NP vs MD – Which Path to Choose?

NP vs MD – Which Path to Choose?

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Working as a Nurse Practitioner (NP), I frequently am asked: “What exactly is the difference between an NP and a doctor?”. While there definitely are differences between them, both function similarly in within many specialties, so it is not always an easy question to answer.

The education and training of physicians is very different than that of an NP. Additionally, their job role and the autonomy/scope of practice with which they practice will vary depending on the state and facility of practice.

If you’re trying to decide which path you want to take, or maybe you are a patient who’s wondering which Provider you should be seeing – this article should help clear up any confusion.

Comparing the Education and Training

To compare NPs with physicians, we must first look at the differences in their education and training.

Physician Education and Training

The Physician education pathThe path to becoming a physician is a long and difficult. First, they must obtain their undergraduate bachelor’s degree – usually in a science such as chemistry or biology. However, the actual degree does not usually matter, so long as they complete the pre-requisites for Medical school. This can be ensured by enrolling in a Pre-med track. During this part of their education, they are not learning any specific medical information. While the science courses that they take will invariably help them in medical school, they are not gaining exposure to the medical field directly. However, most students will be required to obtain a decent amount of shadowing or “real-world” experience with healthcare exposure – whether working as a patient care assistant, EMT, medical scribe, etc. 

Upon graduation, they attend medical school which is typically a 4-year degree. They learn in-depth medical sciences as well as clinical information for practice. During the final 1-2 years, they also complete clinical clerkships in just about every specialty there is. This provides well-rounded medical knowledge, and the depth of knowledge obtained is unmatched. By graduation, they have performed an estimated 6,000 hours of clinical experience, directly learning how to be Providers. Upon graduation, they receive their MD or DO degrees, and are officially “Doctors”. But their training doesn’t stop there.

After graduating from medical school, a physician will then match into a residency – which is on-the-job training for a set amount of years depending on their specialty. This usually is 3-4 years but can be as long as 7+ years with some specialties (i.e. Neurosurgery), and physicians can choose to perform a fellowship year that offers an additional year of specialized training. In general, residencies will provide an averaging of at least 10,000 hours of training. During this time, resident physicians are working in close collaboration with other senior residents as well as attending physicians. They have to take certain board certifications along the way, but once they complete their residency – they are officially attending physicians. This means that they are officially independent providers and can practice without any oversight.

Nurse Practitioner Education and Training

The Nurse Practitioner education pathThe path of a Nurse Practitioner looks very different from that of a physician. Nurses dive right into learning clinical information and medical treatment in their undergraduate nursing education, where they obtain a Bachelor of Science (BSN) in Nursing. During nursing school, they complete a set number of clinical hours within the hospital learning how to be bedside nurses. This will depend on the program, but most will complete around 800 -1000 hours of clinical.

Once they graduate and pass their board certification (the NCLEX-RN), they begin immediately working as a bedside Registered Nurse (RN). If they make the decision to obtain their NP degree, most will choose to begin after an estimated 5-15 years of bedside nursing experience – however for most programs, there really is no minimum years of experience required for matriculation. The NP program will be population-specific. This means that instead of rotating through each specialty – they will obtain 600-800+ clinical hours in their specific specialty under an experienced NP or physician. Most will complete their master’s degree in 2-3 years, and many are able to work at least part-time while doing so. Some choose to get their Doctorate of Nursing Practice (DNP), which instead takes about 4 years to complete. Once they graduate, there is no required residency program. While some residencies are available, this is by far not the norm. Once they pass their board certification (via ANCC or AANP), they can immediately begin practicing as an NP. In most states, they will be working in close collaboration with experienced NPs and physicians, at least until they get more experience as a practicing NP. 

Side by Side

Both routes are difficult – but I won’t deny that the physician route is more rigorous and definitely offers more hours of education, training, and supervision. However, I won’t completely disregard the benefits that the NP route can have.

Firstly, there’s earlier exposure to healthcare and medical conditions through education and clinicals during their undergraduate nursing degree. Pre-med students usually have little if any healthcare exposure. Additionally, NPs usually have years of bedside nursing experience. As previously stated – this should not be equated with formal education, but shouldn’t be ignored either. This experience exposes them to medical conditions and management, improves their assessment skills, and helps improve their communication not only with their patients but also with their medical colleagues. Those of us working in the hospital system can see firsthand just how smart and capable good bedside nurses can be.

When directly looking at them side-by-side, please keep in mind that these are all general estimations as each program, specialty, and specific situation is going to impact the amount of formal education and training.

To illustrate the difference in education between Nurse Practitioners and Physicians.

Looking at these numbers, it is clear that our formal education and training is less than that of a physician. However, I do believe our education is sufficient for us to provide great care to our patients. While an NP is not equivalent to a physician, we have proven ourselves to be knowledgeable and capable Providers in various specialties.

Comparing the Actual Job Role

The actual job role of NPs and physician will vary greatly depending on state and facility. However, usually the specific job duties are very similar.

Both physician and NPs:Provider Job Role

  • Obtain health histories from patients
  • Perform a physical assessment
  • Order diagnostic tests and interpret them
  • Order treatments such as medications and therapies
  • Consult appropriate specialists

In some locations and settings, you will have a difficult time telling the difference based on their job role. This is especially true in primary care or outpatient offices. In many settings and locations, NPs work in close collaboration with physicians. This means they usually work with them and consult them if they have any questions. This is especially true for new NPs, as even in states with full practice authority, new NPs still have so much to learn.

