Time-Management for DNP Students

I am a procrastinator, so I wanted to take a minute to encourage DNP students to please manage your time. The day only has 24 hours and they can go by fast especially if you are in DNP school. DNP programs are all about writing and creativity (2 things that I suck in). Writing and creating something can take up days or even weeks (depending on the grading percentage involved). I spend at least 40 hours a week to write or read something for school. Even with a 40 hour investment, most weeks feels unaccomplished to me.

If possible, please give up on your social life. Remember you can go back to that once you graduate.

This post does not mean that you should deprive yourself of everything except school work. You have to make it a point to find some time during the day to relax or revive yourself; otherwise you will easily burn yourself out from school and studying.

Try to prioritize your schedule daily and take care of yourself.  Good Luck!

Why the DNP program?

The profession of nursing is attempting to provide academic preparation and title comparable to other advanced clinical degrees in the healthcare arena such as Medical Doctor (MD), Doctor of Pharmacy (PharmD), Doctor of Public Health (DrPH), Doctor of Physical Therapy (DPT), etc. The Doctor of Nursing Practice degree (DNP) is the highest academic preparation for nursing practice. For new nursing practitioners, the DNP degree may become the requirement to practice advanced nursing by the year of 2015. The DNP degree focuses on incorporating scientific findings/knowledge into practice, thereby improving the health care services provided to our patient population. According to the American Association of Colleges of Nursing (AACN), today’s health care system requires safe and advanced nursing practice to transition scientific evidence into practice. A DNP program prepares the advanced provider with extensive leadership training and education to lead the changing health care system. The DNP programs are congruent with the Essentials of Doctoral Education for Advanced Nursing Practice recommendations. The essentials guide the curriculum of DNP programs and will reflect much of the coursework. These essentials are as follows:

• ·         Scientific underpinnings for practice
• ·         Organizational and systems leadership for quality improvement and systems thinking
• ·         Clinical scholarship and analytical methods for evidence-based practice
• ·         Information systems/technology and patient care technology for the improvement and transformation of healthcare
• ·         Healthcare policy for advocacy in healthcare
• ·         Interprofessional collaboration for improving patient and population health outcomes
• ·         Clinical prevention and population health for improving the nation's health
• ·         Advanced nursing practice

How to get to your ‘dream’ FINAL DNP PROJECT

Some schools call the final DNP project as the “capstone” project. Anyway, this final project requires the student to synthesize and apply learning’s of these three years in school to a project of the student’s interest.  The focus of a three year DNP program is to enable the student to critique researches, apply research into practice, and evaluate the clinical change that you applied for the betterment of health care. The DNP program encourages evidence-based practice. Therefore, the final DNP project should focus on an evidence-based practice change that will improve health care or patient outcomes in one way or the other.

Choosing a topic for the ideal DNP project is the often stressful process for a student; however, remember that the options for a health care or patient outcome change are endless. A multitude of new research comes out daily, so a student need not worry about running out of topics for your DNP project.

Before finalizing a DNP project topic:

• ·         Ask around for ideas for your ‘dream’ DNP project.
• ·         Formulate a well developed question
• ·         Ensure that the topic of choice can be supported by a sufficient amount of research (preferably systemic review studies)
• ·         DO NOT lead yourself with the belief that the world can be changed with your DNP project.
• ·         Try to take on a project that would not consume too much of your time, because in reality, once you start your project, it takes more time than you could have imagined.  (keep in mind that you will be taking other classes along with this project implementation that semester)
• ·         Do not worry yourself about sample size; the important thing is for you to graduate your program. You can always change the world after graduation as well.

Hope these tips will help you pick the right DNP project. Enjoy researching your topic and implementing a change to improve health care or patient outcomes. 

International Nurse Practitioners

     The role of an advanced practice Nurse (APN) or Nurse practitioner (NP) is becoming familiar in an international level. Two main reasons for many countries to start developing the role of NPs are the shortage of physicians and the need to cut cost in healthcare spending (Kroezen, van Dijk, Groenwegen, & Francke, 2011). The International Council of Nurses (ICN) has defined the role of the Nurse Practitioner (NP) in the following statement.

A Nurse Practitioner-advanced practice Nurse as a registered nurse who

 has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A master’s degree is recommended for entry level (Pulcini, Jelic, Gul, & Loke, 2010, p. 32).

