Dear NP Student, From a New Grad NP: Study Tips

Dear NP Student, From a New Grad NP: Study Tips

Posted on November 13, 2020 | by Michelle Woo, MPH, MS, BSN, RN | Leave a Comment

Whether you are an undergraduate, new graduate, or a seasoned nurse, entering a nurse practitioner (NP) program is an exciting time. However, it can also be a stressful one. In fact, you may discover that NP school will be one of the most difficult academic endeavors you experience. At the end of the day, any advanced practice health provider role requires a great deal of studying and the ability to put complex material into practice.

Despite being a full-time graduate student who was no stranger to hard work, I still remember the stress of my first semester. Luckily, my program provided some insightful resources that helped me recognize the importance of learning how to study to achieve success. Based on my experience, here are some useful strategies for new NP students.

5 Tips for Didactic Study

Most NP programs will begin with one to two semesters of didactics. This means that there are no clinical rotations just yet. Whether they are enrolled part-time or full-time, students will juggle two to three classes at a time. Here are my five tips for success during didactic semesters.

1. Time Management

Prior to beginning the program, reflect on when and where you study best. Also, understand that you need a resting period. Someone once told me that graduate school is like a job and it should be treated like one. When working as a nurse, consider a per diem or part-time schedule to help ease the transition into NP school. Remember that graduate school is not like undergraduate work.

2. Invest In a Tablet

If you have the funds (and that is a big if), a tablet can boost efficiency. You can write, type, download notes, and more, and it is highly portable. While it's not a necessity, having a tablet was beneficial throughout my entire graduate experience.

3. Student-Life Balance

You will likely hear that NP students "have no life." While I had to learn to say no to certain social events, I also knew that life existed outside of school. I would typically study from 8AM to 5PM every day including weekends, reserving evenings for time with family and friends.

4. Know Your Study Style

There is an overwhelming amount of material that NP students are expected to learn. In addition to adjusting to the transition of graduate student life, you're also required to maintain certain grades to stay in the program. My recommendation is to know your study style. Louisiana State University has a great resource with surveys to help you determine your best study methods.

5. Know the Course's Objectives

This is something that I wish I knew sooner. The course's objectives offer incredible insight into what students should focus on when studying. Most of these objectives align with the necessary knowledge for boards. Therefore, be sure to review them in the course syllabi and weekly modules.

Clinical Rotation Study Tips

When you enter the clinical rotations phase, it's important to factor in travel time and patient entries as well as other additional assignments. Both can be time-consuming. Here are some tips to study effectively.

1. Listen to Relevant Podcasts

I often played medical podcasts in the car while driving home. As a Family Nurse Practitioner student, my favorites were American Family Physicians and The CurbSiders Internal Medicine. Many of my colleagues purchased MP3s from multiple board review sources such as APEA and Fitzgerald.

2. Learn in Rotations

Rotations offer an opportunity to apply didactic knowledge in hands-on situations. From suturing cysts to pelvic exams, it's critical to advocate for your participation. Learn how to assess for abnormalities while allowing preceptors to educate you. You will utilize these skills when practicing professionally.

3. Review Material

If there is material that you're unfamiliar with as a student, take the time to review it and gain an understanding of differentials and treatment plans. Even after graduating, it's crucial to become accustomed to reviewing and staying updated on current guidelines for treatment and preventive care. Making this a habit during rotations is important for doing well in clinicals and achieving long-term professional success.

Becoming an NP is a path that can only be understood by those who have experienced it. As a new graduate, I can empathize with the difficult transition to student life and working to pass exams every semester. I hope that new students can learn from my experience and utilize my tips. The journey is tough, but ultimately it is a rewarding one.

What Is the Role of the Nurse Practitioner Student in Clinical Rotations?

Posted on November 7, 2020 | by Amy Quynh L.N. Tran, FNP-C | Leave a Comment

Simply put, the objective of a nurse practitioner (NP) student is to become a competent clinician. Through clinical rotations, he/she will need to develop and implement foundational skills and knowledge for their future clinical practice. To accomplish this, the NP student should be actively and enthusiastically involved in patient care as a member of the diagnosing and treating team—not a scribe or errand-runner. However, the NP student is not an independent practitioner just yet. Therefore, they can only participate in patient care under the guidance and supervision of the authorized preceptor. The NP student should have a clear understanding of their roles and responsibilities to maximize their time during clinical rotations.

What to Expect During an NP Preceptorship

There are several key hands-on duties that NP students are responsible for during their preceptorship.

1. Take Patient History, Perform Physicals, and Propose Differential Diagnoses and Treatment Plans

Depending on the clinical setting, a new patient's history may be collected in one visit (such as in urgent care, the emergency room, and the hospital) or over two or three visits (as done in family or internal medicine, pediatrics, and outpatient clinics). Regardless of the setting, the NP student should begin the visit by introducing themselves and asking the patient what they would like to address.

If the patient has one pressing concern, the NP student should address that acute issue without neglecting other chronic conditions and perform the physical exam that's appropriate for the problem at hand. For example, if the patient presents an aching leg, the exam should be focused on the lower extremities. An exam for the eyes may not be needed, unless there is another reason. Based on the clinical findings, the NP student should learn to formulate three to five differential diagnoses and an appropriate treatment plan.