21 states offer full practice authority for NPs. While I do support full practice authority, I also recognize the need for close collaboration with other NPs and physicians, especially as new providers. The health and wellbeing of our patients are more important than anyone’s egos.

Overall, either path is commendable and offers excellent education and training, but the differences in each cannot be ignored. Physicians clearly have extensive education and training, starting out very broad and narrowing down to their specific patient population within residency. They are continuously learning under other knowledgeable physicians and have a rigorous and long-standing educational format. This is no easy path.

 NPs first get great bedside nursing experience – connecting with patients and being exposed to medical conditions and treatment plans. Then they choose a specialty and focus on their specific patient population. So no, they may not be able to tell you in-depth information about virology or the cytokine p450 system. However, they are educated and trained to treat their specific patient population appropriately. Any research studies comparing and contrasting NPs and physicians show that NPs have not been found to provide inferior care.

The best thing for all of us to work together, swallow our egos, work within our scope and capabilities, and provide top-notch care to all our patients.

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How Much Do Nurse Practitioners Make?

How Much Do Nurse Practitioners Make?

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If you are thinking about or working towards becoming a Nurse Practitioner, the thought of an increased salary has probably crossed your mind. Advancing your nursing career not only can have a positive impact on your job satisfaction, but also tends to positively impact your pay. When I was a broke college student, I would obsess about my future and how much money I would be making as an NP. While money should not be the only factor to consider – it is an important one! Besides – Grad school costs a lot of money – it better be worth it on the other end.

When I would constantly try to figure out how much money I would be making as a future NP, I had trouble finding the right answers that I was looking for. Online forums gave inconsistent answers. Some salaries would seem much too low, and others seemed so high it was unrealistic. I needed an open, honest answer – and I honestly feel as though I never really found it.

Now that I am a practicing NP, I hope to be able to give exactly what I was looking for as a future NP – an honest answer! Not only will I tell you how much I make as an NP, I am going to highlight 4 factors which can help you determine how much you can make as a new graduate NP in your specific situation.

I also made a YouTube video about this above – if you’re not into reading articles the video might be more your style!

Four Factors in Determining NP Salary

Many variables will determine your salary in the healthcare field. I attempt to simplify these into four factors that can help you determine a good estimate on just how much you can get paid as an NP.

1. Experience

This one is pretty much a no-brainer. As in all professions, the more experience you bring to the table – the more value your company will perceive. This tends to mean higher pay. You have put in the work, you company recognized your experience and knowledge, and they reward that.

Glassdoor will tell you that the average NP salary with 0-5 years of experience is approximately $105,000 per year. At the same time, NPs with greater than 15 years of experience make approximately $122,000 per year. This is a $17,000 per year difference. While Glassdoor is a great way to estimate salary, it shouldn’t be looked at alone. Medscape released a 2018 NP Compensation Report which actually supported these numbers. Average NP with 1-5 years of experience had a salary of $106,000, whereas those with 11-20 years of experience had an average salary of $123,000.

This can sometimes be a little frustrating when those who have “put in their time” do lower quality work than you – who might be new but who works very hard. Unfortunately, this is life. You too can reap the benefits in 10-20 years down the road. While the above numbers are great averages to go by, these do not factor in anything other than experience. Instead of how long you’ve been working as an NP, what type of work you do will impact your salary even more.

2. Clinical Setting

Where you work as a nurse practitioner – as in which type of clinical setting – will have a major impact on your salary as a Nurse Practitioner. Acute hospital settings – such as the Emergency Department or Inpatient care – have the highest salary of all the clinical settings. These sites tend to have less desirable hours, higher stress levels, and a worse schedule overall. At the same time – they bring in more revenue. Due to this, Nurse Practitioners working within these acute settings tend to have higher pay. According to the same MedScape Compensation report, in 2017 NPs in these settings made an average of $120,000 per year, whereas those in non-hospital affiliated outpatient offices made an average of $108,000. Even lower paid are academic professionals (education or research), who make $105,000. The lowest setting appears to be college health, which makes $95,000. In general, if you are planning on working for outpatient offices you can estimate $10-15,000 less than you would make if working ED/inpatient.

Each clinical setting has its pros and cons. College health may have the lowest paying salary, but they also tend to have great hours, holiday breaks, and tuition assistance perks. Knowing which clinical setting you want to work in will definitely help you estimate how much you can make as an NP. However, another important factor to consider is what area you will be working in.

In some instances, pay may be higher in rural areas who have trouble maintaining staffing – so keep that in mind.

3. Location

Where you work – as in what geographical location – is another major factor to consider in determining your NP salary. According to MedScape, the best areas for the highest NP salary is the Pacific coast, where it averages $130,000. The more central, generally the less pay you can expect. The lowest paying area is East South Central, which includes Tennessee, Kentucky, Mississippi, and Alabama – averaging $103,000.

Something to keep in mind is that where you work will also determine your cost of living. When I used to work as a Nurse in Western Pennsylvania, my 1-bedroom apartment cost me $435/month. Now I live in Urban New Jersey, 1 hour south of NYC. That same 1-bedroom apartment would cost me TRIPLE what it did in rural PA. Food, drinks, property taxes, and events (such as weddings) can all add up. So while you may be making a higher salary, you may not be earning more effective income.