     There are vast variations in the scope of practice and education of the APN. In the following, the author will discuss the history, regulations, education and attitude of the public towards the APN/NP for a select few English speaking countries.

 

Nurse Practitioners in the United Kingdom and the Republic of Ireland

 

 

Belfast, Northern Ireland

 

     The United Kingdom (UK) medical system is ran by the government under the guidance of the National Health Service (NHS). Advanced practice Nurses in the UK are called Nurse Practitioners. The role of the NP was established in 1998 to create efficiency of use of nurses, cut cost in the NHS and to ease the deficit of physicians (known as General Practitioners [GP]) in community practice, primary care clinics and acute care settings. They are mainly highly specialized and specifically trained in roles that they are filling such as Endoscopy, Primary Care, Critical Care or Emergency. There are three main levels of prescriptive authorities in Great Britain, Independent, Supplemental, and use of Patient Group Directives (PGD) or Medical Directives (protocols). Independent NPs have full prescriptive authority and full liability whereas supplemental NPs collaborate with independent prescribers. British NPs enjoy full prescriptive authority and access to the full British Formulary including controlled and experimental drugs, access to the NHS prescribing budget for reimbursement and support from the British Medical Association (Kroezen et al., 2011). However, some of the setbacks in the role are the British nursing body’s lack of explicit description of the APN role and highly variable training. British NPs can have a bachelor degree, a post graduate diploma or a master degree. Pharmacology training for prescriptive authority is provided at a degree level and NPs only require three years of clinical experience. Also, NPs in the UK are not required to be licensed or registered. Therefore, the British public does not always embrace NPs due to their lack of confidence that NP training is adequate. Forty four percent of British NPs have had diagnostic request denied. As the NHS is cutting the budget but still demanding high quality care, there is a demand in the UK for NPs to fill positions of GPs at a cheaper price. Morgan (2010) recognized that the NPs in the US are better prepared and that the UK needs time to catch up with the US. The Nurse Practitioner United Kingdom (2010) has been lobbying since 2005 for the government to set a standard of regulation for all advanced practice nurses. This group is seeking to learn from other countries such as USA and Australia on how to regulate advanced practice in nursing.

                                         Cliffs of Moher, Republic of Ireland

     The Republic of Ireland (ROI) has a two-tier health care system; the public health care ran by the government under the Health Service Executive (HSE) and the private health care system. All citizens are entitled to use of the public health care system but only 80% utilize it. The private health care system is more attractive to the public because of the belief that it gives faster access to services and better services than the public health care system (Carney, 2010). The role of the Registered Nurse Prescriber (RNP) was established in the ROI in 2007. RNPs enjoy a vast prescriptive authority much like the UK but require registering under the Nurse Prescriber Division of Register and having a written collaborative practice agreement with a medical practitioner. More information on the RNP scope of practice can be found in the An Bord Altranais website (An Bord Altranais, 2012; Carney, 2010; Kroezen, 2011).

 

An interesting fact: NPs in the United States (US) make on average 51,000 pounds ($81,400) as British nurses make at maximum 43,335 pounds ($69,449) (Morgan, 2010).

Nurse Practitioners in Canada

                                                    Niagara Falls, Canada

      Until the 1990’s, NPs in Canada were trained only to fill position gaps in northern parts of Canada.  Now legislation has been implemented to allow NPs to work in areas outside of the Northern Provinces (Alden-Bugden, 2007). There are 3000 NPs in Canada today. Nurse practitioners in Canada can provide quality care, order tests, prescribe medications, diagnose and manage chronic diseases, and refer to specialists as needed. They work in doctor’s offices, community clinics, nursing homes, private homes, Emergency Departments and Critical Care Units. Canadian NPs are certified by passing the Canadian Nurse Practitioner Exam. However, not all provinces require NPs to take this exam. The Canadian Nurses Association is launching a campaign to educate the population about how NPs can improve access of care for Canadians as close to five million Canadians do not have a primary care provider and those who do have one have a hard time accessing care (NPCanada.ca, 2011).

     Although there are currently no colleges in Canada that has a Doctorate of Nursing Practice (DNP) program, the advent of its southern neighbors requiring their entry level NPs to have a DNP by the year 2015 is putting some pressure on nurse leaders in Canada. All entry level registered nurses in Canada are required to have a bachelor degree however advanced practice nurses can have a bachelor or master degree (Joachim, 2008).

