5 Signs You Are Ready To Start A Travel Healthcare Career
It can be difficult to know when to start a travel healthcare career. Many would-be travelers can suffer from “analysis paralysis” thinking about all of the criteria they should meet before traveling. Should I wait until I have more experience? What if I end up somewhere I hate? Will I be able to support myself sufficiently? Do I have to become a wizard at finding a new place to live every few months? While those are all important questions, they are better left for after you decide to commit to a travel healthcare career. We’ve narrowed down five signs to look for when deciding to pursue a travel healthcare career. Signs You Are Ready To Start Your Travel Healthcare Career 1. You want to see new sights One of the most obvious benefits of being a healthcare traveler is right in the name. There are more than 30,000 active job posts on the StaffDNA boards at any given time that span the U.S. and cover a massive variety of locations. Looking to hit the ski slopes in the winter? Some facilities recruit for the winter as early as August. Want to find a nice small town with pretty trees for the fall? Take your pick of northeast states right off the Atlantic coast. One of the main factors stopping travelers from working where they want is having current state licenses, but even that is made easier because most agencies will pay your licensing fees. Additionally, nurses and physical therapists can get compact licenses which allows them to work in multiple states with only one license. Other healthcare professions are working towards implementing licensure compacts as well. 2. You want more control over your pay A traveler’s job flexibility also applies to their earning potential, not just location. The keyword to focus on here is “control,” because while it’s true travelers earn more on average than permanent staff, that doesn’t mean they always will. That’s why it’s important to think about your salary in terms of control—you can control what agencies you work with, the recruiters you work with and the jobs you pursue. Since the traveler job market is fast-moving and highly competitive, travel staffing agencies are constantly fighting tooth-and-nail to offer you the best pay package and solid benefits. 3. You want to build up your professional skillset quickly It’s easy to get stuck in a routine while working at the same facility every year. If you plan on traveling for more than a year, chances are you will work in a variety of different environments with unique challenges. Contrary to conventional wisdom, this constant job hopping can actually help you in the long run because it will show potential employers you are highly adaptable and can face unexpected problems with confidence. Traveling also means getting experience in multiple electronic medical (healthcare) record software platforms, as different hospitals will have their own systems. In a Black Book Research survey, 98 percent of travel nurses said fluency in multiple EMR platforms is a highly valued skill. Since facilities are constantly updating or implementing new EMR platforms, travelers with experience in multiple platforms can apply for EMR conversion contracts, which typically offer much higher pay rates than standard travel assignments. 4. You are sick of healthcare workplace “politics” Bad hospital management, interpersonal drama, pointless gossip, local union disputes—traveling gives you a chance to avoid almost all of the workplace “politics” that permanent staff have to deal with. Since you have the option to avoid toxic workplace relationships as a temporary staff member, that means you can focus more time on patient care and improving your skills. 5. You are ready for a challenge We’ve explained a lot of the benefits to traveling, but that doesn’t mean travelers get to just kick back and rake in money. Healthcare travelers have to be ready to face almost all of these challenges at any given time: Managing and frequently updating compliance documents Maintaining a tax home Managing relationships with multiple recruiters and agencies Applying for state licenses Multiple job interviews every year Calculating travel expenses Frequently looking for (and moving to) temporary housing Adjusting quickly to new work environments with limited orientation Planning on how to travel with friends, family or pets Loneliness or homesickness Constant on-the-job learning High expectations for job performance Avoiding workplace drama If this list of challenges seems daunting, that’s perfectly natural. Traveling has plenty of positive aspects, but it may not be for everyone. Some travelers find they love the challenge as it motivates them to work harder and improve their skills. The most important thing you can do after noticing the signs that you’re interested in traveling is to educate yourself. There are a variety of online resources—including this website—where you can find answers to any lingering questions you may have about being a healthcare traveler.
