Hello I'm a male Registered Nurse (RN) and I'm currently in school at University of Hawaii at Manoa for my masters in Family Nurse Practitioner (FNP). I love technology. This blog is more of a personal one with some others. Which is to blog about my life, tech related stuff, and health related issues. I will try to be as accurate as I can with the health related issues and be prudent enough to use evidence-based practice.
Saturday, April 16, 2011
Sorry I haven't blogged for a while!
Ok so I haven't blogged in here for a while. I've been busy. I guess whenever I finish my program this year, I will start blogging more and give more insight about practice issues after I get certified! :) For now, please follow me on facebook and twitter.
Wednesday, December 15, 2010
Thursday, December 9, 2010
What a year in the MSN-FNP Program
Well this may be a short one. It's nearly the end of the Fall 2010 semester and thus, I'm near the completion of my two years of Family Nurse Practitioner school. I'm on my way to get my masters degree. Some things I've noticed along my journey in FNP school. Well first, the way I view diseases and conditions affecting the quality of life is different from that of when I was in nursing school getting my bachelor's degree from University of Hawaii at Manoa. There are many things that changed since the start of my FNP schooling. My attitude toward healthcare changed. I'd thought, well the hospital is the most important part of healthcare and all nurses should therefore work in acute care inpatient hospitals and all the theory stuff we learned in school is irrelevant to our actual clinical practice. Well guess what? That assumption may be wrong. I'm not saying "it is" wrong, it "may" be wrong.
I've wondered why our nation tries to focus so much on primary care. Now I see why. Everyone working in the healthcare system has their role and without a doubt, they're are critical to sustain our nation's healthcare system. Hospitals are needed because patients do become sicker after they develop a bad disease. We primary care providers should be diligent in looking how to treat diseases to prevent hospital admissions. Unfortunately, a patient with a progressively worsening condition may need to be hospitalized and monitored closely by great nurses who work in these hospitals, namely Queen's Medical Center, Kuakini Health Systems, Hawaii Medical Center East and West, and all of Hawaii Pacific Health. However, it seems obvious that although these great hospitals do provide excellent nursing care, I still see fragmentation amongst nurses in various settings. There seems to be an ego issue and unfortunately, a pay issue as well. With the pay issue, it may not be so relevant to Hawaii, but in the mainland, depending on the department you work in, the pay is different. Well lets take out pay out of this picture now.
So back to the issue of primary care and fragmentation amongst nurses. Now, of course the Advanced Practice Registered Nurses (APRN) such as Nurse Practitioners and Clinical Nurse Specialists, clearly have different roles and scopes of practice than Registered Nurses (RN) who are not independent practitioners. Even though we are still RNs, the scope of practice and educational preparation mindset is different. So that don't count. I'm going to separate APRN and RN. What I'm talking about is all these organizations within the realm of RNs, fragmentation is evidenced by staff RNs, outpatient RNs, nurse managers, nurse executives, etc. We need to work together and make each other professionally equal. I've heard instances where a nurse manager told another staff nurse with more experience, "I'm the nurse manager and I know better". This certainly may be true in the management position, but obviously does not indicate the nurse manager knows more than the staff RN. This is a issue that's been brought up at the American Academy of Nurse Practitioners fellowship that I attended in Washington D.C. in August 2010. Primary care providers need to do the same and collaborate well with each other and putting aside the mindset of "I'm in a specialty and you're just a generalist". Moreover, I don't like being called a mid-level provider by many other healthcare workers. It sounds a bit degrading professionally. We are non-physician clinicians.
Anyway, now to the economic aspects. I see many new grad RNs not being hired in Hawaii because of "inexperience at least 1 year". Sure experience says a lot, but not hiring new grads to give them a chance to develop that experience will hurt our healthcare system in the long run. Think about it, the new healthcare reform kicked in and nearly 32 million uninsured individuals will be insured and the count will increase. If a large population becomes sick at once because of various diseases, will we be able to keep the nurses who are already working overtime sane? Of course not. We are humans and we do get feelings of being burnt out sometime. So training new grads is important. Pretty soon, our new grads in Hawaii will move to the mainland to work and Hawaii will be in a desperate need for nurses. At the same time, there will be more delay of care and quality of health care WILL decline because of poorer work performance by these nurses who are already overworked. This is unacceptable. What I think hospitals should do if they want to decrease cost in hiring new grads is to pay new grads low for the first year and if they have a good work performance, then put them at a regular rate post-1st year.
Also, I think Graduate Nurse Education funds should be able to fund residencies or fellowships for APRNs even though the pay may be low for working long hours in the duration of residencies. This would increase the quality of care because us APRNs would receive high quality training. Just my thoughts...
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