Nurse Practitioners in Australia and New Zealand

     Australia introduced the role of NP in 2000 to relieve the burden of physician shortages. Australian NPs require a master degree, ability to demonstrate clinical assessment and clinical decision making skills and at least five years of clinical experience in order to receive prescriptive authority and endorsement as NPs. However, Australian prescriptive authority is limited compared to British NP prescriptive authority (Kroezen et al., 2011). Since Australia has various states and territories, laws and regulations for NPs vary in each one. The Nurses Registration Board of New South Wales was one of the first states to begin regulation and licensing criteria for NPs. Now Australia is in the process of forming a national regulation (Pulcini et al., 2010).

New Zealand began the role of NP in 2001. Nursing prescriptive authority was historically limited to specialized roles but was just recently expanded to all NP roles. It has similar education requirements and regulations as Australia except New Zealand require only four years of clinical experience and must maintain continuing education in order to maintain their prescriptive authority. NPs in New Zealand get reimbursed the same amount for their services as physicians (Kroezen et al., 2011).   

References

Alden-Bugden, D. (2007, May 25). Welcome to NPCanada.ca. Retrieved from http://www.npcanada.ca/portal/

An bord Altranais (2012). Collaborative practice agreement (CPA) for nurses and midwives with prescriptive authority (third edition). Retrieved from www.nursingboard.ie

An Bord Altranais (2012). An Bord Altranais flowchart for application and registration process for the registered nurse prescribers division [Flowchart]. Retrieved from www.nursingboard.ie

Carney, M. (2010). Challenges in healthcare delivery in an economic downturn, in the Republic of Ireland. Journal of Nursing Management, 18, 509–514. doi: 10.1111/j.1365-2834.2010.01078.x

Joachim, G. (2008). The practice doctorate: Where do Canadian Nursing leaders stand? Nursing Leadership, 21(4), 42-51

Kroezen, M., van Dijk, L., Groenwegen, P. P., & Francke, A. L. (2011).Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a systematic review of the literature. Bio Central Health Services Research, 11(1), 127. doi:10.1186/1472-6963-11-127

  

Morgan, S. (2010). What are the differences in nurse practitioner training and scope of practice in the US and UK? Nursing Times.net. Retrieved from http://www.nursingtimes.net/what-are-the-differences-in-nurse-practitioner-training-and-scope-of-practice-in-the-us-and-uk/5017012.article

NPCanada.ca (2011, October 17). Canadian Nurses Association says ‘it’s about time’ [Press release]. Retrieved http://www.npcanada.ca/portal/

Nurse Practitioner United Kingdom (2010). Regulation [Fact sheet]. Retrieved from http://www.nursepractitioner.org.uk/Regulation.html

Pulcini, J., Jelic, M., Gul, R., & Loke, Y. (2010). An international survey on advanced practice nursing education, practice, and regulation. Journal of Nursing Scholarship,42(1), 31-39. doi: 10.1111/j.1547-5069.2009.01322.x

 

The Research-Focused Doctorate versus the Practice-Focused Doctorate

The Doctor of Nursing Practice (DNP) degree is defined as a "practice focused" doctorate terminal degree in nursing (Chism, 2010).  So what is the difference between this DNP degree and a Doctor of Philosophy (PhD) degree?  The two are compared below:

                                DNP                                    PhD                     
Program               prepares for advanced practice               prepares for nurse research     

Competencies     AACN Essentials                                        Indicators of Quality in
                                                                                                    Research-Focused 

Students              Oriented towards improving                  Oriented towards developing
                              outcomes                                                    new knowledge

Faculty                High level of expertise in                         High level of expertise in
                             speciality area                                            research 

Resources         Access to diverse practice                         Access to research settings;
                            setting; financial aid                                   dissertation support dollars

Program            Health care improvements                     Health care improvement via
Assessment       via practice, policy change                        development of new knowledge
                      
Reference
Chism, L. A. (2010).  The doctor of nursing practice: A guidebook for role development and professional issues. Sudbury, MA: Jones and Bartlett Publishers.

Malpractice Insurance

As nurse practitioners (NPs) assume more autonomy and take on more responsibility, they increase their legal liability. NPs are now being held accountable to their scope of practice. The resulting dilemma is that as scope of practice and autonomy increase so does susceptibility to malpractice exposure.

