Category: -           Jessica Farrone's   Nurse Practitionering Website
 
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Step 1-05/15/10 Graduation from MSN/FNP program 

Step 2- 05/17/10 Request for final transcript submitted to university, paid via echeck per suggestion of registrar (BIG mistake-takes 10-14 days to clear) 

Step 3- 06/04/10 Transcript received, 2 sealed copies, 1 copy opened to check for accuracy.

Step 4 - 06/07/10 AANP application complete now that final transcript received, mailed to AANP

Step 4- 06/17/10 Received letter from AANP "pleased to notify you …application to sit for exam approved" Now need to wait for letter from testing site with "window"

Step 5- 06/25/10 Letter from Prometric with number required and info on date selection, date for exam tentatively scheduled 6 weeks ahead for August 7, 2010 (really losing it now…looked at moon schedule, horoscope and biorhythm prediction before choosing date:)

Step 6- 07/27/10- panic mode, realize that every 1 out of 3 questions will be Pedi, decided to postpone date, to Sunday 8/22/10 (Feast of the Immaculate Heart of Mary, moon entering capricorn, at some kind of astrological crossroad…really losing my mind)

Step 7- 08/22/10- Take exam and pass! On-screen notification "you have successfully PASSED…." after 3 minutes of staring at screen, pure joy sets in!

Step 8- 09/10/10- Receive certificate from AANP in mail

Step 9- 09/30/10- Application for State of Connecticut APRN license mailed (needed to raise $200 for state license fee). Required passport photo; notarized application; proof of graduate level 40 hour pharmacology course, signed by school administrator

Step 10- 11/01/10- Received State of CT APRN license, effective dat 10/25/10 (expires month of my B-day Jan 2011, will need to pay another $200)

Step 11- 11/4/10 Application for State of CT "Controlled Substance…" submitted. One page form, $40 fee. 

Step 12- 12/6/10 Received state DEA license, mailed Federal DEA application with $591 fee

Step 13- 12/15/10 Received Federal DEA license- Now officially ready to work- a full SEVEN MONTHS after graduation

Step 14- 01/05/10 Negotiate employment, construct "Collaborative Agreement" with new MD employer. Apply on-line for free NPI number (federal requirement to bill as practitioner). Receive official NPI number via email same day.

Step 15- 01/13/10 Apply for Malpractice Insurance- $1000 for one year policy (includes new-grad discount, "tail", $1,000,000/$3,000,000 coverage)

Now, work for six weeks learning the ropes. Had to teach myself about CPT codes, documentation requirements for reimbursement, new EHR system, order prescription pads. Still not officially recognized by medicare, medicaid or insurance companies. 03/11/11- Submit application to "CAQH." Very long and painful application process. Required names, dates, description of all clinical rotations, date of initial RN licensure (9/8/91), references, background check, etc. CAQH will submit application on my behalf to multiple insurance companies for approval as provider. Saves time and effort of applying to each individual company. 10 months after graduation, still not done with the red tape. To be continued…

 
This is such a fantastic time to be a Nurse Practitioner! If you are an NP student or considering NP school, you may be feeling discouraged or overwhelmed by some of the negative things you hear from new grads or NPs. There is a lot of talk about difficulty finding jobs, low pay, poor treatment and excessive workloads. While some of it is true, you must take what you read with a grain of salt. Remember that people with negative experiences tend to be more vocal than others. This is not a criticism, by any means, just an observation.

An example from my own experiences: After I graduated in May and began studying for boards, I joined a popular forum that discussed the NP certification exam. The majority of posters had failed the exam, some more than once, and were writing about their experiences. Other posters (like myself) were preparing to take the exam, and writing about their anxieties and fears. I made some wonderful friends on that site who offered important advice that helped me pass. As time went by, I began to notice that once a friend successfully passed the exam, they rarely posted on the site. I began to realize that once they passed, these posters had little more to say on the subject and were moving on to the next phase of their career. So while it seemed like “everyone who took the exam was failing” I was not actually getting an accurate picture of the typical test taker. The fact of the matter is that somewhere between 80-90% of test takers pass the exam. Whether it is on the first try or not, who knows. But if it takes more than one attempt to pass, it is not the end of the world. It is not something you have to disclose on your resume or during an interview.

