mrl3fnp

Before I moved to Houston, I'd already have a job lined up because the competition for nurses is quite high! I used to know RNs there that made about $50/hr in some the hospitals. But you most likely will need 2 or more years of RN hospital experience before anyone will interview you. That's about all the good I can say about Houston is the pay vs. cost of living. Cypress on the northwest side, Katy on the west side and Sugarland on the southwest side are nice cities in Houston terms. In between Katy and Sugarland are VERY wealthy areas. Honestly, Houston is a sewer, filled with very high crime even in the so-called good areas. A few years ago Houston transplanted many folks from Louisiana during the big hurricane. Houston was always dangerous before that. But, gangs from New Orleans have amplfied the danger 10-fold. I would recommend getting a concealed carry license and having a gun loaded in your car and at home? Plan for toll road expenses and commute times which can be quite lengthy due to awful congestion. Plan on pollution. Plan on awful tasting water. Plan on your car getting stolen at some point. Plan on getting flood insurance because most of the city is at risk and nearly every year some part of the city is under water causing everything to be moldy. Houston can be a nice place to visit for vacation and I'd recommend that before moving.

Thanks for the info. I wasn't aware that direct entry programs required no nursing experience. I thought that you had to at least have LVN experience to qualify. I must be showing my age because when I went to NP school every one I looked at required 2 years of RN experience.

Thanks for the clarification. But you questioned whether NP schools have appropriate pre-admission requirements. Did you not? Likewise you questioned whether RNs with certain experience levels are adequately prepared to study as an NP. Did you not? Call it what you want, but if what you saying is true then that is called a bad NP school and that is called a dumb NP student. You speak as if your "crazy morbid curiosity" (your words not mine) has now given you special enlightenment about NP programs. 1) Have you ever been in an NP program??? 2) Do you know how intensive and difficult it is??? 3) Have you ever taken the AANP/ANCC??? 4) Can you back up your claim that NP schools will accept an RN with only 1 year of experience??? (I have never seen any NP school with lower than a 2 year RN requirement). 5) 2 years of direct patient care as an RN = about 3700 hours prior to NP school + any part-time or full-time hours while going to NP school + NP clinical hours an RN could easily acquire more that 6000 direct patient care hours before being licensed as an NP. 6) In contrast, many PA schools that I have seen do not even have a direct patient care hours requirement and if they do it's jobs like CNA, MA, Scribe, etc.....which really isn't the equivalent to direct patient care as an ICU or ER RN. If PAs have a 12 month clinical rotation requirement during PA school = 40hr x 52=2080 direct patient care hours prior to being licensed as a PA. Yet, no one ever mentions that is "crazy with a capital C" (your words not mine). That is why NP schools have a lower clinical rotation hours requirement during NP school.......because as an RN you have an adequate amount of direct patient care hours already acquired. See.......that's the difference between me and many folks out there that have an opinion without any idea of what they are talking about.

If all these NP schools that you speak of are so bad and the NPs graduating from them are so dumb then why do they continually get accreditation and why do the NPs keep passing the ANCC/AANP? Maybe your advocation should be refocused.......

Said the stone-thrower...........Can you focus a moment on efficacy instead of your misandry?

I applaud hospitals and doctors for taking a stand as it relates to breast milk...........Breast milk is a non-negotiable when it comes to positive healthcare outcomes for infants. With that being said, there is nothing stopping anyone in a similar situation from going over the head of a hospital or doctor and renting a pump machine from a DME themselves. I would only use formula as a last resort scenario.

Some states don't require APRN national certifications........In those states, RNs are legally able to practice as a provider. So we need to be careful when we start saying "can't" or "required." I think most nurses come to this website to find truthful answers instead of opinions, feelings, or egos that polarize what we believe to be true.

There is no myth and please there is no ego involved if you have the necessary education.........FNPs are legally able to practice as a provider from ages preterm to death. Women's Health, Neonatal, Pediatrics, Adult, Urgent Care, ER, ICU, Surgery, Psychology, etc......With that being said, and similar to medical students, career options may require additional experience, training, or other factors beyond a successful completion of an FNP program.

EXCELLENT!!

