Eydyey NP

I think it depends on what kind of urgent care position you're going to. There are busy urgent care centers where a provider is expected to see 3-4 patients/hour which gives you about 40-50 patients/day to see and document. Now they're usually acute concerns with pre-existing templates (if you're using an EHR) making charting concise. It also depends on what kind of EHR they're using. We use EPIC and I think it has been really helpful to chart since it has an "express lane" function and some "smart phrases/links/box" which makes charting a lot faster. Something to think about, UCCs are volume-driven and they are happier with more patients coming in. Expect to see 20-30 on a good day and 40-50 on a hectic day. Charting might be a breeze but it's still a lot. Once you get the hang of it though, most of our seasoned providers don't take charting home. They usually spend at most an hour later during their shift on a busy day but they never take it home. Best of luck!

I had an interview with the director and she confirmed around March 18 we should be expecting results. This is for the DNP though.

My differential would be the ff: 1. Eczema - possibly refer to allergy/immunology if not managed with treatment of triggers (Allergens, new medications, etc.) Symptoms seem consistent with allergic/chronic inflammation (autoimmune) symptoms. 2. Fungal infection - Consider since he's diabetic. Might explain chronic ear itching and angular cheilitis, but both symptoms can also be seen in an eczematous patient.

I also get where you're coming from. I understand that not all the situation fits it and have the resources available for them and this blanket policy potentially adversely affecting practice for NPs/PAs practicing at your level. You might be perfectly capable of doing that yourself but what about the thousand others who are entry-level into their careers as NPs. Oh no, I didn't say anything about restricting our practice at all. I'm all about collaboration for safer care to my patients, and IN THIS PARTICULAR situation, I would prefer to OFFICIALLY get a read from someone who does this better than I do. As I said, I often tell my patients, "I don't think you have this, so I'll treat you for this, but If I miss anything that the radiologist see, I'll give you a call." Also, don't get me wrong I am all about standardizing and improving education for NP programs. I will go out of my way to contribute to making the NP education better, but that's completely another topic which I think we both are on the same page about. But this does not solve the CURRENT issue, and the CURRENT issue is that most NPs who are in school and have recently graduated were not trained like MDs/radiologists. I am all for the progression of our profession, but I think we should not compromise patient safety in the process because of our ego. It is only my opinion though for this CERTAIN issue. Now, If It was any other issue such as EKG interpretation or any other ridiculous issue proposed against our profession then I'd be against it. I don't mean to attack/offend anybody. I apologize if I have. At the end of the day, I'll do what's safe for my patient, if it means not waiting for the radiologist and relying on my wet read, then so be it, but I'd be the first to call the patient if they see anything I didn't.

I don't mean to be the debby-downer of our profession but I would always wait for the reading of a radiologist for a proper/official diagnosis. I might have some background and knowledge to say to the patient "I don't think you have a fracture, or pneumonia, etc. but I am still waiting on the radiologist's read to confirm it." I think it's fair for them to put it out there and I understand where they're coming from. I believe this is better for our profession if anything because one NP might have had formal training when it comes to radiology but I'm 100% sure most of the programs don't. This is potentially saving our profession the way I see it. What's not clear on that short section is the Section 193.21(d) number 2 where it states "rendering a diagnosis based on the radiological studies." can't be delegated. Do they mean even after the radiologist has read and interpreted it, we still can't diagnose a patient? Now that's different. But in any event, I don't find it offensive, but that's just me.

Just consider that if you want to pursue a specialty such as orthopedics, you would be seen less of a favorable candidate because orthopedics deal with a lot of pediatrics and I believe AGNPs see patients 18 and above only. AGNPs are more favorable in internal medicine clinics, SNFs, Home risk assessments, etc. I would look into the specifics of a job you ultimately want to pursue and decide from there. Plus if you want to pursue a fellowship in such specialties like orthopedics, I believe they only accept FNPs. Best wishes in your choice!

I am familiar with the SNF environment and actually shadowed one NP when offered a job to work at a SNF. They do not have MAs as well, perhaps you can use the VS or information RNs put in their charting to use for your charting? I don't know if your SNF has an EHR or if they do paper charting but I would rely on the data that the nurses input into the patients' charts.

I am fortunate to have received 5 offers as a new grad FNP. I basically narrowed down my choices to just two. They are both for an urgent care setting in two of the biggest healthcare systems in the pacific northwest. My dilemma is choosing between the two, for the purposes of comparison I would use A nd B. The major difference is between the ff categories: Compensation Both are salary position. A is about $30,000 annually higher than B in terms of base pay, but B offers paid CME days that A doesn't have. With productivity bonus, on-call, and picking up 2 extra shifts / month, A can potentially be $50,000 higher in total than B which only has up to $6,000/year bonus based on performance with no on-call and rarely an opportunity for extra shifts. Benefits for both are almost identical, so that's not an issue. Resources A is more of a retail urgent care and B is more of a traditional urgent care, B has more in-house resources (i.e., POC chem panel, etc.) and functions almost like a mini-ED (they only transferred 2% of their patients to the ED last year.) They try to function as an ED as much as possible (They do IV hydration and antibiotics, etc.), which I think is great because I feel like I will have more opportunities to experience, learn, and do a wider scope compared to the retail clinic "we don't have the proper resources, therefore you need to go to the ED" mindset. B also has 2 RNs who do the triage and help with procedures if needed with 2-3 Medical assistants and 2-3 providers in each building depending on throughput, while A has only 1-2 providers and 3-4 MA's with no RNs, and does not do the higher-level services that B provides. Productivity A is a float position rotating between 3 UC centers not too far away from each other and is a lot busier than B. A expects their providers to see 25-30 patients per 12-hr shift and B expects 15-20 patients per day. The medical director of B told me she expects me to see 2 patients per hour and A told me it is a standard to see 3-4 patients per hour. Any opinion about this matter helps. I feel like a would want B but I can't ignore the $50,000 potential difference. Thank you in advance!