Top Seven Cities for Nurses

The Great Recession displaced large numbers of jobs and as a result, many have begun reevaluating where to base their careers. Due to the inherent need for them in any community, nurses have greater flexibility in where they live. Finding a nursing job in any city is contingent on a number of factors, such as the quality of healthcare providers and the density of an elderly demographic. These seven cities are the most intuitive for finding jobs in the nursing profession:

1. Rochester, Minnesota

Rochester is a community of about 107,000 people and employs three times the national average of nurses with a surprisingly high annual mean wage of $81,650. The city is the best choice for nurses in the country due to the relative cost of living and being home to the renowned Mayo Clinic (pictured below).

2. Boston, Massachusetts

Boston boasts employment numbers well above the national average and has the highest concentration of nursing jobs available among major American cities, in part due to a plethora of accredited hospitals, such as Beth Israel Deaconess Medical CenterBrigham and Women’s HospitalBoston Children’s Hospital. Additionally, of areas with the highest employment of nurses, Boston ranks first in annual mean wage at $94,600.

3. San Francisco, California

The metropolitan San Francisco bay area comprises the four top paying areas for nurses in the country with annual mean wages ranging from $105,000 to $120,000 and employment numbers that all hover right around the national average. The University of California, San Francisco Medical Center is regarded as one of the best hospitals in the country and is also number one for transplants.

4. St. Louis, Missouri

Employing over 36,000 nurses makes St. Louis the 7th largest employer of nurses in the country, but relative to it’s size, it ranks second in concentration of nursing jobs among major American cities. St. Louis is also regarded as a hub for healthcare and is home to the fifth-largest hospital in the world, Barnes-Jewish Hospital.

5. Chicago, Illinois

Chicago has the second largest employment level for nurses in the country. Among New York City, Los Angeles, and itself, Chicago is the only city to meet the national average on nursing employment levels. The Illinois Medical District houses a variety of medical centers, including Rush University Medical Center and The University of Chicago Medical Center.

6. Gainesville, Florida 

Gainesville benefits from extremely low costs of living, as well as a concentration of nurses that is double the national average. This is helped, in part, from institutions such as Shands HealthCareVeterans Health Administration, and North Florida Regional Medical Center.

7. New York City, New York

The metropolitan area of New York City employs close to 100,000 nurses, which is by far the largest in the country. The large population of the city dilutes the concentration of nursing jobs, but the jobs are plentiful and has a very appealing annual mean wage of $83,060.

 

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6 Mistakes That Could Ruin Your Nurse Practitioner Career

This is an exciting time to be a Nurse Practitioner.

As the need for accessible health care continues to grow so do the roles and responsibilities of Nurse Practitioners.

But beware, this growth and increasing focus on NPs puts them at increased risk for malpractice claims.

If you’re an NP, you must practice smart or risk ruining your career.

With the help of the Nurses Service Organization’s 10-year Nurse Practitioner Claim Study, 1994-2004, results, I’ve listed 6 mistakes that could ruin your Nurse Practitioner career and how to avoid them.

1. Working with the wrong physician – The “wrong” physician is any physician that doesn’t provide what you need to grow and thrive as an NP, i.e. leaving a new NP alone in a busy practice, setting unrealistic goals and expectations for NPs, not providing opportunities to learn and ask questions, and asking NPs to practice outside of their scope of practice.

2. Practicing outside of defined scope of practice – Stay up to date with your state Nurse Practice Act and revise collaborative practice agreements and protocols, based on clinical practice guidelines, annually. These are usually the first items the BRN and medical board will ask for if they show up at your practice.

3. Incomplete health information or documentation – A complete health information record is your best legal defense. Each patient visit documentation should include: Discussions with the patient and recommendations for treatment, patient response, informed consent or refusal of recommended treatment, receipt of test results and action taken, referrals for testing or consultation, prescription refills, revised patient problem list and medications with every diagnosis, educational materials given, missed appointments with all efforts to follow up with patient.

4. Failing to seek timely consultation and advice – I hear too many stories about NPs and PAs failing to seek advice when a patient has a recurring complaint that doesn’t respond to treatment and the stories usually don’t end well for the patient.  Listen to the patient and always error on the side of caution. Get another opinion sooner rather than later.

5. Seeing too many patients in one day – This cannot be overlooked. According to Nurses Service Organization’s 10-year Nurse Practitioner Claim Study, there were more claims against NPs who saw more than 18 patients per day at the time of the incident.

6. Not carrying professional liability insurance – This goes with saying. Protect your license, you, and your family’s assets in the event you are sued.

To read the full NSO Nurse Practitioner Survey, visit http://www.nso.com/npclaimstudy2009.

