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.