Latest Comments by ThePrincessBride

ThePrincessBride, BSN, RN 44,094 Views

Joined Jun 13, '10 - from 'Somewhere'. She has '2 RN, 3 tech' year(s) of experience and specializes in 'Med-Surg, NICU'. Posts: 2,136 (61% Liked) Likes: 5,798

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  • 1
    chacha82 likes this.

    If you work in acute care, be prepared to pay your dues.

    I now work days, but I put in over a year on nights. Some of my coworkers worked less graveyard shifts before going to days. But our unit has high turnover and a lot of people are unhappy. The more desirable places will expect at least two full years of nights before having a chance of switching shifts.

    That being said, I loved nights. I miss the people and the money, and it is usually less crazy. However, I love not sleeping my off days away and having my schedule more conducive to having a relationship and a family.

  • 0

    I'm a RN with a BSN and my base pay adds up to only 46k. My weekend requirements and six paid holidays brings me up to about 48k. This next raise will bring me to 50k.

    I am not a new RN. I have been a nurse for over two years.

  • 0

    Job hopping in itself isn't that big of deal if it isn't done repeatedly. I started off at a SNF left after a couple weeks and only three days on orientation. Did not even receive a paycheck, so I didn't count it and it isn't on my resume.

    Then I got a job on a med/surg unit. Stayed there for eight months before cutting down to PRN in order to start my dream job in NICU. I have been at it for almost eighteen months and plan to stay another year before finding another job with better benefits.

    I am getting bored and find myself unchallenged. I love my babies, but it is very repetitive. I dream of other specialties, particularly cardiac step-down/ICU or going back to school for NP.

    But job-hopping really isn't good for career development long term. You never did get pass the new grad phase as a RN and you seem all over the place. Eventually, you will be blackballed out of your current market and be forced to stay put for awhile.

    Ask yourself what it is you want in a job and what you are willing to put up with in order to get it.

  • 2
    ivyleaf and Everline like this.

    It may not be abnormal or unexpected but it is inappropriate and unsafe.

    I went PRN for that reason. Seven patients...ridiculous.

    Quote from saskrn
    I've worked in various units, in a lot of different hospitals as permanent staff and a traveler, and patient ratios can vary a lot. It also depends what shift you're working.

    I like working nights, and on med/surg floors I've seen anywhere from 3 to 13 patients. But for the most part, an average assignment would be 6 to 8 patients.

    You mentioned that the nurses had 7 patients, and that it felt like too many. IMHO and experience, an assignment with 7 patients on med/surg is not abnormal or unexpected.

    Good luck!

  • 3

    Quote from jprn2018
    I currently work as a CNA in a Med-Surg unit. I am set to graduate as an RN next May. I am just not sure which path I want to take to become an APRN.
    You are putting the cart before horse. Worry about boards and getting your first job first.

  • 1
    chacha82 likes this.

    What kind of job are you working now?

    OR usually requires an extremely long orientation and no ICU in its right mind will hire a new grad in a part-time or contingent role. CRNA schools require a minimum of one year of full-time ICU experience...part time won't cut it.

    You need to pick and choose.

  • 1
    prnqday likes this.

    22k is reasonable especially if you work a bit of OT to knock it out sooner. You could wipe out the debt in as little as a year if you wanted.

  • 0

    Hey Emm,

    I am actually in a dilemma over becoming a NNP (I work in a level III NICU). May I ask, what are your reasons for not choosing neonatal NP?

    As for your question, I would keep looking. Switching to another specialty can be difficulty, so you want to make the transition as smooth as possible. This unit doesn't sound conducive to good learning. There are others out there.

    Also, I know some NICU nurses who went to FNP school and didn't bother to get any adult experience. So it is good that you are considering it!

  • 2
    brownbook and OsceanSN2019 like this.

    Pay cut by about 55 cents. And the benefits were not as good. But I got into my dream specialty and work day shift now.

  • 2
    klone and Julius Seizure like this.

    Quote from klone
    Don't roll them too hard, Princess! I remember posts of yours a few years ago, with very similar concerns as the OP's.
    In regards to a career and how it would affect motherhood and wanting to hurry up and get an education before a baby.

    But I never flat out said that anywhere in the twenties was too old for anything. And if I did, feel free to slap me...hard.

  • 1
    Pixie.RN likes this.

