American Academy of Nurse Practitioners / General / General NP Topics

National NP Business Survey

BARBARA PHILLIPS — Mon, 28 Jun 2010 21:21:50 GMT

The National NP Business Survey (sponsored by NPBO™) is directed toward NPs who have a clinical or non-clinical business, or are thinking of starting a business in the next 5 years. This survey will take no more than 5 minutes to complete, please take it today and pass it on to your colleagues.Make sure you are counted! [url=http://www.NPBusinessSurvey.com]www.NPBusinessSurvey.com[/url]Thanks,Barbara C. Phillips, NP

Certification Question from Canadian NP

DONNA ALDEN-BUGDEN — Thu, 06 May 2010 23:46:55 GMT

I am a licensed Nurse Practitioner in Canada having graduated with a Masters in Advanced Practice Nursing in 2003. I have been practicing as a fully licensed NP in Manitoba for 4 years but have been in the NP role for 11 years. I originally took (and passed) the ANCC Family NP exam to license here in Canada but I am not certified by ANCC as the exam was simply the licensing exam our province purchased from ANCC to certify here in Canada. I am also finishing my DNP (Post Masters) at Case Western Reserve University in Cleveland in the next 8 months (just completing the dissertation now). My question is, the NP program I took required only 480 clinical hours but the AANP exam states that the minimum is 500 hours in the Masters program to apply. Does anyone know if my hours in my work practice count as clinical hours and how is it possible to make up those 20 missing hours now that I graduated 7 years ago. I have practiced as a Family NP since 2004. Is it still possible to apply for the exam? I have a current license as an RN in Manitoba and Minnesota and an NP license in Manitoba but I wish to license as an NP in Minnesota as well. I am also a current member of AANP. Since I do not have formal ANCC certification even though I passed the exam, I don't believe I can apply for reciprocity. I tried e-mailing someone at AANP but I got no reply so I thought I would try the forum.Donna Alden-BugdenDonna@NPCanada.ca

Are there other NP practicer owners here yet?

KATHY PATTERSON — Sun, 26 Apr 2009 18:31:01 GMT

I just logged in to explore the forum.
My name is Kathy. I have had my own practice in rural North Carolina for 2 years now. I bought a hospital-owned practice that I already worked at. It's doing great and I love it! We just moved to a new space next to a local pharmacy.

Sometimes I feel so isolated as a practice owner. I'm on some management lists but the people there are HR or management people, not practice owners & clinicians.

Anybody else here? :)

Kathy Patterson
http://www.yanceyvilleprimarycare.com

$150,000/year salary!!!

HELEN ESCHENBACHER — Thu, 07 May 2009 23:47:52 GMT

Come on NPs! Certainly you have lots to say on these forums...I never knew a nurse who didn't have strong opinions on something! I see lots of visits but only a few replies.

Add to the forums. bring up topics...you can't be totally satisfied with our profession!

What do you think about certification? should there be two bodies of nurses each doing thier own certifying? what about continuing ed? do you think it is too narrow? too expensive?? Not comprehensive...a waste of time?

SPEAK UP!!! Add a reply or start a topic today! We're tired of looking at each other...(not really)

What do you think about nationalized medicine? Should it be kept in private companies? How do you feel about bailing out Wall Street while 47 million people have no insurance?

Do you really enjoy being called a md-level practitioner????? Haven't we been seen as second class citizens in our entire nursing careers? Speak up!!

FNP Faculty

KATHY MORRIS — Tue, 02 Feb 2010 16:25:19 GMT

My University is trying to recurrent doctorally prepared FNP faculty.I am a DNP and would love to see more DNP's in the faculty role. Does anyone have any good ideas on how to reach out to new DNPs or know anyone that could be interested in coming to Nebraska?

Bonus Structures for NP's

AMY TROLAND — Thu, 04 Feb 2010 14:55:39 GMT

I am curious to know what types of bonus structures are in place for nurse practitioners in primary care and convenient care. I do a little of both and am looking at making changes to this aspect of my contract. Any ideas would be very helpful.AmyWashington, Indiana

Minute clinic NP role

SUZANNE WEBBER — Thu, 14 Jan 2010 14:53:12 GMT

I was wondering if anyone out there works or have worked in a minute clinic type position. This is something I am considering and would like some feedback.

