We posted previously about the nonprofit Little by Little, founded by NP Sue Walsh and her husband Brian (Nurse Practitioners Involved in Haiti Relief). She wrote more about what she experienced during the quake and the healthcare she was able to provide to earthquake victims on the Little by Little Web site.

Immediately after the earthquake these same 23 volunteers became first responders at a nearby hospital which had very limited supplies, one doctor, and a few nurses. Within an hour a few team members returned with a truckload of supplies including bandages, IV equipment, suturing materials, antibiotics and pain medications. They worked for hours, well past midnight to treat over 100 severely injured people. With prayers, tears and heavy hearts, team members watched the most severely injured die, and all were held close.

They include photos and videos on their site. Take a look - her story is inspiring.

Paulette Kirby, a Rapid City, S.D., nurse practitioner, is signed up to compete in the Wenger Patagonian Expedition Race through Chilean Patagonia. The race starts Tuesday, February 9, and with three other team members Kirby will bike, kayak, hike and climb her way across the remote wilderness of Chile.

Kirby is traveling to Chile before the start of the race, but before she left she told publicists, "The adventure and excitement more than make up for any worries and as long as we make good choices, the rest is chance and nothing we can control. The race excited my imagination because of its remoteness. After visiting Patagonia a few years ago I know how beautiful it is there – and I think this is a race that anyone can win.”

To watch a video about the race, click here.

Stay tuned for news of Kirby's progress!  

 "Before putting the tongue depressor in my mouth, she listened to every word that came out of it."

So reads an expertly executed advertisement in today's Philadelphia Inquirer (page A9). What a great way to educate consumers about nurse practitioner care! The ad, which is for Take Care Health Services clinics in select Walgreens, goes on to state that the company's nurse practitioners "take the time to listen, make the diagnosis that's right for you and thoroughly answer your questions."

Kudos to Take Care for this type of advertising. It benefits the entire nurse practitioner profession, as well as the company's own bottom line. Ahhh.

In addition to a full line of in-person job fairs, did you know that ADVANCE also offers virtual job fairs? Employers in the eastern region will gather on Jan. 26, the central/mountain job fair takes place Jan. 27, and the Pacific region virtual job fair will be held Jan. 28.

Virtual job fairs offer many of the same features as in-person job fairs. You can chat with recruiters, attend education sessions, collect literature about employers, win prizes and make sure your résumé goes to the employers that interest you. You can do this all from home, so you can leave that smart suit on the hanger and "attend" the job fair in your comfiest clothes.

The tips for job seekers at virtual job fairs aren't all that different from tips useful for typical job fairs. Stay confident, seek out jobs that interest you and fit your experience, and do your homework ahead of time. Here are a few more tips:

• Don't forget your résumé. If you were attending an in-person job fair, you'd have a stack of résumés ready to hand out to potential employers. A virtual job fair is no different - but you'll save paper. You can upload your résumé at the virtual job fair and choose which exhibitors receive a copy. If you don't have a fresh résumé prepared, try out the ADVANCE résumé builder.
• Homework is key. Prepare for the virtual job fair like you would for a traditional job fair. Take a look at who's exhibiting, and do some research on facilities that interest you. Potential employers' Web sites can contain information that will make or break your desire to work there, and having some background knowledge about a facility can also help you in one-on-one chats with recruiters by really showing your interest. Knowing which facilities you'd like to speak with during the job fair can also save time.
• Don't be afraid to ask for help. At an in-person job fair, you likely wouldn't hesitate to ask for directions to a room if you couldn't find your way. If you're having issues with the technology used in the virtual job fair, support staff will be available to help you.
• Remember proper decorum. Sitting in front of your computer isn't necessarily the amped-up, formal atmosphere of a traditional job fair, but you're still speaking with employers - it's just in a different medium. It may seem comfortable to slip into online habits, but avoid text message shorthand and use correct grammar and spelling when chatting with employers.
• Avoid being a virtual wallflower. Chat with recruiters from facilities you're interested in, and try not to be the virtual equivalent of the jobseeker hanging out in the lobby or skirting by all the exhibitors. Ask questions, share your résumé, and go get that job you really want.

Finally - what are your thoughts? Would you give a virtual job fair a try? Why or why not? Post your comments below!

Schools of nursing are launching Doctor of Nursing Practice programs left and right. In fact, just this week, several schools announced plans to start up DNP programs, including La Salle University in Philadelphia and the University of Nevada in Reno and Las Vegas.

And Loyola University's School of Nursing in New Orleans, La., has already accepted 10 students into a class of 25 for its first DNP class. The program will be exclusively conducted online. Several of the students were interviewed by the university's public affairs department, and they all agreed that the fact that the program is online was a big draw for them as they raise families and continue to work as nurse practitioners.

