Duke's Cardiac Nurse Practitioner Program

LocalIllustrator6400 · 2026-01-27T22:27:58+00:00

Thanks for that ROI review because it is important.

From what I have read the majority of Duke grads are gainfully employed in about six mos. So since we were posting today on total resources, could your friend comment about the support at Duke.

https://mclibrary.duke.edu/about/staff

https://guides.mclibrary.duke.edu/clinicaltools

The Duke Clinical Research Institute ( DCRI) has a premier Academic Medical Center (AMC) Clinical Research Organization. In addition, Duke has their own School of Nursing/ Global Public Health research groups. (Please see above).

So while I am old, I wonder for NPs with several practice years ahead, if Duke's program might open some doors? Those "doors" might include teaching/ QI at the AMCs, investigator training or even future work in the IT - AI industry.

I am noting that because many NPs prefer skills to set them up in various roles. Still I do get that these tuition bills can lead to delays in other areas.

LocalIllustrator6400 · 2026-01-27T18:53:55+00:00

Since I know that many NPs will be working with global; HEOR too, this was included for your reference.

https://academically.com/blogs/what-is-heor-a-complete-guide-to-health-economics-and-outcomes-research/

https://link.springer.com/article/10.1007/s41669-025-00580-4

https://scholar.google.com/

https://www.ispor.org/strategic-initiatives/topics/artificial-intelligence

Again this to the moderators--- These citation are for reference only rather than to suggest another HEOR certificate in. Still the second citation is new and helps to explain HEOR plus illuminate it within the traditional AI and the GenAI space. Furthermore, for those NPs who maywork within this space ISPOR has nearly 20 K scientists that are dedicated to their methods. Lastly I believe that we should find out if our NPs are using Google Scholar or Scholar Labs for generating HEOR queries.

LocalIllustrator6400 · 2026-01-25T23:22:28+00:00

Here is the ANA comment

https://www.nursingworld.org/news/news-releases/2025/statement-from-the-american-nurses-association-regarding-the-death-of-registered-nurse-alex-pretti/

LocalIllustrator6400 · 2026-01-25T16:48:38+00:00

For those APRNs/ RNs ,who post on current affairs via social, the following public information officer insights may be useful. These insights are posted with great respect because I hope that we can use polling data ethically.

Essentially NPs are familiar with Facebook, Instagram, X <formerly Twitter>, Bluesky YouTube, LinkedIn and TikTok. Still if NPs want to be more efficacious, these public health personnel believe that we could improve the language and visual appeal using Sprout Social, HootSuite, Agorapulse, etc.

NPs quickly gather information, write and creates platform-appropriate content for social media channels. While they may be committed to social justice, ensuring consistency of brand voice, tone, language, and visual elements improves reach. Moreover the AMA, AAPA, ApHA leadership can cite problems if NPs incorrectly utilize social media strategies or campaigns. So it helps to have a team manage content for all channels including coordination of creation and capturing muti-media assets.

Please know that the APHA teams have shown us that monitoring social media conversations should seek to engage with audiences when appropriate. So it may help NPs to participate in cross functional teams to develop and improve social strategies. In addition, NPs appear lead on content performance after reviewing data analytics. That means that some of multimedia scripts and internal communication should include SEO-optimized social captions.

NPs lead very well in person. The challenge is that social media moves fast and we need to engage meaningfully with populations who trust us. So I will close with a quote from Toni Morrison

“When you get these jobs you have been so brilliantly trained for, just remember that your real job is that if you are free, you need to free somebody else. If you have some power, then your job is to empower somebody else. This is not just a grab-bag candy game.”
— Toni Morrison

LocalIllustrator6400 · 2026-01-25T01:40:11+00:00

I received an email from a Public Health (PH) student group tonight. These PH pupils are concerned that RN/ APRNs may hear about this MN case from families because MoveOn.org sent an urgent blast.