4. Contract

What type of employee you are will definitely play a part in your overall pay. Full-time employees have standard pay, but they also have many benefits which increase their overall package. They often receive Paid Time Off (PTO) for vacations and holidays, Medical, dental, and vision insurance, malpractice insurance, Continued Medical Education allowance, life insurance, retirement, license reimbursement, etc. These all really add up. As a Part-time employee, you may receive some of these benefits, but your pay will likely not increase.

As a Per-Diem employee, your hourly pay will likely be somewhat more than Full-Time employees. This is because the company is not contributing any benefits to you, but you basically just work occasionally. Locum Tenens, which is basically just a temporary travel NP, has the greatest opportunity to make money. Rates can be $75-150/hr – however the latter being more rare. These usually require you to be willing to travel often, be very confident in your skills, and to be comfortable working alone. Many critical access hospitals will pay big bucks for you to be the solo Provider for a limited amount of time.

How Much Do I Make as an NP?

I hope the above information you found useful and can use to help you determine your future NP salary. To give you some reference, I will share my salary as an NP.

When interviewing for jobs last year, I had offers of about $100,000/year plus benefits for outpatient primary care offices. However, I ended up taking a job as an inpatient hospitalist working nightshift. I work in urban NJ, three 12-hour shifts per week, 7P-7A, and do receive shift differential. I do get paid hourly, but my yearly salary ends up being between $110-120,000/year. This is great pay for a new graduate NP. Keep in mind though that I do live and work in a high-cost area and I work in the acute inpatient setting. These two factors are really the main reasons why my salary is what it is. I am a FT employee and do receive hospital benefits as well.

I hope you found this article useful! I just know that when I was an aspiring NP, reading something like this would have been motivational and would have offered clarity and perspective. Hopefully this can do the same for you!

 

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Nurse to Physician – Is there a Shortcut?!

Nurse to Physician – Is there a Shortcut?!

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RN to MD featureNursing is an amazing and fulfilling career path full of opportunity and education. Nurses are the front-lines – they are the first to know something is wrong, the first to advocate for their patient, and the last person in the room. Nurses should be proud of the work they do and the lives they save. However, sometimes a Nurse desires to advance their education and become a physician – and there is nothing wrong with that.

Many nurses and doctors recommend just becoming a Nurse Practitioner – as this is “basically the same thing”, “easier”, and will get them toward becoming a practicing clinician much sooner. Honestly – these are good points. However, there are many reasons why being a Nurse Practitioner might not be enough for you.

The path to becoming a Nurse Practitioner (NP) is difficult, as is the path to becoming a physician. While performing similar functions within healthcare – especially in certain practice settings – their respective education is very different with different points of emphasis. Sometimes a nurse might desire more knowledge. As an NP – there are definitely times in my career where I wish I had the knowledge and training that physicians experience. Additionally, pay and opportunities are invariably better for physicians (although work-life balance may suffer). Lastly – while most people respect NPs, unfortunately some do not and there is definitely a higher level of respect towards physicians.

Occasionally someone will choose to become a Nurse Practitioner and then later on decide they actually want to be a doctor. This is okay too!

Long-story short – whether or not you choose to advance your education by becoming an NP, a physician, or an NP and THEN a physician – you need to choose what’s right for you and what fits best into your life and your goals.

But is there a fast-track method for nurses or NPs or nurses to become physicians? I mean – we already have plenty of experience on various medical conditions and treatments. We have first-hand clinical know-how – and our bedside manner tends to be pretty awesome too.

Unfortunately – there is no easy fast-track method for anyone to become a physician. Medical school is a competitive rigorous endeavor. However – if its something you want bad enough – there is no limit on the work that you will do and the success you will have if you put your all into it.

How to Get Into Medical School: Nurse Edition

As an already practicing RN or NP – you will be considered a “nontraditional” applicant to medical schools. Many of the students they accept are fresh graduates of a baccalaureate degree. They will have majored in a science, pre-med track, or have ensured that they took all the pre-requisites. They will have prepared for the MCAT as well.

And then there’s you. Someone who is smart, intelligent, with good base knowledge and first-hand experience. So what path must you take to make becoming a physician a reality? Unfortunately it will be similar to other non-traditional students (no shortcuts).

The Pre-requisite Courses

99% of medical schools require pre-requisites – at least at first glance. Medical school is very competitive, and most schools have stringent admission criteria. Unfortunately, nurses won’t have taken all or even most of the course requirements to be considered for medical school.

BSN students will have taken science pre-requisites – but at most universities these are not the same courses required by medical school. While you may have taken chemistry courses – these were likely geared towards health professionals. Depending on the medical school and your undergraduate courses – these may or may not count towards the pre-requisite requirements.

Med school prerequisitesThe general Med school pre-requisites are below:

2 semesters of general chemistry with lab
1-2 semesters of organic chemistry with lab
1 semester biochemistry (required by some, preferred by most)
2 semesters of biology with lab
1-2 semesters of physics with or without lab
1-2 semesters of English
1 semester of Statistics with or without calculus

As a nurse, it is likely that you’ll have the biology courses completed from your undergraduate education, as well as the English and possibly Statistics. Otherwise, this leaves about 6 courses or 20+ credits that you’ll need to take before you even are able to apply. This may take a year or two depending on how you can make it work with your Full-Time work schedule – or you can work part-time if that is an option for you.

There are a few ways around taking pre-requisites – but these are very rare. A school in NYC Mount Sinai waives pre-requisites for a small amount of students, but these students have to have majored in a humanities – aka not nursing.