Travel Jobs: Where Travelers Applied in July, Expectations for August
Expectations were high for July to be a very active month on the StaffDNA job boards after a sharp jump in application volume in June, and travelers did not disappoint. The volume of applications increased by almost 20 percent, making it the second month in a row with a significant increase in job board activity. This positive trend can be linked to several factors: August is a historically busy month for hospitals in the U.S., but especially for pediatric facilities. Most school districts in the U.S. start the school year in mid- to late August, so parents are likely to bring their children in for a check-up or to update their immunizations. Experienced travelers who took off in the summer were on the hunt for fall assignments. “Snowbirds” who headed back to northern states during the summer are looking to migrate down south for the winter. Job volume kept up with traveler demand. Needs for skilled labor and delivery and OR professionals ramped up in late-June, and less popular summer vacation states were offering competitive pay packages. Travel Healthcare Jobs August 2018 We don’t expect to see another dramatic jump in job board activity for August, but we do expect hospitals will already start recruiting for winter travelers late in the month. “[Pediatrics], ICU, step down, [telemetry]—you’ll see hospitals start to book in September,” a LiquidAgents Healthcare source told HCT Today. “Hospitals that are budgeting and planning early are already putting out January needs.” A quick look at the StaffDNA job board shows several new positions posted within the last two weeks that have scheduled start dates in December. Let’s take a closer look at what we learned from July’s top markets. State ranks are starting to shake up June saw almost no major movement among the ranks of states where travelers applied to the most, but July showed hints of the upcoming seasonal shift, with more Southern states holding or moving up the list. Since August is a transitional month for the traveler job market, we expect to see much more dramatic shifting trends in where travelers apply for jobs. September may prove to be even more volatile, as travelers who got contract extensions through August will start actively seeking jobs. Arizona and Tennessee enter the Top 10 After a month out of the big leagues, Arizona jumped 10 ranks back up to the No. 6 spot of the top 10 most applied-to states. Tennessee also re-entered the top ranks at No. 7. Tennessee seems to be a fairly popular state year-round, but as we’ve seen Arizona is much more prone to seasonal changes. We may see it hop around the ranks in August and September, but we expect it and New Mexico to be very popular with travelers in the winter months. Massachusetts makes the biggest jump, Illinois falls the farthest Illinois dropped 14 ranks, from the edge of the top 10 at No. 11 to middle of the pack at No. 25. Meanwhile, Massachusetts regained most of the ground it lost in June, moving up 12 ranks from No. 41 to No. 29. The drop for Illinois is expected—the northern state enjoys more popularity in the spring, but travelers may be looking to get out before the winter season hits. The state experiences five severe winter storms on average between November and April, according to information from the state’s climatologist office. Massachusetts frequently hangs around the middle of the pack for total applications, so we expect it to mostly maintain its rank during the coming months. July’s Top Markets California Florida Texas North Carolina Georgia Arizona Pennsylvania Tennessee Michigan Virginia Wisconsin Arkansas South Carolina Kentucky Missouri Nevada Iowa Indiana Maine Oklahoma West Virginia New Mexico Oregon Indiana Illinois Colorado Ohio Hawaii Massachusetts Alabama Washington New York Minnesota Maryland Louisiana Montana New Jersey Kansas Mississippi Alaska Wyoming Nebraska Utah Connecticut District of Columbia (Washington D.C.) South Dakota Vermont North Dakota New Hampshire Rhode Island Delaware
An Update On Medicaid Expansion Efforts and How They Affect Travelers
As we move closer and closer to November midterm elections in the U.S., healthcare access and quality issues have become a heated political battleground for legislators and citizens across the political spectrum. Medicaid expansion, a tentpole policy part of the Affordable Care Act passed in 2010, is one of the key divisive topics in this realm. It’s also something healthcare providers—and by extension travel healthcare professionals—are keeping an eye on, as expansion can have an impact on provider funding and patient care. What Is Medicaid Expansion? Under the Affordable Care Act, states can expand Medicaid eligibility to nonelderly adults with incomes at or below 138 percent of the federal poverty level, which equals about $16,700 a year for a single person and $34,600 for a family of four. Expansion states are funneled billions of dollars from the federal government to support expansion efforts and coverage for newly insured populations. In states that haven’t expanded, those adults fall into a “coverage gap” for having incomes above traditional Medicaid eligibility but below the limit to get approved for ACA marketplace premium tax credits. So far 34 states have approved Medicaid expansion, two states—Maine and Virginia—are in the works to implement expansions, and three states—Idaho, Utah