    Quote from Pixie.RN
    I get it, though — if you live in a place where people have babies much younger, it can feel like time is slipping away at 28. I realize I am also a bit of an oddball, being almost 37 weeks pregnant at 45. But seriously, even though 35+ earns the "advanced maternal age" label, it's just that — a label.

    OP, go see the world! But do it when you have enough nursing experience to walk into a hospital and be functional with computers and patient care with about a day of training under your belt.
    I get it to a certain extent as I live in an area where it isn't uncommon for people to having babies in their early twenties.

    However, if you are hanging around a more educated and career-focused ground, people from that group typically are waiting until their very late twenties to early thirties to have their first baby.

    I am going to be 26 soon and while I still get the sense of urgency to hurry up and get an advanced education before motherhood, I realize that, biologically speaking, I have a minimum of ten good childbearing years left before I need to start "worrying."

    And congrats to your new one! I used to work as a tech in L/D and High risk OB and took care of a 50-year old pregnant with twins. So 45 isn't the oldest yet.

  • 9

    I'm rolling my eyes so hard at this post, it hurts.

    My mom had her first at 29 (me), her second at 33 and her last at 36. She could have had more if she wanted.

  • 1
    NotAllWhoWandeRN likes this.

    Quote from applewhitern
    I wish I had taken engineering like my family wanted. My brother, a chemical engineer, makes a ton of money, has lots of benefits, and is highly respected. Me, as a nurse, have a mediocre income in relation to what I do. Barely any benefits. No unions here. Respect? haha. I like nursing, but the pay is so poor, and it seems like it is constant turmoil. I'm not one to say I went into this "to help people," or "it was my dream..." I can help people regardless what profession I am in.

    Haha. My brother just graduated with his engineering degree and his first job offer has him earning almost 30k more than me. What the heck...

    But I just don't think I could handle the schooling.

    As for the OP, I don't think I regret nursing...yet. I love having a three-day work week, flexibility and variety and I ADORE my little itty bitty babies. But from a financial standpoint, the pay sucks in relation to the responsibility and stress level.

  • 0

    Quote from BostonFNP

    As I wrote above, student and novice NPs working in specialty practice are certainly benefited by relevant RN experience in that specialty. Spending three years as a NICU RN (I would assume, I don't have any direct experience) would benefit a student/novice NNP much more so than three years as a RN working in another setting.
    As would a couple years of psych experience for Psych NP, pediatrics for PNP, etc. I have many coworkers who have only NICU experience going on to become FNPs having never touched an adult or older child in their career. Since most FNP jobs are geared towards the care of adults, I don't think it would be too much to ask for adult bedside experience.

    Not all RN experience is equal. I should have said relevant experience.

    Quote from BostonFNP
    If I understand correctly, you are applying to NNP programs currently? As you pointed out my bias, do you think you have any of your own? I think we can all agree that recognizing your own bias is important.
    Actually, when I first started out in nursing school, I wanted to go directly to grad school so I could get finished with my formal education before having children. Working at the bedside has taught me the seriousness and level of responsibility and autonomy that comes with being a neonatal NP. Coupled with the fact that so many low-quality NP schools are churning poorly-prepared NPs left and right and I am pretty convinced that even if I did go straight through, I would have regretted not getting the experience.

    The undergraduate level and the graduate level are two completely different things, and in this scenario, neither you nor the pre-licensure DE students had any RN experience?
    Yet they were taking the same classes as the undergrads and judging from some of the questions they were asking and their level of performance, it was a little scary to believe that many would take the NCLEX and start their NP portion after a handful of months. Even some of the graduate students complained that facilities didn't want to hire them.

    Many program require bedside experience, including many DE programs. Just because a program is DE doesn't mean it doesn't require bedside experience. Some specialty programs require specialty experience, as discussed above. FWIW there are now physician pilot programs that don't require residency; and remember, what residents are called: doctor. Residents are practicing physicians in a collaborative practice, many people forget that thinking they are students.
    And I wonder how many attendings would feel comfortable knowing there are MDs out there without a residency?

    Residents may be called "doctor" but being a doctor doesn't automatically make one an attending.

    If these "DE" programs require bedside experience, then they aren't truly "DE" as they couldn't go straight to the NP portion without any bedside experience. So that just proves my point even further.