New NP Help

AMBER GROSS — Tue, 20 Oct 2009 16:07:41 GMT

I just recently graduated and passed my certification exam, but now I don't know what to do or where to start. I am filling out my state board paperwork to get my license, but I don't know what else I must do. NPI numbers, etc.. Do I wait till I get a job or do I have to do all of this before hand?? Any advice would be greatly appreciated.Thanks, Amber

Initiating Home Health and Hospice Care

CHERESE — Tue, 10 Nov 2009 00:27:09 GMT

As many of you know, due to legal language, we are not allowed to initiate home health and hospice services. There is now a survey by the hospice group in Oregon that you can fill out to evaluate how this impacts our ability to practice. This is one of many steps to try and advocate change. Please go to the following link and complete the survey: http://www.zoomerang.com/Survey/?p=WEB229HVQN7DCJ When you are finished pass this on to as many practicing NP's as possible. The greater the response the greater they can advocate change on our behalf. Thank you!

"mid-level practitioner"

HELEN ESCHENBACHER — Wed, 15 Apr 2009 15:27:34 GMT

Does anyone else have a problem with being the same, or in some cases inferior to PAs? I worked hard for my accreditation and Master's degree yet I get lumped in with "60 day wonders" who are called PAs.

Here at Kaiser, PAs have more standing and are paid higher. In fact Kaiser has eliminaed most of its NP and RN postions. And since PAs are licensed with an MD, Kaiser is allowing them to even do plastic surgery such as Restylane injections and dermabrasion.

I'm an independent practitioner and I watched this "melding" of the professions over the last 30 years.

TriCare

CATHY ARVIDSON — Fri, 09 Oct 2009 12:15:17 GMT

I got the following from one of our Idaho NPs (it is from a tricare newsletter). For those of you in specialty practices have you seen tricare refuse reimbursement of your services? This could set an important precedent for other insurace carriers. I have notified Jan Towers but wanted to hear "from the ranks"

"TRICARE policy states only medical doctors and dentists may do consultations [Code of Federal Regulation (32 CFR 199.22)]. In addition, TRICARE Management Activity (TMA) has determined consultations billed under Current Procedural Terminology (CPT) codes 99241-99275 by nurse practitioners or physician's assistants are not covered by TRICARE."

NP friendly areas

HEATHER LIEN — Tue, 09 Jun 2009 13:39:49 GMT

I am considering relocation due to my husband's employment. I'm wondering about how NPs are treated and utilized in different states/regions. I live in Washington state which I consider to be very "NP friendly". We have good autonomy and compensation seems along with the national average. How are things in your neck of the woods?

Primary care evaluation of MVC patients

KELLY SANDERSON — Wed, 08 Jul 2009 08:16:43 GMT

Anyone out there know of a good resource/reference for evaluating patients that have been in car accidents? I haven't been able to find a good summary anywhere. I've had a few of these patients in the last couple of weeks and want to make sure that I'm doing a thorough evaluation, while at the same time not going off the deep end with too many xrays, etc.

Thanks!

"Cost effective" NPs

BARBARA PHILLIPS — Sun, 05 Jul 2009 15:43:48 GMT

While I enjoy some of the attention we are getting as far as being a health care provider, I do take issue with us being "cost effective". While our salaries are certainly lower than a physician, insurance reimbursement is equally as low.

The problem comes up for those of us with our own offices. Our overhead is on par with that of the physician office (of course, adjusted for size, # of staff, etc). In fact, the only real cost difference is perhaps our malpractice (leaving out provider salary).

My concern is that as NPs emerge as preferred providers for primary health care, will our reimbursements drop even lower? Will independent NPs with their own practices have to struggle to stay open due to the lack of reimbursement?

In WA State, DSHS/Medicare just reduced reimbursement by 11.2%, effectively immediately. This affects all "physician services" thus it affects physicians as well as NPs and PAs. In our office, the cost of seeing someone for a 99213 visit, is at our break even point and means fewer providers in our area will see this population. We also have to re-evaluate our ability to provide services to this population.

I don't expect an answer, but I do want to caution everyone about NPs being "cost effective". It's essential that our reimbursement covers the cost of delivering care - so that we can continue to do so.