The best way to see if you have any alternative options are to email the schools admission team and await a reply. However, more than likely they will say that they have strict admission criteria and there is no alternative route – even if you’re a working nurse.

There are post-baccalaureate programs which generally last 1-2 years, helping you complete your pre-reqs and possibly even having linkage programs with medical schools. This means you would have a better chance of admission into medical school. Additionally, they usually offer a letter of recommendation. Admission criteria to these programs are variable and they may require you to retake various classes (i.e. biologies).

Pre-requisites are important to take regardless, because they help prepare you for the MCAT – which is another strict requirement for U.S. Medical schools.

The MCAT

The MCAT – or Medical College Admission Test – has been used since the 20th century in testing student’s problem solving, critical thinking, and understanding and application of scientific concepts related to medicine. Most medical schools are very strict about the MCAT being taken – and scores play a very big factor in your successful matriculation.

The MCAT was reformatted in 2015 and now incorporates many sections – but a strong science background will definitely help you do well. Don’t think just because you’re a practicing nurse you’ll automatically do well on the MCAT. While questions are often related to medicine, they require deep understanding of principles of chemistry, physics, and biology. They also test your critical analysis, reading, and reasoning skills, and recently incorporated Psychology and social functions of behavior.

The average MCAT score is 500. The highest score possible is 528, however any score above a 523 is considered the 100th percentile (this is very difficult to achieve). Depending on which schools you apply to – they will have different MCAT “averages”, but it is not the only important aspect of an application. However, if you do not meet the minimum MCAT requirement, certain schools may automate you out of their selection process.

Admissions

Medical schools are very competitive. In fact, about 60% of applicants get rejected to medical school completely – and that’s after applying to an average of 16 schools (Ref). If you’re limited on which schools you can apply to – this rejection percentage will likely be much higher!

Obviously specific schools will have different acceptance rates. Harvard’s school of medicine, for example, had an admission rate of 2.4% for the class of 2022, whereas Mercer University SOM has an average admission rate of 53%.

Long-story short – it definitely will depend on which schools and how may that you apply to. Applying to “easier” schools will definitely increase your odds.

Financial Aid

Even if you get accepted – how the heck are you going to pay for medical school?! The average cost of a 4-year public medical school is over $128,000, while private is over $208,000 (Ref). That’s a lot of cash – much more than you’ll be making as a nurse.

Medical school is intense as well – and you’ll likely only be able to continue working occasionally – if at all. You may want to devote most of your free time to studying – especially in the first couple years, and the latter will be saturated with clerkships – you may be burnt out!

Like any other student – you’ll likely need to take advantage of student loans. The annual federal loan limit for Medical School from the federal government is $40,500. As long as you’re not crazy rich – this money is pretty much guaranteed. This will cover most public schools tuition and fees, but may not leave you with much extra spending money or money for living expenses. You may need to look into private loan options to supplement your finances – which will likely be more difficult to get approved.

However, don’t lose all hope! Many schools offer grants and scholarships. The key is to have a stellar application. They are more likely to offer great scholarships to those applicants with very high MCAT scores and GPAs to bolster their class profile.

Nursing Advantage?

As a nurse – there are some advantages to medical school. You will already have a clinical understanding of various disease processes as well as expected symptoms and general treatments. However, the first 2 years of medical school are very science-focused – and many RN-to-Physicians report difficulty within the first few months adjusting.

It will take a lot of time and hard work – just like for all medical students. Once you reach clinical clerkships – you may find it easier adjusting due to your previous experience. A better understanding of healthcare infrastructure and your experience as a nurse will definitely help you be a more well-rounded physician in the future.

Do you have dreams of becoming a physician? Leave a comment below!

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5 Reasons to Become a Nurse Practitioner

5 Reasons to Become a Nurse Practitioner

This post may contain affiliate links, which means I get a commission if you decide to purchase through my links, at no cost to you. Please read affiliate disclosure for more information

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Nursing has become a great career track full of extensive settings and options. One advancement option for nurses that is increasing in popularity is becoming a Nurse Practitioner.

Working in a hospital – it seems as though everyone is in graduate school for their nurse practitioner, or at least thinking about it! Most medical professionals know the role that Nurse Practitioners perform. Nurse Practitioners function similar to that of a physician – ordering tests, diagnosing, and treating various medical issues.

The capacity and autonomy of the Nurse Practitioner really depends on the location, the clinical setting, and the specific facility.

Oftentimes, Nurse Practitioners work hand-in-hand with physicians to provide comprehensive care to patients – both healthy and sick, acute, and nonacute.

To some, this may seem like too much responsibility. To others, it may be the perfect challenge with a whole host of benefits. Here are 5 reasons to consider becoming a nurse practitioner!

1. Better work environment

This one can definitely depend on which job you end up taking as a Nurse Practitioner, but in general you will find a better work environment as a Nurse Practitioner.

The work involved as a Nurse Practitioner is more of a mental game as opposed to a physical one. Bedside nursing is TOUGH – it wreaks havoc on your physical body. Additionally, you take the blame for basically everything and if anyone is getting yelled at – it is likely to be you.

As a Nurse Practitioner, you are “higher up” on the totem pole. Your job is to treat the patient with critical thinking – as opposed to physically carrying out the orders. While this brings its own slew of challenges, it is less physically demanding.

Additionally, patients and colleagues will often treat you with more respect – you’d be surprised the difference a white-coat can make.

Many nurse practitioner jobs offer better hours to supply a better work-life balance. Many office settings work Monday-Friday, with certain days off or “short” days.

