http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=79

    I'm Morgan Elzey and my mentorship was at Campbell Family Medicine, and I was able  to acquire many skills from them that will help me throughout my life. I gained more confidence in myself by talking to multiple people through this mentorship. I also gained the knowledge of how to run a doctor's office, and most importantly how to have a healthy doctor/patient relationship. The main thing that I learned that will help me with any is that communication is key, but it took me a while to get the hang of this one. Knowing this will help you go further, and understand things better by just simply being able to talk it out.
   Some actions that I personally took to get the most from my experiences was finishing every task that was asked of me to my best capability and further. Then, when I was finished with that certain task I would go back and ask "What's next" or "What else can I help with". This helped to show that I want to take initiative to help and my want to be there, and your mentor will surely notice this. It can even help you to get to do cooler things with your mentor, because they believe that you can handle it. Another thing that I did was just simply ask. Some things they did in the doctor's office I was able to watch, but I really wanted to get hands on and do it. I made sure that I asked at the right time, and my mentor was glad that I did. She then would explain to me how to do it, asked me if I had questions, and then let me do it myself. These to things are very simple to do, but can help you out a lot. I always like the saying, "It never hurts to ask," and that is really true.
   This mentorship has prepared me for the future in many ways. First, it helped me to gain confidence in myself, and that will help me with everything, especially in medicine. Secondly, it helped me to really be productive with my time to get stuff done. Lastly, it has taught me that I have made the right decision to go into the medical field and become a nurse practitioner. With this mentorship it has shown me that I do want to become a nurse practitioner in a doctor's office, but in a pediatric office. For the new HMP students the advice I want to give to you is to go into every experience with an open mind, and never be afraid to ask a question, because that is what your mentor is there for, to help you. Also, I want you to know that it is a great privilege and blessing to be in this program. I believe that you guys will do great and hopefully flourish wherever you mentor. Have a great year!
  

Morgan Elzey
Natalie Patiern
Campbell Family Medicine
   During my Mentorship, and my research that I conducted, I was able to find evidence that helps to explain my essential question. Which is why are more medical students becoming Nurse Practitioners rather than Doctors. I quickly learned that there are many components and reasons to this accurance.  First off, Nurse Practitioners ,NPs, can do almost anything a Doctor can in the workplace, with some exceptions depending on the state. However, it is how they go about treating a patient that makes them different in the workplace. Doctors tend to see patients and treat patients as science, because that is how they were trained. While, NPs look at patients as a whole and addresses the needs of the patient on a personal level before addressing their needs on a scientific level. The main points of Doctors and NPs differences are their scope of practice, academic education/training, and responsibilities and salaries. I was blessed this year to be apart of the Honors Mentorship Program, and it helped me to confirm my want to become a Nurse Practitioner

Relevant Presentation

        
 https://www.youtube.com/watch?v=tShavGuo0_E


   The information and tips from this video really helped me when I presented my research. It reminded me that I needed to know my research forward and backwards before I presented it. Also, the mood of the video really keep me interested in it and I paid a lot more attention. It also helped me to be more calm about presenting my relevent presentation. I presented my research to a 7th grade level Science/Health Care class at Otwell MIddle School. The stedents seemed to really absorbed the inforamtion I was telling them, and then at the end I was able to fully answer the questions they asked me. I was able to do this, becuase this video told me to learn your research forward and backward. I'm going to put in a link to my relevent presentation at the bottom of this post for ya'll.


https://youtu.be/BLEFKyPaBhc

Annotated Bibliograpgy

1. Julie Fairman, Making Room in the Clinic: Nurse Practitioners and the Evolution of Modern Health Care, New Brunswick, NJ: Rutgers University Press, 2008.

2.  This article is by Julie Fairman, and it addresses how Nurse Practitioners are going to become dominate in primary care. It also talks about how Nurse Practitioners provide high quality, but cheaper health care. At the beginning of this article Fairman has a paragraph explaining who a Nurse Practitioner is and what it is that they do in health care.

3.

• "Today, many Americans use Nurse Practitioners (NPs) for much of their health care needs and NPs are now fully accepted by both health care consumers and most other care providers as a critical component of a modern health care system."
• "As reports of these experiments were published, the number of programs for nurse practitioners grew rapidly, supported in part by federal funding through the Nurse Training Acts in the next two decades, and through the largesse of private foundations which supported new types of service models and training programs."
• "Today, NPs have proven their effectiveness in delivering high quality lower cost health care services. Health care consumers, recognizing the value of good service flock to NPs for numerous health care needs."

4. This article is very dependable, because it is an article from PENN Nursing Science. It also is from a dependable source, that works. Which is .edu, and this source is very valid. Much of this article is fact based, so it cannot be biased.