and Nebraska—could potentially approve Medicaid expansion this year. Why is Medicaid expansion important to travelers? Simply put, hospitals in states that expand Medicaid can expect to see a new influx of patients looking for care on a regular basis which can affect seasonal staffing needs. A Commonwealth Fund study in 2015 found that 4 out of 10 primary care physicians who accepted Medicaid saw an increase in patients after expansion coverage took full effect. Additionally, studies have shown that hospitals in expansion states have much healthier budgets, which can leave more money on the table for hiring and retaining temporary or permanent staff. According to an analysis by the Kaiser Family Foundation, expansion hospitals saw “significantly improved hospital operating margins.” These factors don’t completely guarantee that facilities in expansion states will overflow with traveler needs, but it can help prevent razor-thin hospital budgets and get executives thinking about how to ease the burden on their permanent staff. What’s happening in states with plans for Medicaid expansion? Maine Medicaid was supposed to be available to newly eligible Maine residents on July 2, but a series of appeals and heated courtroom battles have kept expansion in limbo, leaving more than 70,000 without coverage. At the heart of the issue is Republican Gov. Paul LePage, who has vetoed Medicaid expansion efforts six times in office. Mainers approved Medicaid expansion through a referendum vote with a 59 percent voting majority in 2017, but LePage refuses to submit a plan to the federal government until sufficient state funding—under his terms—is found. LePage was ordered by a Superior Court justice to submit a plan in June, but his administration appealed the ruling to the Maine Supreme Court, saying they did not have to file a plan during the appeal process. Arguments for the appeal took place on July 18, but the court has yet to make a decision. You can view a more detailed timeline of the events leading up to the court hearing by clicking here. Idaho Advocates in Idaho successfully petitioned and gathered 75,314 verified signatures to add a Medicaid expansion measure to the ballot this November. The petition met both state requirements to qualify the ballot measure, gathering at least 56,192 verified signatures that represented at least 18 of Idaho’s 35 legislative districts, according to Ballotpedia. Utah Utah Gov. Gary Herbert signed a bill on March 27, 2018, for partial Medicaid expansion, directing the state to seek federal approval to expand Medicaid to 100% of the federal poverty level. The bill stipulated using the ACA enhanced federal match rate and adding a work requirement for the expansion population. To date, the Center for Medicare and Medicaid Services (CMS) has not approved waivers to access the match rate until Utah approves a full expansion. In the meantime, Utah expansion advocates garnered enough petition signatures to add a competing bill to November ballots that would approve a full expansion. Nebraska Similar to Idaho and Utah, Nebraska advocates have submitted a petition to add a Medicaid expansion initiative to the midterm election ballot this fall. Supporters filed more than 133,000 signatures on July 5, but the Secretary of State office is still verifying the signatures. At least 84,908, or more than 60 percent, of the signatures need to be valid for the initiative to make the ballot.
10 Best Travel Dog Breeds For Healthcare Professionals
Tons of travel healthcare professionals love to bring their beloved pooches along for the ride, but not every dog breed is great for the open road. Breed size, temperament, trainability and need for exercise are all important factors to consider. To help you narrow down your choices, we’ve created a list of the top 10 best travel dog breeds by comparing data and information across many pet health and lifestyle web sources. We also refined our list by considering factors unique to healthcare travelers that could affect the health and happiness of your furry friend. For example, we took border collies off our list because their high-energy nature can be a bad match for busy solo travelers who may not have the time to work off that energy. When you’re looking over this list, keep in mind these are not the only dogs who can travel well. Every dog is different, so it’s very possible you find a mutt, mixed breed or alternative breed dog that happens to be the perfect travel companion. If you have questions about how to travel safely with your pet, make sure to check out our Pet Travel guide for quick tips! 10 Best Travel Dog Breeds 1. Chihuahua The “gold standard” for portable pups, Chihuahuas are compact enough to fit in a large bag anywhere you go. They also have very low exercise and food needs, so you won’t have to worry about bringing along big bags of food or hiring dog walkers very often. If you want small, you can’t go wrong with a Chihuahua. 2. Labrador Retriever Labrador retrievers are happy and ready for adventure. This breed has plenty of energy to happily follow you on the hiking trail and loves to explore. Most importantly, labs are very easy and obedient to train, meaning they won’t destroy your rental while you’re working those 12-hour shifts. 