EP 228: Exploring the World of Registry and PRN Nursing: Flexibility, Pay, and Considerations

EP 228: Exploring the World of Registry and PRN Nursing: Flexibility, Pay, and Considerations

Exploring the World of Registry and PRN Nursing: Flexibility, Pay, and Considerations

Navigating Nursing’s Flexible Path – Registry and PRN Nursing

In the realm of nursing, there exists a lesser-known yet highly sought-after avenue: registry and PRN nursing. These terms might sound unfamiliar to some, but they represent a unique approach to nursing that offers both flexibility and the potential for higher pay. In this blog post, we’ll delve into the world of registry and PRN nursing, exploring how they work, the benefits they offer, and the considerations that nurses should keep in mind.

How it Works: Understanding Registry and PRN Nursing

Registry nursing and PRN nursing share a common thread – they both involve providing nursing care on an as-needed basis, without committing to a fixed schedule. However, there are some distinctions between the two:

1. Registry Nursing:

Registry nursing involves signing up with a nursing agency, which acts as a intermediary between nurses and healthcare facilities. Nurses on the registry list make themselves available to fill in staffing gaps in hospitals, clinics, and other healthcare settings. When a facility needs extra help due to staff shortages, they can request nurses from the registry.

2. PRN Nursing:

PRN nursing, which stands for “pro re nata” (as needed), is a direct arrangement between a nurse and a healthcare facility. PRN nurses are scheduled on an as-needed basis, often filling in for staff vacancies or during peak periods. Unlike registry nursing, PRN nurses typically establish a relationship with a specific facility.

Shifts and Hours: Finding the Balance

One of the most appealing aspects of registry and PRN nursing is the flexibility they offer. Nurses can decide when they want to work, allowing for a better work-life balance. Shifts can range from part-time to full-time, with some nurses even choosing to work sporadically to accommodate other commitments.

Pay: The Financial Upside

One of the major draws of registry and PRN nursing is the potential for higher pay compared to traditional full-time or part-time positions. Healthcare facilities often pay a premium to registry and PRN nurses to entice them to fill in when staffing is low. This can translate to a more attractive paycheck for those willing to take on these roles.

Benefits: Beyond the Paycheck

While the pay might be higher, it’s important to note that registry and PRN nursing roles often do not come with benefits such as health insurance, retirement plans, or paid time off. Nurses considering these roles should carefully weigh the financial benefits against the potential lack of job security and benefits.

The Appeal: Why Nurses Choose Registry and PRN Nursing

Flexibility: For nurses with families, other commitments, or simply a desire for a more adaptable schedule, registry and PRN nursing can offer the flexibility they crave.

Variety: Working in different healthcare settings provides a chance to gain a wide range of experience and exposure to various medical specialties.

Higher Pay: The prospect of higher earnings can be a major motivator, especially for nurses looking to maximize their income.

The Considerations: Downsides of Registry and PRN Nursing

Lack of Benefits: The absence of benefits can be a significant drawback, particularly for those who rely on employer-sponsored healthcare or retirement plans.

Job Insecurity: The unpredictable nature of registry and PRN nursing means that there might be periods of low demand, leading to potential gaps in income.

Limited Connection: As a registry or PRN nurse, you may not develop the same level of camaraderie or familiarity with colleagues and patients as full-time nurses.

Balancing Flexibility and Stability

Registry and PRN nursing offer an alternative path for nurses seeking greater flexibility, higher pay, and a diverse range of experiences. However, the decision to pursue these roles should be made with careful consideration of the potential downsides, including the lack of benefits and job security. Ultimately, finding the right balance between the allure of flexible schedules and the stability of traditional nursing positions is a personal choice that each nurse must make.


