bnw6385

I would do it, but I literally do not qualify after the asthma diagnosis. They will not give me medical clearance. Was really disappointed, but I moved on.

Well, I got diagnosed with mild asthma during the process, so it all got shot. No meds needed to manage it, but it was enough. No active duty. No reserves.

Treating a patient outside of a protocol is not practicing medicine without a license. That is a ridiculous statement. It may get you fired there or make you carry more liability, but we diagnose and prescribe by trade.

I am going to take a different route and probably upset a lot of people on here, but CAN WE PLEASE STOP GETTING SO UPSET OVER ONE JERK'S STATEMENTS?! It makes us look weak and thin-skinned. If you know what you are capable of and do it well, let your work speak for itself. Let this guy make an a** of himself. Get on with your day! Most docs I have worked with have known they were "ship captain," and I worked to the top of my license in collaboration with them. Of course, I work in Critical Care, so it has to be this way. Like it or not, docs learn more than we do and understand patho, in general, to a deeper level than we do. NPs working in specialties should always be in collaboration. NPs working in primary care should have full time experience of at least 3 years but then should be able to go independent. Fight for reasonable goals and get down to reality, that we work damn well under our scope of practice, but thay scope does have its limits. Stop fighting every time someone insults you or your profession. Nursing kills its own image and any chance of being viewed well when nurses are constantly whining about needing respect. Learn to.let stuff like this go and just grow up. Show everuone he is the one with an issue. Getting worked up and into arguments with people like this make us look as bad or worse.

Simply put, NP training relies on your basic health care exposure as an RN so the training can be shorter. By no means does being an RN mean you will make a decent NP, but NP school skips much of the basics. PAs train on a medical model and start from square one. Honestly, they get more standardized and better basic training even though we end up practicing virtually interchangeably. If you do not want to be an RN, go the PA route. It is that simple. There should not by any program out there that offers someone to just go straight to NP.

Many of these nurses criticizing me are the ones "sneering" at the lack of competence of their colleagues when they're taking report on transfers. You know you do it. As for contradicting myself, working as an RN does not teach one to be an NP. It DOES give one exposure to duseases, patients, treatment modalities, and the workings of an Acute facility. These are important to starting advanced practice. That was the point. My statements are not just me by the way. I have spoken to MANY high performing NPs who think the same. I just happen to be the one on here talking about it.

I don't care. You are correct. I appreciate that there are people willing to stay at the bedside, but I expect RNs to provide the standard of care. Many do. I am responding to the fact there are RNs on here who have no idea what it is to be an NP, dog all of the NP profession, and act like they walk on water. A dose of reality doesn't hurt. Concrete examples of poor RN practice: 1. Nurse had no idea WHY her pts were in the ICU at rounds. Had to go get her shift report. 2. ICU nurse had no idea what a CVP was or why we monitor it. 3. ICU nurse not monitoring urine output on a pt with AKI following cardiac tamponade. 4. Pt with elevated CK, multiple fasciotomies, acutely low CVP and Hgb, with falling BP. RN starts pressors and doesn't report to providers. 5. Floor nurse calls at 0300 to report acutely low BP of 110/45. Np BP change in days. 6. Could go on and on. The point is that while bedside nurses may be able to bash NPs on an NP forum, it is time for a reality check. Your work is appreciated, but the providers are saving your tails and educating you sometimes without your realizing it. That goes both ways, unlike how some bedside nurses are making it sound. As for being respectful in the workplace, there is no excuse for any other attitude, despite the fact that I can empathize with the physicians now unlike any time before in my practice. This forum is the kind of place to bypass formalities and get down to the bottom line.

Burn! I did not expect bedside nurses to take that for what it was, criticism of their lack of critical thinking and a call to improve. Nursing is not known for its thick skin and professionalism. My statements obviously do not apply to all, but they apply to enough.

