Contrarian Posted March 17, 2011 Share Posted March 17, 2011 ... I probably would except new RNs can't get hired these days... What....??? What about that "Nursing Shortage" we keep hearing about..??? Link to comment Share on other sites More sharing options...
ankylosaurus Posted March 17, 2011 Share Posted March 17, 2011 What....??? What about that "Nursing Shortage" we keep hearing about..??? According to new graduates (and even some experienced nurses) trying to get hired, apparently the nursing shortage doesn't exist, or hospitals just aren't hiring right now. I'm not really sure though. Link to comment Share on other sites More sharing options...
bobuddy Posted March 17, 2011 Share Posted March 17, 2011 Yes, the nursing shortage is alive and well here in KY - however, the hospitals are laying nurses off instead of hiring and operating at a bare bones staff. And yes, I am also hearing rumblings about the new grad nurses not being able to find jobs. Not sure if it is a reimbursement issue or something else. Link to comment Share on other sites More sharing options...
bobuddy Posted March 17, 2011 Share Posted March 17, 2011 You are gonna be 3 yrs older regardless of whether or not you "act" or "re-act"... the 3 yrs are gonna come and go either way. Hmmm... Maybe there should be a 12 month Masters PA--> MSN/FNP program.... That would be a serious coup d'état by the Nursing Lobby... and together... WE could outpace/out practice Physicians. :;;D: If there was a 12 month bridge, I would consider it seriously. The depressing part is - I have the MS plus the PhD - you would think I would be done with school by now. The thought of going back YET AGAIN makes me ill. Maybe the PA's should get together and approach the ANA about bridging....... Cant beat em - join em...... Link to comment Share on other sites More sharing options...
marilynpac Posted March 17, 2011 Share Posted March 17, 2011 Here's what going on in IL. Since there has been no tort reform malpractice ins premiums are about as high as they can be. The result, many specialist that hire us have left the state, they can't afford to practice in IL. On top of it our Gov just added a 66% tax to our income...so no new business are coming in and many are leaving never to return. That means no new specialist are coming in. To make up for this, many FPs have specialized. My own FP has specialized in geriatric medicine, therefore his practice is over 50yrs of age. Another FP will do OB/GYN and be in practice with a surgeon to do sections/hyst. They hire the FNP, the FNP can be at another location, maybe not, but the FNP does the family part while the doc does the specialty. Remember malpractice ins premiums are lower for a NP and they have the autonomy. Their lobby did this for them, ours has done very little. As I have posted b/f, here in IL we have the AMA and even the docs here in IL don't have to be board certified. So the docs don't have to be certified, the NPs take the test once and done. No interruption of their practice again...you can do cmes online. This is where the anger and frustration is coming from....all we needed was our lobby to do the job they were suppose to do instead of sending out magazines for cmes...I get mine online. Link to comment Share on other sites More sharing options...
discogenic Posted March 17, 2011 Share Posted March 17, 2011 Does NP autonomy vary by state? Link to comment Share on other sites More sharing options...
Contrarian Posted March 17, 2011 Share Posted March 17, 2011 Does NP autonomy vary by state? Yes... as does PA "supervision." Link to comment Share on other sites More sharing options...
marilynpac Posted March 17, 2011 Share Posted March 17, 2011 Yes, in approx 13 states they are completely autonomous...expect that number to rise sharply... Link to comment Share on other sites More sharing options...
Contrarian Posted March 17, 2011 Share Posted March 17, 2011 Also consider that in some states (NC and WA comes to mind) the "supervision" of PAs is in effect the same as a "Collaborative Agreement" that the NPs use. Link to comment Share on other sites More sharing options...
treejay Posted March 17, 2011 Share Posted March 17, 2011 What....??? What about that "Nursing Shortage" we keep hearing about..??? That's what I'm talking about..... From explanations given to me, due to the slumped economy, "nurses are holding onto their existing jobs and older nurses have come back into the workforce". Not sure the degree of truth to this. I mean if nurses are holding onto their jobs, those other jobs that they were allegidly moving into should still be open, no? That statement doesn't imply a net loss in jobs. This discussion is also swaying me from my PA school goal to a direct entry NP program. Why are you all doing this to me !? Link to comment Share on other sites More sharing options...
treejay Posted March 17, 2011 Share Posted March 17, 2011 Also consider that in some states (NC and WA comes to mind) the "supervision" of PAs is in effect that same as a "Collaborative Agreement" that the NPs use. I'm here in WA and I know of at least 1 FNP that owns and runs her own practice. To the best of my knowledge, she doesn't need to collaborate with any doctor. A PA on the otherhand in this state would of course need some sort of minimal SP. So I'm not sure that the "supervision" is the same as "collaborative agreement" here. Link to comment Share on other sites More sharing options...
bobuddy Posted March 17, 2011 Share Posted March 17, 2011 I'm here in WA and I know of at least 1 FNP that owns and runs her own practice. To the best of my knowledge, she doesn't need to collaborate with any doctor. A PA on the otherhand in this state would of course need some sort of minimal SP. So I'm not sure that the "supervision" is the same as "collaborative agreement" here. And this is true in KY also. Here, a FNP can run and own her own business. There are no supervision rules and she/he can be completely independent. No collaboration needed. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 17, 2011 Moderator Share Posted March 17, 2011 Your correct. I think that my 6m insurance was about $1k/yr. mine is 6k/yr...paid for by the group... Link to comment Share on other sites More sharing options...