EXCELLENT!!

My advise is to remain respectful, never speak a bad word about anyone, do not worry who likes you, and refrain from reporting. You can't control the way others treat you. Rise above the drama.

These are the biased, financially corrupt, exaggerated, and mathematically impossible studies the CDC uses to influence hospitals to implement policies that mandate forced influenza vaccinations on health care workers at the risk of getting fired if they do not comply. A 2014 study* showed that flu vaccine reduced children's risk of flu-related pediatric intensive care unit (PICU) admission by 74% during flu seasons from 2010-2012. Financial support. This work was supported by funding from the US Centers for Disease Control and Prevention to Abt Associates, Inc, Cambridge, MA (contract 200-2010-F33396). Potential conflicts of interest. J. F. has received travel support from Sanofi for an unrelated project. Another study published in the summer of 2016 showed that people 50 years and older who got a flu vaccine reduced their risk of getting hospitalized from flu by 57%. Financial support. This work was supported by the CDC. Potential conflicts of interest. W. S. reports receiving fees for serving on a data safety monitoring board from Merck and Pfizer and consulting fees from Novavax and Genentech. Flu vaccination is an important preventive tool for people with chronic health conditions. Vaccination was associated with lower rates of some cardiac events among people with heart disease, especially among those who had a cardiac event in the past year. Collaborator. Solvay Pharmaceuticals, which was sold to Abbott Laboratories in 2009 and is a large manufacturer of the flu vaccine. Flu vaccination also has been shown to be associated with reduced hospitalizations among people with diabetes (79%) and chronic lung disease (52%) Date. Evidence-based practice should not rely on out-of-date data from 1997. Do you have any up-to-date studies??? Vaccination helps protect women during and after pregnancy. Getting vaccinated can also protect a baby after birth from flu. (Mom passes antibodies onto the developing baby during her pregnancy.) o A study that looked at flu vaccine effectiveness in pregnant women found that vaccination reduced the risk of flu associated acute respiratory infection by about one half Financial support. This work was supported by the CDC (contract 200-2010-F-33132 to Abt Associates Inc). Another study found that babies of women who got a flu vaccine during their pregnancy were about one-third less likely to get sick with flu than babies of unvaccinated women. This protective benefit was observed for up to four months after birth. Financial support. Bill & Melinda Gates Foundation. (BMGF provides hundreds of millions of dollars each year to vaccines industries, GMO technologies, and sterilization technologies. BMGF is also a huge global depopulation advocate who is currently being sued by the Indian Government for vaccine-related fraud and the killing and injuring of 100s of girls between the ages of 9-15 during HPV trials).

A 2008 study published in the International Journal of Infectious Diseases concluded that when used correctly, masks are highly effective in preventing the spread of viral infections. Family members of children with flu-like illnesses who used the masks properly were 80 percent less likely to be diagnosed with the illness. Surprisingly, the difference between types of masks used was insignificant. Another study published in the Annals of Internal Medicine reported similar results. Researchers looked at 400 people who had the flu. They found that family members reduced their risk of getting the flu by 70 percent when they washed their hands often and wore surgical masks. Other studies found promising results outside of the household. For example, one such study was conducted by a team of researchers from the University of Michigan on more than 1,000 students living in residence halls. They assigned the student to groups: those who wore masks, those who wore masks and practiced hand hygiene, and those who did neither. The results showed that those who wore masks in residence halls and practiced good handwashing reduced their risk of flu-like illness by an astonishing 75 percent (Story & Cherney, 2015). I have yet to see an unbiased and financially uncorrupt influenza vaccination study showing the effectiveness at reducing the risk of spreading influenza comparable to that of wearing a mask. If health care facilities were really concerned about patient health and reducing the spread of hospital-acquired influenza why do they not implement a mandatory mask wearing policy for everyone? Especially when the flu vaccination is so controversial and so many health care workers have legitimate objections.