2. Present Patient Cases to the Preceptor

During the first initial meeting with their preceptor, the NP student should ask about any format preferences for the presentation. Some preceptors prefer abbreviated versions, while others prefer comprehensive formats for teaching purposes. The purpose of the verbal presentation for the preceptor is to convey the problem-oriented essentials of the patient case. This requires more than just a simple reiteration of what the patient and the labs show. A good patient presentation demonstrates the patient's most concerning issues and includes the NP student's clear plan of treatment and critical analysis.

After seeing the patient, the NP student should spend at least a few minutes organizing their thoughts before presenting the case. They should also aim to keep the presentation concise (about three to five minutes for new complex cases), organized (with history in chronological order, pertinent findings, and labs), and well thought-out (three to five differential diagnoses and rationales for each, as well as recommended treatment and follow up). If the NP student is unable to formulate a diagnosis or plan, they should ask for the preceptor's help. This offers an opportunity to conduct further research online or through textbooks, which demonstrates strong enthusiasm and a "self-starter" attitude.

3. Complete Patient Write-Ups

The note that comes from the NP student should demonstrate a comprehensive grasp on the patient's presenting case. It should follow the SOAP format (Subjective, Objective, Assessment, Plan) as learned in NP programs. Since the preceptor is ultimately the person who is legally responsible for the patient's care, the NP student should review the plan with the preceptor first before discussing with the patient. The ‘plan' includes ordering further screening or diagnostic tests, writing prescriptions, and providing patient education. It is important the NP student learns how to write the prescriptions appropriately under the preceptor's guidance. All notes, orders, and prescriptions need to be reviewed and co-signed by the preceptors.

4. Obtain Constructive Feedback from Preceptors

After presenting the case to the preceptor, the NP student may directly request for any suggested improvements to the presentations or write-ups. If the NP student has a specific need for further instructions, they should ask the preceptor if they can go over a certain physical examination such as a cardiac or ankle exam. Additionally, the student should schedule a mid-term evaluation with the preceptor to gauge how they are doing and where they can improve.

5. Read for More Insights

Reading is a great way to expand your understanding of diseases and different patient cases. Before each visit, it's helpful for the NP student to read the patient's charts and pertinent scientific literature to formulate an approach ahead of time. By understanding the patient's primary concern, the student can determine appropriate questions to ask during the history-taking and establish a physical exam to focus on. Proper preparation before seeing the patient will save time during the interaction.

Before the physical exam, an NP student may briefly read over the patient's chart again or their own notes to ensure that the proposed approaches are correct.

In advance of each case presentation, NP students should review their findings to solidify the rationale and clarify any aspects they are unsure about.

Between patient visits, reading critical medical literature that relates to patient cases can improve overall understanding.

Is A ‘Locum Tenens’ Job For You? The Pros and Cons for Nurse Practitioners

Posted on November 3, 2020 | by Julie Nyhus | Leave a Comment

The U.S. Bureau of Labor Statistics expects employment for nurse practitioners (NPs) to grow 45 percent from 2019 to 2029. Therefore, now is the ideal time to consider temporary clinical assignments—better known as ‘locum tenens' jobs, which is Latin for "to hold a place." These assignments cover all medical specialties and practice settings, with durations ranging from days to months.

How Nurse Practitioner Locum Tenens Jobs Work

It's most common for locum tenens NPs to work with healthcare staffing companies, as they play a supportive role in NP licensing, credentialing, relocation, and placement. However, locum tenens nurse practitioners can also work directly for organizations as temporary employees or independent contractors. Here's a basic rundown of NP locum tenens positions.

The Healthcare Staffing Agency

Healthcare staffing companies handle temporary work contracts from hospitals, clinics, and facilities. Reasons healthcare employers use locum tenens can vary. Some need temporary support due to challenges filling permanent positions or covering for leaves of absence. Staffing agencies are actively involved in the NP placement process, ensuring that candidates are experienced and qualified.

The Contract

A quality staffing company will protect the interests of both the nurse practitioner and the hiring facility. Nurse practitioners can expect a legally binding contract outlining the terms of agreement such as the assignment, start and end dates, pay rate, and stipends. The temporary contract varies by location and facility and becomes an important element of the tax-related requirements associated with locum tenens work.

The Travel

For tax purposes, functioning as a locum tenen means temporary and periodic movement away from your tax home. So, how far away is "away from the tax home?" Although the IRS does not state an exact distance, it must be far enough that rest or sleep are required for the NP to perform the work.

The Reimbursement

Often, the NP pay package will contain tax-free reimbursements. The IRS expects tax-free reimbursements to be for expenses—not substitutions for wages. In order to qualify for tax-free reimbursements, the NP must have a legal and established tax home. This means not working too long in one place, or not working in the same area for more than 12 out of 24 consecutive months. The temporary contracts serve as proof of these requirements.

