I obtained this information first hand. After reading these posts, I called Allergan corporate in Irvine, California. New Accounts:(714) 246-4500. They are THE manufacturer of Botox in the US. As for not breaking even within 18 months of practice--I am amazed. I would suggest reviewing your business plan, and marketing strategies. Or perhaps, your population density/locale is just not conducive to this type practice? Please people, don't just trust something because you hear it second hand. Research it for yourself. If you don't like the fact that NPs can't practice independently in your state, and therefore, you can't order BOTOX, then do something about it!!!!!!!!! Investigate politically how YOU can change this for your state.

CHRISTYS..... word!

Hello WannabFNP: Some schools are no longer requiring either a thesis or a master's project. I guess they feel like it is a lot of energy devoted to something that will just "sit on a shelf and gather dust" (as one nursing dean I spoke with said). There is also another thread on this topic somewhere here. It refers to the problems many have had with thesis papers, and how it has delayed their graduation for a lengthy time, in some cases. I know a few NP's that had nightmarish stories to tell me about their own thesis experience. Needless to say, I have chosen a school that does not require a thesis!