Once again, the legislative powers in Florida have chosen to drag behind the rest of the United States by not giving nurse practitioners prescriptive authority for controls.

Senate Bill 972 and companion House Bill 515 would have given NPs in rural areas the ability to write for controls such as sleep aids, anxiety medications, and various pain medications (Schedule II-V) under a collaborative agreement with their collaborating MD. Nurse Practitioners have been writing prescriptions since 1987. Florida is now one of the LAST TWO states that have continued to have a total block against NPs regarding these controlled medications.

One reason that Nurse Practitioners need the ability to write these medications is that many NPs practice independently in offices in which their collaborating MDs are not working. In the office that I currently work, I am the only provider for right now. They are recruiting a doctor but if I need to write a pain medication for an injury or abscessed tooth, for example, I have to contact my collaborating MD by calling him to pull him out of a room or leave him an email which slows down the processes at both offices. It also delays the care that my patients need at the time. In our office, we send chronic pain patients to pain management so we don't write a lot of controls anyway. It really frustrates me that I cannot write for a sleep aid for insomnia or testosterone for male menopause. 

It is also limiting my practice due to having my front office personnel screening any new patients by explaining that I can do everything that a MD can do (diagnose, treat, refer to specialists, and educate etc.) but cannot write for certain meds. My office is one of the few Tricare Prime, and Signa providers in my area and am having to turn them away causing them to drive additional mileage. This is causing a hardship due to gas prices and causing delays in care. All due to being in one of the last two states dragging their feet. 

How can we fix this? If you are a NP, become more vocal in your practice and have your patients who are being inconvenienced write letters to their State legislature and complain LOUDLY. Become a member of your local NP group and become active in local venues. Speak with physicians in your area and find out about their concerns and show them current studies showing how well nurse practitioners take care of their patients. 

It's time for Florida to get on the ball with patient care!

I work in a rural area where there are limited numbers of health care providers. I often eat at a local restaurant and have heard people refer to a nurse practitioner as "Dr. So and So." I have never seen this person correct anyone when they do that.

This is something that really burns my toast! I ALWAYS identify myself as a nurse practitioner and tell my patients to NEVER refer to me as Dr.

I do not have the MD degree and do not intend to pursue a doctorate in nursing any time soon. If I change my mind, I will let my patients call me Dr. but will remind them that I am still a nurse practitioner. There is much ado about the potential confusion with patients referencing us as Dr. in the medical side of the field. In my office, there is no confusion.

NPs should never pretend to be a MD. We are not and never will be unless we go back to medical school and obtain it. I have no intention of starting over and going through 8 years of college in order to do what I already can now as a FNP. I can diagnose, treat, and interpret tests just fine without it.

Please don't refer to NPs as Dr.

Thanks!

I was reading a blogpost regarding the Doctor of Nursing Practice and wondered if it was truly worth the time and cost of going back to school for three more years. I don't feel the need to add another three years worth of classes to my already burgeoning loan debt after 7 years of school at 83,000 dollars (you read right!).  I would have more schooling than a general MD with 8 years of schooling (DrNP title after 10 years), but will it bring me more money in my current position? I highly doubt it. Will it bring me more respect? I think that the way that I treat my patients and my treatment outcomes already speak for themselves. WIll the new title of Dr. NP cause my patients role confusion? Not in my practice. I already continuously remind them that I am not a MD and don't pretend to be one. Pretty darn close though! There are others in our profession that do not correct patients when they refer to us as Dr. So and So. This is a real pet peeve of mine!

I also have to disagree about the DNP being a new hybrid. Nurse Practitioners with Master's Degrees already work by blending the nursing and medical models together. That's the only way to practice as a NP because we are diagnosing and treating medical conditions. We don't just go by nursing theory contrary to beliefs, or at least I don't.

I have to admit that I was gungho about the new concept and planned to pursue the "end degree" but think that I will reserve judgment until I see the true benefits. I can already teach RN students with a Master's degree so unless I decide to teach BSN or Master's then I would go back. But then, the practice Doctorate isn't really about teaching. It's about furthering our knowledge base and practice experience. I can also do that by going to conferences, doing CMEs and reading the most current practice research. All mostly for free!

Any DrNPs out there who can tell me if it is worth the time and effort currently. Why do you think so or not? Leave me a comment on the comment blog or the guestbook. 

I was checking out my sitemeter and usually research what brings people to my site. One of the most common entries is "Are you happy being a NP?"
Well...let me think about it for a minute...Sure am!! I love my job! I can't say enough about it. It is one of the greatest things that has EVER happened to me. Here's some of the top reasons why I love being a Family Nurse Practitioner.

1. I can actually make patients better! I have the ability to interview patients and get to the root of their health problems and show them ways to  gain some control over their lives.
2. Patients trust me with their lives. What an awesome and humbling responsibility.
3. I get to take care of entire families as a Family Nurse Practitioner. It's fun to take care of the kids as well as the parents. It makes for an interesting visit sometimes.
4. Of course, I make really good money. While it's not my main reason for being a NP, it does help to pay off my student loans and keeps a decent roof over my family's head.
5. I help teach other nursing students when I can. I often have students stop by my office and ask for advice and help with homework. I only wish I could do it more often. I plan to teach one day when I can afford to.
I can't think of any others right now because I'm a little tired. You can tell me some of your reasons for being a health care professional by leaving me a comment on the guestbook or on the contact me page where you will find links to do so. Till next time! Be healthy and help others.

All Florida-licensed RN's and LPNs are now in a 24-month renewal cycle and must complete 24 hours of appropriate continuing education during each renewal period. One (1) contact hour is required for each calendar month of the licensure cycle, including two (2) hours on Prevention of Medical Errors. HIV/AIDS is now a one-time, 1-hour CE requirement to be completed prior to the first renewal. Domestic Violence CE is now a 2-hour requirement every third renewal. For example, if you renew your license on January 31, 2007, you are required to complete the Domestic Violence CE before the January 31, 2011 renewal.

A registered nurse who also holds a current Advanced Registered Nurse Practitioner certificate may satisfy the continuing education requirements for both licenses by completing appropriate courses for a registered nurse, or may satisfy up to 50% of the requirement by completing continuing medical education coursework.

Appropriate subject matter for continuing education are those which meet the professional education needs of the licensee in order to meet the health care needs of his or her patients and consist of content from one or more of the following:

1. Nursing practice areas and special health care problems.

2. Biological, physical, behavioral, and social sciences.

3. Legal aspects of health care.

4. Management/administration of health care personnel and patient care.

5. Teaching/learning process of health care personnel and patients.

6. Subjects at an accredited education institution that are taken and are advanced beyond that completed for original licensure.

7. Personal development subject matter must include application of content as it relates to improved patient care.