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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
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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 (LP)
• Opththalmology (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.
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