One student said, "I looked at the school and what it stands for, and I also looked at programs that would allow me to keep my full-time employment. The online program was very attractive for me as a family woman. I don’t have to sit in a classroom for hours." The school's director also describes the program's focus as "integrated behavioral health approaches in primary care practices as a method to address effective health care delivery.”

Most DNP programs currently enrolling students have some combination of online and classroom work. But we might begin to see an increasing number of purely online programs as the DNP degree becomes more established. 

One area where there are still NP prescribing snags is in mail-order pharmacies. We reported a case in 2003 in Washington where NPs lobbied for out-of-state NPs to be included as prescribing providers for Washington state patients:

Surprise Defeat for Out-of-State Prescribing Bill

A bill that would have added out-of-state nurse practitioners to the list of providers whose prescriptions can be filled by pharmacists in Washington died in the state Senate this spring. Senate Bill 5675 was intended to address the problem of Washington-based mail-order pharmacies refusing to fill prescriptions written by NPs in other states.

Marty Couret, NP, legislative chairman for ARNPs United, attributes the defeat to opposition by the Washington State Pharmacy Association. Couret told ADVANCE that on the strength of the bill's backers, ARNPs United thought passage would be a "slam-dunk" because it should benefit pharmacy business.

Obviously this was an argument that went unresolved, and it is still a problem for NPs to write scripts for controlled substances across state lines (evidently one example of this is Pfizer's Connection to Care program), because rules surrounding NP prescribing differ in each state. This seems to be an issue that should be addressed more aggressively in state legislature. Have you run into barriers related to cross-state prescribing?

As the news continues to pour in about the disastrous after-effects of the Haiti earthquake, we are proud and humbled by an increasing number of news stories about NPs and NP organizations getting involved in relief efforts.

For one, there's Susan Walsh, NP, from Glenview, Ill., who was already in Haiti at the time of the earthquake, working with her healthcare nonprofit program called Little By Little. She worked tirelessly with her husband and the NP students who were with her, helping victims of the quake until on State Department recommendation she had to return to the United States. "This earthquake and the misery, destruction, devastation and death it brought came from below, but love, strength, help, hope and life will come from above," Walsh told the Chicago Tribune. "Please pray for Haiti."

Then there's Mary Lou Ryder-Larkin, NP, from Bronx, N.Y., who is medical director of Haiti Marycare, a group that since 1994 has delivered healthcare and humanitarian relief to the poor in Haiti. Ryder-Larkin has spent hours on phones seeking donations for the Haitian victims, and also received a donated plane fare. She'll be traveling to Haiti to provide healthcare to the quake victims, many of whom are still suffering from injury-related infections.

Pam Scott, NP, from Milwaukee, is also in Haiti providing healthcare at her own clinic. 

And NPs who aren't able to get to Haiti are helping with the mighty power of the pen, like our own editorial advisory board member, Barb Dehn, NP. Her article on Huffington Post calls for empathy for the victims of Haiti's earthquake.

Hats off to these extraordinary NPs!

ADVANCE for Nurse Practitioners hosted our first Twitterfest, where we asked NPs on Twitter to sign in and participate in a hashtag conversation about technology (see details here). We had a small turnout but it didn't surprise us, because we doubt many NPs use Twitter yet, and we know that during the day many of you are busy treating patients! Below is a digest of the tweets we sent and received, from newest to oldest. Consider joining us to share information in real time at our next Twitterfest!

