Becoming an NP: The Growing Issue of Finding Clinical Placements

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While weighing the decision to become an NP, I thought about the time and money it would take to get into and through the program. I was very interested in the subject of psychiatry and thought it was a good fit for my personality and skill set. I found a program that worked for my schedule and budget and was able to complete the program. I’ve now been in practice for two years. What I didn’t have to worry about when I weighed the pros and cons of becoming an NP was where I would do my practicum or clinical rotations. That’s because the school I attended arranged those for me. However, many NP students are not as fortunate.

The growing difficulty of finding a placement.

Like many colleagues, I have been contacted by students on multiple occasions who are trying to arrange their own clinical placement. There are also numerous posts on message boards and social media from students pleading for someone to take them on at their clinical site. Students have reported having to sit out multiple semesters or not being able to graduate because their schools have left them with the responsibility of securing these arrangements on their own. Others report driving several hours to attend sites far from home or even moving temporarily to get to a practicum site.

One would expect that, when paying thousands of dollars in tuition, the school collecting this money would include the responsibility […]

2022-06-23T10:36:29-04:00June 23rd, 2022|Nursing|1 Comment

Self-Disclosure in the Nurse-Patient Relationship

“How much of ourselves should we share with our patients?”

Illustration by Jennifer Rodgers for AJN

The ‘therapeutic use of self.’

Early nursing theorists wrote about how the “therapeutic use of self” helps us to forge close working relationships with our patients. Today we talk about authenticity, and it’s been noted that “the essence of nursing care comes from bringing our authentic selves to the nurse-patient relationship.”

We each develop a nursing “style,” weaving our own identities into the way we relate to patients and families. But where do the parts of ourselves that are very much “us” but not immediately evident to others come into the picture?

“Would a single mother hesitate to share her story of adopting a child without
a male partner? Would a widower refrain from correcting the assumption that
his spouse is still alive?. . . . I am compelled by the belief that sharing truth in either
scenario would enhance the authenticity of the relationship. Nevertheless, I remain
reluctant to correct my patients’ misperceptions of my family life.”

To disclose or not to disclose?

In this month’s Reflections column, “A Lie by Omission?“, nurse practitioner Charles Yingling takes a thoughtful look at what we choose to share with our patients, and what […]

NPs ‘Move Mountains’

Rear Admiral Susan Orsega, chief nurse officer of U.S. Public Health Service

Last week I attended the annual conference of the American Association of Nurse Practitioners (AANP) in Denver. Yes, I was there for the record attendance (over 5,000) and the record heat wave (104 degrees). As with most large nursing conferences, there were numerous concurrent sessions—but here, many of them were like skills labs, including things not part of most RNs’ skill set, like performing a thoracentesis.

What was also different from other meetings was that the legislative and policy sessions, which were of high interest to me in order to find out how NPs are doing with scope of practice authority, were closed to media. No one could say exactly why.

Audio interview with U.S Public Health Service CNO Susan Orsega.

I did get a chance to speak with the keynote speaker, Rear Admiral (RADM) Susan Orsega, MSN, FNP-BC, FAANP, FAAN, chief nurse officer and assistant surgeon general of the U.S. Public Health Service. She focused on the critical role of NPs in addressing health inequities. She urged NPs to become active advocates to improve health, and, mindful of our Colorado setting, she charged them to “Go, move mountains.” You can […]

Is It Time to Retire the Term ‘Midlevel Practitioner’?

Rachel_Scherzer_photo_and_calloutWhat are the implications of calling advanced practice nurses “midlevel practitioners”? According to Rachel Scherzer, a nurse educator and critical care nurse, such a term pigeonholes APNs in an implied (and disproven) hierarchy of value and quality of care rather than in relation to specific competencies and expertise.

In the Viewpoint essay in the July issue of AJN, Scherzer describes some of the reasons why such terms aren’t just inaccurate, they damage the standing of the profession:

Policymakers use the term while developing health care policy, health care economists use it when reporting data and performing cost analyses, and other health care providers use it in the clinical setting. . . . This term is both diminutive and inaccurate, implying that these professionals cannot provide the same level of care as other members of the interprofessional care team. Referring to APNs as “midlevel” practitioners contributes to a general misunderstanding of their role and of the services they provide.

[…]

The First 50 Years of NPs: An Illustrated Timeline Shows Triumphs, Continuing Practice Barriers

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

This year marks the 50th anniversary of the nurse practitioner (NP) role. Themes of innovation and sustainability emerge as one examines an illustrated timeline of the history of NPs in AJN‘s October issue and reads the accompanying text. (The first section of the timeline is below. Click to enlarge.)

Screen Shot 2015-10-14 at 1.48.08 PM

How did this advanced practice nursing role come into being? As the timeline explains, ” [d]uring the 1960s, health care was becoming increasingly specialized. Physicians were moving out of general practice and into more complex and lucrative specialties, creating a void in primary care and prevention services, and in care of the chronically ill.”

To fill this void, public health nurse Loretta Ford, working with Dr. Henry Silver at the University of Colorado in 1965, launched the first NP certificate program, a seminal moment in the history of this prevention-driven, primary-care-focused nursing role.

Ford wrote about the compelling need for NPs. Calling health care a capital investment, Ford said:

“We have failed to realize the full potential of professional nurses to improve the quality of life. This group has great unused potential for bringing about health care reforms. Properly prepared and effectively utilized, nurses could advance the nation’s health […]

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