What a day. Guy was fixing AC at office, fell through the ceiling, in the lobby.
Then 8 people show up and walk in to be tested for COVID - ONE was previously positive. They were supposed to wait in their car. So all of us exposed.
Then one of my Vivitrol patients proceeds to tell me how to get Fentanyl on the street or dark web.
Apparently you can buy what looks like a cassette tape and its really a brick of Fentanyl....
Cancelled the rest of the patients for the day, office is a mess. I need some wine!!
People have asked why I have “flipped” from a advocate of FPA to a advocate of Physician led team care. Although I have explained it several times, I am going to do it ONE last time for everyone to read. Please read carefully. /1
I have always been an advocate of safe care. Patients come first, always. Their needs outweigh my needs. Always. It’s been that way since day one. Since I first called myself a nursing student. That has not changed and will not change. /2
I used to be an advocate for Full Practice authority. I believed that nurse practitioners were every bit as capable as caring for patients on the same level as a physician, providing the same care, and that we were simply being held back by physicians and legislators, /3
Who defines the practice of NPs? You would think it would be other healthcare professionals. Instead it is legislation & money. When a NP states they "want to practice at the top of their scope" or "not have restrictions on their license to practice" that NP is sadly repeating /1
Rhetoric that lobbiestst use to change the scope of practice. Fact is, if the NP is following the rules set forth in their state they are practicing at the top of their education and utilizing all skills/scope that their boards approve them to use.
Please remember that.
/2
Next time you see a NP lobbying for increased scope, increased practice rights, etc.
There is a reason the original laws were put into place. The profession was created to work with a physician-- not on our own. /end
A 🧵 ~
As #nursePractitioners we must take a stand and say enough is enough. #FPA will continue to ruin our profession in many ways. Here is one way: forcing unprepared NPs into FPA to be marketable in today’s job market. /1
Over the last 10-15 years Nurse Practitioner educational standards have become less rigorous. Online schools rely heavily on paper writing versus hands on clinical learning, yet the drive for FPA has continued at full speed. /2
Some will state that “their school was just fine, very rigorous, with high quality education that taught them to practice at the top of their education. What is the “top of our education” and why do we equate it with FPA? /3
Today, I will ask my supervising physician what he thinks of independent practice for nurse practitioners. I will tell you his unfiltered response later today. Stay tuned!! #nursepractitioner#MedTwitter
Ok, here is the answer.
"I think it depends on the competency of the NP-but Primary Care isn't easy & shouldn't be thought of as easy. There needs to be a mandatory competency test prior to a NP working independently even after 20-years, just to make sure everyone is on /1
The same level. We have to be fair to our patients and provide high quality care across the board. Nurse Practitioners are usually more empathetic with patients, take time to connect with patients, and thus have happier patients - but the care needs to be equal. /2
Why doesn’t @AANP_NEWS address the education issues going on with today’s NP schools? We know you are not the accreditation board, but you do advocate for FPA around the country. How can AANP in good faith continue to advocate for FPA when NP schools appear to be getting worse /1
As a major association for all nurse practitioners shouldn’t AANP be advocating to clean up our educational programs first, before seeking to allow new grads FPA? Wouldn’t it benefit the entire profession to refocus efforts on strengthening our standards? /2
As a FNP I am worried about our profession. As a preceptor I witnessed numerous ethical issues with students in relation to their studies, Multiple students taking tests together, cameras covered in lockdown browsers, test banks being shared - and /3
My tweet was meant to highlight my views on the failings of NP schools and training as is now in the U.S. I do not agree with diploma mill schools that offer 100% acceptance rates, force students to find their own preceptors often at hefty fees, and /2
Prep the NP student so much with practice boards, they have likely seen very similar questions by the time they take their test. Because for these schools, certification rates are how they measure success - not if their students get well rounded education. /3