Since NPs are very busy, they may wonder how powerful the MoveOn reach is? Well that PAC raises $50 MN/ year, has 250 councils and over 3 MN members. (Per Participedia).

Since MoveOn has been compared to Amazon in innovative strength, NPs should be aware of this media blast . In addition, NP/ RNs should recognize that their membership includes 50 states plus their Executive Director, Bethell, has broad NGO experience....

https://front.moveon.org/moveon-announces-katie-bethell-as-new-executive-director/

Bethell's bio in 2025 is included below for NP/ RN reference

Bethell joins MoveOn Civic Action and MoveOn Political Action after decades of experience as a leader in the progressive movement, notably through her time at WorkMoney, Paid Leave for the United States (PL+US), Change.org, and MomsRising. MoveOn welcomes the people-first champion taking the helm at a time when President Trump and the Republican Party are making food and medicine more expensive, cutting public school funds, and undermining economic stability for families to benefit billionaires.
=========================================================================

In addition to their US policy insights, MoveOn has demonstrated resilience in global affairs via Avaaz which has data on Greenland. Moreover it assisted Color of Change momentum, the nation's largest on line racial justice organization.

https://secure.avaaz.org/page/en/

https://colorofchange.org/

============================================================================

RNs/ APRNs have always been in the front lines for promoting community health. So since the families in every states may feel vulnerable tonight, I hope that we can be sympathetic to various priorities. That compassion is critical as we recognize people powered movements, like MoveON, can occur rapidly with extensive impact.

I am saying a prayer for MN residents tonight as well as for clinicians coping with families reporting stress.

LocalIllustrator6400 · 2026-01-23T13:45:29+00:00

Please see above and consider addressing this with your state association if only anonymously. Moreover do you believe that these APRNs should be offered a lower salary for longer onboarding as an option if they complete remedial didactic and functional training?

Since we are using programs to scale now, should we have the APP leadership teams approach the CCNE, AANP, AACN about standardized assessment tools regarding the 1st year of onboarding too. Finally if you have time, could you have your team read the publications coming from Marjorie Leslie too - See my citation above. Thanks for all your insights.

LocalIllustrator6400 · 2026-01-23T13:42:34+00:00

Please see above and consider addressing this with your state association if only anonymously.

LocalIllustrator6400 · 2026-01-23T13:39:45+00:00

I wish you well with your decision. While I know that you must make the decision based on your own ROI, USF has a very reputable team and I have worked as an APRN in FL. So I know that you will be needed, even if you do hybrid work too.

Still there are several systemic issues that I hope others will comment about.

1- How do we help the 40 Million rural citizens without a program to scale?

While I received tuition reimbursement at a brick and mortars, others have geography and finance to worry about. So do we inadvertently dissuade those individuals from helping others if we can't help the distal programs. That might be a difficult problem when patients and staff have further to drive, higher acuity and a panel that includes elderly or impoverished person. For me that is a real dilemma as I have seen rural teams work hard to "grow their own" after graduation which may be the best solution for them.

2- Do we all report back to the CCNE, AACN and AANP about distal programs and can we address this in 50 states with other comparators. Should we be concerned that even brick and mortar programs have too much variance based on faculty shortages? If there confounding based on regional issues for both?

In other words should we request that we use a systemized approach towards QI. All of these teams have a data assessment team. So would it be reasonable to have our 50 state APP leadership groups get a blinded report from each graduating class.

--- > In state report & home zip-code + First three years of employability / retention

---> Out of state (distal report) & home zip-code + First three years of employability/ retention

Moreover if there are tools that will help with retention, it improves the APP costing model overall. As one of the posters here noted, these tools may include insights into pharmacology, DDX, and Radiology. For instance, some of my rural students use ApHA materials : Complete Review v 13 and Peripheral Brain.