Contrarian Posted March 17, 2011 Share Posted March 17, 2011 I'm here in WA ... brevity edit... So I'm not sure that the "supervision" is the same as "collaborative agreement" here. You completely MISSED the point. In states and/or settings where a collaborative agreement is required of NPs... the "collaborative agreement" is in effect the same as PA-Supervision (+/- written "Protocols.") In some states like WA and NC... the level of PA "supervision" is so minimal that pa "supervision" is basically the same as the minimal NP "Collaboration" requirments. There are MANY medical settings (even in states where NPs have total autonomy) where for them to practice in that setting... they MUST have a collaborative agreement (Supervision). Family Practice-No Psych-No Womens health-No Diabetes Mellitus management-No The following Internal Medicine Subspecialties-YES Very few... (if any) healthcare organizations/facilities/hospitals are allowing NPs to perform the following INDEPENDENTLY/Autonomously. Even in States where they have complete autonomy. Cardiology Endocrinology Gastroenterology Hematology Infectious disease Oncology Nephrology Pulmonology Rheumatology Clinical cardiac electrophysiology Critical care medicine Interventional cardiology Hospital medicine Sleep medicine Sports medicine Surgery Transplant hepatology Urology Imagine the line of physicians that would line up to testify for the plantiffs case if NPs were allowed to do this. Link to comment Share on other sites More sharing options...
marilynpac Posted March 17, 2011 Share Posted March 17, 2011 If they lose their SP do they have to find another b/f they can practice...or do they shut their practice down until they find another? I'm talking NPs and PAs... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 17, 2011 Moderator Share Posted March 17, 2011 our 1 np has 100% chart review within 24 hrs just like the pa's in our group. neither group is required by our respective state boards to do this but it is a hospital requirement. Link to comment Share on other sites More sharing options...
marilynpac Posted March 17, 2011 Share Posted March 17, 2011 Actually I'm talking about the one's that own their own practice... Link to comment Share on other sites More sharing options...
Contrarian Posted March 17, 2011 Share Posted March 17, 2011 In the inpatient setting... its a simple matter of "assigning" another "Collaborator" because most likely the NPs and Physicians are all hospital employees. In most cases... they usually only "own their own practice" in specialties where they don't need a SP/Collaborator... (FP, Acute Care, Womens Health, Geriactrics, Psych/MH) Link to comment Share on other sites More sharing options...
marilynpac Posted March 17, 2011 Share Posted March 17, 2011 One forum member is in the process of starting up and owning his own practice in your state. He had to have an SP. So you're saying even if he was an NP he would still have to have an SP? This stands for both family practice and for specialties? This is not hospital connected.. Link to comment Share on other sites More sharing options...
Hemegroup Posted March 17, 2011 Share Posted March 17, 2011 You completely MISSED the point. Is it really necessary to speak/write to someone that way? Link to comment Share on other sites More sharing options...
Contrarian Posted March 17, 2011 Share Posted March 17, 2011 One forum member is in the process of starting up and owning his own practice in your state. He had to have an SP. So you're saying even if he was an NP he would still have to have an SP? This stands for both family practice and for specialties? This is not hospital connected.. No... as a NP here he could have a Headache practice with NO SP. It mostly physical exams, counseling, referrals for imaging and Rx's. Here a NP could open a Infusion clinic, Acute Care/Walk-in Clinic or weight loss clinic and not need a SP. If the PA wanted to do this, they still could, but would need a SP. Thing is that if the PA is nationally certified, and experienced, then there is NO chart review requirement here. This certified and experienced PA-C could simply file a practice plan with the state as a "remote-site" which requires that the SP only be on the clinic site ~10% of the time. If the PA-C opens his/her clinic, hires a SP and sets up a standing bi-weekly lunch appointment then the SP only needs to come to the clinic 24 times/yr to pick up their retainer/consultant fee... :wink: Is it really necessary to speak/write to someone that way? Ummm... Yes... if they COMPLETELY MISSED THE POINT... just as you apparently did. YOU don't get to dictate to me how I respond. It seems like YOU would have figured this out by now. Don't like it... don't read it...!!!!! Contrarian Link to comment Share on other sites More sharing options...
marilynpac Posted March 17, 2011 Share Posted March 17, 2011 Exactly!!!! This is what we need to fight for.....Where is our Lobby????? Link to comment Share on other sites More sharing options...
bradtPA Posted March 17, 2011 Share Posted March 17, 2011 My supervision in NC consists of discussing quality improvement once every six months and documenting it. Link to comment Share on other sites More sharing options...
Contrarian Posted March 17, 2011 Share Posted March 17, 2011 Which is to my point that in some places/states... our "Supervision" is mere "collaboration" in its weakest or strongest sense. YMMV Contarian Link to comment Share on other sites More sharing options...
bradtPA Posted March 17, 2011 Share Posted March 17, 2011 Exactly!!!! This is what we need to fight for.....Where is our Lobby????? IMHO, the best lobbying can be done by the state organizations. The state PA organization in NC is well funded by high membership rates compounded by the length of time we have been active in the state. Join your local organization if you are not a member and voice your opinion to your elected representatives if you want change. Link to comment Share on other sites More sharing options...
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