1. AndyPDANP @ADVANCEforNPs good drug ref (Epocrates or Lexi); gen clinical ref (5MCC) #NPtechnology 3 days ago from Echofon    
2. ADVANCEforNPs Thanks to those who participated in our first Twitterfest! You can still respond using hashtag #NPtechnology if you weren't able to join. 3 days ago from web    
3. ADVANCEforNPs One last question before we sign off: What tech/applications do practicing NPs recommend NP students become familiar with? #NPtechnology 3 days ago from web    
4. StephenNP #NPtechnology I think utilizing text messages for patient reminders and communication is where we need to be more active 3 days ago from web    
5. ADVANCEforNPs How has social networking - Facebook, Twitter - helped you professionally? #NPtechnology 3 days ago from web    
6. FSMFN RT @ADVANCEforNPs: NPs with smartphones: Have they made your job easier? How? #NPtechnology 3 days ago from web    
7. ADVANCEforNPs @AndyPDANP Good to know about hashtags being case sensitive! Do you think it would be useful if the EMR could send text msgs? #NPtechnology 3 days ago from web    
8. AndyPDANP RT@AndyPDANP:Our EMR uses secure messaging, like what you get from your bank but 1-way. Our Wellness Dept is also on Facebook.#NPtechnology 3 days ago from web    
9. AndyPDANP OK, so that's why my first tweet didn't show up-hashtags are case sensitive! LOL #NPtechnology 3 days ago from web    
10. 
     ShopAdvance Any NPs out there? Join the NP Twitter Fest hosted by @ADVANCEforNPs, happening now. Visit http://bit.ly/88nLOR for info. #NPtechnology 3 days ago from web    
11. AndyPDANP I only have to carry 1 device on my hip at work now; iPhone w/lots of med apps on it. Most freq used by me: drug ref and 5MCC #NPtechnology 3 days ago from web    
12. ADVANCEforNPs NPs with smartphones: Have they made your job easier? How? #NPtechnology 3 days ago from web    
13. ADVANCEforNPs @StephenNP I'd bet that's pretty standard. Do you think there's a place for Facebook and Twitter in NP practice? #NPtechnology 3 days ago from web    
14. StephenNP #NPtechnology In my current setting, I am using the good old telephone, snail mail and e-mail to communicate with patients. 3 days ago from web    
15. ADVANCEforNPs FYI, I'm Jen, tweeting for @ADVANCEforNPs today. So, a Q: What tech do you use to communicate with pts? #NPtechnology 3 days ago from web    
16. ADVANCEforNPs Welcome to the #NPtechnology Twitterfest! We'll be here from noon to 2 EST. Visit http://bit.ly/88nLOR for info. Share your tech thoughts!

On Friday January 8, from noon to 2 p.m. EST, ADVANCE will host what is called a "Twitterfest," where you can join a real-time discussion with other NPs about the technology that gets you through your day. This post will explain how it works.

On Twitter, these discussions are also called "hashtag conversations," because they use a "hashtag" (#) to filter out related posts (tweets). For those of you new to Twitter, or hashtags, here's the deal: a hashtag is something added to a tweet so that users can search and find a real-time list of just the posts that use the tag. You can see a list of the most popular hashtags at any time by looking to the right of your Twitter feed under "Trending Topics." On Friday, the hash tag we'll be using is "#NPtechnology." Here's an example of what someone might post:

I really want my employer to implement an EMR, but I don't have a clue where to start. Does anyone have any suggestions? #NPtechnology

Anyone who has typed #NPtechnology into the Search box in Twitter and clicked the magnifying glass next to it will see these, and only these, hashtagged posts come up in their feed (you’ll see the search box in the right-hand sidebar on Twitter). So that your fellow NPs see your tweets, be sure to add the hashtag #NPtechnology each time you post! And remember, each tweet can be only 140 characters in length. Come see what others are saying about technology used by NPs - sign in to your account any time between 12 p.m. and 2 p.m. this Friday, January 8, search for #NPtechnology, and all the tweets will continue to show up as they’re written/submitted. Click on the yellow notification box when Twitter alerts you of "more tweets since you started searching" to refresh the list. If you can't make it, you can also search this hashtag later to see what others had to say.

@ADVANCEforNPs will be there during the two-hour conversation to help with any issues and also to throw out discussion topics. If you have questions beforehand, send a direct message to @ADVANCEforNPs or email jford@advanceweb.com. We hope to see you there!

Anne Perry, NP, is a representative in the state government of Maine, and she has introduced legislation that will remove language referring to physician delegation of nurse practitioners in Maine. Maine NPs have had independent practice authority for years, but some ambiguous language still remains in statute.

Hear Perry comment on the legislation on the Maine Public Broadcasting Network: Legislator Proposes Updating Nurse Practitioner Law.

Tomorrow is the day the Senate votes on the bill for healthcare reform. Nurse practitioners have been speaking up in the media to voice their opinions about the bill. Local Arkansas TV station 4029tv.com interviewed family NP Chantal Sumlin at the public health clinic where she works. She says she hopes the bill passes, because "We see many patients that establish here for care that have waited months and months to be able to access care.” Watch video of her interview at "Public Health Clinics Want Health Care Bill Passed."

Stay informed about this potentially life-changing legislation - it will affect you, your family, your patients and your practice! For a run-down of headlines and information about the bill compiled by the Washington Post, see the Political Browser.

And here's wishing you Happy Holidays from ADVANCE for Nurse Practitioners! 

NPs are about to reach the final frontier - of Canada, that is. On Friday, CBC News of Canada reported that within the next few months regulations should be in place allowing nurse practitioners to practice in the Yukon, the one remaining territory in which NPs have yet to obtain legal authority to practice (see "Yukon to allow nurse practitioners").

"Our core philosophy is sort of individualized care, as well as approaching care from a preventative, health promotion and wellness perspective, as well as encouraging patient education," said Shawn O'Donovan, an NP who has been practicing as an RN in the Yukon.