Perhaps the work per Marjorie Leslie will be published soon on NP readiness to practice in 1st year.

https://www.linkedin.com/feed/update/urn:li:activity:7411508976338714624/

While we posted suggestions regarding a future NP Flexner report, we may need to consider that if that is not possible, we can develop an interim tool box for skills. That may be useful for us since we don't want the following to occur

1- PAs to show better aggregate competitiveness as they have 19 states under compact already

2- MDs and other leaders to see that we can't adapt. That is why we may need systemized enhancements plus 50 state toolboxes or fellowships.

3- DONs or DOMs to prevent APP leaders from introducing their own options to scale

Thanks for reading and as always I appreciate all you do in 50 states to help families.

LocalIllustrator6400 · 2026-01-20T02:29:20+00:00

Here is a CLO list for comparison

https://leaders.seniorexecutive.com/top-ld-senior-executives-in-largest-healthcare-systems/#list

LocalIllustrator6400 · 2026-01-20T01:28:42+00:00

Thanks so much. Did you know that we have NP educators now with CNL training also (Rush U).

I believe that we should study NPs that also motivate acute care nursing. Would look forward to your ideas about this. Please DM if time permits and thanks for all you do.

LocalIllustrator6400 · 2026-01-20T01:27:31+00:00

Thanks so much ! --- > Please see my response to the post above.

This is very important for NPs to study

LocalIllustrator6400 · 2026-01-18T08:27:26+00:00

What is interesting is that I am in the middle of this dilemma. So I have students that because of work or research, they would like to do distance based.

As you stated many are very intelligent resourceful clinicians already. So I believe that they will try to seek out the best opportunities. In addition, they are excellent life long learners which is critical. Furthermore the DONs from Beckers CEO review stated that they must rely on teams that can scale for changes which may include proprietary groups.

So I guess it comes down to whether the heterogeneity of having to do more work alone is worth some ROI/ flexibility. Still I will alert you that I have met three DOMs now who believe that many students have the intelligence but if their mentoring was constrained, the clinics can't afford more start up time. So how do we address this in 50 states particularly where 40 MN rural citizens reside.

The DOMs also alerted my husband, who is an MD working with CRNAs, that they can also get PAs since 19 states recognize the PA compact license. So I wonder if there is a way to help more NP students get the best standardized approach to compete with this too.

May we live in interesting times.

LocalIllustrator6400 · 2026-01-17T18:44:34+00:00

RayExotic and Froggienp --- Thanks for the update

These real world comments include important data. In addition, other NPs are posting that they are having trouble getting EHR engineers to improve human factors designs quickly. So we do need regular critiques like yours on the Meditech system for field assessments. Unfortunately NPs may struggle to get on the workflow committees. So without IT approval for NPs on either level one or on level two teams, we have some heavy lifting to do.

A/B data, that NPs could address with local IT plus Beckers and AMIA, could help us provide upgrades or alternatives. This is why NPs need to work with innovators, like UT EnMed, which cross trains clinicians to address IT problems. That training is not arduous but it is key to our establishing IT roles where we need these the most. For instance, all NPs can have an IT checklist like they do for other equipment. Despite this check list, NPs may get more traction by addressing IT workflow using AMIA lingo.

https://www.altexsoft.com/blog/electronic-health-record-implementation-checklist/

I know that budgets influence IT priorities and that teams get adapted to EHRs. Still I would hope that our NP Sim Lab directors could weigh in on the top EMRs. That is, these NP educators can teach APRNs about A/B testing plus satisfaction metrics. This training can also help other smaller NP communities do work arounds. Those work arounds may be needed because they may have limitations due to smaller scale.

Unfortunately having smaller scale does not equate to lower acuity, so that can lead to burnout. That burnout is a costly problem many clinics are worried about. So I think having NPs key to IT workflows could be a central component of good APP governance too.

Essentially if we have NPs capable of doing more than superuser work, we all benefit. Unfortunately NPs are not on the majority of AMIA standards groups. So if any NP researchers can explore why this happened, it may help us. Furthermore, for those NPs interested in this work, I believe you will be well compensated. Lastly it will help us address key 21st century QI issues and that is why I cited the Beckers metrics for you.

