ADVANCE for NPs & PAs Discussion Board

FNP certification exam prep resources

Joel Ruiz — Tue, 09 Apr 2013 16:05:12 GMT

I am starting this post because I will be graduating May 2014 as a FNP. So, at this time I am starting to think about the certification exam that follows graduation. I would like to know what certification prep resources have any of you used? A quick Amazon search reveals quite an assortment of possibilities. But, I want to know what recent NP graduates have used and found helpful after taking the exam. I see books by Leik and Fitzgerald are popular on Amazon. Have any you used either of these books?

billing question when RN working with NP

Amy — Thu, 25 Apr 2013 19:58:50 GMT

When you are working in an office setting, can you work with RNs seeing patients with you, and bill for those patients? example: RN collects data about the patient, including HPI, PMHx, and ROS and Exam. Then I go into see them I do my own ROS, physical exam, and make the plan. Esentially the RN is acting as a scribe. Then the RN does the dictation, and both of us sign the dictation.

any thoughts??

FNP working orthopedics

Larry Rachal — Thu, 11 Apr 2013 01:56:17 GMT

I will be graduating in May and will sit for certification as FNP. In recent job interview with an orthopedic clinic I was asked if working in orthopedics fall within my scope of practice. It had never entered my mine, I just assumed that orthopedics was no different then cardiology or urology. Is it withing the SOP of an FNP to work orthopedics, if any FNP has had similar issues how did you work it out or what will I need to do to find this information.

Questions about NPs and PAs

Emily Hoehn — Wed, 08 Feb 2012 22:19:30 GMT

Hello, I am a 3rd year BSN nursing student at Miami University of Ohio. I am currently in a health informatics class in which the teacher is trying to get us to incorporate health informatics and nursing. I joined this forum to learn more about nurse practitioners and physician's assistants because I am interested in becoming either one of those some day. I have a few questions that would be great if I could get some feedback on. Why did you choose to be a NP or a PA? What do you feel your role is in nursing and how do you contribute to patient's care and outcomes? Do you recommend going onto more schooling to become either a NP or a PA? Any feedback at all related to NP and PA would be greatly appreciated! Thanks!

iPad

Joel Ruiz — Thu, 03 Jan 2013 15:27:17 GMT

I am writing this post to ask how current NP/PAs or student NP/PAs are utilizing iPads or other tablets. I will be starting my second semester of NP school and I want to get a tablet to have my texts book be on it. I am wondering what tablets others have used and have liked? Also, does any one have a suggestion on how much memory should be on the tablet (16 or 32 gig models are what I will most likely purchase)?

Attention 2012 Nebraska NP salary respondents

Joel Ruiz — Sat, 13 Apr 2013 13:58:42 GMT

I will be graduating from Creighton University May 2014 with my FNP degree. I would like to make contact with those Nebraska NPs who completed the 2012 Advance Survey. I am interested in meeting local active Advance NP members from Nebraksa.

Your Best Weight Loss Advice

Michelle Pronsati — Tue, 05 Oct 2010 14:34:13 GMT

The statistics about obesity scream at us every day. We're preparing an article about barriers to effective obesity treatment, and we'd like to hear from you with an answer to the following question: What is your best piece of advice for weight loss?

BNP and CHF

Kathryn Hanson — Mon, 11 Mar 2013 21:09:39 GMT

I am writing to get feedback on a commonly ordered test--BNP in evaluation of CHF status.

Recently had a patient with diastolic CHF and multiple comorbidities including stage IV renal failure, aspiration issues, restrictive COPD with emphysema, etc.. Very complicated and delicate scenario.

In absence of edema and weight gain, but presence of respiratory symptoms (basilar rales, wheezing), is there benefit of
"rechecking" BNP in a patient with chronically elevated BNP?

In this case, I essentially checked a BNP to "see if it had risen significantly" when trying to decide whether adjusting meds to decrease preload and/or afterload would be of benefit (along with CXR, CBC, etc). In the end decided upon changing up nebs, extending abx, adding short burst of steroid, etc, but didn't fiddle with diuretics or BP meds (sats good, VS stable, etc).

In presence of severe renal disease, I am hesitant to jump on the increasing diuresis bandwagon if there aren't other clinical indicators to do so. I was looking to the BNP to see if further imaging (ie echo) or referral back to cardiology seemed warranted (as well as possible med adjustment). I am unclear how long it takes these levels to increase in relation to physical ramifications such as peripheral edema, weight gain and respiratory symptoms.