Finding a job may be more challenging than you would like it to be. BUT...that is true for ANY job seeker in this economy. There ARE jobs out there, but you will have to put some time and effort into getting one. During the time I spent studying for the exam, I also made sure I spent some time every day on the job hunt. I will go into this more in future post, but just know that there IS a market for new grad NPs.

In terms of low pay and/or excessive workloads, I think it is partially true, Again, you have to consider the source. Any new grad, RN or NP, has to start at the bottom. And there is always a period of time when a new grad feels overwhelmed and overworked. It is part of the transition to a new role. As time passes and experience grows, the work gets easier and each patient takes less time. As you become more efficient, the work takes less timeIt’s the whole “Novice to Expert” concept that Patricia Benner writes about in her books and articles. And for experienced RNs who become NPs, it’s actually novice RN to expert RN, back to novice as an new grad NP. It’s a challenging time, but not impossible and it’s something that every new grad goes through. Just keep plugging along and take it one day a time. It may seem overwhelming and impossible right now, but you will get through it!

 
       Even though I have officially graduated from the program, I cannot practice as an FNP. I need to get certified and licensed by the state of Connecticut. Unlike the NCLEX for RNs, there are two different tests that are offered by two different accrediting bodies to obtain certification. Certification by one of the two accrediting bodies is required in 48 of the 50 United States. California and New York do not require certification to practice as an A.P.R.N. I live less than an hour from N.Y.C. and have considered skipping the test and commuting into the city. Unfortunately, even though certification is not required in NY, most of the insurance companies won't pay you unless you're certified. (Making it especially difficult to find a job!).
        I am struggling with the decision of which test to take for accreditation. Most of my classmates are taking both exams - something that every NP I talk to says is a waste of time and money. Most employers don't care who certifies you, as long as you are certified. I too have decided that I would like to be accredited by both bodies. My thinking is that if two similarly prepared NPs are applying for a job, the candidate with two certifications has an edge. At the very least I think it shows ambition and drive - plus a few extra letters after your name. The problem is the added expense and the thought of having to endure taking two exams is almost unbearable.
         The first accrediting body is the American Nurses Credentialing Center (ANCC). This is the larger, more widely recognized accredeting body. They are an extension of the American Nurses Association (ANA). An FNP who passes this exam can use the initials FNP-BC after his/her name. (or ANP-BC for adult nurse practitioners). So far I can tell you that their application is much more involved. There is a 10 question section that must be completed and signed by the program director from my school. I handed it in nice and early to ensure it would be completed. Unfortunately, the only thing I got back was 10 blank questions with a signature on the bottom. Lesson number 1 - make sure the form is actually filled out prior to getting it back. My fault for not checking! Now I need to chase down the director to find out who accredits the FNP program, which classes met each requirement, etc
          The second accrediting body is the American Association of Nurse Practitioners (AANP). Until recently, their accreditation was not recognized by all 50 states. (Their letters are "NP-C" after the APRN's name). Other than a much simpler 2-page application, the AANP is very similar in terms of exam process, level of difficulty and cost. I did, however discover a little bit of a loophole in the process. (My obsessive reading and endless hours of online searching may pay off after all!) It seems that the AANC will grant reciprocity to APRNs accredited by the AANP. In other words, if I take and successfully pass the AANP exam, all I need to do is submit an (abbreviated) application to the ANCC and I will be accredited - NO EXAM REQUIRED. So what I've done so far is submitted my application to the AANP. I haven't done anything with the ANCC.
           The problem I am having is...I am the only one I know, or ever even heard of that has done it this way. It seems like everyone and their mother is taking or has taken the ANCC exam. Am I making a mistake? Am I missing something? I did confirm with BOTH bodies via email the reciprocity thing. The AANP only offers it for NPs who were certified prior to 1995. The ANCC confirmed it and I've downloaded all of the info about it from their site. The information is literally buried on their site and no one ever mentions it - not in the NP program, review courses, review books or on the NP forums. Either I truly am "on to something" here with this reciprocity thing or I am seriously missing something and making a huge mistake. Only time will tell...