Pros of Locum Tenens Assignments

Nurse practitioners who enjoy the challenge of working in new environments often gravitate toward locum tenens positions. This is also a good arrangement for NPs who don't want to be tied down with a permanent position, or even for those looking for extra work on the side. Other advantages include:

No quotas. Locum tenens are paid hourly or weekly wages. With no productivity quotas, the primary focus is patient care.
Great pay. Reimbursement depends on the specialty and state that you work in, but it is always comparable to market value. NPs should negotiate a competitive hourly or weekly wage, along with travel or lodging expenses that are paid or reimbursed by the agency. Additional benefits may include malpractice insurance or free continuing medical education credits.
Flexibility. Will you work full-time, part-time, or extra shifts? When, where, and how long will they be? You can let the agency's travel team arrange housing and travel accommodations, or find it yourself. It's your choice!
Discover. Traveling involves discovering the culture and tastes of new places. It also means a variety of unique clinical experiences—from serving patients in rural areas to working with front-line technology in leading teaching hospitals. Even if your locum tenens assignment doesn't take you too far from home, exploring a different healthcare organization or part of town can give you a fresh perspective.

Cons of Locum Tenens Assignments

The unpredictable nature of locum tenens jobs is not suited for every nurse practitioner. Before you commit to this type of working arrangement, be sure you are aware of the following:

You will be expected to hit the ground running. You won't need a ton of experience, but you will need to know what you're doing. These positions do not offer long orientations or drawn-out breaking-in periods.
You will need to be alert. Recruiters don't work for you—they exist for their clients. Some staffing agencies will earn commissions on each NP salary. This isn't a bad thing, but it's important to recognize that not every recruiter will have your best interest in mind. The final choice is always yours.
You will need extra advice. Prior to beginning a locum tenen assignment, consult with your tax preparer. Discuss taxation laws, as well as taxable and nontaxable reimbursements in the states you're traveling to (if applicable). Do not depend on the staffing agency to give you tax advice.

How to Get Started As a Locum Tenens Nurse Practitioner

If you've weighed the pros and cons and come to the conclusion that you'd like to try out locum tenens NP positions, the following tips will make your transition much easier:

Know what you want. Do you need benefits, travel, lodging? Will you need a 1099 or W2 for payment? Where do you want to go? How far from home are you willing to travel? What are the practice laws in the states you're traveling to? Ask yourself these questions before you contact a staffing agency.
Make a timeline. If substantial travel is required, getting started means lining up your own travel readiness with the requirements of the state or region you're heading to, and then aligning that with current demand. Maintaining a multi-state RN license in a Nurse Licensure Compact state can help you find work faster while obtaining licensing for other states.
Research agencies. Choose at least four agencies with strong reputations. Good recruiters are those who return calls and follow up. It's not uncommon for NPs to use multiple agencies, depending on their needs.
Gather and organize. Keep all of the documents you need in one place. Make PDFs of licenses, certifications, vaccination records, reference letters, and CEUs so they are ready to email at a moment's notice.

4 Essential Projects to Improve Primary Care Office Flow for Nurse Practitioners

Posted on October 31, 2020 | by Andrea Mosher, CPNP | Leave a Comment

The demand from the healthcare system on providers such as nurse practitioners appears to be growing daily. Whether it's driven by increasing patient volumes or the heightened requirements for insurance reimbursement, it can seem like an ongoing game of catch-up. While the ultimate goal of a healthcare system is to create high-quality and high-value care for its consumers, most of the responsibility ultimately falls on the physicians, nurse practitioners, physician assistants, nurses, and support staff. With ever-changing technology advancements and the continuous evolution of health disparities, it is critical to avoid the "it's always worked, so why change it now?" mentality. At the same time, attempting to achieve these goals without a proper plan can be exhausting, expensive, and inefficient. Therefore, it is important to understand the purpose of quality improvement and how to effectively execute performance improvement programs.

Purpose of Quality Improvement

Some people question why providers, clinics, and hospital systems even worry about quality improvement, as they perceive it as "fixing what isn't broken." However, that is far from the truth. There are several reasons why quality improvement should be at the forefront of healthcare providers' radar, as it is imperative in the following:

Improving the health of the population
Enhancing the patient experience and outcomes
Improving the provider experience
Reducing the per capita cost of care

How to Design a Project

Designing an improvement project is a relatively simple process, and several factors should be considered beforehand.

Clinical Setting: What is the available timeline? Which strategy for performance improvement is appropriate for this particular clinical setting?
Current Performance: Are there any easily identifiable areas of improvement? Which performance aspect should be prioritized?
Patient Population: What are the major features of the clinic's patient population (i.e. age, race, gender, health disparities)? Which intervention will have the most positive impact on the majority of the population?
Institutional Commitment: Who will be at the forefront of the project? Who are the key stakeholders? Will this require a financial commitment?

Plan-Do-Study-Act

A classic approach to the design and implementation of a quality improvement project is the Plan Do Study Act approach. This multistep process systematically breaks down the process and allows for proper monitoring of progress:

PLAN
The first step of quality improvement is to identify a gap in care and define the goals for improving the performance. Quantify the desired improvement and set a timeframe to achieve the goal.

DO
Complete the plan based on the defined time frame, ensuring that the duration is long enough to collect an apt amount of data.

STUDY
Monitor the progress of performance improvement and compare the results to the goal that was set during the planning stage.

ACT
Depending on whether the performance improvement was achieved, move forward with fully implementing, modifying, or resigning the program.

