aok7

The hospitalist role as a FNP-trained new NP should be a role that you ensure excellent training and support is available. Both roles show fair pay, and pay comparisons as the bulk of the presentation of each job, I would be concerned that I might be earning every cent+ of the hospitalist role if I were not appropriately prepared. I think I would do whatever I could to get your hands on some "mock" cases and imagine if you were completely managing the cases whether you are either prepared or interested in investing in being prepared if you're not. I say this because ACNP programs are gearing more toward in-patient preparation for graduates.

I have also had experiences like you are describing. It feels horrible, and the tendency I found was to try to work harder to "prove" that I am worthy. A very kind (and impressively confident) NP colleague at the time (this had been in my 2nd year during my first job) shared with me the power of owning our "power," and she compared the importance of genuinely trusting our value to that of the senses of a horse, where she described how horses KNOW if we are anxious, nervous, or whatever. They'll knock us off, no doubt, she said. She compared patients the same. And the more we try to please this type, or serve, the more they will pounce. This was completely practice-changing for me. There are always going to be a few patients who are difficult, and they likely would be for physicians or anyone else, too, but we have to get to a point where we truly believe we are a gift, OUR time is their gift, so to speak. And it is all with the same patient-centered respect, the same great care regardless. And whatever you do, do not show you are "trying hard" for them, no matter how you feel inside.

You are wise to ask the questions about where you want to work. In my relatively short time of 5 years of having been a NP I have found employers are becoming MUCH more interested in background and area of study. Acute prepared NPs do have a lot of options outside the hospital (thinking specialty outpatient with often inpatient mix). I am adult-primary focus and am in nephrology, and part-time positions arise in my field not uncommonly. FNP would honestly provide you with the most options in regard to flexibility and the like. That said, employers are much more picky about capturing evidence for targeted preparation both in RN and NP roles because sadly the light is ON that NP licensing does not necessarily confer preparation for practice. All the best, and congrats on all of your accomplishments.

I am pleased to see how medications like semaglutide are helping to open a pathway toward understanding how obesity management requires the same kind of respect and evidence-based practice as any other medical condition. That said, as a NP who orders medication like GLP-1 agonists, SGLT2-inhibitors and other medication toward reducing risk for kidney disease progression (thinking obesity, cardiac, diabetes management,...), I have to fight hard to argue to get medication like these newer agents approved through insurance. At that, I would not be the one to pick up (or get) the medication from pharmacy...it would be the patient. And honestly, I would not personally administer maintenance medications like this, as this is more the role of RN/LVN if it were to be. The question is that of the order and "mass" sharing of supply...which patient has the supply in their name?...or is the midwife (here too, high risk as this agent is not used in this specialty) who is ordering it personally for ? who. So much here does not match, and it would be very easy for the appropriate regulatory board to figure this out if not legit. I wonder what's in that TB syringe?

practice answering test questions

I did not maintain my active RN license where I also earned it first in MI. I maintain WA, OR, and CA licenses for RN and NP because these are the states where I would be most interested in practicing. I live and work in OR. CA license is the only exception where I would say if you have established it then keep it up since the process of getting it is long and can be more complicated.

Office nursing, as where I work in an outpatient clinic the RN is inherently lead for medical assistants and in general. Hours are the great benefit and not with the physical work which sounds as though you have put in your time. Pay overall is less but as I see lifestyle is the reward.

I am afraid we as a profession have already solidified our reputation. Just imagine any medical or PA school opening their doors to anyone interested with minimum standards? And then promoting students onward with such broad and flimsy requirements...to where among students there can be an argument of whether written and verbal professional communication skills are necessary! And if instead of ensuring solid science core and clinical competency skills were met in clinical setting that instead sending a message of confidence ruled? The old "fake it!" and "act like you know what you are doing" permeated? The NP identity just is not in-and-of-itself able to represent and carry us. We have to work and prove our worth unlike those with whom we are supposed to stand among. And actually we have to work even harder now at baseline, as there is no longer even a question of the implosion of our profession due. It is a tragedy we have created ourselves. I feel sad for the NPs attending for-profit and other sub-par schools, but at some point this has got to change. I mean, we each need to ask ourselves if we would want to be seeing ourselves if we were the patient with the particular complaint. And start from here in a very painful way of probably closing down many schools who do not provide outcomes and limiting student number in general to match actual availability of quality instructors and clinical staff.

