ENP Fellowships: Transition to Practice Eric Roberts, DNP, FNP-BC, ENP-BC
Why AAENP Mission Statement: Support training and education in emergency care Leadership conference: Leading the tide of change What are we currently doing in practice? What is our vision? How does it involve you?
What are we doing? https://www.youtube.com/watch?v=rxgunj-neyg
Clinical Hour Comparison 6000 5000 4000 3000 2000 1000 0 Susanna Rudy, DNP, AG-ACNP, FNP, ENP (AAENP, 2016; NCCPA, 2016; Stowell, Vohra, & Luber, 2015)
What are we doing? We have 12,000-14,000 practicing ENPs (AANP) 9 academic programs (1300) TOTAL: 9.3 10.8% 9 fellowship programs (45) Typically 2 fellows/cycle (accept PA and NP) Approx. 5 yrs and 1 NP/cycle TOTAL: 0.3 0.4%
Our Vision Developed Jointly: Roberts, E. & Wllbeck, J. (2017)
Our Vision Developed Jointly: Roberts, E. & Wllbeck, J. (2017)
Proposal Encourage program development We need to Increase awareness FACILITATE program development We need a HOW TO We need a Support structure
APGAP Making the case Britney Broyhill, DNP, ACNP-BC
APGAP: Costs Administrative Licensure Interview expenses Marketing Salaries and benefits CE Directors/ Staff Mentor/Lecturers Simulation Costs Britney Broyhill, DNP, ACNP-BC
APGAP: Benefits Key drivers Employee engagement scores Turn over rates Recruitment costs Decrease in open position time Lower workforce costs Revenue generated by fellows Productivity differential Cost/Benefit ROI Britney Broyhill, DNP, ACNP-BC
Typical Fellowship Program Pay: $45,000 $75,000 Length: 12 18 months Didactic 4-5 hours of lecture weekly Grand rounds Journal club
Typical Program Clinical: 16 shifts/month Fast track/ Main ED (28 weeks) Orthopedics (4 weeks) Radiology (2 weeks) Anesthesia/ Surgery (2-6 weeks) Trauma (2-4 weeks) (Ophthalmology, Derm, Peds ED, Neuro, ICU, Tox, Telehealth)
Current Work: AAENP Identified core educational content Data collected from practice analysis (AANP-CB) Curricular data collected from fellowship programs Developing: AAENP Standards for ENP Fellowship & Academic Training
Standards Build on National Organization of Nurse Practitioner Faculties (NONPF) Organization and Administration (2) Student (2) Curriculum (7) Resources, Facilities, Services (4) Faculty and Faculty Organization (4) Evaluation (3) AANPCB, 2017
Standards ENP Practice Domains Medical Screening Medical Decision Making/ Differential Diagnosis Patient Management Patient Disposition Professional, Legal, Ethical Practices AANPCB, 2017
Standards Skills: General diagnostic skills (EKG, radiology, US, etc.) Cardiovascular (Cardiac arrest, emergency access) ENT (Dental blocks, epistaxis management, foreign body) Forensics (SANE, evidence preservation, mass casualty) GI (Paracentesis, FAST, G-tube) Skin (I&D, burn resuscitiation, wound mgmt.) Ortho (Splinting, traction, compartment syndrome, athrocentesis) (Wilbeck, Roberts, & Rudy, 2017)
Standards Skills: Neuro Opththalmology (LP) (Slit lamp) Psych (substance abuse screening, suicide risk assessment) Pulmonary (Airway management, thoracentesis, chest tube, vent mgmt) Reproductive (precipitus delivery, neonatal resuscitation) Urology (testicular torsion) (Wilbeck, Roberts, & Rudy, 2017)
Call for Leadership What can must we do Need to promote development Need to develop standards What can must you do... Need to incrase awareness Chanel interested parties appropriately EVERY JOURNEY STARTS WITH ONE STEP!
Don t push the birds off the cliff Help the baby birds fly https://www.youtube.com/watch?v=q3cyj0fpooo
Help me, help us What do you think? What are we missing...? What else should we be doing...? This is from us, about us, for us... for the future of ENPs. Thank you!
References American Association of Nurse Practitioners Certification Board (AANPCB), (2017), AANPCP Emergency Nurse Practitioner Specialty Certification 2017 Candidate Handbook. Retrieved from https://www.aanpcert.org/resource/documents/emergency%20np %20Handbook.pdf National Organization for Nurse Practitioner Faculties (NONPF), (2017), Nurse Practitioner Core Competencies Content. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/ competencies/2017_npcorecomps_with_curric.pdf Wilbeck, J., Roberts, E., Rudy, S., (2017), Emergency Nurse Practitioner Core Educational Content, Advanced Emergency Nursing Journal, 39(2), p. 141-151.