Professional liability insurance (PLI), also known as malpractice insurance, is an insurance policy that provides financial protection in the event of a malpractice claim. PMI is sold in two forms:

Claims-made policy – covers claims made while the policy is in force but not if a claim is made after the policy expired.

Claims-occurrence policy – covers claims made at the time the policy was in effect regardless of when the claim is made.

How much malpractice insurance is enough?

The best answer is: As much as you can get and afford.

To Avoid a Malpractice Lawsuit

• Do not establish a duty to a patient when you do not have to
• Do not offer advice, diagnosis, or treatment outside of your scope of practice and expertise
• Base your diagnosis and therapy on guidelines and references commonly accepted in your area of practice
• Order a consultation or refer a patient if the history and examination suggest a differential which includes a deadly condition, and you have not ruled out or treated that condition
• If you order a test or consultation, follow through to be sure it was done and that the results were dealt with appropriately
• If the standard of care calls for screening for disease due to your patient’s age, gender, or risk facts, conduct the screening and follow through if the results are positive
• Document carefully so that your actions are justified and your process for medical decision making is discernable to an outside evaluator
• If you cannot practice safely in your current work situation, for whatever reason, leave that situation and find somewhere you can practice safely
• Purchase your own “occurrence” malpractice insurance policy

Picking a Policy

• Ask these questions of companies from which you are considering purchasing malpractice insurance:
• What does the policy cover?
• What is excluded from coverage?
• What are the policy limits?
• How long have you been in business?
• How long have you been writing policies for NP’s?
• What is your financial stability rating?

What questions should I ask my employer about their policy?

• Am I protected individually under the policy? (i.e., am I specifically named as an insured?)
• Does my insurance include License Protection to help defend me in an administrative or disciplinary situation
• If I leave my employer, will its policy cover me for an incident that occurred while I was still employed? (i.e., is my employer’s policy “Occurrence”?)
• Do I have my own individual limits of liability?
• What level of coverage do I have?
• May I see the policy?
• Do I have coverage 24 hours a day

References

ACNP (2012). Frequently Asked Questions about NP Liability Insurance. Retrieved from

http://www.acnpweb.org/frequently-asked-questions-about-np-liability-insurance

Buppert, C. (2008). Frequently asked questions, and answers, about malpractice insurance. Dermatology Nursing, 20(5), 405-406.

The Role of the Hospitalist Nurse Practitioner

     The hospitalist role is a new role for all healthcare providers. It was first termed in 1996 to describe a physician who devotes his or her time to the care of a hospitalized patient. The role of a hospitalist focusing on the hospitalized patient helps relieve the burden on the Primary Care Provider (PCP) so that the PCP can focus on his or her outpatient population (Sullivan, 2008). The hospitalist coordinates a team of healthcare professionals consisting of physicians, nurse practitioners, physician assistants, pharmacists, case managers, social workers, and physical therapists to manage the care of the hospitalized patient (Sheridan, 2011). 
 

 

      A Hospitalist Nurse Practitioner is a nationally certified nurse practitioner who has no primary care or tertiary care practice outside the hospital. He or she is usually trained and certified as an Acute Care Nurse Practitioner but can also be a Family Nurse Practitioner, Adult Nurse Practitioner, Geriatric Nurse Practitioner and Pediatric Nurse Practitioner. The primary duty of a Hospitalist Nurse Practitioner is to admit and discharge patients, manage the hospitalized patient's care with the collaboration of a Hospitalist Physician, make rounds and write orders as needed, interpret laboratory values, make simple diagnosis, plan and coordinate discharges and rehabilitation, and perform procedures within the scope of practice (Sullivan, 2008). The salary of a Hospitalist Nurse Practitioner ranges from $70,000 to $100,000.

 

     The Hospitalist Nurse Practitioner specialty is rapidly growing to help close the gap between the large demands for but lack of available Hospitalist physicians (Sheridan, 2011). I work as a Hospitalist Nurse Practitioner in a small 20-bed rural hospital that sees an average of 6-7 patients a day. I work during the night and admit around 1-2 patients during my shift. I work closely with my collaborating physician and learn a lot from him things that are unique to the hospitalist experience that were not taught in The Doctorate of Nursing (DNP) program or even in medical school. I have learned a lot about how various acute care patients with diagnoses of pneumonia, chronic obstructive pulmonary disease, colitis, acute renal failure, pancreatitis, congestive heart failure, angina, transient ischemic accident and various other medical problems are managed in an acute care setting. Our service only sees patients with medical problems and we have to be careful to not accept a patient with an issue that may require surgical intervention as the surgeon in our hospital would manage those patients. We also only accept patients that are 18 years old or older. We also have to be careful to not accept patients that may require services that are not provided in our hospitals such as critical care, neurosurgery or cardiac catheterization. These patients would be transferred to a bigger hospital that has these services available. The position of a Hospitalist Nurse Practitioner can be challenging but is very rewarding as well.