I think your post should be considered by students and those wishing to become NPs and so is much appreciated. The steps taken toward a NP career are critical, as each job we take kind of etches opportunities and, sadly, can close other doors. I wanted to be a nephrology NP with a passion but was with more geriatric/internal medicine RN then NP experience. I pretty much paid (right) to get a preceptor in nephrology and seriously would have volunteered in a dialysis clinic if I had to in order to get where I am. To many this would seem insane, but nursing competition (for the ideal jobs and highest paying/best experience jobs) is not unlike law or business. There's a RN working in dialysis who is in NP school with the plan to be in women's health. I beg her to get a job in the hospital in ob/gyn or the like. She is certain (per her school, jobs abound LOL) that she will be hired in ob/gyn without the RN experience. You might have to put in some time which is less than ideal but more aligned with your goals. Doors will then open, you'll meet people who help direct you, and before you know it this current situation will be part of your character and history.

I have licensure by endorsement in CA and am currently practicing in OR but maintain my CA licensure after the extensive time and effort required to get the license. It took me no less than 6 months for the processing of my license in CA. I don't think there are any special tips, just follow the basics of what is required. As well, I had to contact my school for supportive information. This took a good deal of time. The salary of NPs (and RNs) in CA is one of the highest (if not the highest) in the country. The desperation certainly does not seem to be on the side of the State of CA. Don't lose sleep over this or stress about it, as there's nothing against you and certainly the system per CA is not broken, truly. This has been years and years of a state where nurses seek practice. It's super expensive, as well, incredible fees for full practice as a NP.

I am so sorry to hear this for you. NP education is becoming a joke, it is so sad and only our fault as a profession. If I were to have to do it over again I would direct my effort toward PA school. Of course, very competitive, high standards at base of consideration for entry, and would not be able to complete the program while working full-time (or likely even part-time), but I would be prepared to practice with solid investment from my school and profession ensuring that I am truly competent at baseline.

Yes, both. I started as a CNA and though the steps from LPN to MSN continuously through school and I would not go backward with any step but would not bypass any of them either.

And sorry, to clarify your specific question, perhaps if you worked in a specialty geriatric ED which ONLY sees adult you would only need adult. As I said in above, there are outliers.

The consensus model in many hospitals IS being followed, most notably in the eastern states. I am finding it becoming more important to have a career direction (as you do) prior to going to NP school, if possible. Within the hospital in general (not necessarily ED), acute care NP is important for credentialing. For example, I was still a RN in NP school when a co-worker a semester ahead of me was hired for a hospitalist role at our hospital. She was family. She actually started training, was well-established and respected by the docs, all that...well horrible here she ended up not being credentialed by the hospital. I get goosebumps still thinking about this. She ended up working getting a job in outpatient setting, but it was months waiting for credentialing and turning down job interviews, etc., thinking she had a job. Anyway, if you want to work primary with all ages then family is the way to go in urgent care or family, in general. Ob then the midwife etc. ED, find an ED program. Peds, either acute pediatric program or family. Hospitalist or ICU acute adult. Outpatient specialty or adult/geriatric, adult/gero primary. Psych, of course psych. You will find there are a lot of post-graduate programs, and this will be your answer if you want to cover a spectrum of, say, completing an adult program but then doing a year of post-grad family to capture pediatrics for kids. Or working in a hospital and needing acute, do an acute post-grad, as my friend was considering.

Sorry to hear. Get back up! Fitzgerald is a course I did for prep and I recall very clear direction in advertising on the site about hours directed for CE such as this, but as above I always ensure the facts from the source.