Ideas to Implement Into Daily Workflow

Primary care NPs can take the following steps to make concrete quality improvements in their offices:

Improving Annual Screenings in Wellness Exams: An annual screening can be time-consuming to complete, and time is not readily available in the medical world. However, continuously screening patients is imperative. Depending on the Electronic Health Record capabilities, patients may receive a request via online portal, email, or physical mail to complete and return by their appointment time.

Improving Slot Utilization in Primary Care: Effectively utilizing all available appointment slots is important to providing quality care and access to a patient population. One approach to improving slot utilization is to create a plan that schedules patients as close to the desired time as possible, rather than several days or weeks in the future and sending reminders. Additionally, in the case of cancellations, it is imperative to prioritize patients who were scheduled further out than clinically appropriate.

Increasing the Consistency and Efficiency of Medicare Annual Wellness Exams: Annual Medicare wellness exams are often lengthy, tedious, and time-consuming. However, they are pertinent for the geriatric patient population. To ensure that all patient appointments are consistent and efficient, a clinic may choose certain staff members to serve as the cardinal staff members who manage these appointments. Additionally, creating a checklist or flowsheet for these visits can keep them organized and boost the efficiency of each appointment.

Maximizing Patient and Provider Experiences by Improving Appointment Agendas: Creating appointment agendas can be an effective way to keep appointment times on-track and in turn allow a provider to see a larger patient load. A typical agenda design includes:
- Asking the patient to list their concerns
- Planning the visit by prioritizing immediate issues and saving the other concerns for a follow-up appointment
- Reiterating the plan with the patient
- Concluding visit and discussing follow-up

Continual monitoring of primary care workflow leads to efficient patient appointments and potentially better patient outcomes. Appropriate workflows can also reduce the incidence of provider burnout, as providers know what to expect for the workday and can prepare accordingly. If you already have a great workflow in your clinic, check out this list of other performance improvement projects.

Have You Seen “FAANP” After a Nurse Practitioner’s Credentials and Wondered What It Means?

Posted on October 30, 2020 | by Fran Fasching, DNP, RN, FNP-BC | Leave a Comment

Inducted as a Fellow of the American Association of Nurse Practitioners (FAANP) in June 2020, Dr. Carol Gullo Mest, PhD., RN, ANP-BC, FAANP is the chair of graduate education at DeSales University in Center Valley, PA. In addition to 35 years of community NP practice, Dr. Gullo Mest’s career accomplishments include developing all of the MSN and DNP programs at DeSales. Dr. Gullo Mest successfully secured over $2.5 million in grants to support nursing students and faculty by starting a simulation program at the university as well as community health programs. She has served on many healthcare-related boards and is an active member of various nurse and nurse practitioner organizations. Her proactiveness has advanced the nursing profession and positively contributed to nursing education and community health. “I’m really a humble person at heart, but I'm at the age where you look back on what you've done and I thought my contributions are something that they're looking for," said Gullo Mest. "I want to be able to continue to contribute even after I retire. By being a fellow, I'll be able to do that."

Being elected as a Fellow of the American Association of Nurse Practitioners (FAANP) is the highest professional designation for a nurse practitioner. In the year 2000, 21 charter fellows vowed to create and support mentorship and leadership programs for nurse practitioners and NP students. This elite group fosters growth and professionalism for NPs. Less than one percent of NPs within the AANP are designated FAANPs.

FAANP Leaders

FAANP leaders make outstanding contributions to NP education, policy, clinical practice, and research. The fellows work toward furthering the NP profession, developing NP leaders of the future, and enhancing the AANP’s mission. Fellows are chosen on an annual basis after a rigorous application review. Currently, 874 fellows out of about 290,000 nurse practitioners serve coveted leadership roles as FAANPs.

How Do You Become a Fellow?

The process starts with self-assessment. Reflect on your career and ask yourself the following questions:

Am I an AANP Member?

Membership in the AANP governing body is a given. At least two years of membership is necessary for FAANP eligibility.

In My NP Career, Have I Demonstrated Exceptional Contributions?

Candidates must demonstrate contributions and outcomes in two of the following areas: research, clinical practice, education, and policy. Inducted fellows have started and advanced NP programs or participated in and published original studies. Other fellows opened community clinics or contributed to state and federal NP policy to ultimately advance the profession. Expanding NP leadership through company board positions or nonprofit management is also impressive.

How Do I Find a Sponsor?

FAANP membership is conducted via invitation from a current fellow that agrees to serve as a sponsor. NPs research fellow biographies to find one with a similar background and interests. The fellows are then contacted by the NP, who sends a professional letter of interest that incorporates their resume, previous leadership experience, and NP initiatives. A primary sponsor and a secondary sponsor are then secured. If a fellow agrees that the NP's contributions advance the nursing practice, the primary sponsor invites the NP to apply. Secondary sponsors are selected in the same way, but their role is to mentor the applicant throughout the process. If the NP meets the induction criteria, the next step is acceptance for mentorship and sponsorship.

What Do I Submit to The Sponsors?

Finally, NPs provide evidence of their career contributions and outcomes for the profession as a whole. This involves presenting completed research, policy and community health projects, and NP education successes to the sponsors.