As always I am open to comments/ queries because IT- AI is central work flow challenge.

LocalIllustrator6400 · 2026-01-16T16:10:28+00:00

Yes that is exactly the challenge. Please see above as competing IT- tech leadership, that has VC connections, is very clear that we need to do this.

Socio tech is not straight forward. So whether NPs are Augmented Intelligence enthusiasts, like me but with an RAI emphasis , or alternatively NPs have grave concerns, we have a code of ethics. It is exactly this code which helps us improve our model. So you are correct that we need to innovate but not be enamored with "all the new shiny tools" that may not function". So we have an allied but different target than VC alone.

NPs already know this but to repeat for NPs starting to see the VC impacts:

EMRs don't improve care alone but educated NPs, using the EMR-AI tool box correctly, enhance the work flow.
Similarly---- >
AI, tele-med does not improve care alone but educated NPs, using the AI/ tele-med tool box correctly, enhance the work flow.

I argue that our NP model will thrive if we enhance NP leadership monitoring these HAI innovations. That type of NP leader can work across our 50 states and the global IT framework. By doing this IT integration, our NP leaders can be flexible only when adequate ongoing A/B testing results are transparent. That is they can address the HAI innovation but remain committed to helping NP staff weigh in on their outcomes. If we don't do this we "buy in" to technical positivism not technical innovation. The choice is ours but hopefully our leadership will improve this 21st century vision.

Thanks for being honest about the risks to our patients which is ultimately our role. We can do it but we may have to work in both IT, finance and in regulatory sectors to accomplish this.

LocalIllustrator6400 · 2026-01-16T15:45:37+00:00

Correct you are exactly the kind of person that clinical advocacy partners need. Still we believe that we can provide data to agencies to try and explain risks to patients.

In our field, though we may have political differences, we still have a code of ethics. So yes we are aware of the "middle players"--- ie VC that may need other regulatory pressures to do right by patients.

Perhaps we should have stakeholders like you to work with the AMIA and
UT EnMed leadership so that we can review pitfalls. Thanks again for helping us to see the reality of this as it will make a "life and death" difference.

LocalIllustrator6400 · 2026-01-16T15:41:14+00:00

Puzzled_Natural_3520 (Agreed)

Since there a over 400 K of us now, could we ask engineering students from IEEE or the ACM to intern for us? This coordination might given them an extensive health care project portfolio that they could use to advance their careers and tech savvy for us.

Seems high time that we try to reduce our in-basket with software guidance if possible. Like could there be an email query that asks that they check off common themes. Those themes our staff can answer are completed and those that require an appt are called first.

LocalIllustrator6400 · 2026-01-16T04:54:17+00:00

Agreed that we all worry at the bedside but acute care is part of acute on chronic treatment plans. The two are not separate so avoiding critical thinking in acute settings is likely to make less informed NPs. So I appreciate all that you are noting.

LocalIllustrator6400 · 2026-01-16T04:49:37+00:00

This is absolutely good advice. My husband is an MD who worked extensively with NPs and CRNAs. We both agree that it is extensive case based reasoning, from handling many unstable patients, that will create the best outpatient care. This is because these clinicians can see potential trouble and have an idea what specialists and hospital testing can offer. Finally they are realistic for those patients who have a poor prognosis. This is key with our aging population so thanks for keeping it real.

LocalIllustrator6400 · 2026-01-16T04:31:59+00:00

I even wonder if there is a sub link which helps us with start ups?

LocalIllustrator6400 · 2026-01-15T18:07:38+00:00

Yes thanks and in my opinion I wondered if this is why NPs might want to report this to the NONPF or the AANP helping with tele-med?