3. Pomeranian In terms of travel convenience, Pomeranians are basically fluffy Chihuahuas. Their super-compact size means they are ready to go anywhere in a moderately sized bag, and they are just as loyal and affectionate as their less poofy brethren. Shedding is obviously a downside of breeds with thicker hair, so plan to brush your Pom on a regular basis to weed out excess hairs before they end up everywhere. 4. Boston Terrier Boston terriers are adaptable and friendly. With a gentle, happy-go-lucky temperament, Boston terriers are great car-ride companions and want to tag along with you no matter where you’ll move. As a snubnose breed, it’s not recommended to take Boston Terriers on any planes. Becuase of their narrow airways they can asphyxiate at high altitudes. 5. Bichon Frise Bichon Frise’s have easy-going and sassy personalities—perfect for dishing about all the stuff that happened after a crazy shift. Like the Boston Terrier, this breed is also quite adaptable and comfortable around new people. 6. Great Dane You’ll have to make some room for your massive Great Dane, but what they lack in compact size they make up for with their loving temperament and gentle nature. Despite a large frame, Great Danes actually need very little exercise to stay healthy. Combine that with minimal grooming needs and you have a large, loveable and low-stress travel companion. 7. Yorkshire Terrier One of the benefits of owning a Yorkshire Terrier, other than their compact size, is their tendency towards sociability. Yorkshires are one of a handful of breeds that do very well in urban environments with lots of other dogs and owners, which is great for travelers who want to stick with metropolitan areas and larger hospitals. 8. Dachshund If RV travel is your method of choice, you can’t go wrong with a Dachshund. An inquisitive breed, Dachshunds form strong bonds with their owners and make great guard dogs. Just like the other small breeds on the list, they are compact, low maintenance and ready to accompany you anywhere. Keep in mind this breed is a bit more territorial of their owners and less tolerant of curious youngsters, so they are not recommended for travelers with children. 9. Golden Retriever Opposite from Dachshunds, Golden Retrievers are the perfect family dog and an all-around great first pet. They are eager to make friends with every new person they meet, which makes them a great tagalong for outdoor activities and social events. Just like their Labrador cousins, they are also very easy to train. Goldens do like to enjoy more open spaces and they may not do as well in urban environments. 10. French Bulldog A very trainable breed, French Bulldogs are just as happy playing around as they are lounging all day. Their laid-back attitude and low maintenance grooming and exercise needs mean they are great for long drives and in most living situations. As a snubnose breed like the Boston Terrier, French Bulldogs should not fly on planes. Stick to car travel with this dog.
TravCon 2018: Organizers see strong early registrations for September conference
Signups for TravCon 2018, one of the largest annual conferences for traveling healthcare professionals, remain steady after a strong burst of early registrations in April, TravCon event coordinator Michelle Freitag said. “650 attendees have signed up so far, which is a little less than last year at this point,” Freitag said. “It’s very common for us to have an initial rush of registrations, and then a lot of signups at the very end.” At the 10th annual conference last year, 1,250 travelers attended marking the largest year ever for the event, according to the official conference website. The event has grown exponentially in the past five years in both the number of attendees and the diversity of classes, events and exhibitors it offers, Freitag said. Participation from allied health travelers at last year’s conference greatly increased, so organizers have added classes specifically for allied professionals. “60 percent of our [educational sessions] are new this year,” Freitag said. “We have a traveler self-defense class, a Destination: Guam class which we’ve never done before…and three new panels that will be very interesting. We have a CEO panel with a Q-and-A talking about the state of the healthcare industry.” Attendees can learn from travel healthcare experts at 40 educational sessions over three days and meet in person with travel healthcare staffing companies from around the country. Travel nurses, physical therapists and occupational therapists can also receive upwards of 17 CEU credits to help maintain their professional licenses. Out of the 105 registered exhibitors this year, 78 of them are staffing companies, Freitag said. One of the main draws of TravCon every year is for travelers to meet with their favorite agencies—possibly for the first time. “Generally travelers may never meet their recruiter or company, so we bring them together so that you can meet your company or to find your future company,” Freitag said. “It’s a great way to get together professionally to find your next job or who you want to work for.” The conference will take place from Sept. 9-11 at Bally’s Hotel in Las Vegas, Nevada, which is located on the Vegas Strip. Attendees can arrive early for the unofficial meet and greets and other pre-conference events, according to the TravCon website schedule. Registration for TravCon 2018 is open until Sept. 6. You will also be able to buy conference passes at the door, but availability will be limited. Those interested can learn more by visiting the TravCon website.