 

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What Every Nurse Practitioner Grad Must Have in Their Resume

Congratulations, NP! You’ve reached the finish line. Graduation day is just around the corner.

You’ve worked so hard in school to get here.

Now you’re ready to begin practicing as a nurse practitioner.

Or are you?

If not, don’t panic!

The current job market for NPs is very competitive so it is not uncommon for new grads to feel unsure or overwhelmed about finding their first job as an NP.

To land the best Nurse Practitioner job, you need the best advice from the best in the field.

Family Nurse Practitioner and career coach, Renee Dahring, has made helping Nurse Practitioners find their dream job her passion.

An NP with experience in the nurse practitioner recruiting business, Dahring knows what employers are looking for when hiring new nurse practitioners.

She believes resume writing, interviewing, and working with recruiters are critical skills to learn.

According to Dahring, “A nurse practitioner who is looking for a job MUST have a well organized and coherent resume. Resumes for nurse practitioners are unique and require information in a specific format. “

Note: Using a general resume template from the internet is not applicable to NPs.

Instead, I highly recommend Dahring’s, Nurse Practitioner Resume Guide and New Grad Resume Sample Format. Both have everything you need to write a successful resume that highlight, The “Big Three,” your education, your experience and your credentials.

Before you start writing, she advises tailoring your resume to the employer by “researching the organization and the position they have advertised, taking that information and using it to revise your Nurse Practitioner resume so that you can best showcase how YOUR qualifications and experience meet their needs.”

If you follow the advice carefully, your resume will rise to the top and soon, you will have the NP job of your dreams.

Best of Luck!

You can find more invaluable NP job advice and tips at Renee Dahring’s website, Nurse Practitioner Job Search and connect with her on Facebook.

 

REFERENCES:

2012 Guide for New NP & PA Graduates online at Advance for NPs & PAs.

 

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Top 9 Study Tips for Online Nurse Practitioner Students

Pursuing an online nurse practitioner degree is attractive for many nurses who need the flexibility of learning from home but make no mistake, online learning is just as rigorous as classroom learning.  The time you save commuting and sitting in the classroom will be spent reading, writing and studying.

Online learning is not for everyone. Success as an online student takes a lot of self-discipline and planning. To be successful, plan on spending a minimum of 10-20 hrs per week for each class studying, with weekly quizzes and papers crammed within a 5 week course. In addition, online classes usually require you to post 1-2 well-written comments daily online.

Knowing these expectations upfront can save you time, money and frustration and give you the opportunity to be better prepared before you begin.

Do you have what it takes to be a successful online Nurse Practitioner student?

If the answer is yes, here are 9 survival study tips to help you succeed.

Best Success!

Work Part-Time if you can –  Online learning may allow you to continue to work full-time but remember, online courses require a lot time. If you cannot balance work and school, consider cutting your hours back at work. See if your employer can help you financially through tuition reimbursement programs, etc.

Participate in Online Orientation – Taking the time to read the orientation guide/tutorial for your school’s online learning system will help save you time and frustration down the road. Better yet, attend an orientation workshop online or on campus, like those offered by the University of Phoenix, before you enroll.

Study the Syllabus – Stay on top of your assignments from the beginning by understanding the course description, software and textbook requirements, bookmarking recommended websites, and adding weekly tests & assignment due dates to your calendar.

Use a Webcam and USB-based headset that plugs into your computer’s USB port to get the best quality sound with online conversations.

Connect with Other Students – One major drawback of online learning is the lack of face-to-face interaction with other students. Stay connected through video chat, email, message boards and discussion groups daily.

Develop a Study Schedule to keep up – plan to set aside 10-20 hrs a week for each course. Set aside the same day/time each week to study and stick to it.

Study Smarter with online smart tools like Easybib for easier bibliographies, Flash My Brain to make fast & easy study notecards, and Evernote and OneNote for easy notetaking and more.

Join a Discussion Group – Stay connected and motivated with class discussion groups. If your class does not offer one, consider joining one through Google or Yahoo groups.

Get Help from your online professors – This one cannot be overstated. Say hello and introduce yourself at the beginning of the course via class chat or email.  Before asking a question, search for answers in the class syllabus, website, and discussion boards. Ask your question politely and give them time to answer.

 

 

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7 Keys to Staying Healthy for Nurse Practitioners

How important is your health?

As a nurse practitioner, you have dedicated your life to achieving health in your patients, but what about yourself?

You’re on the front line of illness every day so protecting yourself should be priority one.

And let’s face it. When you’re down, so is your practice.

Five years ago, I learned this first hand.