The primary physician felt checking BNP in this case was basically a waste of time and advised to treat based upon symptoms.

I was hoping to find some feeback from an individual with cardiac background for feedback on what is usually recommended.

Thank you

Kathryn

Did you find it diffuclt to make the move to an NP position from a staff nurse role?

Lauren — Fri, 13 Jul 2012 02:08:07 GMT

While i'm looking forward to the challange and patient interaction that becoming an NP will provide and that I am now lacking as a staff nurse, I have fears of transitioning to a NP role where (1) I have A LOT more professional responsibiltiy and (2) My salary will remain the same or less.

Have any of you wrestled with the same emotions? I start my clinicals soon and am hoping I fall in LOVE with it. This will be motivation alone and will outweigh the reservations I have.

Hmphh..

Shadowing opportunities

Kristin Harris — Thu, 21 Feb 2013 01:08:25 GMT

Hello,

I'm looking for Physician Assistants to shadow in the San Diego area. I will be applying to schools around May/June and I am looking for a shadowing opportunity to continue my pre-PA education/experience from now until roughly Spring 2014. Any information will help greatly..thank you!

Kristin

NP Schools

mynursecoach — Mon, 14 Feb 2011 16:31:47 GMT

I have been looking for online NP schools for Adult Health but haven't found much. Anyone have any recommendations to any good and reputable online NP schools. I am looking for online classes since I work full-time and have irrgeular hours which makes going to a traditional school harder for me.

Thank you in advance.

Anna

I need some infos and advises for international student.

Tomoka Tanaka — Wed, 09 Jan 2013 16:09:27 GMT

Hello, my name is Tomoka Tanaka.
I live in Tokyo, Japan.

Currently i'm doing master's in university to get a licence of oncology clinical nursing specialist.

It's my first year, and i'm seeking for DNP program in US after i graduate school in March 2014.

There are planty of schools, so i don't know which one is good for me.

But i would like to study in a university which has good reputation.

And i have so many questions for that, and i had a chance to talk with a faculty,and she said she will email me for those information,

But it's been 2 months, and i haven't heard from her yet( even i e-mailed her that i would like to hear from her).

So i was wondering if i could talk to someone who is doing (or done) DNP , and she or he is international student, that would help me a lot.

Also, if you know about the community sites i can talk with someone to ask those stuffs, let me know.

Thank you for your help.

I'm sorry if i wrote something rude or anything, my first language is not English,

and i have never lived in the country that spoken language is English.

Best Regards,

Tomoka Tanaka

New grad dermatology position

Nancy Watson — Wed, 14 Sep 2011 15:53:54 GMT

Hi,

Can anyone tell me what is a good starting salary for a new grad in dermatology. I have been offered 65K for the first 6 months, then 75K for the next 6 months, then 75 for second year and 85 for 3rd year. Will get productivity bonus after 6 months and 30% of collected cosmetics. Being a new grad, I have no idea if this is a good offer. Cannot find new grad salary scale for derm anywhere. Also, will give me

15 paid days off

400 professional fees

1500 cme

Need to give him a decision fast so any speedy help would be much appreciated.

Clinical Resources

Angela — Thu, 10 Nov 2011 18:31:38 GMT

I will be graduating in 4 weeks with my FNP. I was wondering from those of you practicing which programs and electronic devices you reccomend (i.e. Epocrates, Lexicomp, iPhone, iPad)? Do you use the free versions or do you purchase a package?

Thanks

Angela

New grad board certified FNP can't get a job

Gail B. — Wed, 24 Aug 2011 05:02:07 GMT

I graduated at the end of May with an emphasis on family practice. I am also board certified by the AANP. And yet I can't get a job in the Los Angeles/Orange County/San Diego/Inland Empire, CA. The whole not having a furnishing license has really stopped anyone from hiring me. I've been on over 50 interviews with no offers. I've even had some doctors tell me I should have been a PA because then I could get a job right after certification. I also can't get a RN job because nurse educators/recruiters say I'm overqualified and therefore undesirable. What is going on??