What Do NP Fellows Do?

As part of the AANP, fellows work to advance the profession and set the stage for the next generation of NP leaders. The fellows' focus is to:

Promote nurse practitioner roles
Foster NP research
Positively impact healthcare
Change NP policy
Sponsor a mentorship program
Develop a policy education program
Share progress with AANP members through a quarterly newsletter, monthly podcasts, and website updates

Reaching New Heights

So when you see "FAANP" as the last NP credentials, you now know that person is a fellow and serves as a leader for nurse practitioners within the AANP. That NP leader positively influenced the practice landscape, educated nurses and NPs, and conducted and disseminated research. Both individually and as a group, the fellows continue to lead and promote NP practice and set an example for those who follow. If you think that you may have made a difference in NP practice, education, or policy, consider reaching out to a sponsor or applying for mentorship. This highest professional designation is worth working towards, as it will simultaneously advance your career and the NP profession.

Securing Nurse Practitioner Preceptors: Why Are Some Schools and Students Paying for the Privilege?

Posted on October 27, 2020 | by Michelle Woo, MPH, MS, BSN, RN | Leave a Comment

"Get a medical student. The medical schools pay you."

As a nurse practitioner (NP) student, it was shocking and discouraging to hear my physician preceptor say this to his colleague. Whether students are attending a school that supports them with placements or working toward securing one independently, securing preceptors for clinical rotations is a challenging task. Unfortunately, many are desperate enough to pay agencies to find preceptors for them. Has advanced practice education really come to this — all because medical schools pay offices to take on students?

According to a 2014 article from the Society of Teachers of Family Medicine, 23% of medical schools offered payment for community preceptors. In fact, 63% of those who received payment for precepting were also paid by other learners. The article cites the increased competition among other healthcare schools to place students in community settings as the leading reason for providing payment. This ultimately leads to decreased opportunities for NP students, which is why many are having a difficult time securing placements.

The Difficulty with Precepting Nurse Practitioner Students

During NP school, I saw the many challenges that preceptors faced. From meeting quality measures to seeing patients and charting, providers were required to fit teaching students into their already hectic schedules. According to "Incentives & Barriers to Precepting Nurse Practitioner Students" the stress involved in the daily workflow of the clinic makes it difficult for providers to precept students – despite their desire to give back to the next generation. If productivity is impacted, a provider's income is affected as well. It is not uncommon to hear providers question their capacity to take on students when they can barely sustain themselves. This is why many providers ultimately choose not to precept students, although they would ideally like to teach.

In the same article, the authors mention the potential benefits of providing some sort of stipend to preceptors as an incentive. While this may help students secure preceptors more efficiently, it won't be useful for a student who is already paying a hefty tuition to serve others.

Thoughts About Payments to Precept

As a newly minted family nurse practitioner (FNP), I decided long ago that I would eventually precept the next generation of FNPs. As one of my preceptors put it, "I'm going to be under the care of you one day. Therefore, I'm going to teach you my ways so that you can care for me and not kill me!" These words always stuck with me, and I've since committed to give back to the next generation by becoming a mentor. Seeing the work that NPs and other providers put in, I know it won't be easy. However, I also know that the issue of paying for preceptors isn't going anywhere.

Precepting students as a nurse practitioner has traditionally been done free of charge. It was a service that NPs committed themselves to as a way to encourage and empower new NPs to effectively serve their communities. However, the shift of medical schools now paying clinical sites to host students has affected both NP and physician assistant students. Some schools are paying up to $100-$450 per week, with anecdotal research revealing that agencies such as NPHub will pay preceptors up to $3,000 per month. Whether it's the school or students who pay for preceptors, it's the student who is ultimately affected.

Looking back at my experience overhearing my physician preceptor and his colleague, I recall my hours being rushed to completion in order for them to take on a medical student. This led me to the realization that incentivized stipends for preceptors can lead to poor clinical experiences. If clinics and their providers are interested in empowering the next generation of practitioners, more support needs to be provided outside of stipends and financial incentives. Should this trend of paying for preceptors continue, I'm curious to see the implications on students' clinical experiences at rotations and the way they practice upon graduation.

Clinical-Community Linkages: Why Public Health Needs Nurse Practitioners

Posted on October 24, 2020 | by Michelle Woo, MPH, MS, BSN, RN | Leave a Comment

Public health and healthcare agendas can seem to run parallel to each other rather than together. Some clinicians lament that public health agencies don't understand the difficulties of primary care services. On the other hand, providers often discuss how overwhelmed they can get by 15-minute appointments, as it prevents them from spending quality time with their patients.

Public health agencies and nurse practitioners have the same overall agenda — improving people's health. Despite maintaining similar goals, they work on separate tracks. Public health and nursing — specifically nurse practitioners — can work together to improve the health of their patients and communities through clinical-community linkages (CCL).

Why Nurse Practitioners and Public Health Go Together

Nursing focuses on the health of all people. Florence Nightingale, a renowned nurse who was known as the Mother of Nursing, paved the way for professional nursing in the mid-19th century by utilizing scientific approaches and health education across the community. Nursing has since evolved, with opportunities ranging from working inpatient in hospitals to outpatient in research and a variety of other careers. Nurse practitioners take this one step further, gaining additional education to reach specific patient populations. According to the American Public Health Association, public health promotes and protects the health of people and the communities where they live, learn, work, and play. Based on both descriptions, advanced-practice nursing and public health can join forces to improve the health of individuals and communities.