Watch the full episode: https://youtu.be/bGHJdK49IGE

EP 227: Healthcare Price Exposed: Unraveling the Truth Behind Costs

EP 227: Healthcare Price Exposed: Unraveling the Truth Behind Costs

Surgical Costs Exposed: Unmasking Hidden Expenses

The healthcare industry is an intricate ecosystem, where patients and providers navigate a labyrinth of policies, practices, and pricing structures. Unfortunately, one of the most perplexing aspects of healthcare is the lack of transparent pricing, especially when it comes to surgeries. Patients often find themselves in the dark about the true cost of medical procedures, leaving them grappling with financial uncertainties. In this comprehensive blog post, we will delve deeper into the intricacies behind hospitals’ reluctance to disclose surgery costs, exploring various factors that contribute to this enigma.

Fragmented Pricing: Navigating a Complex Landscape

The financial aspect of healthcare is not straightforward. Hospitals have to deal with multiple parties, such as insurance companies, government programs, and other third-party payers, resulting in a fragmented pricing landscape. Each of these entities negotiates their rates for specific procedures, leading to a wide range of prices for the same surgery. Consequently, presenting standardized prices for surgeries becomes an uphill battle for hospitals, given the multitude of variations in pricing based on the patient’s insurance coverage or payment method.

To add to the complexity, hospitals may even negotiate different rates for the same surgery with different insurance providers or individual patients. The lack of a unified pricing structure makes it challenging for hospitals to disclose a single, all-encompassing cost for a particular surgical procedure.

Unveiling Billing Practices: Discrepancies and Realities

Behind the scenes of healthcare billing lies a maze of complexities. Hospitals maintain a charge master, a comprehensive list of services and procedures with their respective prices. However, these prices often diverge from the actual amounts patients with insurance end up paying. Insurance companies negotiate discounts and rates with hospitals, resulting in different billed amounts depending on the insurer’s agreements. This leads to a significant difference between the price on the charge master and what patients ultimately pay out of pocket.

Furthermore, individual cases may present varying complexities, leading to additional services, tests, or post-operative care. These additional elements further contribute to discrepancies between the originally billed amount and the actual final cost, making it difficult for hospitals to offer patients precise cost estimates upfront.

The Competitive Landscape: Negotiation and Discretion

Competition is fierce within the healthcare industry. Hospitals must vie for patient loyalty and secure profitable contracts with insurance providers. To maintain their market position, hospitals often engage in negotiations with various insurance companies and third-party payers. They may offer preferential pricing to some insurers in exchange for a larger patient volume or more favorable terms.

As hospitals navigate these competitive waters, they may be hesitant to disclose their negotiated rates openly. Revealing such information could potentially compromise their bargaining power, resulting in less favorable agreements with insurers and diminishing their competitive advantage.

The Absence of Consumer Pressure: The Urgency Factor

Unlike consumer goods and services, healthcare often involves urgent or critical medical needs. When facing a medical emergency or a necessary surgical procedure, patients may not have the luxury of time to shop around for the best price. The urgency of healthcare decisions limits patients’ ability to compare prices or negotiate costs, reducing the pressure on hospitals to be transparent with their pricing.

The Complexity of Variable Costs: Beyond One-Size-Fits-All

The cost of a surgery is not a one-size-fits-all figure. It varies significantly based on multiple factors, including the complexity of the procedure, the patient’s medical condition, the need for specialized equipment or personnel, and post-surgery care requirements. Each patient’s case is unique, leading to a wide range of potential expenses.

Attempting to provide a standard cost for surgeries that encompasses all possible scenarios is an immense challenge for hospitals. Instead, cost estimates may be best suited to be tailored to individual cases, taking into account the specific variables and nuances associated with each patient’s situation.

Unlocking a Transparent Culture: A Paradigm Shift

Transparency in healthcare has been a long-standing challenge. While some hospitals are becoming more willing to disclose prices, the overall culture within the industry has been relatively opaque. Achieving transparency requires a transformative shift in the entire healthcare system, involving collaboration among hospitals, insurance companies, and regulatory bodies.

To foster a culture of transparency, stakeholders must work together to establish standardized pricing mechanisms, promote patient education about costs and billing processes, and streamline communication channels between healthcare providers and patients. Additionally, innovative technological solutions, such as price transparency tools and online cost estimators, can empower patients to make more informed decisions about their medical care.