I was working as an NP in a busy pediatric practice and within a few months, I contracted a nasty stomach bug and, shortly after, pneumonia that nearly put me in the hospital!

While I avoided the hospital, I decided to end my career in pediatrics.

I no longer trusted my immune system to keep me healthy.

I knew I had to make changes if I expected to have a long career as an NP.

Thankfully, since then, that’s exactly what I did.

I looked to health & wellness experts for answers and learned critical keys to building a healthy immune system.

As Nurse Practitioners, we must make health priority one for ourselves.

Here are 7 keys to building health I hope you find helpful.

1. Eat Healthy – A poor diet: mostly sugar, refined flours, processed food and inflammatory fats such as trans and saturated fats leads to inflammation & immune system imbalance. Find out if you have food allergies and stop eating them. Eat whole, unprocessed foods and healthy fats from olive oil, nuts, avocados and omega 3 fats from fish like sardines, herring, sable, and wild salmon.

2. Exercise – Do I need to say more?

3. Lower Stress – Relax by doing yoga, meditation, deep breathing or taking a hot bath.

4. Take probiotics (good bacteria) daily – Your entire immune system depends on the ecosystem in your gut. “There are five hundred species and 3 pounds of bacteria in your gut…Too many of the wrong ones like parasites, yeasts or bad bacteria, or not enough of the good ones like lactobacillus or bifidobacteria can lead to serious damage to your health.” 1

5. Detoxify by getting rid of environmental and internal toxins. This includes toxic relationships too.

6. Take Fish Oil with EPA/DHA – 1 to 3 grams a day from a pure source (i.e. Metagenics, Nordic Naturals) to boost immunity.

7. Take a quality multivitamin daily that will support your immune system.

 

REFERENCES

1. Hyman, Mark, M.D. UltraWellness Lesson 4: Gut & Digestive Health. April 28, 2010. http://drhyman.com/blog/2010/04/28/ultrawellness-lesson-4-gut-digestive-healt

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Top 25 Websites For Nurse Practitioners & Nurse Practitioner Students

Nurse practitioners are connected at the heart, or at least they should be.  

Why?

It is this connection that provides the professional support and guidance needed to bring out the best in each of us personally and professionally in daily practice.

As an FNP, I can’t imagine where I’d be without my NP mentors who’ve given me invaluable advice and direction in my career and education.

NP mentors like Barbara C. Phillips, owner of Nurse Practitioner Business Owners (NPBO), who opened my mind to the possibilities of starting my own NP wellness practice, giving me a blueprint from start to finish. Thank you, Barbara.

Websites like WebNP Online, which keep me connected to the world of NPs.

So, whether you are an NP student or an NP in practice, staying connected to each other and the NP world is essential and with today’s technology, it has never been easier.

I’ve scoured my personal resources and the web to find NP movers and shakers and the top websites for NPs on the web.

Here is a list of my top 25.

I encourage you to bookmark them and connect with them online through Facebook and Twitter whenever you can.

I hope these websites will enrich you as an NP as much as they have me. Enjoy!

 

Advance for NPs & PAs

Advance for Healthcare Careers

American Academy of Nurse Practitioners and AANP Smart Brief

American College of Nurse Practitioners

APEA – Advanced Practice Education Associates -Amelie Hollier, DNP, FNP-BC, FAANP

A Nurse Practitioner’s View  - Stephen Ferrara, DNP, RN, NP

Carolyn Buppert – Carolyn Buppert, CRNP, JD

Eileen T. O’Grady PhD, RN, NP – Certified Nurse Practitioner and Wellness Coach

Fitzgerald Health Education Associates, Inc. – Margaret A. Fitzgerald, DNP, FNP-BC, FAANP, CSP

Heartstrong Blog

Hospice NP

Infant and Mental Health for the Pediatric Nurse Practitioner

Medscape

Merck Manual Apps

NP Central

NP Freebies – Alfredo Bimbela, PhD, MSN, FNP-C

NP News and Views – Jennifer Butler, NP

Nurse Barb – Barb Dehn, RN, MS, NP  

Nurse Practitioner Business Owner – Barbara C. Phillips, NP, Business Coach

Nursing Times

Pri-Med

The Nurse Practitioner’s Place

The Clinical Advisor

The Nurse Practitioner Journal

WebNP Online

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10 Things All Nurse Practitioner Students Should Have

As a nurse practitioner student, you need quick access to quality, concise, information to make the best clinical decisions every day in your clinical rotations.

Surprisingly, as a clinical NP instructor, when I arrive on the scene, I often find students buried in piles of books without the best diagnostic tools to help them find answers ASAP (picture deer in headlights when asked pertinent questions).