 

Reference

Sheridan, T. (2011). Hospitalist: An emerging choice for nurse practitioners (Online Exclusive). Health Callings. Retrieved November 10, 2012 from http://career-news.healthcallings.com/2011/08/15/hospitalists-an-emerging-job-choice-for-nurse-practitioners/

Sullivan, L. (2008). The role of nurse practitioners- The hospitalist (Online Exclusive). StudentNurse.com. Retrieved November 10, 2012 from http://www.stunurse.com/features/new-role-nurse-practitioners-hospitalist

Recognizing “Burnout”

Nurse practitioners are at high risk for burnout. It is important to recognize the warning signs of burnout. Burnout is described as specific psychological condition brought on by excessive, prolonged and unrelieved work-related stress.

Burnout occurs when enthusiasm is replaced by frustration and disappointment. If left unaddressed, it can lead to irritability and resentment, productivity drops, behavior changes, confidence and passion are lost.

Risk factors include:

Job-related stressors:

• Unclear Requirements
• High-Stress Times with No “Down” Times
• Big Consequences for Failure
• Lack of Recognition
• Impossible Requirements
• Poor Communication
• Insufficient Compensation
• Poor Leadership

 Personal characteristics:

• Perfectionist Tendencies
• Type A Personality
• Pessimistic
• Poor Fit for the Job
• Lack of Belief in What You Do
• Feel they must always give “110 percent”
• Personalize failure for outcomes beyond their control

Common warning signs:

• Increased absenteeism
• Rushed patient care
• “By the book” approaches
• Emotional outbursts
• Boredom
• Tend to procrastinate
• Withdraw from friends
• Self medicate with alcohol
• Physical symptoms can include:
• chronic headaches
• sleep disturbances
• fatigue/exhaustion
• stress/anxiety
• overall sadness
• irritability
• forgetfulness
• GI upsets
• Cardiac arrhythmias 

Transition to full-blown burnout:

• Can be rapid, or...
• Can be progressive and insidious
• Progressive pessimism
• Dissatisfaction and increased absenteeism
• Low work productivity
• Withdrawal and depersonalization from relationships leads to desire to                                  disappear, and potentially, to thoughts of suicide

Preventing burnout:

• Realize that self care is not selfish
• Take care of yourself first
• Create relaxation time, even at work
• Take a few minutes during the day to meditate, read or go for a walk
• Go out to lunch, or get out of the office
• Be realistic of your expectations
• Create balance in your life
• Talk to others
• Ask for support when you feel the need  

Reducing Stress in the Health Care Workplace

• Build group cohesiveness through regular training, discussions, and in-services.
• Encourage peer support
• Offer recognition for success and excellence
• Vary professional responsibilities
• Create a monthly newsletter with updates an kudos
• Let staff know it is all right to ask for a “stress break”
• Watch for signs of significant stress in staff, and offer them help.

Self-Care Tips to Prevent Burnout

• Take care of you. It will relieve some of your stress and allow you to take better care of others
• Treat yourself with the same care you give to your patients
• Allow yourself to say no. Offer alternatives if you feel unable to say no
• Develop a routine to help ease the transition from work to home (Do not use alcohol to unwind)
• Avoid over-identification with patients
• Recognize and accept your own feelings
• Practice stress-reduction techniques (exercise, relaxation, meditation, distraction)
• Plan for regular breaks, conferences, and vacations
• Know when to say “enough”. If necessary, change to another practice environment

Life needs to be approached from the preventive perspective. We need to live what we have been preaching to our patients. Create relaxation time, even at work. Create balance. Take care of yourself first!

