birdie22, BSN 4,206 Views
Joined Jun 2, '10.
Posts: 230 (28% Liked)
I'm not saying there aren't some good FNP programs out there - although no NP programs have an appropriate required number of hours and every student should get at least 2000 or so, no matter the program. But FNP attempts to cover peds, OB, adults etc and ends up with just a couple hundred in each , which isn't serving anyone well. The only way an NP program works, IMO, is by specializing. If FNP programs required as much time, both in didactics and clinicals, as PA programs, I would have chosen one.
In summary, I wish NP programs included a surgical rotation.
My job as a circulator, regardless if you have a tech or not, is to be at the bedside, the whole time, until the tube is in, and SECURE
We've always used Hibiclens or the cheaper chlorhexidine gluconate, the use of an alcohol product just threw me off.
The patient signed the consent (not that that would probably make a difference in the end, either) and the CRNA on the record was the one that got the consent and gave the sedation if there was a question could clarify. A non-issue, IMO.
But that doesn't mean a business casual nurse with a clip board and a whistle couldn't harass you about it.
Someone once said a cardiologist could be replaced with an app, a primary could be replaced with a Wal-mart greeter.
I took that to mean that PCP's just refer patients out, loosely, by the body system, and specialists get so used to seeing the same thing, they can write orders in their sleep.
Sure, I work in the Northeast and I make roughly 120K with 2 years experience.
I've received quite a few PMs recently regarding how I became a surgical NP. Which specialty is the best route and in general what my typical day looks like so I thought I'd post something.
I started as an Med/surg nurse and then a travel nurse in cardiac step-downs but OR nursing always intrigued me. So I became an OR nurse and was there for about 10 years. My hospital had an excellent reimbursement program and a friend of mine had started NP school and I decided I didn't want to be a lifer lol so I decided to start chipping away at an NP program too.
I always envisioned myself doing something procedural based with it. I didn't really see myself as a primary care NP so that was always my goal-although none of my training in NP school was in inpatient surgery. I decided to go with an FNP program figuring that that would be the broadest education. At that time the Acute NP programs were just becoming more popular-still I feel like FNP works well.
It took me quite a bit of work to get my first surgical NP job. I hounded my first boss with emails when I saw position posted and when I finally got an interview I really played up my OR nursing experience.
My training was all hands-on. They were generous enough to pay for my RNFA program-RN first assist program which is required in my state for all NPs to practice in the operating room. It Required about 200 hours of precepting from a surgeon and it took me roughly 5 months together these hours. By no means did I feel skilled at the end of those hours but I felt competent enough for small cases/closures.
I've been at it for about two years now and have since changed hospitals. I do not take call, work weekends or holidays. I typically round by myself and chat with the doctors either on the phone or via text. I assist in the OR almost every day and I love it. I feel like I'm getting a lot better. I occasionally see patients in the ER, consult and consent for procedures. I dictate on consults after speaking with the surgeon and discharge plans. I oversee patients in the day surgery unit and write prescriptions and orders for them as well.
I'm thrilled with my move. I feel like I've been able to spend a lot more quality time with my family and I even still moonlight at my old hospital for 'play money'!
I definitely recommend the specialty although it is difficult to get your first job and your foot in the door as we all know we are not typically trained this way so it helps to know people or to have the luxury of waiting for the perfect job.
Also, read surgeon preference cards before you open anything. This not only saves money but also avoids the classic "didn't you read my preference card " from surgeons.
Listen to everyone without getting defensive or offended. This is an environment where so many things can go wrong so fast, which means people are very direct and blunt. They aren't being rude, they are being professional and safe.
I would assume the first step to take would be to see what the requirements are to obtain a license as a foreign educated nurse in the countries that interest you.
A good scout should always be paying attention to the needs of the scrub team. For example, If we're doing a laparoscopic case and things are going pear shaped then they should be prepared for the patient to be opened up. Sponges, suction, ties, sutures, laparotomy retractors etc.
If the surgeon needs an instrument or something and it's not on the back table then the scout should be listening and anticipating what will be required. I hate having to repeat everything that the surgeon asks for, it's like playing monkey's telephone.
One thing I loathe is the scout nurse interrupting the surgeon while he is operating to dictate some irrelevant phone message. If it's not urgent then why are you being a secretary? It's OR etiquette to ask the scrub nurse if it's ok to interrupt. I have a very strict rule in my OR that phone calls are not our responsibility. Did you study to become a nurse or a secretary?
1) able to leap tall buildings with a single bound. Seriously, able to visualize the big picture.
2) good customer service (pt, family, Dr, staff, & reps)
3) able to multi-task.
4) does not know everything, but. knows where to get the info.
5) knows anatomy nearly as well as the med students (easier to anticipate/estimate length of case to keep room running well)
6) immunity to most non-life threatening illnesses.
7) mania (gets a lot done with very little sleep)
8) able to withstand a doctor yelling while realizing they are not mad at the nurse but at the situation.
9) a bladder the size of a Volkswagen.
10) ambidexterious (able to prep or place folly with both hands)
11) flexibility you may not always get your favorite service/doctor
12) strong hands and knees you'll be on them often if your doing your job right
13) great assessment skills you may have to spot a pt going south before anesthesia or the Dr see them
14) never-ending quest to learn
15) a questioning mind, our practice only advances because we ask is this truely the best practice
16) team player
17) no social/family life (call)
18) not color blind (if its blue or red, don't touch it)
So do I give him a pass on this one time?
Ultimately you have to make the decision, Russianbear. I know two NPs at work who were in primary care programs but are now working in acute care. I also know of an NP (six degrees of separation) who was working in acute care and has transitioned to primary care. It seems that whatever you choose, you won't be stuck in it.
I am glad that my babbling found a spot with you all. For your kind words, I remain humbled and tingly and struggling not to vomit rainbows of utter idiotic glee.
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