This is great news for NPs and for patients, but as might be expected, the Yukon Medical Association isn't a big fan of the idea. Rao Tadepalli, the president of the Yukon Medical Association, told CBC News "I do not see nurse practitioners being able to function independently.” 

We offer our support to the NPs blazing the trail to better patient care up north. 

Nova Scotia NP Karen Snider was fired from her position a month ago, and the media and the community are rallying behind her because they feel the reasons were unjust.

According to a news report (and this one as well), Snider made comments about the need for a full-time office staffperson to help manage the growing number of patients the South West Nova district health authority was seeing daily. After that, she was fired. Then, when she appealed to have her job reinstated, the health authority said they might consider doing so if she assumed guilt by making a formal apology, to be published in three newspapers and shared with the public. Here's what a health committee liaison said in the Chronicle Herald:

"We have a perfectly capable health practitioner who’s going to leave Nova Scotia (and) we don’t feel a proper replacement is going to come in.

"She was liked by the people. The people felt they were being properly looked after. The clinic was working better than it’s worked since it was established there.

The problem may have originated when the nurse practitioner commented locally in a community newsletter about how a clinic receptionist-clerk should be given full-time hours because more than 20 patients a day were often being seen.

"So the nurse practitioner made the case . . . (for) full-time funding by going directly to the public to argue for good health care for the islands," Andy Moir of the Islands health liaison committee said in an earlier interview.

 The community supports Snider wholeheartedly - the residents of the area started a blog tracking the events related to Snider's job. "Save Our Nurse" includes a calendar of events, letters of support for Snider, and links to news reports. They hope to help Snider get her job back.

"Too bad our health care is left to hoping," said one blog contributor.

In keeping with the spirit of the recent vampire hype sweeping the nation, we thought we'd write about what doctors of nursing practice and vampires have in common. What on earth, you ask, might they have in common? Well, read on:

1. They've both been around for a long time.

Both vampires and DNPs have gotten a lot of attention recently, but really they're not all that new. True, vampire lore has been around for centuries, but the DNP isn't just something new that cropped up in 2004 when the American Association of Colleges of Nursing recommended that all nurses seeking NP credentials as of 2015 earn a DNP degree (read more here). In fact, the first clinical nursing doctorate program started in 1979. 

2. They both have trouble coming into the light.

We all know that vampires and light don't mix. But NPs earning a DNP have faced challenges now that the degree and 2015 recommendation has gotten more attention. They've faced political challenges and MD push-back ("What, oh what, will happen when NPs start calling themselves 'doctor' in the clinical setting?!"). Then there was the Columbia University DNP exam. The jury is still out on that one for many people.

3. They're both misunderstood.

Poor vampires. People are up in arms, trying to kill them, but they're just trying to do what they do best. (Granted they want to drink your blood, but sometimes they can be lovable... and I digress). And the DNP? Obviously working toward the highest clinical nursing standard. Many people still confuse the DNP with an academic doctorate. And there's still a lot of confusion among NPs about whether the DNP is a good idea.

4. They're both up all night.

However, vampires have the luxury of sleeping all day.

5. They both have sharp teeth.

Vampires literally have sharp teeth, for survival. The DNP graduate, however, has figurative sharp teeth to "sink into" information that help them synthesize it and think about healthcare on a broader scale. And maybe they need them for survival, too, if we consider the challenges we talked about above.

For a much more detailed (and Vampire-free) look at the DNP, including information from reader surveys we conducted, read our ADVANCE exclusive on the DNP: Coming Into Focus.

Florida's NPs have been fighting a long fight to win controlled substance prescriptive authority in the state. One roadblock is the proliferation of "pill mills" in Florida - clinics of ill repute where seemingly anyone can purchase prescription medications. Read some recent news about pill mills in Broward County, Fla., which some are calling the pill mill capital of the country.

NPs need to educate legislators about their skills to ease their fears that allowing NPs to prescribe will only make a bad drug abuse problem worse. And they've been doing just that; recently a Florida representative and two staffers met with several NPs who argued that giving NPs prescriptive authority will reduce the number of patients that physicians will prescribe for without having met - a serious issue in Florida.

And here is a well-written letter to the editor of The Jackson County Floridian from an NP student addressing the prescriptive authority issue. In the letter, he refers to a 2008 Senate Committee on Health Regulation report that was favorable toward NPs: "It is time to stop the suffering of millions who are out of work and uninsured. It is time for the Florida Legislature to take its own good advice and join the rest of the country in lifting the ban against ARNPs from prescribing controlled substances."

The Florida Nurse Practitioner Network is gearing up for a rally at the state capitol in March, and are circulating letters to send to representatives. Get involved at www.fnpn.org.