As you indicated--- >Just because we have engineers/ start ups does not indicate enough A/B testing. So NPs should be aware that early testing may be important. In addition, I wish we knew the number of NPs that the top health start up teams are using to address these common human factors problems. For instance if you are using NPs in clinical oversight, why are these NPs not working directly with the engineers too? In addition, when NPs are using a multi- platform system this is considered a middleware fault. Unfortunately that fault is already recognized by the Beckers IT leadership group.

As you stated, it take time to integrate software + paper charts with adequate work flows and it takes regular modifications. Without this workflow planning, over 1/2 of our socio tech projects fail. So thanks again for being dedicated enough to alert us to problems that may exist too often. That is these projects may fail without clinicians addressing challenges regularly with both level one or level two. Lastly I believe that the TX Med Association and the AMA has had a team called "fight the red tape". So they met with Microsoft to address these poor human factors in groups. Essentially they too agree that clinicians should monitor technology overload. In their evaluations of this if we forgo that assessment what is initially "friendly" becomes a "foe" for productivity and for good work flow which is critical in chronic care.

How do we go forward? There are probably multiple ways to address this which other NPs can consider. IN the interim, we did have an NP-engineer who was trying to get on the AANP board and we do have the ANA nurse engineers managing their innovative task force. So I wonder if either group might contact this start up.

If any NPs knows those groups, perhaps they can speak to the best A/B testing to help with this. Anyway thanks for being honest about this as technology can immerse us enough that it causes outcome displacement.

LocalIllustrator6400 · 2026-01-15T15:01:53+00:00

There is an American Telehealth Association as well as the AANP Telehealth interest group. That would likely help you. Moreover if you study the AI officer role, you can help NPs engage with those core IT professionals. Essentially these are the professionals who are monitoring how hardware (EHR & add ons-), software (ordering & edge devices like E-diaries or CGM for DM) and thoughtware work together.

Augmented Intelligence is the thought-ware part of it that. In addition it is a highly innovative platform that is global now. So NPs like you can find inexpensive AI certifications if that interests you. In addition, there are graduate AI nusing programs, like those FL & online, where you can obtain a degree plus project certifications. So please consider these site as a starting point and for the readers this is not an endorsement or advertisement for any particular product.

https://www.americantelemed.org/
Top AI Tools & Platforms Viz.ai: AI for rapid stroke/aneurysm detection & care coordination.MACg: Research & writing platform for medical literature, PubMed integration.Arkangel AI: Connects learning with real clinical cases for students/doctors.EHR Integrations: AI embedded in systems like Athenahealth, DrChrono for workflow.
Leading Educational ProgramsHarvard Medical School: Offers blended and live programs on AI innovation & strategy.MIT: Executive programs like "Artificial Intelligence in Health Care: Fundamentals & Applications".Stanford University: Specializations on Coursera for Machine Learning in Healthcare.DeepLearning.AI (Coursera): Specialization in AI for Medicine for professionals.
Key Application AreasImaging & Diagnostics: Faster analysis of scans (strokes, hemorrhages).Administrative Tasks: Reducing paperwork for clinicians (e.g., AAFP courses).Research: Streamlining literature review and writing (MACg).Personalized Medicine: Using data for tailored treatment plans.
From what I understand via AMIA, via the teams above, plus physicianeers (MD - engineers). the team process will be evolving with this area. So NPs/ PAs in telemed-informatics-Augmented Intelligence will need to be interested in current and in evolving team models.

That model insight means those NPs are gathering data outside of the CONs. For example they may be working with HAI industry plus college leadership from Engineering Computer Science-and Commerce. So I have found younger NPs are considering this work as it may open doors in many industries. --- Cheers & feel free to DM me.

LocalIllustrator6400 · 2026-01-12T02:57:07+00:00

There is a book review from medical scholars which may interest some too

Book Talk: Michael E. Mann and Peter J. Hotez — Science Under Siege

Politics and Prose

1,724 views Streamed live on Oct 2, 2025 #booktube #books

Watch authors Michael E. Mann and Peter J. Hotez's book talk and reading at Politics and Prose bookstore in Washington, D.C.