Listen: A Sudden Freeze On ACA Payouts And What It Means For You
Over the weekend, Seema Verma, administrator for the federal Centers for Medicare & Medicaid Services, said she was suspending $10 billion in “risk adjustment” payments that helped stabilize the insurance markets created under the health law. Julie Rovner, chief Washington correspondent and host of KHN’s What The Health podcast, explains the national picture on the Takeaway for WNYC: Can’t see the audio player? Click here to download. Chad Terhune, senior correspondent, explains the effects of this development in California and other states for South California Public Radio: Can’t see the audio player? Click here to download. They examine what health insurers and Covered California officials have described as another curveball from the Trump administration meant to weaken the Affordable Care Act. Verma said the “risk-adjustment” payments and collections had to be halted in response to a New Mexico court ruling in February that said elements of the program were flawed. Another court in Massachusetts had upheld the program in January. The risk-adjustment program was meant to stabilize the insurance exchanges by taking money made through low-risk consumers and shifting it to higher-risk pools. The federal government collects money from some insurers that enrolled healthier patients and then transfers money to other insurers who had sicker enrollees. Because the Affordable Care Act requires insurers to accept all people regardless of their medical history or preexisting conditions, architects of the law created the program to prevent insurance companies from cherry-picking the healthiest people. The Republican-led Congress failed last year to repeal and replace the ACA. However, Republican lawmakers and the Trump administration have made a series of moves intended to weaken the health law, such as halting subsidies that covered some consumers’ out-of-pocket costs and eliminating the penalty. This story originally appeared on Kaiser Health News (KHN) Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.
As Maine Medicaid expansion stalls, hospitals and enrollees are left in limbo
Maine’s Medicaid-eligible residents, which make up more than 70,000 people, were set to enroll on July 2 as part of the expansion plan approved by nearly 59 percent of voters last November. But after a month of battles between advocacy groups and stonewalling efforts by Gov. Paul LePage’s administration, the enrollment date has passed and hospitals are left waiting for an influx of patients and staffing needs that may not come anytime soon. “A hospital representative I work with said they all have their fingers crossed that [the expansion] gets approved and it all goes smoothly, but she agreed it is a mess currently,” said Larry Jenkins, a sales team member for staffing agency LiquidAgents Healthcare. “There are no plans for additional staff at this time.” For clarity, here’s a timeline of where Maine’s Medicaid expansion plan stands: November 2017: Maine voters approve Medicaid expansion under provisions outlined in the Affordable Care Act, making Maine the first state to approve expansion by referendum. The Maine Department of Health and Human Services is required to file a plan by April 3, 2018 April 3, 2018: No plan is filed by Maine DHHS. LePage said he would not move forward with a plan until adequate funding is approved by the legislature to support expansion efforts. April 30, 2018: Advocacy group Maine Equal Justice Partners sue Maine DHHS to force the administration to submit a plan, citing a $130 million surplus fund that could be used to fund the expansion for 2019. June 4, 2018: Superior Court Justice Michaela Murphy rules in favor of Maine Equal Justice Partners, citing a “complete failure to act” by Maine DHHS in missing the April 3 deadline. They are ordered to submit a plan by June 11. June 7, 2018: LePage’s administration files an appeal for the decision, and requests to not file a plan by June 11 while the appeal is considered. June 18, 2018: Justice Murphy denies the appeal and orders DHHS again to file a plan with the federal government. Gov. LePage’s legal team appeals the order to the Maine Supreme Judicial Court to delay the deadline while the original appeal is considered. Arguments are scheduled for July 18. June 29, 2018: Gov. LePage vetos a potential expansion funding bill. Lawmakers must decide to override or uphold the veto on July 9. July 2, 2018: Maine Equal Justice Partners encourage eligible residents to apply for Medicaid anyways despite ongoing litigation. July 9, 2018: Conservative legislators uphold the veto in an 85-58 House vote. LePage and House Republicans criticize “one-time” funding sources included in the plan, saying Maine needs a long-term funding plan. Monday’s vote on the veto of Maine’s Medicaid expansion funding bill marks the sixth time LePage has stopped expansion legislation through the use of veto during his two terms of office. The final verdict on Maine’s Medicaid expansion efforts may set the precedent for lawmakers in Idaho, Nebraska and Utah. Advocacy groups submitted similar ballot initiatives after successful petitions to let voters decide the fate of Medicaid in their states this November. Utah’s ballot initiative passed state scrutiny and was added to the fall ballot. Secretaries of state in Nebraska and Idaho are reviewing petition signatures to confirm they represent a specific percentage of voters in each state.