5. This article will help me provide research for my essential question. I will also use it to back up some of the answers I received when I conducted my interview.

http://www.nursing.upenn.edu/nhhc/nurse-practitioners-shaping-the-future-of-health-care/

Assignment #17

I am still working towards my essential question. I have decided to conduct another interview with the questions I asked with Allyson Cole, but With the questions being a little different and interview a doctor for the second interview. I want to see what a doctor thinks on why more medical students are becoming nurse practitioners rather than doctors. I believe this will help to provide answers for my essential question and help to show two sides of the medical field.

Annotated Bibliography Summary

   The source for my bibliography is Pawlyk, Oriana, "Nurse Practitioners to treat Vets without Doctor Supervision." 2016. This article contains information about how the VA passed a nationwide rule that all nurse practitioners that worked at VA hospitals now have the authority to work with patients without doctor supervision. They explain how they want the best care for the retired veterans coming to their hospital, without them having to wait very long for care. Also, now in 21 states and the District of Colombia nurse practitioners can already provide care without doctor supervision, but now with the rule from the VA every nurse practitioner that works with the VA in any state can work without doctor supervision.

     I will be able to use three quotes from this article. The first one says, "The Veterans Affairs Department beginning next month will allow certain nurse practitioners to treat veterans without the supervision of doctors across the agency for the first time." Another quotes that I will be able to use states this, "The regulatory change permits three types of nurse practitioners-- certified nurse practitioner (CNP), clinical nurse specialist (CSN), and certified nurse-midwife (CNM)--"to practice to the full extent of their education, training and certification, without the clinical supervision or mandatory collaboration of physicians, "in states"." The last quote that I am going to use says that, "While in 21 states and the District of Colombia already grant nurse practitioners so-called "full practiced authority," the rule marks the first time in the VA established a nationwide framework for such specialists to provide direct care to Vets throughout the system."

     This article was published on the website Military. com. With it coming from ".com" it could be potentially biased about the topic, but this article is based mainly on facts. The article is about the VA making better care for our countries retired soldiers. It is also credible, because it is based on real facts that are happening in the medical field happening right now. Also, because it is off the additional sources that were given to us. Which was http:/www.sweetsearch.com.

     I will potentially use this in my research for my essential question in my capstone project. It will help to drive my research, and back-up my essential question. Also, it will help me to work harder in my career knowing that nurse practitioners will hopefully soon be able to dominate primary care.
    
    

Annotated Bibliography

Annotated Bibliography Graphic Organizer

Copy and paste to your own document to complete this chart to turn in

 

Name: Morgan Elzey    http://www.military.com/daily-news/2016/12/14/nurse-practitioners-treat-vets-doctor-supervision.html

Source #____ Bibliography (MLA or APA)   10 pts	Pawlyk, Oriana, “Nurse Practitioners to Treat Vets without Doctor Supervision.” 2016
Annotation: (Describe ALL info. that might be important for your paper. Explain to the reader and/or summarize what might be found in this source)   35 pts	This article contains information about how now the VA passed a nationwide rule that all nurse practitioners that worked at VA hospitals now have the authority to work with patients without doctor supervision. They explain how they want the best care for the retired veterans coming to their hospital, without them having to wait very long for care. Also, how in 21 states and the District of Colombia nurse practitioners can already provide care without doctor supervision, but now with the rule from the VA every nurse practitioner that works with the VA in any state can work without doctor supervision.
Potential Quotes: (Are there any significant quotes you can use or paraphrase from this source?)   15 pts	“The Veterans Affairs Department beginning next month will allow certain nurse practitioners to treat veterans without the supervision of doctors across the agency for the first time.”   “The regulatory change permits three types of nurse practitioners -- certified nurse practitioner (CNP), clinical nurse specialist (CNS), and certified nurse-midwife (CNM) -- "to practice to the full extent of their education, training and certification, without the clinical supervision or mandatory collaboration of physicians," it states.”   “While 21 states and the District of Columbia already grant nurse practitioners so-called "full practice authority," the rule marks the first time the VA established a nationwide framework for such specialists to provide direct care to vets throughout its system.”
Assessment: (Analyze and explain why this source is credible)   15 pts	This article was published on the website Military.com, and is about the VA making care better for our counties retired soldiers. It is also credible, because it is based on real facts that our happening in the medical field now. Also, because it is off of the additional sources that were given to us. Which was http:/www.sweetsearch.com.
Reflection: (How will you potentially use it?)   25 pts	I will potentially use this in my research for my essential question in my capstone project. It will help to drive my research and back-up my essential question. Also, it will help me to work harder in my career knowing that nurse practitioners will hopefully soon be able to dominate primary care.