The complexities of hospital surgery costs are deeply intertwined with the fragmented pricing landscape, billing practices, competitive dynamics, urgency factor, variable costs, and the prevailing transparency culture. These factors collectively contribute to hospitals’ reluctance to disclose surgery prices, leaving patients grappling with financial uncertainties in the face of medical needs.

While strides are being made to enhance price transparency in healthcare, achieving comprehensive and straightforward pricing transparency remains an ambitious endeavor. Addressing the multifaceted nature of this challenge necessitates unwavering commitment and cooperation from all stakeholders involved. Only through collective effort can we create a more patient-centered healthcare landscape, where pricing transparency becomes the norm, and patients can navigate medical decisions with confidence and clarity. As we strive for a more transparent healthcare system, we inch closer to a future where patients can confidently access high-quality care without being burdened by financial uncertainties.


Watch the full episode: https://youtu.be/A8oypZ85FVk

EP 226: Navigating Ethical Dilemmas in Nursing: Real-Life Scenarios

EP 226: Navigating Ethical Dilemmas in Nursing: Real-Life Scenarios

Navigating Ethical Dilemmas in Nursing Practice: Real-Life Scenarios

Nurses play a critical role in patient care, advocating for their well-being and ensuring ethical standards are upheld. However, the complex nature of healthcare often presents nurses with challenging ethical dilemmas. In this blog post, we will explore real-life scenarios where nurses encounter ethical challenges, ranging from respecting patient autonomy to navigating conflicts of interest. Let’s delve into these thought-provoking scenarios and discuss how nurses can navigate these ethical dilemmas while prioritizing patient safety and care.

Patient Autonomy vs. Beneficence:

Scenario: A pregnant patient with a life-threatening medical condition insists on continuing with a treatment that poses serious risks to her and the unborn child. The medical team believes that the treatment should be postponed until after childbirth to maximize chances of survival for both, but the patient is adamant about proceeding with the treatment. How can the nurse respect the patient’s autonomy while also ensuring the best outcome for both the patient and her baby?

End-of-Life Care:

Scenario: A patient’s advanced directive states they do not want to be kept on life support if they become terminally ill. However, the patient’s family disagrees with this decision and insists on pursuing all available life-sustaining treatments. The patient is unable to communicate due to their condition. How can the nurse advocate for the patient’s end-of-life wishes while balancing the family’s desires and emotions?

Resource Allocation:

Scenario: A hospital is dealing with a surge of patients, and there is a shortage of ventilators in the intensive care unit (ICU). Nurses must decide which patients should receive the limited number of ventilators, knowing that some patients may not survive without this life-saving equipment. Additionally, some patients may have pre-existing health conditions that put them at higher risk for severe complications.

Confidentiality and Privacy:

Scenario: A nurse discovers that a prominent public figure has been admitted to the hospital for a sensitive medical issue. The nurse faces pressure from the media and public to disclose the patient’s condition, but doing so would breach patient confidentiality. How can the nurse uphold patient privacy and confidentiality in the face of external pressures?

Informed Consent:

Scenario: A patient is admitted to the hospital with a life-threatening condition, and urgent surgery is recommended. However, the patient is in a state of confusion and is unable to provide informed consent. The patient’s family is unavailable, and the medical team must make a rapid decision. How can the nurse ensure the patient’s best interests are served while acting in the patient’s best interest under emergent circumstances?

Cultural and Religious Beliefs:

Scenario: A young patient’s parents belong to a religious group that rejects modern medical interventions. The child has a treatable condition, but the parents insist on using only prayer and faith-based remedies. The medical team believes the child’s life could be saved with medical intervention. How can the nurse navigate this ethically challenging situation that involves potentially life-saving medical treatment and respecting the parents’ religious beliefs?

Refusal of Treatment:

Scenario: An adult patient with a severe psychiatric condition refuses to take essential medications, which have previously been effective in managing their symptoms. The patient’s condition worsens significantly, and they pose a danger to themselves and others. The patient’s refusal raises ethical concerns, as they are unable to make rational decisions in their current state. How can the nurse balance respecting the patient’s autonomy with ensuring their safety and well-being?