What Are Clinical-Community Linkages?

Clinical-community linkages are one of the many ways that nurses, nurse practitioners, and public health agencies can work together. This extends beyond working in a government agency, such as Health and Human Services. Instead, clinical-community linkages are connections that community organizations and clinics form and utilize to better serve individuals within the local community.

According to the Agency for Healthcare Research and Quality, CCL offers the following benefits:

Patients receive more help with changing unhealthy behaviors
Clinicians are supported in offering services to patients that they cannot provide themselves
Community programs are connected with clients who their services were designed for

Here's an example of how clinical-community linkages can work. A patient who is at risk for diabetes visits a community clinic for a follow up. A nurse practitioner has approximately 15 minutes to talk to the patient about what it means to be at risk for diabetes and how to prevent it, and then sends them on their way. Through CCL, a nurse practitioner can network with organizations in the community that may provide free diabetes education classes, such as the National Diabetes Prevention Program, community walking groups, and more. This type of linkage provides opportunities for healthcare clinicians to help patients connect with community organizations to improve their health. As a bonus, some of these programs are free.

How Nurses and NPs Can Get Involved

Healthcare doesn't have to be secularized to only a provider or a clinic. As healthcare moves toward an interprofessional model, clinicians can look outward and determine which community organizations can serve their patients' needs. It can be remarkable to see so many organizations involved in community-clinical linkages. However, they often lack a key player — healthcare providers. Public health agencies are often reluctant to receive feedback from clinicians on their programs and associated implementations. While these groups need to be more accessible to clinicians (i.e. scheduling times when clinicians aren't seeing patients or charting), it’s surprising that many clinicians who want their voices heard on improving others' health do not attend these work groups.

Nurse practitioners and clinicians can play an active role in supporting individuals' health within a community. It can be as simple as emailing local public health agencies about opportunities to be involved in public health initiatives, attending public health webinars or conferences, and networking with community organizations.

A Personal Connection

Working in public health, I have been able to learn about all of the excellent resources that are available on a local scale. While studying to be a family nurse practitioner, I was told about how important it is to educate older patients about falls. However, we were never provided with resources or available classes where patients could learn more about fall prevention Through public health networks, I eventually learned about the National Council on Aging and where I could access fall prevention resources. However, it's likely that not all clinicians know about these resources. That is why clinical community linkages are so important.

Public health and healthcare don't have to work on separate tracks towards the same goal. With the help of clinical-community linkages, both groups can network together and build strong links within the community to effectively serve patients.

5 Unexpected Perks of Joining a Professional Nurse Practitioner Organization

Posted on October 23, 2020 | by Fran Fasching, DNP, RN, FNP-BC | Leave a Comment

Kesha Walton, DNP, RN, FNP-C is a practicing family nurse practitioner who also serves as an officer in an NP professional organization. During a recent meeting, the members discussed the noticeable decline in membership. This conversation alerted Dr. Walton to a professional concern and sparked an idea for her DNP evidence-based capstone project. Research for the capstone project revealed the following reasons for low participation in NP professional organizations:

Personal and professional time constraints
Cost of membership
Working too much
Lack of understanding around the nature of the organization

Are any of these reasons keeping you from joining an NP professional organization?

What Is a Nurse Practitioner Organization?

While many organizations exist, the national group that represents all NPs is the American Association of Nurse Practitioners (AANP). The AANP charges one affordable annual membership fee that connects the NP to one of eleven regions. Each AANP region has their own regional director and state representatives. Many other specialty NP organizations exist in conjunction with the AANP. All professional organizations share similar benefits:

The ability to enjoy discounts on education and board certifications
Access to practice and career support services
The opportunity to engage in political advocacy
The chance to collaborate through networking events

Acknowledging the professional expectation of membership, many NPs will pay the membership fee and take advantage of a few discounts and services. Identifying the unique value that you offer the organization is critical to accessing additional perks that are only known by those who participate in the group. NPs who are willing to actively engage in the organization are able to experience these unforeseen benefits.

Top Perks of Joining a Nurse Practitioner Organization

1. Discover a New Arena to Demonstrate Skills and Expertise

Finding like-minded professionals to support NP efforts and exchange ideas about current and future healthcare challenges is the key to staying engaged in your patient care practice. Taking an active role in subgroups of a professional organization showcases your value and unique perspective.

2. Increase Your Social Acumen

Social acumen refers to making the most of every moment you have with others. This means becoming comfortable with the "meet and greet" moments and other social rituals we use to connect with each other. You will develop a sense of confidence in making your first impression, which is critical to establishing memorable relationships and serving as a notable presence in the organization.

3. Find New Resources and Best Practices

Expanding your network of NPs and healthcare leaders will expose you to creative changes in your own environment. NPs who are excited to share novel projects, initiatives, and successes with their networks are a great source of support for making positive adjustments in your own practice.