  

References

Duffy, V.J. (2012). Beating burnout. Advance for Nurse Practitioners and Physician Assistants. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/Beating-Burnout.aspx

Nadan, R.J. (2012). Dousing burnout. Advance for Nurse Practitioners and Physician Assistants. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/article/dousing-burnout.aspx

Developing a Business Plan

Definition:

A business plan is a formal document that explains plans to develop a financially

successful practice.

• It is a blueprint of the practice
• Lack of planning is the principal reason for business failure!!!
• Required by most lenders when financing is sought
• May run 25 to 40 pages, if consultants are involved
• Seek advice of an experienced corporate attorney and an accountant

Why develop a business plan?

            While nurse practitioners (NP) may have the confidence in their professional ability to be independent practitioners, success depends on knowing the practice climate, the competition, laws governing NP practice, and the public’s perception to NP’s. A good business plan, therefore, takes the big picture into account.

            The key steps in developing a business plan include conducting an assessment, identifying business objectives, developing strategy, conducting an impact analysis, and developing an implementation plan.

Business plans analyze:

• Whether there is a need for the NP to fill
• Whether there will be enough business to support a practice financially
• The barriers the practice must overcome to be successful
• The business skills the NP need to operate the practice

Elements of a Business Plan:

• The description of the business
• The marketing plan
• The financial plan
• The management plan
• Additional elements:

Ø  Cover sheet

Ø  Table of contents

Ø  Executive summary

Ø  Supporting documents

Ø  Financial projections

A good business plan:

• Provides detailed information about all aspects of the business
• Makes projections about the practice over the next few years
• Points out potential adversities, competitors, and other vulnerabilities
• Should display in detail how the money will be used for practice
• Provide solid data such as estimates, industry norms, and rate sheets to support projections
• Will provide tools to implement changes and foster profitability
• Should be updated regularly

Several factors that should be reached prior to opening your practice:

• The need for the service
• Community interest in the service
• The size of the potential patient pool
• The willingness of the community to use NP services
• The willingness of the third party payers to reimburse NP services

Sources of Assistance:

• Small Business Administration
• Service Corps of Retired Executives
• Graduate business students who do plans as components of coursework
• Business oriented community groups
• Professional journals
• Libraries and business plan software programs

Sample Outline of a Business Plan:

• Cover sheet
• Table of contents
• Executive summary
• Detailed description of the business
• Market analysis
• Financial plan
• Management or organizational plan
• Financial documents
• Supporting documents

Good luck with your new practice venture!

References

Bachrodt, A.K. & Smyth, J.P. (2004). Strategic business planning linking strategy with financial reality. Healthcare Financial Management, 58, 60-66.

Galloway, M.J. (2004). Best practice guideline: writing a business case for service development    in pathology. Journal of Clinical Pathology, 57, 337–343. doi: 10.1136/jcp.2003.012518

Reel, S. (2003). Developing a business plan: Getting down to specifics. Advance for Nursing        Practitioners, 11(6), 53-54.

5 Interviewing Tips for Nurse Practitioners

When you make it to the interview stage of applying for a nurse practitioner position, you need to take steps to be prepared as possible. Preparing for a nurse practitioner job interview involves:

1. answering interview questions
2. compiling a portfolio and resume
3.  paying attention to details about the practice
4. appropriate appearance 

5 Things to have ready:

1.  Challenging experiences/general questions

• Have a couple of challenging experiences ready to showcase how you dealt with a difficult situation.  Show teamwork, and an interdisciplinary approach.
• Be prepared for general questions about your strengths and weaknesses, accomplishments, and ambitions. 

2.  Educating others about the doctor of nursing (DNP) degree

• Speak upon the DNP degree and why it is important.  Know who you are and how having a DNP prepared nurse practitioner in the practice would better them.

3. The portfolio 

• Compile your work from the DNP program.  Highlight clinical expertise, hours completed, and your DNP project.  Highlight any manuscript submissions, posters, or presentations done at conferences.
• Pay attention to detail and appearance. This allows the interviewer to know that you are professional.

4.  Have questions ready for the interviewer

• Research ahead of time the organization you are interviewing for and have questions prepared.  This lets the interviewer know you are serious about their place of work.

5. Show awareness of the latest evidence-based research in the field

• As a DNP prepared nurse practitioner, it is essential that we practice to the latest evidence-based research.  Show you knowledge on how to access literature databases, how you have implemented evidence-based care in the past, and how it will impact the practice.