Scenario: A nurse working in a prestigious hospital discovers that some physicians and surgeons are engaging in unethical practices to manipulate patient data, including falsifying medical records and test results. The purpose of these actions is to move certain patients higher up on transplant lists and make them appear more eligible for specific surgeries, even when other patients may have a more urgent medical need. The nurse is deeply troubled by these manipulations, as they compromise the integrity of patient care, prioritize certain individuals over others unfairly, and potentially put lives at risk. However, the nurse fears the repercussions of reporting this misconduct, knowing that the involved physicians are influential within the hospital and may have strong connections with hospital administrators.

Conflict of Interest:

Scenario: A nurse working in a pharmaceutical company is asked to participate in a research study evaluating a medication produced by the company. The nurse is aware that the medication has potentially serious side effects that are not adequately disclosed to study participants. How can the nurse navigate the conflict between professional obligations and the company’s interests?

Social Media and Privacy:

Scenario: A nurse posts a photo on social media, inadvertently capturing a patient’s face in the background. Despite not identifying the patient by name, the post leads to the patient’s identity being revealed in the comments section, breaching their privacy. How can the nurse address the inadvertent violation of the patient’s privacy and take appropriate measures to rectify the situation?

As healthcare professionals, nurses face complex ethical dilemmas that require critical thinking, compassion, and a commitment to patient advocacy. By exploring these real-life scenarios, we have gained insight into the challenges nurses may encounter and the importance of upholding ethical principles in providing quality patient care. Through continued education, open communication, and support from colleagues and institutions, nurses can navigate these ethical dilemmas while remaining steadfast in their commitment to patient well-being and safety.

Watch the full episode: https://youtu.be/GFYVgduFV_k

EP 225: 2023 Nursing Strikes and Their Outcomes

EP 225: 2023 Nursing Strikes and Their Outcomes

2023 Nursing Strikes and Their Outcomes

Nurses are a crucial part of the healthcare industry, playing a vital role in patient care and well-being. However, in recent years, the United States has witnessed an increase in nurse strikes, which serve as a means for nurses to demand better working conditions and advocate for their rights.

First, we will go over what a strike means and then the nursing strikes we’ve had in 2023.

Understanding Nurse Strikes

A nurse strike is a labor action where nurses refuse to work as a form of protest against their employer. It is a response to various issues such as poor working conditions, inadequate staffing, low wages, and lack of benefits. Nurse strikes aim to bring attention to these concerns and prompt employers to address them by disrupting the provision of healthcare services.

Consequences and Risks of Nurse Strikes

Nurse strikes can have both immediate and long-term consequences for nurses and patients alike. Patients may experience:

  • Delays in receiving care
  • Potential lack of attention during the strike

Nurses who participate in strikes face:

  • Financial loss
  • Potential damage to their professional standing
  • Disruptions to their personal and family lives

However, nurses typically view strikes as a last resort after exhausting other communication and negotiation channels.

Reasons for Nurse Strikes

Nurses engage in strikes due to several underlying issues, including:

  • Poor working conditions
  • Low wages
  • Inadequate staffing
  • Lack of benefits

Increasing demands placed on nurses include:

  • Additional roles
  • Extra shifts
  • Heavier patient loads, contribute to stress, burnout, and compromised patient care.

Impact of Nurse Strikes on Patients

Nurse strikes have a significant impact on patients, affecting their access to quality healthcare. This can result in:

  • Increased risks of medical errors, infections, and complications
  • Challenges for patients requiring specialized treatment or 24-hour care
  • Exacerbation of existing staffing issues, compromising patient safety

Expectations During Nurse Strikes

When nurse strikes are anticipated, several key actions and measures are typically implemented, including:

  • Striking nurses providing advance notice
  • Employment of temporary replacements, such as travel nurses, to fill staffing gaps
  • Transfer of patients to adjacent healthcare institutions
  • Hiring temporary employees to assist during the strike

However, the presence of unfamiliar staff and protocols can result in potential inconsistencies in patient care and lower-quality service.