4. Discover New Career Directions or Make a Job Change

A shared environment is a great place to hear what other NPs are doing, learn about jobs, and let others know that you are interested in new opportunities. Policy is a critical element of nursing. As the highest employment group in healthcare, it's important that nursing has representation in the government to guide lawmakers in patient protection and healthcare law. Ask to represent NPs on national committees or take part in research and data gathering to help legislators advance the NP role. You can also consider taking part in the Multi-state Reimbursement Alliance, an organization that tackles NP insurance reimbursement and credentialing. Additionally, the field of healthcare informatics requires educated professional users to participate in discussions about future needs and patient protection in the current internet age.

5. Gain Recognition for Your Accomplishments

Many professional organizations offer fellowships and mentorship connections, which showcase accomplishments and guide industry contributions. Review award nominations and set professional goals for future consideration. Inform other NPs that you're interested in the awards and adding to NP professional contributions. Speak up and never apologize for it – NPs are educated, communicative leaders who deserve recognition for their accomplishments. Your success will inspire others, leading to future mentorship and a respected position in healthcare.

The Bottom Line: Become an Active Member of Your NP Organization

Joining a professional group offers an opportunity to develop relationships, share ideas, and expand your network. Being an active member provides you with a venue to maximize your strengths and improve on weaknesses. Active membership is about more than paying an annual fee and taking advantage of a few discounts. Consider investigating current policy initiatives and notifying members through emails or phone calls. You can also write articles for the organization's blog, suggest ways to increase membership, or participate in different committees. When people see your work, they will have a better idea about your competence and reliability—two aspects of NP life that are highly trusted and valued. Active membership allows you to gain recognition for your contributions, which ultimately leads to personal and professional growth.

Tips and Tricks For Nurse Practitioner Networking

Posted on October 15, 2020 | by Whitney Weingarten, FNP-C | Leave a Comment

"If you want one year of prosperity, grow grain. If you want ten years of prosperity, grow trees. If you want one hundred years of prosperity, grow people."

This Chinese Proverb is a testament to the magic of networking with other professionals in a similar field. In fact, a survey conducted in 2016 revealed that 85% of jobs were fulfilled through networking. So why are nurse practitioners not actively practicing this method? It is not stressed in school, since our profession is not a sales-driven community. However, networking may land you in a top working environment, or provide you with connections that can continue to benefit you as you transform your professional identity.

Networking Tip #1: Offer Incentive

I am not suggesting you pay for your network, but sometimes it can help if you offer to treat your prospective referral with a coffee or lunch date. The life of a nurse practitioner is busy; work-life balance is an entire topic in itself. It’s courteous to offer to pay for a meal or coffee in exchange for picking their brain a little on their current career position. Suggest that they pick the best time and date for their schedule, so they are more willing to proceed with the meeting. During these unprecedented pandemic times, it may be harder to meet in person due to social distancing. This may work out in your favor for those who are busy! Familiarize yourself with Zoom, and suggest a quick Zoom call to check in and catch up. If you can't offer coffee or dinner, offer your help in some other way, such as promoting their practice or suggesting a referral program.

Networking Tip #2: Rehearse Your Questions and Conversation Starters

Consider your networking event like a very casual interview. Although you will most likely be conversing in a friendlier atmosphere, it is always a possibility a job may come from your networking experience. Write out a few points to make sure you cover during your meeting, and highlight any questions you have for your resource. It is also a good idea to have a quick, thirty second "elevator pitch" about yourself and your current job situation.

Networking Tip #3: Scroll Through Your Rolodex

Not many people actually have a Rolodex anymore, but you understand the concept! The good news about obtaining a nurse practitioner degree is that you are required to have clinical time with other nurses, and this gives you an automatic contact list. These former classmates of yours may be working for employers who are looking for new providers, and they will be able to vouch for you first-hand and speak to your work and school ethic. Don't forget about the friends you made in nursing school, too! Many of them may have become NPs or advanced practice providers as well, and you can pick their brains about where they stand now. Sometimes it can feel awkward to message someone out of the blue, but more often than not your former schoolmate will be excited to reminisce and catch up. If you don't have their number, try messaging them on a social media platform.

Networking Tip #4: Join a Facebook Group and Tidy Up Your LinkedIn Account

Facebook is a great tool to use for networking; the entire premise of the application is to mingle with other like-minded individuals. There are many local and statewide Facebook groups that pertain particularly to nurse practitioners and advanced practice providers, and they can be a great networking tool! The groups highlight many job postings, volunteer opportunities, and educational resources. This may also be an easy way to initiate a prospective in-person meeting, where you can have face-to-face contact with other NPs in your area. LinkedIn is a prime tool for networking – it is literally a network of millions. Update your profile picture, provide some links to your page, and ask some of your connections to endorse you and your skills.

“Networking is a lot like nutrition and fitness: we know what to do, the hard part is making it a top priority.”
– Herminia Ibarra

There is an art to networking, and these tips only brush the surface. It can sometimes feel uncomfortable approaching someone that you do not know very well, but most professions run entirely off of networking. Although the healthcare field does not rely solely on mingling to make business run, if you break your comfort zone a little and make the right connection, you may find yourself in your dream job that would not have been possible previously by a sea of online applications.