 

Proposal

   There are many things that are driving my research. The most important thing driving my research is helping others and myself to make the right decisions for our future in the field of medicine. There are so many people and websites telling you what is the best decisions to make, and I am trying my best to use my research and my experience from shadowing with Dr. Campbell to put forth a great source for many upcoming medical students to see. Another thing that is driving my research is getting to shadow with Dr. Campbell and Natalie at Campbell Family Medicine. They help me so much with understanding the things that happen on medicine from a doctor's perspective and a nurse practitioner's perspective, and even the perspective of the managing of a doctor's office. The question that is also helping to drive my research is my essential question. It still has not changed since the beginning of the year. It is, "Why do people want to become nurse practitioners rather than doctors, and why do I want to become a nurse practitioner?"
    For my final project I intend to use the required website, but some other tools that I plan to use to showcase my research will be to organize a handbook for my group, and to organize and participate in a debate. Then for my "real inquiry" I will be doing multiple interviews with doctors and nurse practitioners. I will use all of the information and opinions I receive from them to put together a answer to my essential question.

Interview with Allyson Cole, Nurse Practitioner Student

How did you decide to become a Nurse Practitioner?

While pursuing my nursing degree, I worked at an urgent care that utilized lots of mid-level providers (NP’s and PA’s). While working herein that facility, I was fortunate to get to shadow the NP’s and really started to see myself in the role of an advance practice nurse. I loved the interaction with patients, the level of care they provided, and the satisfaction they all seem to have for their job. As a nurse, I felt that being an NP was the avenue that would allow me to make the greatest impact in the health of my community. Also, what drove me to become and NP, was that even as a nurse, I never wanted to work in a hospital. I do not like acute care. I am much more interested in preventative health care which is underutilized by the general public due to financial burden and access. An NP, makes healthcare more attainable by making it more affordable. So, I wanted to become an NP to give more people access to healthcare and to hopefully avoid hospital stays with good health maintenance in the outpatient setting.
Reflection: As Ms. Cole explained how she decided why she wanted to become a nurse practitioner, it surprised me how she said she started off working to become a nurse.  

I loved how she expressed how she looked at both of the positions of the doctor and a nurse practitioner, and how she then chose to become a nurse practitioner. Due to how doctor seemed to be rushed with his/ her patients, and how a nurse practitioner seems to care about spending more time with the patient to find out how to get them better.

Why did you decide to become a Nurse Practitioner, rather than a doctor?

​I decided to become an NP rather than a doctor mainly because I wanted to be a nurse. I grew up with a mother, step-father, and step-mother who were all nurses, so when I went to college I knew that was what I wanted to be too. I wanted to have a good paying job with the ability to care for people all at the same time. I did entertain the idea of going to medical school. What ultimately made me not want to become a doctor was actually working in the hospital and watching the doctorsinteract with their patients. The doctors were so over worked and so rushed when they talked to their patients they usually left the room without addressing the patient’s needs or even laying hands on the patient.  Doctors look at patients like they are science, because that’s how they are trained. Nurses and nurse practitioners looks at patients as a person and address the needs of the patient on a personal level before addressing the needs on a scientific level. (This is a big generalization—there are wonderful doctors out there that care for the patient first before the medical issue, but for the most part doctors are over worked and over stressed and I want to have a life outside of my job).
     Reflection: I like how she said she wanted to become a nurse, because of her close relatives that already were. Then how she then learned the role of the doctor and how they interacted with the patient. I liked how she also addressed how doctor only look at patients as science and nurses and nurse practitioners look as them as real people and working to get them better. 

What are the differences between a Nurse Practitioner and a Doctor?

 ​Main difference between the two is scope of practice, which indicates what a medical professional is and isn’t allowed to do. Each state determines the scope of practice of the Advanced Practice Nurses practicing in that particular state. Scope of practice for the NP is categorized into full practice authority, restricted practice authority, or reduced practice authority. In states with full practice authority (most notably Oregon) there is essentially no differences in the scope of practice between an MD/DO and an NP. Here in Georgia, a restricted practice state, as an NP you can manage your own patients (including diagnosing, medication prescriptions, lab diagnostic ordering and interpretations, and certain procedures-suturing, punch biopsies) with minimal physician oversight. The “restricted” part of Georgia nurse practice act, prohibits NP from prescribing schedule II medications and necessitates 10% of NP charts be signed off by a physician. The NP scope of practice can be expanded with onsite training—for example the NP who is working primarily in a Derm clinic could be trained in melanoma excisions and can perform them, even though for most NP’s this would be out of scope.  

Scope of practice is further differentiated between different types of NP’s, fiimilar to how it is with doctors. In NP school you pick a specialty- Family practice, geriatric primary or acute care, pediatric primary or acute care, neonatal acute care, psychiatric, intensivist, midwifery, or woman health. This further designates what an NP is able to do in their scope. (if you are a primary care NP you generally can no practice in acute care). This is similar to the residency specialization of a doctor, where they receive advanced training in a particular area of medicine and this narrows their scope to that particular area—the primary care doctor is not specially trained in preforming surgery therefore they do not perform surgery. 