In all fairness, as an NP student without much clinical experience, how would you know what you absolutely should have to help you in clinical practice?

As a follow-up to my previous blog, 10 Books Every Nurse Practitioner Should Have, here are 10 things all Nurse Practitioner Students Should Have for success.

No more panic attacks when your clinical instructor arrives.

1. Smartphone– I’m sure most of you know this by now but I can’t stress it enough. Whether is the Apple iPhone, Motorola Android, or Blackberry, smartphones just may be the most valuable tool a nurse practitioner student can have. They are light, portable, and can free you from all those printed books!

2. E-Reader or iPad – Another reason to replace those printed textbooks. Download them for a fraction of the cost, from an e-reader store instead!

3. Littmann Cardiology III Stethoscope  or Littmann Master Classic II Stethoscope depending on your budget. Littman is the leader in stethoscope sound quality and durability.

4. Dr. Mom Professional LED Fiberoptic Otoscope My favorite otoscope! Uses Full Spectrum white LED Light Similar to Sunshine, allowing you to see more clearly.  Pus, the LED bulb is virtually indestructible and is warranted for life to never go out.

5. White, Pressed Lab Coat– You are representing nurse practitioners, always look professional. When you graduate, have your name, NP embroidered on it.

6. Omron’s Aneroid Sphygmomanometer – Whether you’re working in the office or out in the field, always be prepared to take a manual blood pressure by carrying your own sphygmomanometer.

7.  Student NP Association Membership – Join a local and/or national NP group or association such as the American Academy of Nurse Practitioners (AANP). It is their mission to promote excellence in NP practice, education and research.

8. Monthly Subscription to The Nurse Practitioner – Written by and for NPs. Stay up to date and earn CEUs with the American Journal of Primary Healthcare.

9. Medical Tote Bag – To help you carry all those books and papers. Check out different styles at Hopkins Medical Products.

10. Malpractice Insurance – Although reported NP malpractice is extremely low, you may still want to consider malpractice insurance to protect you and your family in the event of a lawsuit.

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Don’t Get Sued! 5 Legal Tips For Nurse Practitioners

Nurse practitioners be on notice. When prescribing medications, you can be held liable for the actions (including murder) of your patients.

Welcome to another court case gone bad.

This week, in a landmark case involving the 2008 murder of Kristy Ragsdale by her husband David, the Utah Supreme Court ruled in favor of the victim’s family stating that the nurse practitioner overseeing Mr. Ragsdale’s care, “owed a duty to exercise reasonable care when prescribing medications that pose a risk of injury to third parties.”

David Ragsdale shot his wife while on six medications prescribed by the nurse practitioner, including Valium, Doxepin, Paxil, Concerta, pregnenolone and testosterone. Read full story.   

Although blood toxicology reports show that the drugs he was taking were “within the prescribed ranges,” the lawsuit claims that the NP was negligent by “not consulting with a medical doctor in prescribing and increasing dosages of the medications and for keeping Ragsdale on the medications despite signs of toxicity,” a theory the convicted killer himself has used for his defense.

Isn’t it tragic; the convicted killer in this case has a better defense than the nurse practitioner.

But whether you agree with the ruling or not, NPs be on notice; The door is wide open for family members to sue you if they are “impacted” when things go wrong with a loved one’s care.

Your duty is no longer only to the patient but to the third parties connected to the patient as well.

So how do you protect yourself from this type of lawsuit? 

I cannot over simplify the challenges of managing complex clinical cases but must stress the importance of using best practice guidelines and prudence that will serve as your best defense.

First and foremost, when prescribing, educate yourself, patients, and family members about all potential side effects and have them alert you immediately if they experience any of them.

Stay within your written scope of practice as defined by state law and agreed upon by you and your collaborating physician.

Know your limitations and consult with experts when possible, especially when dealing with psychiatric and chronic pain conditions that are resistant to initial treatment.

When prescribing drugs for these conditions, document all education regarding possible drug side effects, any outside consultations, and your rationale for initiating, adding, or increasing drug dosages.

Monitor the patient’s response to treatment, including any changes in medication, often, as defined by treatment guidelines.

Finally, for every prescription you write, use SCRIPT analysis (Side effects; Contraindications; Right medication, dose, frequency, and route; Interactions; Precautions; Transmittal).

Following each of these tips will help ensure that YOU have the best defense in any court of law.

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Doctors! Leave Us Nurse Practitioners Alone!

I call for a 60’s style protest.

The kind that inspired a whole generation of young people to sing songs of protest, rise against “the establishment,” willing to risk everything for THE cause.

