Troll_Patrol

Totally understand Job 1: Glorified nurse - MD looked at all labs, XRs and nurse documentation and then placed all orders and made all changes while I was expected to do physical assessments and write the notes Job 2 (Sx specialty) Glorified Scribe : - Thought i'd Get great hands on procedures and ICU exposure since that's my background... NOPE! Expected to notify MD of all issues to obtain verbal orders and babysit the pager for "notify provider calls" and expected to see patients and write note before any information like labs and xrs are done ... O and for consults I just stand there while the MD talks to and assesses the patient in order to write the notes Seriously wish I didn't spend money to go back to school (especially to spend 4yrs on a dual cert) considering just working in a damn fast track or urgent care ... did I mention Job #2 is a 2 hr commute one way so I have to pay rent to stay there for my shifts?

Totally see this every day! A couple of the attending a I work with would like to use me as a Glorified RN or scribe... I have heard "o it doesn't matter what you write as long as there's a note in the chart" I take offense to this and refuse since it's my license on the line

My understanding is that you are referring to opening an outpatient private practice to work there as well. I don't know whether or not midwives can open like private birthing centers or CRNAs opening private practices since I can only speak for my certifications and state requirements. There are many outpatient Psych clinics run by NPs, but not sure of the others. Again this is if you plan to practice there, I'm sure technically you can open any kind of business you want since medicine is essentially a business with providers as employees, but if you plan to practice there of course it would need to be within your scope of practice... hope this helps

I'm pro Acnp -ag! Just because I'm a CCU nurse at heart lol. But your scope of practice is the same for both. Also most states say you can't do primary care as an ACNP but you can open an urgent care or work in an internal Med clinic depending on your state. If you want to do "family" med you could go back to school to get the family portion and sit for FNP boards ... or you could do like me and go through a dual role course and sit for both boards (FNP and ACNPC-AG)

Trauma center NP here in the south (restricted practice state) I place chest tubes, central lines, art lines, pretty much anything... my collaborating docs are busy doing actual surgeries so it helps them a lot to have someone like me to help do those things when **** hits the fan lol ;-) love to see others like the adrenaline as much as me

Unfortunately I have to agree... I am very naive and found out while I was in my last semester of my NP school (that required 2 years RN experience) that programs are allowing new grad RNs to go straight into NP school! *****!? They don't even know how to be a nurse in the real world yet. I would never precept a straight-through NP ... I hate when I have to babysit new 2nd year residents. That being said and now that you all probably think I'm an awful person I did have trouble finding preceptors because no one wants to do it, so I do feel for the NP students out there that are qualified and ready for practice...I lucked out, ended up using all MDs as preceptors (because many NPs won't precept ) and had a very good preceptorship experience. Ugh this struck a nerve Rant Over LOL

I absolutely see this and I get asked at least 2x a day by nurses about NP school. My area is saturated with FNPs because 5 more local universities started FNP programs ... luckily I am dual certified as an AG-ACNP/FNP which gave me an advantage since there are no ACNP programs in my area. I am also seeing extremely low salaries being accepted by new NPs (like lower than what I made as a CCU RN) and seeing FNPs being used as nurses that can do MD *****-work (i.e. Write all the H&Ps and progress notes while the MD does all the actual patient care and dictate orders for the NO to put in the EMR). It's sickening and I was extremely discouraged when I graduated after seeing this being an acceptable practice.

I am a dual certified Adult Gero ACNP & FNP always working in the acute care setting in a collaborative practice state and I have questions for other NPs in collaborative states. My questions to other NPs (especially those in ICU and Hospitalists positions): 1. What is a normal day like for you? 2. Do you ask permission from your collaborating MD on any and/or all orders? 3. Do you put in orders they tell you to put in without question or if you are unsure of the rational behind the order, disagree with it, or didn't personally examine the patient? If not, do you ask for rationale? or say no? 4. Has your collaborating MDs ever been upset with an order you put in? If so how was it resolved? Not saying those things happen but i just changed jobs from working with one physician I've known forever to working with and getting used to a service with multiple physicians and I'm having trouble feeling out my boundaries since I came into this position after being pretty autonomous in my last position and just trying to get insight on what is acceptable practice. Thanks

Btw I usually enjoy a glass of wine after a stressful day - ignore my grammar and run-on sentences, today I am enjoying vodka ;-)

I have never posted here before but I need advice from other professionals as I regret my life choices. I was an ER nurse then a Critical Care nurse for 5 years before deciding I wanted to further my education and scope of practice by becoming a provider - I've worked with excellent NPs and I chose to go for Acute Care NP and FNP with the hopes of Landing an ICU or hospitalist position with the FNP title just to fall back on ... got a promising job right out of school as an "ACNP Hospitalist" but once I started I felt like merely an overpaid scribe for the MD... I gave it time because credentialing and training take time, and to build a trust with the MD ... Almost a year in and I feel as if I'm losing my NP skills that I never use.. This was not the job description I agreed to I am so done with being an NP I have honestly considered going back to the CCU I worked in ... titrating drips, CPR, fresh hearts, LVADS, TPA, IABPs, educating new nurses, loved all of it, especially the adrenaline and felt as if I made a difference... and now I'm signing an order for zofran because someone has a tummy ache because I get the calls that aren't considered important enough for the MD, but I'm a "hospitalist" because I write progress notes and sit in a hospital while I order Tylenol and stool softners and make sure patients have am labs who need them... Sorry for the Vent Please tell me I didn't waste my time,money, and sanity for this? Any other ACNPs that can give me hope that this is not actually what I have to look forward to. Any advise would be greatly appreciated

I am dual FNP/AGACNP and the training is a completely different experience in each program. Where I have worked as a nurse I have seen FNPs in CCU/ICU but they are only there to assess "easy" patients and write progress notes, H&Ps, etc... for the MD, whereas the ACNPs / AGACNPs function moreso like the physicians in that they manage patients and take call for the practice. So I guess to answer your question, it would all depend on what scope of practice you are interested in (and the state you live in). I would recommend getting at least a post-grad cert in AGACNP to cover yourself when caring for ICU patients without direct physician oversight. I hope this helps, I wish you the best!