The Future of Nurse Strikes

Given the ongoing challenges faced by nurses, including staffing shortages and inadequate working conditions, nurse strikes are expected to continue in the coming years. The COVID-19 pandemic has exacerbated these issues, with a significant reduction in the nursing workforce. Nurses will likely persist in their demands for:

  • Better wages
  • Improved working conditions
  • Adequate staffing ratios to ensure safe and effective patient care.

Nurse Strikes in 2023

The following are notable nurse strikes that occurred in the year 2023:

January 2023: Seven Hospitals in New York City

Who: 12,000 nurses at seven hospitals in New York City, including:

  • Health System of BronxCare
  • Hospital Medical Center of Flushing
  • Medical Center of Maimonides
  • Mount Sinai Bronx
  • Mt. Sinai Medical Center
  • Mount Sinai West and Morningside
  • University Medical Center of Richmond

Reason: The strike was in response to:

  • Inadequate staff members
  • Frequent staff turnover
  • Fatigue

Outcome: After a three-day strike, the parties reached an agreement on a three-year contract. The contract included the following provisions:

  • Introduction of enhanced staffing standards and enforcement
  • Improvement in healthcare benefits
  • Salary increases of 7%, 6%, and 5% over the three-year contract period

January 9-11, 2023: Montefiore Medical Center and Mount Sinai Hospital, New York

Who: 7,000 nurses at Montefiore Medical Center in the Bronx and Mount Sinai Hospital in Manhattan, New York

Reason: The strike was in response to:

  • Numerous staffing shortages
  • Fatigued nurses from pandemic-related overwork
  • Inadequate training process for new nurses
  • Nurses managing dangerously high caseloads

Outcome: After coming to tentative deals with management on better staffing and pay, the strike was ended by thousands of New York City nurses. The tentative agreements at Montefiore Medical Center in the Bronx and Mount Sinai Hospital in Manhattan involve raises totaling 19% over three years.

January 2023: MyMichigan Alma and McLaren Central in Michigan

Who: 150 nurses work at MyMichigan Alma and 100 at McLaren Central in Michigan

Reason: Nurses at MyMichigan Alma and McLaren Central had been working under expired contracts since November 2022. 

They claimed that hospitals engaged in unfair labor practices, such as bad faith negotiating.

Outcome: A strike was averted as agreements were reached before a settlement. 

  • Agreements were reached, preventing the need for a work stoppage. 
  • A new three-year contract was approved by the nurses at McLaren Central Hospital in Mount Pleasant, and nurses at MyMichigan Alma endorsed their tentative deal. 
  • Both contracts were immediately implemented upon ratification.

February 27, 2023: South Shore University Hospital Northwell Health (SSUH) in Bay Shore, New York

Who: 800 employees at South Shore University Hospital Northwell Health (SSUH) in Bay Shore, New York

Reason: The strike was in response to:

  • Better salaries
  • Safe staffing ratios

Outcome: A strike was averted as a tentative deal was struck. The tentative agreement includes provisions for:

  • Wage increase
  • Improved compensation to retain nurses
  • Enforcement of safe staffing standards
  • Enhancements to retiree health benefits

March 20, 2023: Henry Mayo Newhall Hospital in Valencia, California

Who: 700 employees at Henry Mayo Newhall Hospital

Reason: The strike was in response to:

  • Unfair contract
  • Retaliation threats against workers’ rights to engage in concerted union activity
  • Interference with union bargaining committee member’s participation in contract negotiations
  • Failure to provide timely information requested for negotiations
  • Refusal to address low wages in negotiations

Outcome: This one-day strike marked the first strike in the union’s 19-year history. The purpose of the strike was to pressure the hospital’s management to cease illegal bargaining strategies and engage in sincere talks to address high employee turnover. Discussions for a new collective bargaining agreement are underway between employees and Henry Mayo.