Activities during ELMSN FNP program

Leia Lang — Tue, 15 May 2012 01:47:49 GMT

Hello all

I am currently in a ELMSN FNP program that is 2.25 years long. Graduation is next summer and I was wondering what activities people have been doing during their programs besides working as a RN (my program is too accelerated to be able to commit to a regular PT schedule). I'd love to do a FNP residency program but I feel lack of exp/activities during the NP program will hurt me.

Dual License NA/PA

Lety Costa — Sun, 20 May 2012 21:24:55 GMT

Does anyone have a dual license?

AANP vs. ANCC for Adult-Gero certification

Sarah Jax — Tue, 18 Dec 2012 01:02:05 GMT

I'm graduating in 3 days (woo hoo!) from an Adult-Gero NP Program. I am looking into both AANP and ANCC for my certification and am wondering if anyone has any recommendations (pros or cons) regarding the 2 certification bodies? I am interested in taking the new A-GPCNP certification exam (Adult-Gero exams combined), but have heard that AANP will not be accredited for the first 500 exams!

Any knowledge or preferences is helpful!

Thanks in advance!

Family Practice/Internal Medicine Preceptor in the greater Green Bay WI area

Lynn Wilson — Thu, 22 Nov 2012 06:04:39 GMT

Hi,

I am looking for an (NP, PA, or MD) preceptor for the Spring 2013 semester beginning the last week of January. Willing to travel. Please contact me if you'd like more information.

Thank you,

Lynn

Looking for NP Preceptors in Wisconsin

Ruth Staszak — Sat, 17 Nov 2012 18:05:56 GMT

I live in Central/East Wisconsin in the Fox Valley area (Greenbay, Oshkosh, Appleton). I am looking to make connections with someone who would be willing, or knows someone willing to be a preceptor. I start 12/3/12 in my program, so clinicals would not be for at least another year or more but I want to make connections early :)

help

jeff mckim — Fri, 16 Nov 2012 21:17:42 GMT

can anybody help me find the location of Np Coleen M fries she has left her office in langhorne pa . She has helped me alot, and cannot find her can anybody tell me how to find her ive tried alot of options any suggestions

Vacation time

Lorrie Tate — Thu, 25 Oct 2012 06:12:03 GMT

I am curious as to how vacation and sick time works where some of you are employed. Are you allotted so many sick days and vacation days per year? If so, how many?

Where I work, we have to rearrange our schedule and work more days in a long stretch to have a long stretch of days off. If we are out sick, we have to make up the day.

I am curious as to what the norm is.

Thanks,

Lorrie

preceptors wanted!!

Maggie Austin — Sun, 30 Sep 2012 06:30:34 GMT

Anyone out there wanting to be a preceptor for me? I live in IA in the Waterloo area.

PANCE review

Christian Lorentzen — Wed, 29 Aug 2012 01:34:34 GMT

Any recommendations for online review class for the pance exam? Has anyone used the kaplan orUMDNJ (mycme.com) for a review class?

New NP needing encouragement

Sara Sullivan — Wed, 05 Oct 2011 01:27:54 GMT

So I recently found out that I made a mistake prescribing a patient medication. (I'm in primary care and addiction medicine in a community health clinic). This patient had been previously diagnosed by rheumatology as having possible RA vs scleroderma but had not followed up with them in over 2 years and had been on plaquenil all that time. She came in complaining of severe bilateral joint pain in her shoulders which were extremely tender to touch with limited ROM. I tried to call rheumatology but was unable to reach anyone for consult, so decided to start the patient on methotrexate with leucovorin and get her in to see the rheumatologist ASAP. However, though I sent the referral, it took them 3 months to actually see her. I was monitoring her CBC and CMP as required while on methotrexate therapy and she seemed to be responding well and her labs were all normal. I had realized somewhat late that typically methotrexate is prescribed by a rheumatologist and not a PCP, but she seemed to be doing well so I figured I might as well continue.

Well, the rheumatologist recently emailed me after the patient missed her appointment and we discussed the current treatment. She told me that while she could tell I was trying to help the patient, this was NOT appropriate, the dose was too low and the leucovorin would counteract the effects of the methotrexate anyway (Epocrates led me astray: said it should be prescribed with the methotrexate but I guess it's better to do folic acid 1mg).

Although the patient wasn't hurt, I feel really bad about it, and I just need to hear some mistakes other people have made in their careers and what the process was like of getting through the beginner phase.

Thanks