There much more data in the literature and many more conclusions in the discussion………………. Policies of enforced HCW influenza vaccination are gaining popularity in North America, bolstered primarily by four cRCTs broadly interpreted to prove substantial patient benefit. Our analyses, however, show that these policies lack a solid empirical underpinning. Although RCTs represent the gold-standard study design for assessing interventions, unblinded cRCTs are at greater risk of bias and where their conclusions appear implausible caution is required in their interpretation, particularly if used to guide policies that abrogate individual rights. In that regard, each of the four cRCTs used to champion compulsory HCW influenza vaccination policies reports patient benefits that are mathematically impossible under any reasonable hypothesis of indirect vaccine effect. Whereas it is assumed on the basis of these studies that unvaccinated HCWs place their patients at great influenza peril, we show through detailed critique and numerical recalibration that these impressions are exaggerated” (De Serres et al., 2017) Cluster RCTs are at greater risk of bias to explain findings than trials with individual randomization. As highlighted by the Cochrane group, the cRCTs showing patient benefit through increased HCW vaccination in LTCFs suffered multiple methodological issues including failure to conceal group allocation (i.e. blinding), poor performance in increasing HCW vaccine coverage, insufficient power to assess specific influenza outcomes and the possible influence of selection bias. None of the trials provided information on other co-interventions such as hand washing, quarantining, or requesting/requiring HCWs with ILI to stay home or mask. Education and other promotional efforts delivered as part of a program to increase voluntary vaccination within intervention sites may have simultaneously enhanced awareness of and compliance with these other more broadly protective practices, which may have then confounded or compounded the vaccine effects” (De Serres et al., 2017) Supporters of compulsory policies have cited other studies, including an additional cRCT conducted by Riphagen-Dalhuisen et al in acute care facilities. The main objective of that trial, however, was to assess whether a multi-faceted intervention could increase HCW influenza vaccine coverage. Influenza illness in patients was only assessed as a secondary outcome, without standardized surveillance and based only upon retrospective assessment through computerized discharge notes. The authors reported a significant 50% reduction in the combined outcome of pneumonia and/or influenza among patients in the department of medicine despite just 8% difference in HCW vaccine coverage between the intervention and control groups. As per above, it is not possible to attribute this magnitude of reduction in patient outcome to such minimal change in HCW vaccine uptake, particularly since many pneumonias do not have influenza as a root cause and are not preventable by influenza vaccine, directly or indirectly” The US CDC review also considered four observational studies that have reported indirect patient benefit through HCW influenza vaccination. These observational studies are even more susceptible to bias: each reports percentage reductions (three of four in relation to ILI) that substantially exceed increments in vaccine coverage and are irreconcilable with the principle of dilution” (De Serres et al., 2017) De Serres, G., Skowronski, D. M., Ward, B. J., Gardam, M., Lemieux, C., Yassi, A., . . . Carrat, F. (2017). Influenza Vaccination of Healthcare Workers: Critical Analysis of the Evidence for Patient Benefit Underpinning Policies of Enforcement. Public Library of Science, 12(1). doi:10.1371/journal.pone.0163586

Unbiased studies with no financial corruption................ Dionne, Brett, Culbreath, and Mercier (2016) concluded that once the rate of influenza-vaccinated healthcare workers reaches about 50%, there is no further reduction in the rate of patients with hospital-acquired influenza.” At a certain point, you don't have a real return on vaccination for reducing nosocomial flu, and we should look to things like hand-washing, better screening of patients, surgical masks, and better isolation precautions." During the five flu seasons from 2010 to 2015, there was a significant increase in the rate of vaccinated healthcare workers at the University of New Mexico Health Sciences Center.” However, the rate of hospital-acquired influenza - defined as infections diagnosed at least 48 hours after admission in patients who presented to the hospital without influenza-like symptoms in the previous 24 hours - plateaued once about half the healthcare personnel were vaccinated” (Dionne, Brett, Culbreath, & Mercier, 2016). Dionne B, Brett M, Culbreath K, Mercier RC. (2016). Limited Effect of Healthcare Worker Influenza Vaccination Rates on the Incidence of Nosocomial Influenza Infections. Infection Control Hospital Epidemiology, 37(7). 840–844. Retrieved from DOI: Potential Ceiling Effect of Healthcare Worker Influenza Vaccination on the Incidence of Nosocomial Influenza Infection | Infection Control & Hospital Epidemiology | Cambridge Core