Travel Jobs: Top 10 States for June, July Market Predictions
In our June traveler job market predictions, we talked about the “summer stall”—less new job postings, more competition for every job and more interest in atypical summer job states. Based on StaffDNA job board data, two of our predictions were on target. Job application volume increase by nearly 20 percent from May to June, marking the most active month since January. What we didn’t expect was for supply to match pace with demand. Hospital systems in many states, including popular summer destinations like California and Virginia, bounced back after the late-May and early-June slump. Part of this can be linked to vacation plans for permanent hospital staff, according to travel agency sales staff sources. As the regular staff takes off for the summer or cuts back on hours, that provides opportunities for travelers to fill the gaps. We expect for this market momentum to stay strong in July, as travelers who took time off in June will be planning ahead for the start of the school season in August or to find a fall contract in September. The back-to-school rush marks a yearly milestone for many travelers with children or grandchildren. They will typically take a break during the summer for childcare, and return to hospitals once the kids are back in school. “The experienced travelers know it can take four to six weeks to find and start a job, so they start the search for an agency and position mid-summer,” said Kate Quinn of LiquidAgents Healthcare. Let’s take a look at what we learned from our top markets for June. Rankings barely shift as travelers settle in for the summer While April and May saw a lot of “movement” in terms of where healthcare travelers applied across the country, ranking shifts were much more conservative in June, despite the high application volume. Most states moved up or down the list by 5 ranks or less, and five states—North Carolina, Pennsylvania, Nevada, Wisconsin and Washington—didn’t move at all. We expect the list to remain mostly stable for July, August and potentially in early fall, as traveler won’t start making big moves until we get closer to the holiday season. Michigan, Missouri, Virginia enter the Top 10 For the first time this year, Missouri joined the likes of Texas, California and Florida in the top 10, moving up two spots from May to No. 9. Virginia moved back up as anticipated, jumping up five ranks to No. 10 on the list. The state is both a top travel destination for summer 2018 and one of the top five highest paying travel nurse states in the U.S. Montana, Wyoming climb the charts; Connecticut drops to dead last Montana and Wyoming both moved up seven ranks to take the No. 41 and 42 slots, respectively, while Connecticut dropped 16 spots to the bottom of our list. Connecticut has consistently ranked in the bottom half of the list for job board applications. It’s also one of the most expensive states to work in as a traveler because of the high regional cost of living and low average pay packages. Interest in Maine uncertain as Medicaid expansion remains in flux Enrollment for the voter-approved Medicaid expansion was supposed to roll out on July 2, which would have provided a $500 million shot in the arm for healthcare funding in the state and coverage for more than 70,000 eligible recipients. Pending litigation surrounding the expansion has left the issue in limbo. A Maine judge forced Gov. Paul LePage to submit an expansion plan to the federal government by June 11, but LePage’s administration submitted an appeal for the ruling. While the appeal is pending, LePage also vetoed the expansion bill this week. Because of the political turmoil, it’s uncertain whether the expansion will have an impact on the Maine traveler job market as expected. June’s Top Markets Florida California Texas North Carolina Georgia South Carolina Michigan Pennsylvania Missouri Virginia Illinois Indiana Kentucky Tennessee Arkansas Arizona Nevada Idaho Oklahoma Iowa Wisconsin West Virginia New Mexico Maine Oregon Colorado Washington Hawaii Ohio Alabama Louisiana Maryland Mississippi New Jersey Alaska Utah Kansas Montana Wyoming Minnesota Massachusetts North Dakota New York District of Columbia Delaware Nebraska New Hampshire Rhode Island South Dakota Vermont Connecticut
More Nurse Practitioners Now Pursue Residency Programs To Hone Skills