This schedule is desirable to many professionals with families. However, some people enjoy their 3-day work week, and there are hospital jobs available to Nurse Practitioners to fill that desire as well.

2. Better Income ($$$)

Let’s not kid ourselves – this is probably one of the biggest motivational factors involved when someone considers becoming a Nurse Practitioner.

A pay raise is expected when transitioning from a bedside nurse to a Nurse Practitioner. While this isn’t always the case depending on your location and current bedside nursing job, most people can expect a significant pay raise when making the career change from bedside nurse to Nurse Practitioner.

While starting out as a new graduate Nurse Practitioner may not be a dramatic income increase, the potential for earnings with experience is undoubtedly much higher.

According to Glassdoor, the average base salary of a Nurse Practitioner in the US is $117,298. This does not factor in benefits or bonuses – which will also vary depending on the specific job.

No – you won’t always be able to expect this income as a new graduate nurse, but higher cost-of-living areas or very rural areas may offer great pay even to graduate Nurse Practitioners – especially in the inpatient setting. 

In the outpatient office setting, Nurse Practitioners can expect to make less (somewhere between 80-100K), but higher salaries are not unheard of in areas of need.

Related Article: How Much Do Nurse Practitioners Make?

3. Better Benefits

This seems to be a universal perk of being a Nurse Practitioner. While benefits as a bedside nurse aren’t terrible, benefits that come along with a Nurse Practitioner are better and negotiable.

Yes – all the standard benefits are almost always included with a Nurse Practitioner’s benefits including medical, dental, and vision. Retirement options are usually included as well with various options.

In addition to standard benefits – Nurse Practitioners can expect more time off each year. 4 weeks of vacation isn’t unheard of, and you should also be given time off for continuing education.

There should also be money set aside (~$1000-$3000) for continuing education which you can use yearly.

As a bedside nurse, you are lucky to get 2 weeks of vacation each year, with no money for continuing education.

Many companies will pay for the Nurse Practitioner’s certification and licensing fees as well as renewals. This includes your state licenses (both RN and NP), your DEA license, your CDS license, and your NPI. This can all add up, and it is helpful when the employer offers this perk.

Additionally, it is standard for employers to offer professional liability insurance – which is an absolute necessity when practicing at the Nurse Practitioner level.

Benefits will vary from employer to employer, but you can definitely expect better benefits as a Nurse Practitioner as opposed to a bedside nurse.

4. More Knowledge

If you like challenging yourself and learning as much as you can – becoming a Nurse Practitioner is the logical next step of your career.

Graduate and/or doctoral school is challenging and difficult. There is SO MUCH to learn, especially when patient decisions are going to be in your hands.

You will be responsible for the patient’s well-being – their lives literally depend on you.

Furthering your education is not meant to be easy. Physicians are given extensive time and training before they are able to make autonomous decisions for a patient. Nurses go back to school for 2-3 years and then are expected to practice in a similar manner. While completely possible – especially with physician collaboration – this is challenging.

You will learn so much – and you will continue to learn throughout your career. If you are a bedside nurse and find yourself constantly wanting more – then go for it! Sometimes there is just a deep desire and yearning for advancement that no amount of money or thrill as a bedside nurse can fill.

5. There is a Definite Need

There is a huge need for nurses, and some might say an even bigger need for Nurse Practitioners. This is because of the need for physicians – and Nurse Practitioners are being used to fill this gap and to practice at the highest level of their scope of practice. Nurse practitioners are needed in every setting – outpatient and inpatient, office and hospital, walmart and CVS.

If you find these 5 reasons to be worth going back to school, then go for it! Only you are holding yourself back. However, becoming a Nurse Practitioner is NOT for everyone. It is definitely demanding and will challenge you like nothing before. If you are unsure of whether or not to advance your career in this manner, here are 5 reasons to possible reconsider:

5 Reasons to Reconsider

1. You’re only thinking about the money

People want the higher paying job, but if they don’t love what they do – it might not be worth it.

There are many bedside nursing options that can vastly increase your pay without spending thousands of dollars on graduate school.

Graduate school is NOT cheap – I spent over $70K on my graduate education alone. You can consider travel nursing or management options if you only seek advancement for financial reasons.

2. You enjoy bedside nursing

Bedside nursing can be fun and enjoyable, especially in a well-managed department. Personally, working in the ER is fun and enjoyable, and the camaraderie is like none other.

This is still possible as a Nurse Practitioner – but likely will look different.

Besides, there is still a huge need for RNs, and if everyone became a Nurse Practitioner, who would actually be at the bedside with the patient!?

3. You struggle with tests

A Nurse Practitioner program will be full of exams. While more straightforward, exams will test you on a wide range of knowledge related to various medical conditions and their appropriate treatment.

If you are someone who struggles with tests, this may be something to consider before applying.

Additionally, there will be a certification exam through the AANP or the ANCC which you must pass before being able to practice as a Nurse Practitioner.

4. You can’t stand research or theory

There is a TON of research and theory involved in the Nurse Practitioner curriculum.

While some consider it to be too much (and not enough clinical-based education), there is undoubtedly a LOT of research articles you must read, research papers you must write, and other information to learn which isn’t directly clinical.

This includes classes such as ethics, leadership, family theory, and health promotion and maintenance. If you cannot stand these topics or the thought of taking these classes – you might want to reconsider.