March 28, 2023: MarinHealth Medical Center in Greenbrae, California

Who: Nearly 600 nurses at MarinHealth Medical Center

Reason: The strike was in response to:

  • Alleged hospital administration’s refusal to address nurses’ concerns regarding patient care, safe staffing, nurse retention, and recruitment

Outcome: A strike was averted as registered nurses tentatively agreed to a three-year contract on March 21, 2023. The contract includes provisions for:

  • Health and safety measures
  • Provision of personal protective equipment (PPE)
  • Establishment of an Infectious Disease Subcommittee
  • Implementation of safe staffing provisions
  • Health benefits improvements
  • Measures to enhance nurse retention and recruitment
  • A 16.5% wage increase over three years

May 2-4, 2023: St. Rose Hospital in Hayward, California, and John Muir Behavioral Health Center in Concord, California

Who: 200 registered nurses at St. Rose Hospital in Hayward, California, and 78 registered nurses at John Muir Behavioral Health Center in Concord, California

Reason: The strike was in response to:

  • Hazardous staffing levels
  • Poor working conditions
  • Inadequate pay
  • Management’s refusal to respond to nurses’ requests for fair contracts

Outcome: At the last minute, a two-day nurses’ strike at St. Rose Hospital in Hayward was called off due to progress in contract negotiations. The contract negotiated by the John Muir nurses and the union after 30 bargaining sessions may be put to a vote if the union leaders agree or permit a vote.

May: PIH Health Good Samaritan Hospital (PIH GSH) in Los Angeles, California

Who: Registered nurses at PIH Health-Good Samaritan Hospital in Los Angeles, California

Reason: The registered nurses at PIH Health-Good Samaritan Hospital in Los Angeles, California had concerns regarding patient safety due to management actions, including:

  • Understaffing
  • Inadequate supervision of safe meals and rest breaks by RNs
  • Poor patient outcomes

Outcome: Strike averted

  • A one-day strike scheduled to start on May 11 was avoided.
  • Registered nurses reached a tentative deal on May 6, 2023.
  • The agreement will be in effect until November 2025.

May 22, 2023: HCA Healthcare

Who: 3,000 healthcare workers at HCA Healthcare

Reason: The healthcare workers at HCA Healthcare had concerns regarding:

  • Staff shortage
  • Nurse retention
  • Poor working conditions

Outcome: Strike averted

  • Five HCA hospitals in California were at risk of being impacted by the strike.
  • Negotiations between the parties resulted in the cancellation of the strike.
  • A tentative agreement was reached on the new contract.
  • The agreement includes significant investments in the workforce and salary increases to retain experienced healthcare workers.
  • Over a period of three years, a raise of 15% will be implemented.
  • The agreement also ensures the protection of healthcare and education benefits for workers.

June 12, 2023: St. Charles Health System’s Bend in Central Oregon

Who: Nearly 1,000 nurses represented by the Oregon Nurses Association at St. Charles Health System’s Bend in Central Oregon

Reason: The nurses at St. Charles Health System’s Bend had concerns regarding:

  • Inadequate staffing to meet patient demand
  • Better pay
  • Nurse retention issues

Outcome: Strike averted

  • After over 40 hours of negotiations, the Oregon Nurses Association and St. Charles Bend reached a tentative contract early on Thursday.
  • The tentative agreement addresses several key issues, including:
  • Guaranteed meal breaks
  • Increased compensation
  • Security of employment in the event of a change in hospital ownership
  • The agreement is subject to the approval of the nearly 1,000 nurses represented by the nurses’ union, who must vote on the tentative agreement.

June 12, 2023: NewYork-Presbyterian Brooklyn Methodist Hospital

Who: About 1,250 nurses at NewYork-Presbyterian Brooklyn Methodist Hospital

Reason: The nurses at NewYork-Presbyterian Brooklyn Methodist Hospital had concerns regarding:

  • Staffing cuts leading to unsafe patient care

Outcome: Strike averted

  • Nurses were initially scheduled to go on an indefinite strike on June 12.
  • However, a new contract has been approved by members of the New York State Nurses Association, allowing them to avoid the strike.
  • The agreement includes the following provisions:
    • Full retroactive pay for the nurses
    • Three years’ worth of pay increases totaling 18%.
  • These terms ensure that nurses will receive fair compensation for their work.