By Michelle Andrews, Kaiser Health News contributing columnist The patient at the clinic was in his 40s and had lost both his legs to Type 1 diabetes. He had mental health and substance abuse problems and was taking large amounts of opioids to manage pain. He was assigned to Nichole Mitchell, who in 2014 was a newly minted nurse practitioner in her first week of a one-year postgraduate residency program at the Community Health Center clinic in Middletown, Conn. In a regular clinical appointment, “I would have been given 20 minutes with him, and would have been without the support or knowledge of how to treat pain or Type 1 diabetes,” she said. But her residency program gives the nurse practitioners extra time to assess patients, allowing her to come up with a plan for the man’s care, she said, with a doctor at her side to whom she could put all her questions. A few years later, Mitchell is still at that clinic and now mentors nurse practitioner residents. She has developed a specialty in caring for patients with HIV and hepatitis C, as well as transgender health care. The residency program “gives you the space to explore things you’re interested in in family practice,” Mitchell said. “There’s no way I could have gotten that training without the residency.” Mitchell is part of a growing cadre of nurse practitioners — typically, registered nurses who have completed a master’s degree in nursing — who tack on up to a year of clinical and other training, often in primary care. Residencies may be at federally qualified health centers, Veterans Affairs medical centers or private practices and hospital systems. Patients run the gamut, but many are low-income and have complicated needs. Proponents say the programs help prepare new nurse practitioners to deal with the growing number of patients with complex health issues. But detractors say that a standard training program already provides adequate preparation to handle patients with serious health care needs. Nurse practitioners who choose not to do a residency, as the vast majority of the 23,000 who graduate each year do not, are well qualified to provide good patient care, they say. As many communities, especially rural ones, struggle to attract medical providers, it’s increasingly likely that patients will see a nurse practitioner rather than a medical doctor when they need care. In 2016, nurse practitioners made up a quarter of primary care providers in rural areas and 23 percent in non-rural areas, up from 17.6 and 15.9 percent, respectively, in 2008, according to a study in the June issue of Health Affairs. Depending on the state, they may practice independently of physicians or with varying degrees of oversight. Research has shown that nurse practitioners generally provide care that’s comparable to that of doctors in terms of quality, safety and effectiveness. But their training differs. Unlike the three-year residency programs that doctors must generally complete after medical school in order to practice medicine, nurse practitioner residency programs, sometimes called fellowships, are completely voluntary. Like medical school residents, though, the nurse practitioner residents work for a fraction of what they would make at a regular job, typically about half to three-quarters of a normal salary. Advocates say it’s worth it. “It’s a very difficult transition to go from excellent nurse practitioner training to full scope-of-practice provider,” said Margaret Flinter, a nurse practitioner who is senior vice president and clinical director of Community Health Center, a network of community health centers in Connecticut. “My experience was that too often, too many junior NPs found it a difficult transition, and we lost people, maybe forever, based on the intensity and readiness for seeing people” at our centers. Flinter started the first nurse practitioner residency program in 2007. There are now more than 50 postgraduate primary care residency programs nationwide, she said. Mentored clinical training is a key part of the programs, but they typically also include formal lectures and clinical rotations in other specialties. Not everyone is as gung-ho about the need for nurse practitioner residency programs, though. “There’s a lot of debate within the community,” said Joyce Knestrick, president of the American Association of Nurse Practitioners. Knestrick practices in Wheeling, W.Va., a rural area about an hour’s drive from Pittsburgh. She said that there could be a benefit if a nurse practitioner wanted to switch from primary care to work in a cardiology practice, for example. But otherwise she’s not sold on the idea. A position statement from the Nurse Practitioner Roundtable, a group of professional organizations of which AANP is a member, offered this assessment: “Forty years of patient outcomes and clinical research demonstrates that nurse practitioners consistently provide high quality, competent care. Additional post-graduate preparation is not required or necessary for entry into practice.” “We already have good outcomes to show that our current educational system has been effective,” Knestrick said. “So I’m not really sure what the benefit is for residencies.” This story originally appeared on Kaiser Health News (KHN) and NPR. Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.