The kind that inspired a whole generation of NPs, like Loretta Ford, who bucked the system in the 1960s to create the NP profession as a means to “really enhance health care and bring health care to more people.”

We’ve come too far to lose any ground, anywhere, now.

Last month, I wrote about Missouri Nurse Practitioners fighting to remove barriers to fully autonomous NP practice. If you missed my blog about this, you can read it here.

This month, Oklahoma Nurse Practitioners are fighting The Oklahoma Board of Medical Licensure, who wants to limit NP autonomy by requiring  physicians who supervise nurse practitioner to see their patients at least half a day every week.” Read the full Tulsa World article here.

Their reason?

“It would help limit prescription drug abuse, a major problem in Oklahoma.”

Are you kidding me?!!

This is nothing more than smoke & mirrors by the doctors who feel threatened by NPs.

First of all, it’s the DEAs job to police prescription drug abuse.

Second, there’s no evidence NPs overprescribe.

According to OK representative for the AANP, “Some of the states with the lowest rates of prescription drug abuse are also states that don’t require a collaborative agreement with a physician.”

No need to look further than the media to confirm this.

Physicians, not NPs, are notorious for overprescribing.

Anna Nicole Smith, Michael Jackson, Whitney Houston – all died at the hands of DOCTORS.

In a time of great economic struggle and physician shortage, I’m outraged that physicians in rural areas are targeting nurse practitioners and their right to independent practice because of their own insecurities.

NPs  have earned patient’s trust and are the key to solving our nation’s healthcare crisis.

To try to tarnish this image and limit health care to those most in need is criminal.

In the spirit of Loretta Ford and others who’ve gone before us, we must rise against “the medical establishment” and continue to fight to remove barriers to fully autonomous NP practice.

Here is your protest song.

(sing to the tune of Pink Floyd’s, Brick in the Wall)

“We don’t need no legislation.”

“We don’t need no practice control.”

“No doc supervision ordered from the courtroom.”

“Doctors leave those NPs alone.”

“Hey! Doctors! Leave us NPs alone!”

“All in all your just another threat to us all.”

 

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6 Scholarships for Nurse Practitioner Students

So you’ve made the decision to go back to nursing school and become a nurse practitioner. You’ve researched and found the right NP school and put your colleagues, friends and family on notice that you’re life is about change.  Now, there’s only one question. How will you pay for your NP education? NP school can cost over $30,000 on average. I’m betting, you can use all the help you can get. Here are 6 scholarships for nurse practitioner students worth looking into.

Military Scholarships

This is a great way to receive financial aid for college to cover the cost of nurse practitioner school. The Air Force, Navy, and Army offer federal nursing scholarships for nursing students who are interested in serving in the US military. For more information about military scholarships for nurses, visit:

Air Force Scholarships for Nurses

Navy Scholarships for Nurses

Army Scholarships for Nurses

University of Phoenix Paying it Forward Online Student Scholarship Program

Through Paying it Forward, graduates of the University of Phoenix can nominate one of the Universities current online students, a nomination which could earn them a completely full ride. The scholarship was established for the thirtieth anniversary of the University of Phoenix, which means that 30 students can take advantage of this great opportunity. You must be nominated to qualify. Visit Paying it Forward for details.

GetEducated.com Excellence in Online Education Scholarship Program

To qualify for this $1,000 award, you must be enrolled in a U.S. based online program and write a 500-word essay about what a college degree means to you. These awards are available at the end of the fall semester, so visit the GetEducated.com website around October to find out more. Go to GetEducated.com  for complete details.

 AANP Foundation NP Student Scholarship & Grant Program

The American Academy of Nurse Practitioners (AANP) Foundation works hard to address the nursing shortage by working closely with corporations, philanthropic organizations, individuals and others to secure and help direct financial resources where they are most needed. Each year between $2,000 and $10,000 in scholarships and grants is awarded to NP students. AANP membership is required for eligibility.Visit the AANP for more information.

National Health Service Corps (NHSC) Scholarship

The NHSC scholarship is a competitive program that pays tuition, fees and a living stipend to students enrolled in accredited nurse practitioner schools. Awards are given to applicants most committed to serving underserved communities.  For each school year or partial school year of support received, students agree to work full-time in primary health care for one year in an assigned NHSC-approved site in the HPSA of greatest need. Visit NHCS Scholarship Program for more information.

Tylenol Future Care Scholarship 2012-2013

This national scholarship program offers $1,000 – $10,000 scholarships worldwide, with 40 scholarships reserved for college students in the US and Canada. The 2012 Tylenol Scholarship application process starts March 12 2012. To access the Tylenol scholarship application online, visit the current scholarship page for the Tylenol Scholarship Application.

 

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