5. Your schedule/finances

While this is always a factor – you will have to weigh your desire to becoming a Nurse Practitioner with your actual ability to complete school.

Your personal finances, your personal schedule, and your family-life will dictate your ability to complete a Nurse Practitioner program.

As stated before, it is a demanding and time-consuming process to become a Nurse Practitioner, and if you cannot allocate enough time to advancing your career, maybe now is not the best time. 

Many nurses, including myself, have worked or currently work full-time while completing their graduate programs. Depending on the program, this is possible – but this will not always be possible depending on your current situation.

If you cannot devote 80-100 hours to work full time and complete school, then you should possibly reconsider.

If you are lucky enough to be able to work part-time or not at all, then this will make your decision easier. Whether or not you recently decided to become a nurse practitioner, or it has always been your end-goal – it is a great option for the advancement of your career. There are tons of benefits to becoming an Advanced Practice Provider, and if it is something you desire – do your research.

Being a Nurse Practitioner is a rewarding career and you won’t regret it – so long as you do it for the right reasons.

Any other reasons you can think of to become a nurse practitioner? Let me know down in the comments!

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NP Credentialing Process: Steps After Graduation

NP Credentialing Process: Steps After Graduation

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So you’re just about to graduate from your Nurse Practitioner program (or already have), and you are ecstatic! But where do you go from here? The NP Credentialing Process can be a bit overwhelming.  After I graduated, all I wanted was an easy-to-follow tutorial to streamline the process. While the specifics may vary from state to state, the general steps are the same. Follow these steps to quickly and efficiently be one step closer to obtaining your license and practicing as a Nurse Practitioner.

1. NP Credentialing Process: Apply for Certification

The road to becoming a Nurse Practitioner is a long one! If you’re anything like me, you’ve probably been too focused on your studies to research what exact steps to take after graduation. In order to apply for your state licensure, you must first prove your competence at taking a certification examination either through the American Academy of Nurse Practitioners (AANP), or through the American Nurses Credentialing Center (ANCC).

AANP offers exams for the Family Nurse Practitioner (FNP), the Adult-Gerontology Primary Care Nurse Practitioner (A-GNP), and the Emergency Nurse Practitioner (ENP).

ANCC offers exams for the Family and the Adult-Gerontology Primary as well, but also offers exams for Adult-Gero Acute NP, Pediatric NP (PNP), and Psychiatric-Mental Health NP (PMHNP).

You must create an account and apply for a certification exam within your respective specialty. The unfortunate cost of certifying with these agencies is quite high. The AANP will cost $315 for an initial certification, or $240 ($75 discount) if you are an AANP member. For the ANCC, non-members will pay $395, but discounts are available for AANP members ($340), AANP Student members ($290), and ANA members ($270).

You will need access to your previous class schedules and information, as the initial application for certification requires that you enter information about the classes you have taken. You will also need to list the names and addresses of your clinical sites, as well as the contact information of your previous preceptors.

2. Send Verification Information

The next step in the NP credentialing process is verification. Whether you apply through the AANP or the ANCC, you will have to verify that you are a student just about to graduate – or that you have already graduated. To do this, you MUST send an official transcript indicating that you have graduated from an accredited Nurse Practitioner program to the certifying bodies (AANP or ANCC). You can do this through your universities online portal. Many universities offer fast email delivery, usually for a small fee.

If you haven’t graduated yet, or if you finished school but the conferral date of your degree has not yet passed – you may still apply. You will need to send an official transcript of your work-to-date. This will allow you to sit for the exam, but you will need to resend ANOTHER official transcript AFTER your conferral date to prove that you successfully graduated.

Send your correspondence to the following:

ANCC Email: [email protected]
ANCC Mail: ANCC PO Box 8785, Silver Spring, MD 20907-8785

AANP Email: [email protected]
AANP Transcripts Email: [email protected]
AANP Mail: AANPCB, P.O. Box 12926, Austin, TX 78711

You will get weekly emails from your certifying agency updating you on your required documents. The average processing time is 3-6 weeks. For ANCC, processing time can be shortened to 5 business days using the Expedited Review Procedure but will cost an additional $200.

3. Take the Exam

After everything has been received and processed, and if you have been deemed eligible, the AANP or ANCC will send an Authorization/Eligibility to Test email. In this email, it will give you instructions on signing up for an examination date and location.

You will take the exam at a testing center – similar to the one you may have taken your NCLEX-RN at. You MUST bring 2 forms of ID, one of which must be photo ID, and the other can be a debit/credit card with a signature on the back. Make sure you arrive at least 30 minutes early.

The AANP examination has 150 questions and you will have 180 minutes to take it.
The ANCC examination has 200 questions and you will have 240 minutes to take it.

Immediately after submitting your answers, you will have to take a quick survey. After the survey, you will exit the room and the testing proctors will give you printed information. On this information will have your preliminary results – and hopefully will say “you passed!”.Nurse Practitioner: Licensure Timeline Infographic for newly graduated #NursePractitioners #NP

4. Wait for Official Certification

After taking the exam, you will have to wait for your official results. These will come in the mail, but will also update on the certification websites, so be on the lookout. This process typically takes 2-3 weeks. Once you get your official certification, you can begin your state BON application for License as a Nurse Practitioner.

5. Apply for Licensure with the State BON

This step in the Nurse Practitioner Credentialing Process is the most variable from state to state. Google “_______ BON nurse practitioner license”, and you will likely find your state’s BON section on their website. It may have the application in pdf form for you to download, or you may have to email a secure email and request an initial certification application.