Top 10 #NurseProblems Posts That Made Us Say #Truth
1. Ah yes, because the doctor can easily do it better, right? #nurseproblems Nurses be like… 😝⠀ .⠀ .⠀ .⠀ #nurses #nursing #nurselife #nurseproblems #nursesofinstagram #medlife #nursememe #registerednurse #nurse #murse A post shared by BoardVitals (@boardvitals) on Jun 25, 2018 at 6:12am PDT 2. Off the clock = No one bother me for at least 24 hours. I just need to be alone right now 😂😭 ❤ @nurseabnormalities * * * * * * @nurseabnormalities #nurseabnormalities #nurselife #nurseadvocate #nursesrock #medicallife #medical #dr #rn #md #lpn #medicalhumor #nursehumor #nurselove #nurseproblems #hospitalproblems #nursingstudent #nurseblogger #nurseblog #medschool #doctor #nursepractitioner #dnp A post shared by Danielle LeVeck © (@nurseabnormalities) on Jun 25, 2018 at 5:23am PDT 3. Those times when you just have to say #byefelicia Welp. You supposedly understand the implications and have decision making capacity… so do as you wish. 🤨 #love #rn #nursinglife #nursing #nightnurse #nurseproblems #nurses #hospital #nursehumor #medicine #nurselife #nurse #murse #medstudent #nursepractitioner #nurseofinstagram #LPN #nursingproblems #HealthCare #CNA #Murse #NursingSchoolLife #NurseRock #ClinicalLife #girldoctor #clinical #nursingschool #nursememe #NursingProblems A post shared by NURSE INSPIRATION (@nurse_inspiration) on Jun 28, 2018 at 11:18am PDT 4. No, really. Go ahead and Google “c diff” for us. We’ll wait. Along with every other bodily fluid 🤮🤣 #stripinthegarageforareason A post shared by Gina L Krueger (@rnnursefit) on Jun 28, 2018 at 10:37am PDT 5. The next time you press that call button I’m coming in here with a hazmat suit. 😂😂😂 #nurseproblems #nurselife #nursesweek #nurseonduty #nurseryart #nursepractitioner #nurseryinspo #nurse #nurseryinspiration #nurse💉 #nurseswag #nurseydecor #nurse💉💊 #nurseprobs #nurselove #nurseday #nurseflow A post shared by Nurse Talks (@nurse.talks) on Jun 28, 2018 at 10:09am PDT 6. …What do you mean, “another test?” 😒😒😒😒😒 Good luck to all the new grads taking their exams in the upcoming weeks! 🧡💛 #nurseproblems #friends #doctor #hospital #lifenurse #medical #instanurse #nursingstudent #NursesWeek #inspirational #nurse #futurenurse #healing #nursepractitioner #joking #NursesRule #nursingteam #nursing #registerednurse #nursinghumor #NursingProblems #rn #clinicallife #nursehumorprn #medschool #nursingschoolproblems #nursegif A post shared by NURSE INSPIRATION (@nurse_inspiration) on Jun 28, 2018 at 8:46am PDT 7. “What’s the ratio of USD to Shift Bucks?” Follow 👉 @nursegram_new For More Post ➖➖➖➖➖➖➖➖➖➖ Shift Life ➖➖➖➖➖➖➖➖➖➖➖ 📷 All rights and credits reserved to the respective owner(s) #rnlife #nurseonduty #womeninmedicine #icu #medstudent #clinicals #physician #nursesrock #lpn #usmle #stethoscope #medicalstudent #futurenurse #med #hospital #nurses #nurseproblems #nurselife #rn #paramedic #premed #scrublife #health A post shared by NurseGram (@nursegram_new) on Jun 28, 2018 at 2:15am PDT 8. Oh thank goodness, I don’t have to do more stuff. *Lets out a very long and tense breath* SHEEEEEESH!! #nurse #rn #cna #lpn #np #nurselife #nurseproblems #nursehumor A post shared by Medical Scrubs Collection (@medicalscrubscollection) on Jun 27, 2018 at 9:30pm PDT 9. Nurse Team, ASSEMBLE!! “Awesome! 💖 Follow me @ilove_Nurse for more 💗 ❤ Update new pictures everyday! ➖ 📌 Tag someone to make their day better. ❤ Double Tap & Tag your Friends Below⤵ #nursingschool #nurse #nursing #nurselife #instanurse #nurseproblems #nursingschoolproblems #nursesrock #nightshift #nurseup #rn #registerednurse #nursingtees #nursinghome #pediatricnurse #nursingstudent #nursingstudents A post shared by Nurse community (@ilove_nurse) on Jun 27, 2018 at 9:14pm PDT 10. Look, we never said we were perfect. #nurse #nursing #nurselife #nursepractitioner #instanursing #nurseproblems #nursingschoolproblems #scrublife #nursesrock #nurselife #nurses #rnlife #rninspiration #lpn #nurseonduty #nursehumor #nursehumorprn #registerednurse #cna #nurses #rpn A post shared by Maira_nurse (@maira_nurse) on Jun 27, 2018 at 9:00pm PDT