Scope of practice is also different between NP’s and PA’s, although most think the rolls are synonymous. The PA scope of practice in all states is limited more than NP’s. The scope of a PA is to preform delegated tasks of an MD. Whereas a NP can work for the most part autonomously, the PA has more physician oversight.   
Reflection: Wow! This is eye opening to the many differences between a nurse practitioner and a doctor, because I have always heard that a nurse practitioner is basically the same as a doctor just a lower degree. It gives a wide perspective of all the differences between them, and some of these really suprised me.

​

It has been said that NP’s and PA’s will soon dominate Primary Care, do you see this happening?

YES! & sooner rather than later! Students getting out of medical school are no longer going into primary care but rather are going either into specialty practice, emergency medicine, or surgery; leaving a huge gap in primary care. Although I do see mid-level providers dominating primary care in the near future, there is much to be done to make this feasible for NP’s. Nurse practice acts have become stricter and narrowed NP’s scope of practice in many states in the last few years. These regulations have to more lax, to allow NP’s to work to the full extent of their education and training before NP’s will be able to totally dominate. 

     Reflection: This really helps to authenticate my essential question, because it shows a medical student who has considered and experienced shadowing doctors and nurse practitioners and how they feel towards why so many people are becoming nurse practitioners rather than doctors.

What do you plan to specialize in as an NP? With your specialty could I work in another department?

I am getting an FNP, which a Family Nurse Practitioner. This is the broadest in terms scope of any specialty education for an NP. With an FNP my scope includes pediatrics, adolescents, adults, geriatrics, women’s health, and psychiatric. Essentially I can work in any specialty (cardiology, pulmonology, urology, ect). I do plan to work to the full extent of my scope by working in a family care practice upon graduation. But, I have a large interest in dermatology and at some point in my career would love to work in a dermatology clinic. 

     Reflection: I like this question and how Ms. Allyson answers it, because many people nurse practitioners can only go into limited practices. When in reality Ms. Cole says they can work in many specialties. 

Explain the education you have and are receiving to become an NP?

To become an NP you must first be a Registered Nurse with a Bachelors of Science in Nursing (4 year degree). Then to be able to sit for certification exams to become an Advanced Practice Nurse or NP, currently you must complete a Master’s of Science in Nursing degree. There is talk of changing the rule to become an advance practice nurse to a doctoral degree rather than a masters but this has not been changed yet!

The education I am currently receiving is both in the classroom and in clinic. I take a full class load, 16 hours of didactic work that is supplemented by 360 hours’ worth of clinic work with a preceptor per semester. Most NP schools take 2 years to complete but the program I am attending is an accelerated master’s program and only takes one year to finish!

     Reflection: I thought it was really cool how Ms. Cole has received her education, because it shows that you can take many paths that can get you where you want to eventually be. 

Where did you go to College?

I took the roundabout way to my BSN—I went to a school that still had an Associate Degree of nursing, so I received my ASN from University of North Georgia(3year program), then my BSN from Georgia College (one year program), and I am currently pursuing master’s degree from Vanderbilt University which in total will take one year. I hope to continue my education to receive a doctorate through Vanderbilt after graduation with my masters. The Doctoral program will take another 4 semesters to complete. 

     Reflection: I thought it was really Cool how she went to many different colleges, and by doing this even though it might of worried her at the time for doing that it really worked and helped her finish school earlier. 

If you could do it again would you change anything?

​No, at least I don’t feel like that now. I always thought I would regret going through an ASN program and then a BSN program. But, the way I did it got me out into practice sooner where I really was able to learn and master the art of nursing. I do feel like at the end of this year in NP school I will have wished it would not have gone by so fast (at least that’s what all my professors say). So in a year my answer to this would probably be: I wish I would have taken advantage of having a preceptor following up on all of my patients. 

     Reflection: It really encourages me to hear that she wouldn't do anything over or differently. This happened because she was so self-motivated and worked her hardest. It also makes me excited to keep on my journey to becoming a nurse practitioner. 

Do have advice for future NP’s?

​Go into every experience with an open mind! This is for nurses or just anyone wanting to go into any aspect of the medical field as well. You may think going into nursing school or NP school that you absolutely want to work with one population and one population only, but once you get into other areas of nursing you may find yourself loving something you never in a million years thought you would love. And if your mind is so closed off to other areas you won’t ever get to that realization! 

​Also, work in the medical field as soon as possible. Get a job at the front desk of an office, work as a tech on the floor of a hospital, anything to get exposure to real life medical problems. This real world experience is better than anything you get in the classroom! And the connections you make will usually come to your benefit later down the road!

     Reflection: I like how she encourages anyone who wants to work in the medical field to get in as soon as possible as working in the front desk and really diving I to show that you are serious and hardworking!