NP stats

The Kaiser Family Foundation recently released a fact sheet on the number of nurse practitioners in the US, with a breakdown by state. In total, the US has 147,295 NPs. The states with the most NPs are: California, with 15,230 NPs, and New York, with 14,272. The states with the least: North Dakota, with 343 NPs, and South Dakota, with 372.

back for more

OK, vacation's over, and I'm back to blogging. This post is kind of a grad student/public health combo. The grad student aspect of the blog is this: one more semester to go. I have one more semester until I am supposedly qualified to diagnose and treat a wide variety of ailments. Yike. The summer semester of my program, which ended just before my last post, was frighteningly bereft of clinical information. I had a class on violence and ways it may come up in clinical practice, which did make some excellent points. I had another class on the logistics of being an NP. It was devoted to admin things like licensing, practice agreements, insurance, etc. Important stuff, but it didn't really feel like it should take priority over, say, more diagnosis and management. Finally, we had a seminar where we presented cases, and that was useful. But we only met for two hours every other week, so...Anyway, suffice it to say I've gone online and bought some review books to supplement my already expensive education.

Now to public health. The President and CEO of the Kaiser Family Foundation, Drew Altman, recently wrote one of his "Pulling It Together" columns about the state of HIV prevention funding in the US. He notes that NYS is the top funder of HIV prevention, spending $88 of the $600 million spent nationally. This is slightly less impressive than it sounds, since NY is home to 17.6% of the people in the US living with HIV, and $88 million is only 14.6% of the overall funding. Still, a good start. However, the column notes these figures are for FY07, and things are likely to have changed since then thanks to the economy's shenanigans. The column also links to one of previous columns about attitudes towards HIV nationally.

nurse practitionering

Lately I've been concentrating a lot on the "public health" aspect of this blog, and less on the grad school aspect. Since the blog really should be about both, this'd be a good time for me to talk more about studying to be a nurse practitioner.

Not everyone is totally clear what a nurse practitioner is. The basic idea is that a nurse practitioner is a registered nurse who has completed master's level coursework, and has been licensed by the state to diagnose and treat illness. An NP's privileges vary by the state: most states require that the NP work with a "supervising physician" and limit an NP's prescribing privileges. New York policy is very liberal: NPs here have full prescriptive power, and work with a "collaborating physician". Many NPs see the future of the profession in the provision of primary care; as US physicians become more and more specialized, and as we move (fingers crossed) towards more comprehensive health coverage, a "primary care gap" like the one that has emerged in Massachusetts since the insurance reforms of 2007 is expected to become more and more prevalent. This is, to the minds of many, where NPs come in.

In order to be an NP candidate, one must already be an RN, usually with a BSN, although there are some associate-to-master's programs. (Columbia used to have one, but it was discontinued.) My program is four semesters worth of coursework. The first semester was: Pharmacology, Physical Assessment, Health Policy, and Introduction to Primary Care. That semester had no clinical component. This past semester (Spring 2009) was Diagnosis and Management I, Seminar in Primary Care (basically case presentations), and Genetics. We also had a clinical requirement, which I have blogged about in the past.

I also work part time at a NYC facility for formerly homeless adults, but that's for another post. :)

report on health care workforce

The Center for Health Workforce Studies, at the University at Albany's School of Public Health, recently published a 136 page study of the health care workforce in New York. The report, which includes a section devoted to NYC, has some fascinating stuff: between 1990 and 2007, the health care workforce of NYC grew by 29%, whereas the workforce of NYC as a whole grew by 16% during the same period. Almost all of the jobs were in the private sector; private hospital jobs increased 3% while public hospital jobs went down 4%. (Hospitals provide about 50% of NYC's healthcare jobs.) Interestingly, the study reports that the number of RN positions in NYC went up 18.9% between 2002 and 2007, while the number of RNs increased only 3.1% between 2003 and 2007. The number of NPs went up 27% between 2003 and 2007. (Good luck with that job search, Laura.)

Overall, the study projects that there will be openings for nearly every type of healthcare job in NYC from 2006-2016. However, recent events have indicated that for RNs, and I would imagine other healthcare workers as well, the the picture has changed dramatically thanks to the recession.

Another unsurprising finding of the study is that minorities are underrepresented in New York State's physician workforce, even as the nonwhite portion of NYS' population continues to grow. Physicians who come from racial minorities are more likely to work in underserved communities and have on average a higher percentage of Medicaid patients.

nursing school

So despite the fact that this blog is formally about grad school, I've had very little to say about my graduate experience thus far. That's largely because class for this semester only started last week. I'm in three courses: Genetics, Diagnosis and Management, and Seminar on Primary Care. It's the second semester worth of classes for my MS, and I'll have two more semesters to go after this.

In addition to my coursework, I am at a clinical site one day per week. The site is a private practice with two NPs near Union Square. The NP I work with seems knowledgeable and competent, and I am confident I'll learn a lot from her.

I'll have more to say as the semester progresses; if anyone reading this has any questions about becoming an NP, please don't hesitate to ask and I will do my best to respond.

Hello

My first post will be just a quick introduction. I am a registered nurse pursuing a Master's degree in Nursing. My BS in Nursing was my second undergraduate degree; it was a one year accelerated program designed for students who wanted to be nurses but who already had four year degrees in other fields. My BA was in the social sciences, and one of the only two science classes I took in college was nicknamed "Sex" by the student body. (The course guide opted for the more discreet title "The Evolution of Human Nature", but it obviously fooled no one.) So transitioning into classes that actually had right and wrong answers was not easy. However, I was lucky enough to take care of my prereqs quickly, and to begin my nursing degree almost exactly a year after finishing undergad.

I was also lucky enough to get into my first choice nursing school: Columbia University. Its medical campus is centered around Columbia-Presbyterian Hospital, in the Washington Heights area of New York. A year after starting my degree at Columbia, I finished the bachelor's portion of the program and became a registered nurse. Like most people in my class, I moved on immediately to my Master's in Nursing, which, combined with passing the state's nursing boards, will qualify me to practice as a Nurse Practitioner in New York. I will complete my degree in December 2009.

In addition to nursing , I'm interested in public health, particularly in New York and particularly as it pertains to HIV. I intend for this blog to discuss all three subjects, although the ratio is to be determined. To that end, an interesting study recently came out from the New York Department of Health exploring a link between binge drinking and HIV among MSM. You can download the full study at the end of the press release.