Once you have the PDF, fill it out with Adobe Reader (or whatever application that works for you), or print it off and fill it out by hand. Ensure that every section is filled out correctly – as it may delay your licensure if done incorrectly. 

Requirements vary from state to state, but generally, you will need:
*Passport-Style Photo
*Filled out Application
*Copy of Birth Certificate or US Passport (Proof of citizenship)
*Fingerprints or Release to Collect previous fingerprints (Background Checks)
* Check for fingerprint release (~$20)
*Application Fee (~$100)

You also MUST send verification of your passing the certification exam. You can do this through the AANP or ANCC websites by clicking “verify”. Verification to your state BON is FREE.

There may be other various requirements for each state. Pharmacology requirements differ per state, but if you had at least 1 Pharmacology class that should suffice in most instances. If you didn’t have a specific Pharmacology class but it was within other coursework, you must have a specific integrative pharmacology form filled out. If it has been greater than 5 years since you took your Pharm course, you may have to take CEUs toward Pharmacology and submit verification. Some states, such as New Jersey, require everyone to take a certain amount of CEUs towards prescribing controlled substances (6 credits for NJ). Again, read the specific instructions on the application, and follow them exactly. This will ensure quick processing and no delays.

Your State BON may or may not require you to sign the application in front of a Notary official. If this is the case – there will be a Notary Affidavit within the application. Take the application to the courthouse, the UPS store, or another agency and get it notarized before submitting it.

If your state BON allows an online application to be submitted – fill that out as it usually offers quicker processing times. However, if your state does not have an online application or if you prefer to print it out and send it, collect everything needed and send it in a secure envelope. I prefer to send my important documents to the BON through the UPS store, but any service which offers quick delivery, tracking, and safe delivery will suffice.

6. Wait for State Licensure

This step is invariably the longest step in the NP credentialing process. Depending on the efficiency of your state’s BON, this can take a long time. General wait-time is said to be 8-12 weeks for most state BONs. However, you have to be proactive in some situations. If your state offers online verification, check online to see that your application is pending. If it has been 8 weeks, call and get an update on the status of your application.

However long it may take, once you receive your state licensure, you can apply for your DEA, NPI, and in many states your secondary controlled substance license.

7. Apply for your DEA License

Apply for your DEA license here. This will cost $731, and processing time can take 4-6 weeks. Once on the website, under Form 224, click “Mid Level Provider”, and then “Begin”. Fill out all required information and pay with debit or credit card of your choice. While this is expensive, it covers you for 3 years within your state and you may be able to get your future employer to reimburse you for it.

8. Apply for your Secondary Controlled Substance License

Many states, such as New Jersey, require a secondary Controlled substance license. Often called Controlled Dangerous Substance (CDS) or Controlled Substance Registration or License, this is required by just less than half of the individual states.

You may need to wait for your DEA license to be completed before applying for this. Your state BON should also have this information on their website, but you can google “_________ BON CDS application”, and Google will not lead you wrong. The cost is usually low (~$20), and the processing time is generally 2-4 weeks.

9. Apply for your NPI

The NPI, or National Provider Identifier, is a 10-digit number which identifies you to Medicare and Medicaid Services. To apply, you must fill out an application online here. Create an account, sign in, and then click “Apply for an NPI for myself”. Fill out the information correctly, and click submit.

In general, as long as the online application is filled out correctly, you will receive your NPI number within 10 days, and your application is FREE. You can actually apply for your NPI as a nurse, and once you obtain your NP license you can update it.

And THOSE are the general hoops you have to jump through throughout the NP credentialing process before officially becoming able to practice to the full extent of your education as a new Nurse Practitioner! Things may vary state-to-state, so be sure to read your state’s BON website very thoroughly.

Some jobs may let you start working sooner, getting accustomed to the work environment, the electronic medical record, and the facilities themselves – you just will not be able to see patients independently until you at least get your state licensure.

Did I forget anything? Comment below if this was helpful or if you’d like another step-by-step instructional.

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Top 5 Nurse Practitioner Apps

Top 5 Nurse Practitioner Apps

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Check out these Top 5 nurse practitioner apps for when you’re at clinicals or even at work! The internet can be a clinician’s best friend. With the implementation of easy-to-use apps for smartphones, evidence-based recommendations are literally at your finger-tips. Not only will this information be helpful in a pinch, but you can also rest assured you are giving your patients accurate and updated information. 

1. The Best Nurse Practitioner App: UpToDate  

UpToDate Medical Resource App IconUpToDate, according to its website, is an “evidence-based, physician-authored clinical decision support resource” for use in “point-of-care” decisions. Basically, experts in their respective fields write in-depth recommendations for every disease or complaint you can think of. Think of it as a comprehensive textbook regarding all things medical in the palm of your hands or on the screen of your computer. This can be an extremely useful nurse practitioner app to utilize!

UpToDate guarantees evidence-based recommendations that are quite literally up-to-date. Each article contains relevant figures, tables, and pictures to aid in understanding. In addition, Continued Medical Education (CME) hours can be turned in to various certifying bodies (AANP, AMA, ACEP, etc).

While UpToDate is an invaluable resource, there are some negative drawbacks. This requires a monthly subscription, and you may be looking at paying more than $50/month. An additional $6/month will be added if you want to use the UpToDate app on your smartphone. However, many hospitals offer this service free-of-charge, as well as many universities. Additionally, if you are an Advanced Practice Provider or Physician, many places of employment will be willing to pay for this service. If you are a student or medical resident, there is a significant discount applied which ends up costing $19/month ($25/month with smartphone app access).

