Grumble88

All nursing is evidence based. People draw dramatic conclusions about the difference in education between PA and NP. Realistic differences: In PA you'll have a large number of brief clinical experiences across multiple specialties and will be trained as a generalist who can then work under any physician willing to hire/train you in pretty much any specialty. You will not have a license and will have no option to practice autonomously anywhere in the US. In NP school you will receive additional training in primary care to augment your RN training, but your education will be mainly focused on your specialty area. There is more of a societal/holistic approach to education in NP school than PA, so be prepared to discuss poverty/healthcare policy/societal issues in great depth. You will not have the practice mobility of a PA, even as an FNP you will still technically be a "primary care" specialist, and will be more limited in where you can practice. You will be a licensed healthcare provider with more autonomy and the option to practice independent of physician supervision in about half the country.

Q: "Well who is going to train new grad NP's?" A: experienced NP's I don't advocate for the removal of physicians from primary care. NP's do need either real supervision or a residency period for 1-2 years, but the opportunity for experienced NP's to supervise new grads is reasonable. Beyond 1-2 years supervision becomes entirely about MDs profiting off NPs and the red tape that experienced NPs in supervised states deal with is a detriment to patient care.

Accelerated RN programs? I suppose it depends on the individual, but I don't see any point to spending extra time in school. Nursing school prepares you to take the NCLEX and be minimally competent, you learn how to be a real nurse your first year in the job.

Your lab should be redrawing hemolyzed samples, not reporting them, but regardless don't stress about it. If you're really worried call whoever is on shift and report it to them so they can follow up.

As above poster said, Psychiatric/Mental Health Nurse Practitioners can provide psychotherapy, but are generally put into a role of med mgmt only, though I know several who provide psychotherapy in a practice owned by a private physician.

Anesthesiologist, about $300,000 more per year from the last figures I saw

Hey there, I recently passed my NP program and passed my board exam. I also suffer from a tic disorder (primarily throat clearing, grunting, sniffing, and blinking). I've dealt with this all my life. It has eased up in my adult years somewhat, but it gets exacerbated greatly when under stress. I wanted to share to let you know that it's not a hindrance in your NP education, especially if your lucky enough (though you may not feel lucky!) to only have a sniffing tic, which 9/10 people aren't even going to notice. It may seem hugely noticeable to you, but most people are too into their own little world to ever notice mild tics. You also have to consider that you're going to be in class with NURSES, the most caring and accepting group of professionals out there. Everyone has their burden to bear, this new tic disorder just happens to be yours. Unless you want to be a radio show host a mild tic disorder will never hinder you in a profession, the embarrassment of it only exists in your head. Get out there, live your life, and pursue you goals.

Hi Sublee, I was looking for work and just happened upon the position. Technically I was a "lab assistant." My work trained me, but I never actually received a certification. There are hospitals that will train and certify you, call around to local hospitals, especially places that have their own in-house lab. The place I worked at was a rehab hospital.

I only got 6 SATA and passed in 75, don't buy into the whole "more SATA means you're doing well" thing

Restraints and emergency medications are unfortunately fairly common place and necessary at times in psychiatric settings to protect the patient and others on the unit. This sounds like one of those times, just not in a psych setting. I'm certain the physician didn't expect you to restrain and administer the EMed alone, but you did the right thing communicating with your charge nurse when you weren't comfortable/confident with a situation and now you know how to better handle this in the future - speak with your charge nurse about recruiting volunteers to assist in the hold if you can't talk the pt into taking the med voluntarily. What surprises me is that you and your coworkers are expected to restrain a patient without any training on proper restraint procedures. That poses a large risk of injury to the patient and the staff and places the hospital, the physician, and YOU in a very liable situation should an injury occur.

Allowing the VA to let APRNs practice to their full scope would increase the number of APRNs the VA could employ without having to worry about compensating physicians to "supervise" them, allowing more veterans to receive care more quickly.

The VA Rule On APRNs Should Not Be Doctors vs. Nurses "To quote the American Medical Association's Principles of Medical Ethics, 'As a member of this profession, a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self.'" When they care more about fattening their paychecks than allowing veterans to access care, it seems to me the only principle being followed by these physician advocacy groups is responsibility to self. What are y'all's thoughts?

If you know you want to be a clinician and know the specialty you want to pursue, go for the direct entry and save yourself time and money. If you aren't sure what your end-goal is and just want to explore nursing before committing to a field, go for the BSN. PS don't listen to the people on this forum who will insist that RN experience is absolutely required before pursuing an APRN education. It is not. You'll get all the RN experience you'll need while working during the MSN portion of your direct entry program.

New grad FNP in TX? Expect to be low-balled with offers in the 80's. I recommend holding out for a job that pays at least 90 plus benefits and CME reimbursal. Don't let anyone sucker you into paying for benefits like liability insurance out of your salary.

It's the same in my state. Talk about an uphill battle... When your licensing entity refers to you as a "mid-level." Maybe one day that monocre will be removed, but I think it'll be a long time coming.

Thanks, and yeah this is what I've gathered from other sources as well. A colleague of mine has the exact situation you've described, only he hires only PMHNPs in lieu of PAs. He owns and runs the practice and contracts with a third party physician to "supervise" himself and the NPs he employs.

PyschGuy, I meant delegate in the same way a physician delegates prescriptive authority to NPs in restrictive-practice states and PAs. As in physician contracts with NP, charges a percentage of his/her billing, and in return "supervises" him/her allowing the NP to prescribe legally in that state.

In my first undergrad degree almost everyone I went to school with wanted to be a child life specialist, I think only two or three actually went through with it and they married partners who were able to provide a living for them, everyone else went the pre-school teacher route after finding out how wildly competitive the field is and how low the pay is

Thanks evolvingrn, that's what I was asking. Looks like the answer is a "no" regardless of independent practice, though. Thanks for everyone's responses.

Renting a location, contracting with a delegating physician for himself and the NPs he hires, contracting with NPs to work in his practice, malpractice insurance, and making ends-meet doing telemedicine while he built his practice

If it makes you feel better I know the UT Austin program only considers your upper-division gpa, not cumulative gpa from undergrad. I would assume some others schools also follow this practice.

Currently preparing for it using Barkley review and the ANCC review book. I'm having a hard time finding decent practice questions, bought the ANCCs two practice exams and 5 exams from anccprep.com, but there seem to be so few and they are crazy expensive.

I had a long conversation with a colleague recently who started his own practice in Texas. I wouldn't even try in a restrictive state like Texas, but in an independent practice state it would easily be worth it if you do the appropriate preparation and draw up a solid business plan. Lots of responsibility and work, but potentially huge payoff as well.

Get straight A's in the prereqs, it's easy to do at a community college level, one or maybe two B's won't disqualify you, but aim for all A's. For expected GPA and GRE scores, contact individual schools and they'll be happy to share that information with you.

Not all advanced practice settings require crazy hours and being on-call, in fact if you find an area where your specialty is in demand you can negotiate a pretty great schedule. A few examples - in my area my specialty is in high demand. In school a preceptor of mine worked 8-3 no on-call, no weekends and 2 days a week she worked from home doing telemedicine for her company. Another example, I recently accepted a position offering 8-5 m-f, no on-call, no weekends with 32.5 paid vacation days and 10 days of paid cme leave per year. Another colleague of mine recently accepted a position with no on-call only working M-Th. Point is, if you're smart with your chosen specialty and the area you work in, you can negotiate great schedules as an APRN. Or just go into practice for yourself and make your own schedule...