Reference

Chism, L. A. (2010). The doctor of nursing practice: A guidebook for role development and professional issues. Sudbury, MA: Jones & Bartlett Publishers.

National Organization Spotlight: NPWH

Nurse Practitioners in Women's Health [NPWH] spotlight

As NPWH's annual national conference is held this upcoming week, let's take a look into this organization.

What is NPWH?

• A national nurse practitioner association dedicated to quality health care to women of all ages by nurse practitioners
• Provides a venue for nurse practitioners for education, practice and women's health issues

Why Join NPHW

• Special expertise in reproductive health as well as primary care women's health issues
• Contraception
• Cancer detection/prevention
• Menopause
• Management of cervical disease
• Sexually transmitted disease
• Pregnancy
• Women's wellness
• Sexuality 
• Management of female urinary problems
• Primary care issues for women
• Professional continuing education
• NPWH is the organization for accreditation of women's health nurse practitioner programs 
• Offers guidelines for practice and education

Membership

• Membership categories
• Includes a student membership for $55
• Active membership is $95
• Membership benefits
• NPHW journal: American Journal of Nurse Practitioners
• Numerous continuing education activities
• Weekly updates
• Copy of The Women's Health Nurse Practitioner: Guidelines for Practice and Education
• Searchable NP database
• Registration discounts
• RX savings card

Some Current CE Opportunities

• "Heavy Menstrual Bleeding: Update on Best Practices and New Options"
• "Individualizing Contraceptive Care: Using the 2010 US Medical Eligibility Criteria Guidelines"
• "The Role of the Clinician in Preventing Cancer: Hereditary Cancer Assessment as a Emerging Standard of Practice"
• "Mood Disorders in Women"

Using NPWH as a Resource

• NPWH.org providers a great resource for NPs
• Publications online and are archived 
• Easy access to topics for providers and patients
• Access to evdience-based guidelines
• Up to date policy information

All information from www.npwh.org

Nurse Practitioner Residency Programs

As I was looking for a Nurse Practitioner job, I had also looked at and applied for two residency programs, Penobscot Community Health Center in Maine and Family Health Center of Worcester in Massachusetts. Unfortunately, I was not picked for either of the limited and highly competitive positions.

First Nurse Practitioner (NP) Residency Program was started in 2007 in Community Health Center (CHC) in Connecticut. The structure of the program was designed to be in compliance with Institute of Medicine’s (IOM) principles of health care for the vulnerable population. The facilities used in the residency programs are Federally Qualified Health Centers (FQHC). Subsequent NP Residency programs have been following the structure of CHC (Penobscot Community Health Care, n.d.).

Community Health Center, Inc.
Connecticut

Community Health Center of New Britain

1 Washington Square, New Britain, CT 06051

860-224-3642

Community Health Center of Meriden

134 State Street, Meriden, CT 06450

203-237-2229

• The purpose of the NP Residency programs is to serve the underserved, uninsured and homeless population in an FQHC facility in compliance with the IOM 2010 compliance report and to provide a training bridge for NPs from education to practice.
• The program is a 12 month salaried education program that provides precepted clinics, independent clinics, weekly didactic training sessions, and specialty rotations.
• Qualification: Applicants must be recent graduates (18 months or less) from an accredited Masters or DNP program, licensed in Connecticut and be FNP-C. Spanish speaking is preferred or if not Spanish speaking, must take an intensive Spanish course prior to start of residency. Commitment to practice careers as primary care providers in an FQHC is strongly emphasized.

Penobscot Community Health Center (PCHC
Maine

1012 Union St.,
Bangor, ME 04401
(207) 945-5247

• Established in 2011 from new NP to skilled Primary Care Provider and provide care for the underserved and uninsured.
• Funded by a grant from the Health Resources and Services Administration (HRSA).
• Program is a one year employment with benefits that includes continuity clinics, didactic sessions, team clinics, rotation through specialty clinics within PCHC and locally, and a comprehensive clinical evaluation.
• Qualification: same as above except requires licensing in Maine.

Required for application:

Letter of introduction and interest

Cirriculum vitae

Official Graduate school transcripts

Photo ID Confirmation

Three letter of recommendations with one being from a faculty member of a graduate program.

Family Health Center of Worcester (FHCW)
Massachusetts

26 Queen Street,
 Worcester, MA 01610

Established in 2009, is the second oldest residency program for nurse practitioners in the country.