June 19, 2023, Providence Portland Medical Center, Providence Seaside Hospital, and Providence Home Health and Hospice

Who: Roughly 1,800 nurses at Providence Portland Medical Center, Providence Seaside Hospital, and Providence Home Health and Hospice

Reason: The nurses at these facilities have raised concerns about:

  • Unfair labor practices
  • Failing practice standards
  • Overuse of temporary nurses
  • Unsafe nurse-to-patient ratios
  • Failed nurse retention
  • In late May and early June, union members voted to approve strikes.
  • Contract talks between nurses, clinicians, and management began in the fall of 2022.
  • The most recent contract expired in 2022.

Outcome: Current negotiations and bargaining are ongoing. 

Looking at the financials for Providence in Oregon

1st quarter numbers of 2023

  • Total hospital value of assets: $28,806,511,000
  • Net assets (assets – liabilities): $17,224,530,000
  • Cash and Cash equivalents on hand: $1,233,382,000
  • From 2019-2022 total salaries and benefits went up 15%
    • This doesn’t mean RNs got paid 15% more, the total of all employees, CEOs, Managers, administrators, and benefits
  • Operating expenses Q1 2023: -$345,000,000 (-$510,000,000 in 2022)
    • Keep in mind hospitals lost millions to billions of dollars in 2021 and 2022 but it looks like they are slowly making it back


June 27, 2023: Ascension Seton Medical Center Austin (ASMCA)

Who: 900 registered nurses at Ascension Seton Medical Center Austin (ASMCA)

Reason: The registered nurses at ASMCA have cited concerns related to:

  • Unsafe staffing levels
  • Alleged mismanagement of resources by hospital administrators

Outcome: Current negotiations and bargaining are ongoing. Historic one-day strike at Ascension Seton Medical Center in Austin (ASMCA), the largest nurse strike in Texas history. 

  • Nurses were locked out until July 1st as the hospital hired temp nurses to fill the strike.
  • Nurses will not be sharing details of negotiations publicly, out of respect for the process and to ensure Ascension will settle strong contracts as soon as possible.


Watch the full episode: https://youtu.be/250grmnCPXM

EP 224: Should I Become a a Nurse Practitioner?

EP 224: Should I Become a a Nurse Practitioner?

Becoming a Nurse Practitioner

Are you a registered nurse (RN) with a Bachelor of Science in Nursing (BSN) looking to take your career to the next level? If so, becoming a nurse practitioner (NP) might be the ideal path for you. In this blog post, we will explore the journey of becoming a nurse practitioner, comparing the different routes available, discussing the financial aspects, and highlighting the increased autonomy that comes with this advanced nursing role.

Exploring Specializations: Different Types of Nurse Practitioners

As a nurse practitioner, you have the opportunity to specialize in various areas of healthcare, tailoring your expertise to specific patient populations and healthcare needs. Here are some common types of nurse practitioners:

  • Family Nurse Practitioner (FNP): 
      1. FNPs provide primary care across the lifespan, from newborns to older adults. They diagnose and treat common acute and chronic conditions, offer preventive care, perform routine check-ups, and collaborate with other healthcare professionals to promote overall wellness.
  • Adult-Gerontology Nurse Practitioner (AGNP): 
      1. AGNPs specialize in the care of adults, including young adults, middle-aged adults, and older adults. They manage acute and chronic illnesses, conduct health assessments, and focus on health promotion, disease prevention, and management of age-related conditions.
  • Pediatric Nurse Practitioner (PNP): 
      1. PNPs focus on delivering primary care to infants, children, and adolescents. They provide well-child exams, immunizations, and developmental screenings, and manage common pediatric illnesses and conditions. PNPs play a crucial role in promoting children’s health and supporting families.
  • Psychiatric-Mental Health Nurse Practitioner (PMHNP): 
      1. PMHNPs specialize in mental health and psychiatric care across the lifespan. They assess, diagnose, and manage mental health disorders, prescribe medications, provide therapy, and collaborate with interdisciplinary teams to promote mental well-being.
  • Women’s Health Nurse Practitioner (WHNP): 
      1. WHNPs specialize in women’s health, including reproductive health, gynecological care, prenatal care, family planning, and menopausal management. They conduct screenings, offer health education, and provide comprehensive care to women throughout their lifespan.
  • Acute Care Nurse Practitioner (ACNP): 
      1. ACNPs are trained to manage acute and critical illnesses in various settings, such as emergency departments, intensive care units, and specialty clinics. They provide complex care, perform procedures, order and interpret diagnostic tests, and collaborate with other healthcare professionals in emergency situations.
  • Neonatal Nurse Practitioner (NNP): 
      1. NNPs specialize in the care of newborn infants, particularly those who are premature, critically ill, or have complex medical conditions. They provide comprehensive care, perform procedures, monitor growth and development, and support families in neonatal intensive care units (NICUs) and other neonatal settings.
  • Geriatric Nurse Practitioner (GNP): 
    1. GNPs focus on the specialized needs of older adults, including managing chronic illnesses, promoting healthy aging, and addressing age-related issues. They work in various settings, including long-term care facilities, assisted living centers, and geriatric clinics.

