JellyDonut

I remember having this discussion years ago with an LPN when I worked as an ADN in a long term acute care hospital. I explained that even with similar responsibilities the pay should not be equal. The RN has more education and has invested more time and money into achieving the designation. As an ADN at that time I fully supported BSN making more than me and MSN earning more etc.. The LPN and everyone along the chain has the opportunity to move their career forward with additional education and with that the expectation for increases in salary. To assume an NP and board certified intensivist should be paid the same is just ridiculous.

If I were younger I would go the MD route... I know now they are not that bright and I could coast their program

I served as an RN and it is something I am very proud of. I would suggest requesting to shadow an FNP as it is a different world in the military. I encourage everyone to serve... it is the ultimate honor, but know exactly what you are getting into...esp as an FNP...I have several friends who have gone that route

My first year was horrible as I was a spanking new grad in a specialty with two physicians who help pulmonary and critical board certifications. It took two full years to receive my very first compliment. And by year three i no longer received the "side eye" for questioning their plan of care. I studied..asked questions..spent hours reading..and finally reached the point where i earned their trust...I can now tell either of them they are wrong and they do the same. it takes a while...but in the end it is so worth it!!!

I have worked in a specialty for several years now and I often work on my own. However, I always have specialist who know way more than me to check in with if I am unsure or I need more of an expert opinion. I cannot imagine treating patients without support with only a fe months training. I can't see that being a safe environment and you could be opening yourself to liability.

I had to chuckle at this one...No one on Earth orders more useless testing than do residents. The hear hoofbeats and immediately think Zebra or unicorns.

Depends on where you live. Where I practice the NP hospitalist and most of the NPs rounding IP are ANP or FNP. I have met maybe 3 acute care NPs in the past five years. Sure, we were told about the consensus model in the state I completed my FNP, but it has not seemed to gain the traction we were told. Even if my state adopted it everyone would be grandfathered in as there is no way they could replace all of us with ACNPs. If you work in a state with the model - stay in your lane, but if you have the opportunity to work acute and don't mind a learning curve - then make it happen. You can always bridge later if you need to.

In my practice we sign for each other all the time. it is usually refills, rehab referrals and oxygen. Did not even think of it as an issue.

In clinic anything...however, there are some off medicate rules about rehab and home care. In patient is different, you require sign off by MD (i have been told this is still the case in full practice states, but i have not confirmed it).

Way back in the olden days when i was an ICU nurse we commonly wrote orders for certain providers daily. This was back when paper charting was all the rage (LOL). it was how I learned the ropes in the ICU and I worked with very experienced nurses. Often the surgeons would leave and yell out verbal orders along with, "and whatever else you think they need". Our open heart standing orders had at the end, "or whatever else the RN deems necessary". Those were different times back then. Years later I move and work for a teaching facility where you did nothing without a physician order. I found it frustrating and honestly felt it sometimes got in the way of caring for the patient. I remember a patient desaturating and I started bagging the patient and performing some deep suctioning. I was later reprimanded for not calling a rapid response as nurses cannot determine the proper treatment for saturations under 90%. In reality they wanted the residents to handle these type of situations. in the end I think it was my frustration with the restrictions that pushed me to get out of nursing and reach for new goals.

i never ever thought open visitation was a good idea in the ICU. I have read a few studies, but always questioned the validity as there is more than family satisfaction. In Texas we had a unit that allowed 30 minutes ever two hours and it started at 0900. We could could take care of AM care before families arrived then when they left we could do dressing changes, reposition, clean and take care of other procedures that needed to be taken care of and then when families visited it was their time with the patient. I have worked in open visitation facilities and most families are okay, but there are always a few who make it difficult to care for the patient. they keep the patient awake and make it difficult to get things done. In the ICU the focus needs to be on the patient and not the crazy aunt or drug addicted sister. I have some horrible stories of families twisting ETT or climbing into bed with burn patients. ICU nurses thrive on control and open visitations impact the ability to be in control.. Sorry...but in most cases I feel it is more harm than good.

Go with your gut. not every provider/patient relationship works and it is sometimes better for all to seek another provider.

Experience as an RN is still experience and helps to broaden the depths of knowledge the person has. I attended NP school and it was much easier because I had the experience of being a critical care nurse for 100 years (at least it felt like it). NP school only scratches the surface to get you into an entry level role but the experience does help fill in some of the gaps along with a good mentor and hours upon hours of self study. There are many ways to get to the entry level role of NP but to state that RN experience is not benefit is just sadly incorrect. It plays a role and depending on the experience and the individual it may play a larger or smaller role. Most NPs come out of school and do not know jack, the best ones know that and work to make up the difference.

So arbitrary. FNPs practice in more acute care settings than ACNPs. If the goal is to align specialties then there needs to be more available specialty programs available to rural areas and it needs to be set with the same deadline as DNP requirements. The consensus model is a urban myth where I live and practice - maybe the next generation will deal with that along with the for profit NP factories, but I doubt it impacts me in the near future.

There are dual DNP/PhD options available.