I do fully believe admission standards are becoming more of a joke for NP school by the day, and we are overestimating the market which drives down our wages. The physicians talk about enrollment needing to increase while simultaneously lobbying against it to protect their incomes. I do think we should go to that extent, but the assembly line of NPs has to slow dowm, and admission standards must go up. As for the thought processes between RNs and NPs, generally speaking, RNs are reactionary by training. Sure, they can and do see some disasters on the horizon and notify the provider, but they do not have to run down the differential and treat for the multitude of possibilities. That is not a knock on them. That is what the training of the RN is, and many are good at it. However, many should not even be licensed. I do not make my nurses feel their calls are unwelcome. That is simple customer service, and I want to be available the times they get it right. As for them being more my colleague than new NPs, that is still the "eating your young" mentality that runs rampant in this profession. Lobby the schools to make changes to admission requirements if you think they should change, but until then, treat the new NPs well and teach them what is necessary. Like it or not, you can try to separate your practice from theirs as much as you want, but you will be judged by their practice and the practice of poor NPs in general. Again, I will probably take a ton of heat on another statement, but I will make it anyway. Nurses should not be allowed into NP school, of any kind (except L&D nurses going to Midwifery), without at least one year in an ED or ICU. As others have stated, there is a level of assumption of knowledge base of the newly minted NP student. It is not insurmountable to make up for this as one goes, but I want the best as my colleagues and a limited number of graduates, not someone who just barely managed. Those shortcomings do become evident in the clinical arena. I acknowledged my shortcomings coming out of school despite my ICU experience and worked internal medicine for two years before going to work with Intensivists. The vast majority of students bypassing the bedside work will have to acknowledge some considerable limitations on graduation. I know I went over a couple things in this post, but it needed to be pulled back to the OP's inquiry.

Ruas, any substantive remark or just the sarcasm?

It is easy to be respectful and professional in the workplace, Jules. I have no problem doing so. I am not surprised at the reaction here, though. It is funny, however, that you would react this way, but when RNs are insulting all of our colleagues and speaking as to how fantastic they are, you seem to find no problem with it. I was speaking to the FACT that I have constantly had to keep RNs from seriously hurting patients, and when covering floors, feel like half my job is keeping those nurses from killing their patients. I educate and correct, with respect, but it does not mean that I do not remember what happened. Unfortunately, I entirely understand where RNs would and do lose autonomy. Since becoming an NP, I have been thoroughly disappointed at the lack of critical thinking skills. When those calls are not being directed my way, but going to physician who are seeing that on a more massive scale, it hurts the nursing profession as a whole and is utterly embarrassing. It then is no wonder they seek to limit NPs. Call me what you like, but I will not sugar coat this outside the workplace to make people feel better. Call me a coward for doing it here. That is okay, as well. I have a thick skin. I also habe the guys to call things as I see them...at least in an arena where I won't be fired.

Somewhat off topic, but someone has to say it. To the bedside RNs here, your work is much appreciated. I got out of that as soon as I could. I have been a critical care NP for 3 years now and an ACNP for nearly 6 years total. New grad NPs should be watched pretty closely, agreed. However, that is up to the NP, PA, M.D., or DO, the NP is collaborating with. It is your job to clarify orsers. There may even be things you can teach an NP because no one knows everything. All that being said, the things I habe seen and been asked by critical care nurses are truly horrifying and downright dangerous. These were the same CCRNs walking around acting like their you know what was top notch. When corrected, they got defensive as opposed to learning from errors, even though it was done respectfully. Granted, the floor nurses are leaps and bounds scarier and likely kill people on the regular, but for RNs to come in the NP section and act like they know it all and how to do our jobs better than many of us is...frustrating...to put it lightly. The job is totally different, barely even nursing anymore. The thought processes are entirely reversed. The knowledge base is miles beyond RN teaching. Sure, it takes APPs time to get there, but until you're there, the RNs like the one who called the OP a sellout (paraphrasing) just need to keep quiet.

I always discuss my income with other NPs. My colleagues have been settling for far too little with far too many demands. It is only getting worse as more and more new grads poor out into the streets. ALWAYS discuss pay with your colleagues. Their salary negotiation failures will become yours in the long run. I also agree with one of the previous posters. All I heard was whining. Grow up, suck it up, and go kick some tail. Stop being the victim.

It is NOT recognized in any branch. You go in as a Critical Care RN or Emergency/Trauma RN or Flight RN.

By the way, on this 15th Anniversary of 9/11, I want to say bless those who lost their lives in the cowardly attacks. Bless the officers and firefighters, my fellow health care workers, and all servicemembers who responded to the call to defend this country. We live in an amazing time of technology combined with Medieval Barbarism. If anyone on here is reading this and thinking of serving the country, thank you for even making the consideration.