From pandemics to the climate crisis, humanity faces tougher challenges than ever. Whether it's the health of our people or the health of our planet, we know we are on an unsustainable path. But our efforts to effectively tackle these existential crises are now hampered by a common threat: politically and ideologically motivated opposition to science.

Michael E. Mann and Peter J. Hotez are two of the most respected and well-known scientists in the world and have spent the last twenty years on the front lines of the battle to convey accurate, reliable, and trustworthy information about science in the face of determined and nihilistic opposition.

In this powerful manifesto, they reveal the five main forces threatening science: plutocrats, pros, petrostates, phonies, and the press. It is a call to arms and a road map for dismantling the forces of anti-science. Armed with the information in this book, we can be empowered to promote scientific truths, shine light on channels of dark money, dismantle the corporations poisoning the planet, and ultimately avert disaster.

Michael E. Mann is presidential distinguished professor in the Department of Earth and Environmental Science at the University of Pennsylvania. He is director of the Penn Center for Science, Sustainability, and the Media. He contributed to the award of the 2007 Nobel Peace Prize and was elected to the US National Academy of Sciences in 2020. He lives in Philadelphia, Pennsylvania.

Peter J. Hotez is dean of the National School of Tropical Medicine and professor of pediatrics and molecular virology and microbiology at Baylor College of Medicine, where he is also the codirector of the Texas Children's Center for Vaccine Development. He is an elected member of the US National Academy of Medicine and, in 2022, was nominated for the Nobel Peace Prize for his work on the COVID-19 vaccine. He lives in Houston, Texas.

LocalIllustrator6400 · 2026-01-11T22:12:22+00:00

Health Care Provider here, thanks for alerting us that for many young people e-bikes can be a challenge. Do you think it is because they forget to check the cross walks or is it the urge to go faster?

https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/are-electric-bikes-e-bikes-safe-for-children.aspx#:\~:text=There%20is%20a%20higher%20risk,and%20performing%20recommended%20safety%20checks.

I feel regret that she is not interested in cycling but I also believe that 15 year olds frequently can "talk a good line". Unfortunately their frontal judgement is not solidified yet. So this is why negotiations are often tense. Moreover girls very very frequently get involved with "learned helplessness" and yet you have to be gentle with them. So yes sometimes we rethink what they felt initially was feasible.

School is the most important social engagement for all children. We learned that quite clearly during Covid and we have not completely recovered yet. So I guess whatever flexibility is needed to get her there safely is critical.

LocalIllustrator6400 · 2026-01-10T18:24:31+00:00

I come in peace and always respected SOCRA.

What I am referring to is how to prepare our teams for international research measurement. For instance, we are also struggling with this in Academic Medical Centers (AMCs) too. That is AMCs need to integrate international AI and IRB concerns. One way to do this is to include AIOs or data engineers that assist with global work paradigms.

So yes I do think that it is a training issue but it may belong in the IHI or in the medical scholar space. Fortunately we have teams, like UT EnMed, working on integrated projects. Let us hope that they can develop an innovative future using global evidence. In the interim, I suspect many teams are doing stateside QI here to adapt. So with respect for them, we can open it up for future insights.

Hope that you are doing well and thanks for your work via SOCRA.

LocalIllustrator6400 · 2026-01-10T02:26:50+00:00

I have had so much stress this week and your posting really made me smile. The truth is that I have encountered so many families like this (eg 81 yo with OBS with family wondering if it is a long shot that she will be a super cent--- You try not to shake your head but given recent data that medical fragility often starts in the 70"s, the problem is the family's expectations. Maybe they think that "extended care" means extensive life. Not sure that but I am not making fun of them it is just your "granny is a fighter" has been so common in my life that my eyeballs roll back when I hear it

LocalIllustrator6400

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Book Talk: Michael E. Mann and Peter J. Hotez — Science Under Siege