Additionally, some say that UpToDate has a layout that is verbose and sometimes difficult to follow. This may lead to trouble using it on-the-fly while at clinical or work. However, from personal experience – once you get used to the layout, the speed and effectiveness of the service increase dramatically.

Regardless of price, UpToDate is WORTH it, and once you use it you won’t regret it! This nurse practitioner app can be used on the fly for a quick refresher or can be studied in-depth for a complete understanding.

2. Epocrates  

Epocrates Medical Resource App IconHailed as the #1 Medical Reference App, Epocrates has set itself apart as the go-to nurse practitioner app that over 1 million healthcare providers are using. This app offers a wide array of services from Updated Guidelines, Disease Overview, Medication Interactions, Drug information, Differential Diagnosis tools and much, much more. Best of all, Epocrates has a free version. While somewhat limited, the free version is still very useful for nurse practitioners, other clinicians, and nurses alike.

Epocrates free version does include access to their drug information and clinical practice guidelines – which are very useful in the clinical setting. Additionally, the free version offers medicine interaction checks, as well as a few other features which I have found to be non-useful. The Premium option is MUCH more inclusive and offers a wide variety of useful tools. The Premium option is available for $174.99/year, which is less than $15/month. This version offers all of the features included with the free version but adds many more. This includes it’s most useful section, the Disease Information (see below). Additionally, it offers ICD-10 code lookups, CPT codes, Lab information, and Infectious Disease treatments.

With all the features available in the Epocrates app, the most useful feature is the Disease Information. With a simple query, you have access to the disease highlights, treatment options and approach, history and physical exam findings, differential diagnosis, complications, and follow-up information. As you can tell, this pretty much does your job for you – you just need to know where to look. I have found this feature to be useful during clinical – where I used it almost every day.

If you are a student in a medical field (such as a nurse practitioner), university faculty, or a medical resident/fellow, then you can obtain the premium version at a discount of only $49.99.

Epocrates is sleek, offers up-to-date information, and is easy to access on-the-go. While not in as much depth as UpToDate, it offers quick easy-to-access information which makes referencing medical information at clinical or work to be effortless. Many users find it much easier to navigate and find what they are looking for. Additionally, Epocrates is offered MUCH cheaper and just a fraction of the cost of UpToDate – however, MUST be bought for a full year as opposed to monthly payments.

3. MedScape  

Medscape Medical Resource App IconMedscape is very similar to UpToDate and Epocrates in the information it offers – primarily disease and drug information. However, the big difference is in pricing. Medscape is 100% FREE. However, the information provided is HUGELY beneficial to the medical professional in every medical setting.

Medscape has in-depth information for most medical conditions, in-depth drug information and interactions, pill identifiers, various useful calculators, and more. However, something that sets Medscape apart is its Procedures information.

The Procedures feature offers step-by-step techniques for every procedure imaginable, as well as important information regarding anesthesia, complications, and postoperative care. This is VERY useful to students who will be doing procedures in clinical, as well as medical professionals who need to brush up.

Additionally, Medscape offers a fun interactive diagnostics feature that lets you test your skills at interpreting X-rays, CT scans, and the like! Similar to UpToDate, learning on Medscape can be beneficial too for those who need to accrue CEUs for renewing their licensure.

Unlike UpToDate, Medscape does not seem to offer as many tables and figures, although it does offer many pertinent images. Additionally, I have found the Medscape app to be somewhat harder to navigate and absorb information from than both Epocrates and UpToDate.

Best of all, Medscape is 100% free. In order to access some of the features, a free account needs to be created with a valid email address. Overall – Medscape is underrated and underused – but a wonderful nurse practitioner app to use!

4. Merck Manual  

Merck Manual Medical Resource App IconThe Merck Manual, originally published in 1899, is quoted as the world’s best selling textbook. Merck & Co has developed an app which gives the wide information from the Merck Manual at your fingertips.

In-depth, expansive, and searchable, Merck Manual offers innumerable information on various diseases and conditions – breaking down pathophysiology, etiology, evaluation, treatment, essentials, and key points. Merck also offers videos on various procedures and disease overviews. While not all of these videos are made by Merck, they are easy to find and watch within the app.

Similar to the others, Merck Manual does offer some clinical calculators which can be useful in the clinical practice setting. Also like Medscape and FP notebook, Merck manual is 100% Free – No registration or subscription required, and no ads.

5. FP Notebook  

FP Notebook Medical Resource App IconThe Family Practice Notebook, or FP Notebook, is a point of care resource which began in 1995, and now has expanded to 31 specialties and more than 6100 linked interlinked topics. Like the others listed above, FP Notebook has searchable disease information. However, it is limited to just that.

Although FP notebook does NOT offer extra tools, features, or drug information, it does offer easy-to-follow notes on many disease processes. FP Notebook reads more like notes that you would take in class with numbers and sub-numbers. This adds the benefit of finding the relevant information that is useful for clinical practice and takes away the added verbiage – making navigating to the essential information quickly and painlessly.

While FP Notebook does seem to give updated information – it is not prided on delivering the utmost updated information. However, like Medscape, it is 100% free to download.

And there you have it – the top 5 nurse practitioner apps for the working NP! Please leave a comment down below if there are any apps that we missed that you find useful!

 

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