Barbara C. Phillips, NP
Practice Owner
www.NPBusiness.ORG

Nashville Conference

BARBARA PHILLIPS — Tue, 23 Jun 2009 20:45:18 GMT

Wonderful conference this past week! Thanks to everyone who made it happen. :D

I am looking on the website for slides. At several talks, we were told the updated slides would be on the website. Can someone point me in the right direction?

Thanks,

Barbara

Hospitalist NPs

PATRICIA MEADOWS — Thu, 16 Apr 2009 19:27:23 GMT

I recently changed from working in the ED to being a hospitalist NP. I love my new job but feel like there is so much I need to catch up on. The learning curve has been huge. Are there any other hospitalist NP out there?

NP process protocols and practice agreements for free

ALFREDO BIMBELA — Tue, 19 May 2009 00:46:17 GMT

In the effort to make it easier to enter the nurse practitioner profession, there is now a place to download and share forms and documents with other nurse practitioners.

The best part:

No Login
No Registration
No Membership
No Fees

Please feel free upload your forms so that others can benefit from the NP freebies.

NP Locum Tenens

CHERYL BURLEY — Sun, 03 May 2009 15:26:30 GMT

Hi!

I have been an FNP for 7 years in primary care and a PMHNP for 2. I was a critical care nurse for 20 yrs before going back to school. I was just about ready to hit the road and take up doing locums to see the country in my RV when the economy tanked. Now I am a little nervous about taking 3 month assignments not knowing if there will be another when I finish. I'd love to hear from other NP's who have experience doing locums with recommendations about which agencies are best to work with, questions to ask before going or any other pearls you have picked up.

Cheri

prescriptive authority

HELEN ESCHENBACHER — Wed, 06 May 2009 17:47:06 GMT

I know that all states have varying legislation on what they can prescribe. I have had APRN licenses in 4 different states before specific prescriptive legislation. Is it now difficult to meet specific prescriptive authority from state to state?

Has anyone tried?

Print size on screen

MICHELE C. — Fri, 08 May 2009 18:23:57 GMT

Personally, I do not need glasses and can read the screen print just fine. However I have been on other forums and the print is larger, closer to the size you see when you are typing a reply. I'd like to see the print size increased.

Also, when you enter a topic to catch up, I hope ther will be a "Go to last unread" button.

Any New-Grad NPs out there?

KELLY SANDERSON — Fri, 08 May 2009 07:32:30 GMT

I just completed my first year of NP practice. I can't believe what a year of growth and change it has been! I'd love to hear from other new NPs and compare notes on how their transition to advanced practice is progressing. Is it meeting your expectations?

Also--I'm in the very early stages of developing a mentorship program for my region for new NPs. I would love to hear from new NPs about the kinds of things they struggled with in their early years. Do you think you could have benefited from having more experienced peers available to answer questions that came up?

Looking forward to seeing this forum blossom...

Returning to profession

HELEN ESCHENBACHER — Wed, 15 Apr 2009 15:20:10 GMT

Because of a severe disability I have been unable to work at all since 1995. I have kept up with advances in medicine by podcsts from peer review journals, major newspapers, nursing publications but it seems as if I have no confidence left.

Yes, I'm doing online continuing ed and local seminars (what few there are in Hawai'i), but I used to have such complete confidence in my skills, observation, analysis, and treatment protocols. Now I don't have that confidence...

Any suggestions? I love being an NP and even used to have my own rural practice and own medical clinic. I delivered babies, did my own xrays and labs, handled all chronic diseases, mionor and major trauma, acute MIs...Now I don't know if I could treat head lice.

BTW what is a "forum jump?"

Helen, Honolulu, HI

charity work

HELEN ESCHENBACHER — Wed, 06 May 2009 18:03:55 GMT

As a nurse I have worked with many charities. I am NOT advocating or shilling for any charity but if you use the search engine www.goodsearch.com you can donate one penny to the charity of your choice every time you do a search. And if you buy anything certain companies using this search engine that company will give a percentage of that sale to your chosen charity.

This is not spam and it is an approved site. I have used it for MJFF (Michael J Fox Foundation for Parkinson's), but you can use it for any of the thousands of legitimate charities. It's just one more way we can help our patients and ourselves who have disabling conditions.