Serves over 33,000 patients in the greater Worcester area.

All residents are hired providers at the FHCW.

Contact personnel:

Betty Morse

508-860-7988

 

elizabeth.morsefhcw@umassmed.edu


Santa Rosa Community Health Centers
California

• Started in January 2012
• 12 month Family Nurse Practitioner program full-time paid appointment.
• Goal is to graduate 4 residents per year.
• Located in various locations in the Santa Rosa, CA area- Vista Family Health Center and Southwest Health Center.

• Email Donna Tully, MSW, PA-C for further queries donnat@srhealthcenters.org or visit the website at http://srhealthcenters.org/nursepractitionerresidency/

Methodist Hospital Nurse Practitioner Program Fellowship
Texas
6565 Fannin

MGJ 11-002

Houston, Texas 77030

Transplant Fellowship and Neuroscience Fellowship programs.

Both 12 month programs with competitive pay and benefits. 

For more information, visit the Methodist Hospital website at http://www.methodisthealth.com


As one can see, the NP Residency program is in its infancy. Hopefully in the future, more of these programs will be established to allow future NP's to take advantage of this transition from education to practice.

 

Reference

Community Health Center, Inc. (n.d.). America’s First Nurse Practitioner Residency Training Program. Retrieved from http://www.npresidency.com

Family Health Center of Worcester (2012). Family Nurse Practitioner Residency. Retrieved from http://www.fhcw.org/en/Academics/FamilyNursePractitioner

Penobscot Community Health Care (n.d.). PCHC NP Residency Program. Retrieved from http://www.pchc.com

Santa Rosa Community Health Centers (n.d.). Family Nurse Practitioner Residency. Retrieved from http://srhealthcenters.org/nursepractitionerresidency/

The Methodist Hospital System (2012). Nurse Practitioner Program Fellowship. Retrieved fromhttp://www.methodisthealth.com/

The Benefits of Being an AANP Member

I am a member to American Academy of Nurse Practitioners (AANP). I became a member in 2011 when I decided to take my exam through AANP.

These are the perks of being a Student Member
($55 per annum):

 

I received a $75 discount on applying for the AANP exam.

I got my professional liability insurance through Marsh U.S. Consumers which is sponsored by AANP.

I get a subscription to AANP Smartbriefs, a daily email of new updates. Smartbriefs presents daily emails of new studies that were published, updates in medications approved by the FDA, and news in legislation pertaining to nurse practitioners and the changing healthcare system in our country.

I have free subscription to the monthly Journal of American Academy of Nurse Practitioners (JAANP).

I have access to AANP Careerlink, a career placement service website for nurse practioners.

I can receive savings on hardware and software through the AANP Mobile Solutions Center.

I only pay $50 registration fee for the AANP National Conference.

One more thing I like about being an AANP member is that I know that AANP is advocating for me continue to be professionally recognized and to be able to extend my scope of practice in more states which will give me more opportunities in the future.

Professional Membership ($125 per annum):

Same as above including:

Access to continuing education (CE) activities.

$50 discount on Physician Quality Reporting Systems (PQRS)- A voluntary reporting system of quality measures for covered services provided to Medicare beneficiaries. This program provides financial incentives to healcare providers who are involved.

Discount on Medic ID products for members and their patients by joining MedicAlert Foundation. MedicAlert Foundation also provides 24 hours Emergency Response System in which medically trained personnel will transmit healthcare records to responding facilities and communicate to the patient's nurse practitioner of patient's status for ensuring proper coordination of care.

Discounted registration fee to AANP National Conference.

A party can also apply as a Group Membership for invitation to Regional Group Member Leadership Meetings and Regional Leadership Meetings. Group members also receive free registration for two elected officials or executives to AANP National Conference and free exhibit space exchange.

For more information. Visit the AANP website at http://www.aanp.org/

Reference

American Academy of Nurse Practitioners (2012). Group Member Benefits. Retrieved from
http://www.aanp.org/membership/group-membership

American Academy of Nurse Practitioners (2012). Professional Member Benefits. Retrieved from
http://www.aanp.org/membership/professional-membership

American Academy of Nurse Practitioners (2012). Student Member Benefits. Retrieved from
http://www.aanp.org/membership/student-membership

MedicAlert Foundation (2012). AANP members and patients. Retrieved from
http://www.medicalert.org/landing/aanp.htm