Six Nurse Practitioner Visionaries You Should Know About

Posted on October 8, 2020 | by Fran Fasching, DNP, RN, FNP-BC | Leave a Comment

Most nurse practitioners can recall the reason that they decided to advance their nursing practice and pursue advanced practice degrees. Whether it's experiencing the individual care of a gifted NP or witnessing a talented NP interact with a team of healthcare professionals, the impact that an NP leaves behind is truly magical and career-changing. In this current healthcare environment, it's especially important to remind ourselves of the talent surrounding us. Keep reading about these six nurse practitioner visionaries to boost your inspiration!

1. The Original Visionary

Loretta Ford, EdD, PNP, FAAN was the first nurse practitioner and founder of the nurse practitioner model and training program. In the 1960s, Dr. Ford recognized how a shortage of primary care physicians was affecting the care of families and children. Partnering with pediatrician Dr. Barry Silver, she began a nurse training program to extend care to these populations. Inducted into the List of Living Legends by the American Academy of Nursing and the National Women's Hall of Fame, Dr. Ford successfully transformed the nursing profession and made healthcare more accessible to the general public. Dr. Ford educated a variety of nurses and nurse practitioners, authored over 100 publications, and lectured and consulted across the country.

2. The Health Care Visionary

Courtney Vose, DNP, MBA, RN, APRN, NEA-BC is the Vice President and Chief Nursing Officer of Nursing and Patient Care Services at New York-Presbyterian (NYP)/Columbia University Medical Center, NYP/Allen and the NYP/Ambulatory Care Network. She is also a clinical instructor at the Columbia University School of Nursing. As a result of her transformational leadership, NYP/Columbia University Irving Medical Center achieved Magnet recognition from the American Nurses Credentialing Center. Magnet achievement honors the highest levels of nursing excellence and professionalism. Dr. Vose has co-authored many research studies related to nursing care and processes. She recently conducted research on the emotional toll of COVID-19 on health care workers and is advocating for frontline worker loan forgiveness. Serving as an ongoing champion for nurses and patients, Dr. Vose is an exemplary leader.

3. The Nursing Informatics Visionary

Christopher Caulfield RN, NP-C, MSN is a nurse practitioner and the co-founder of IntelyCare, an on-demand mobile healthcare staffing company for post-acute facilities across the U.S. While working as a nurse administrator, he identified sources of nursing burnout and staffing challenges. He co-founded Intelycare to address these issues while highlighting the importance of nursing informatics in modern health care. Based in Massachusetts, IntelyCare helps facilities reduce nurse burnout, streamline administration, and improve overall care. It also provides nurses and nursing assistants with flexible shift scheduling, in-app education, and support to optimize patient care.

4. The Holistic Care Visionary

Herline Raphael, MSN, AG-NPC, CPCA is a holistic care nurse practitioner in Pennsylvania. Herline began her work in global care by founding Helping Hands and Beyond, a volunteer organization that offers aid to impoverished world populations. The organization has completed over 30 mission trips, supporting thousands of people in Haiti, Grenada, and the hurricane-struck Bahamas islands. Helping Hands and Beyond has built several clinics, as well as a girls’ orphanage in Haiti. As a nurse practitioner, Herline continues to serve her mission of providing healing and holistic care in her practice. BIX Homes and Wellness is a family-centered medical health and wellness center that combines east and west treatment modalities for all life stages. The center also offers disease management and coping and transition support programs that guide patients and families through illnesses, home care transitions, and health education. Herline's view of holistic care includes all aspects of patient life—physical and spiritual health, and family and social life.

5. The NP Education Visionary

Michael E. Zychowicz, DNP, ANP, ONP, FAAN, FAANP is an award-winning NP professor at the Duke University School of Nursing and the Director of the Duke-Durham VA Academic Partnership. Dual-certified in acute care and orthopedics, he leads the only Orthopedic NP specialty program in the U.S. Dr. Zychowicz is an active board member and the current treasurer of the National Organization of Nurse Practitioner Faculties, an organization driving nurse practitioner education. He was selected as a Fellow of the American Academy of Nursing in 2013 and the American Academy of Nurse Practitioners in 2007. He has edited several books, remains active in research, and frequently lectures at conferences. Dr. Zychowicz serves as a progressive educator for NPs on the cusp of change in the current U.S. healthcare climate.

6. The Political Visionary

Congresswoman Lauren Underwood (D), RN, MSN/MPH serves Illinois' 14th district, which encompasses the north and west suburbs of Chicago. Congresswoman Underwood is the first woman, a person of color, and a millennial to represent her community in Congress. She is also the youngest black woman to serve in the United States House of Representatives. President Obama appointed this health care and political champion as the disaster preparedness Senior Advisor for the US Department of Health and Human Services (HHA). Through her work with the HHS, she helped implement the Affordable Care Act and contributed to the new focus on quality and value in U.S. healthcare. She also educated nurse practitioners through Georgetown's online NP program.

These non-conformist advanced practice nurses demonstrate strength, innovative action, and growth. We should continue to look to them as a source of inspiration for leading healthcare in a positive direction. Consistently included as a part of the most trusted profession, NPs have successfully advanced education, professionalism, and public support to implement change. Do you know an NP who inspires you?