Different Routes to Becoming a Nurse Practitioner

Aspiring nurse practitioners have multiple paths to choose from based on their prior education and experience. The two main routes are:

  • Master of Science in Nursing (MSN): This is the most common and traditional path for becoming an NP. It typically requires two to three years of additional education beyond the BSN degree. MSN programs offer specialized tracks such as Family Nurse Practitioner (FNP), Adult-Gerontology Nurse Practitioner (AGNP), Pediatric Nurse Practitioner (PNP), and more.
  • Doctor of Nursing Practice (DNP): This is a terminal degree in nursing and provides the highest level of education for NPs. DNP programs typically take three to four years to complete, with an emphasis on advanced clinical skills, leadership, and evidence-based practice.

Financial Considerations

When considering the financial aspect of becoming a nurse practitioner, it’s important to factor in the cost of tuition and the potential pay increase. The average tuition for an MSN program ranges from $20,000 to $60,000, depending on the institution and location. On the other hand, DNP programs can cost between $30,000 and $100,000. While these figures may seem significant, it’s essential to remember that many nurses qualify for financial aid, scholarships, and loan forgiveness programs.

Pay Increase and Professional Growth

One of the most compelling reasons to pursue a career as a nurse practitioner is the potential for a substantial pay increase compared to an RN with a BSN. According to the Bureau of Labor Statistics, the median annual wage for nurse practitioners was between $115,890 and $135,677 significantly higher than the median wage for registered nurses. Moreover, NPs have greater opportunities for advancement, specialization, and leadership roles within the healthcare system.

Autonomy and Expanded Scope of Practice

Transitioning from an RN to an NP brings an increase in autonomy and a broader scope of practice. NPs are trained to assess, diagnose, and treat patients, order and interpret diagnostic tests, prescribe medications, and provide comprehensive care. While they work collaboratively with physicians, NPs often have more independence in managing patient care, particularly in primary care settings and underserved areas where access to physicians may be limited.

Duration of Schooling

The length of time required to become a nurse practitioner depends on the educational path chosen. MSN programs generally range from two to three years, while DNP programs typically require three to four years. It’s important to consider personal circumstances, such as work commitments and family obligations, when deciding which path is most feasible.


Becoming a nurse practitioner is an excellent way to advance your nursing career, enhance your earning potential, and gain more autonomy in patient care. Whether you choose the MSN or DNP route, embarking on this journey will provide you with the necessary skills and knowledge to make a lasting impact on the lives of your patients. By exploring the various types of nurse practitioners, you can find a specialized area that aligns with your passion and contributes to the health and well-being of individuals and communities. So, if you’re ready to embrace the challenges of an advanced nursing role and make a significant difference in the world of healthcare, becoming a nurse practitioner may be the right path for you.

Remember, your journey as a nurse practitioner is not just a step forward; it’s a leap toward making a significant difference in the lives of individuals and communities.

Watch the full episode: https://youtu.be/Ad4ffRlvIac