    True, but the bedside RN job is very different from the hospitalist job. I am not sure you can find many practicing NPs that have worked at the bedside that will tell you they learned nothing in NP school because they already knew it all from the bedside.
    No. But I bet you'll hear many NPs who value their bedside experience and are glad they didn't go straight through either. You seem to want to completely divorce NPs from RNs; you can't. Otherwise, an RN license wouldn't be required.

    Book smarts and a quick wit isn't a bad start, to be honest. Most physicians fit that mold don't they? Intuition is fine if you have it, some RNs do and some don't, some providers do and some don't. The more time you spend in a role the better that gets. The intuition at the RN level isn't enough to make you a good provider. It needs to be pared with knowledge and experience in the provider role.
    Yes, but I don't want an NP who is starting from ground zero diagnosing patients, and a Nurse Practitioner without any (relevant) RN experience is just that. As a NICU RN going on my second year of practice, I can say for sure that all of what I learned on the floor will help me see the "bigger picture."

    And remember, LIVES are at stake.

    It isn't about what is best for the NP student's personal life, it is what is best for the patient.

    Something to consider as you move forward with your RN and APN career: do you think you have the relevant expertise to accurately judge a provider competence, regardless of the degree, and when you are a novice in the APN role how will you respond to a RN who doesn't want to follow your orders simply because they don't think you are good enough?
    Shouldn't you be asking this question to all the NPs without any RN experience?

    And hopefully, rather than refusing to follow orders, that RN would ask for more information as to why a certain treatment was ordered, ETC. A competent NP would be able to walk that through with the bedside RN, and believe it or not, many bedside RNs with more than a couple years of experience can tell the incompetent provider from the competent one. We may not be following orders, but after sometime on the bedside, we start to learn to accurately anticipate the next step in the poc.

    But I have a feeling that you have it in your mind that bedside RNs are clueless about the NP role and that bedside experience is overrated, so this feels like a waste of a post.

    Have a good one.

  • 4
    SmilingBluEyes, Cvepo, AJJKRN, and 1 other like this.

    Quote from BostonFNP
    Everyone's opinion is biased, hence my comment about "from both sides". Bias is one thing, a lack of experience with the topic is another. I do think it is ironic that some posts here about how APNs absolutely need experience come from people that have no experience with APN education or the APN role.

    I went to one of the top NP programs in the country. I worked as a floor RN on heme/onc floor for a year and a half prior to working as an NP. I have been involved in NP and MD education, both clinical and didactic for many years.

    So what is your experience, where did you go to NP school and how long have you been practicing as an APN? What is your bias?
    My experience? I work in a specialty (NICU) that requires its NNPs to have a minimum of two years of clinical bedside experience prior to clinical practicums. Neonatal NPs were some of the first NPs to emerge from the advanced practice nursing force.

    It would be an injustice to the neonates to go into to AP with the bare minimum. Hence why I am now just starting the application process so that, by clinicals, I have more than the minimum.

    I also had the interesting opportunity while in undergrad to take classes side-by-side the direct-entry students. They were just a few months away from graduating from the RN portion and entering the NP part of the program. Some of them couldn't take a blood pressure manually. Nor did they seem to have an understanding of basic pharmacology. For example, some didn't know that heroin is consider a "downer" not an "upper" and that heroin and morphine work and metabolize similarly in the system.

    That is terrifying.

    And make no mistake. This is also a reputable and highly-ranked NP program. That is scary.

    If bedside experience isn't so important, then why are many advanced practice schools (NNP, CRNA and, up to a certain point, Acute Care AGNP) requiring their applicants to get that bedside experience? Why aren't MDs being hired without residencies? And more importantly, what is the point of being called an advanced practicing nurse if one doesn't have the BASICS down?

    I can also speak from a less specialized field: med-surg. Do you know how many patients and how many different diagnoses a bedside RN can see and learn how to manage on a fundamental level? At my med/surg job, I can have up to seven patients with seven different CCs and multiple comorbidities.

    As an NP, one has to know how to prioritize which diagnoses to treat, how to treat them and when to recognize even the slightest variation from a patient's baseline to prevent a patient from going down the tubes. Now I know some direct-entry NPs think that book smarts and a quick wit is all that is needed to be a good NP, but here is something one cannot learn in a classroom: intuition.

    So while you think it is "ironic" that a bedside nurse is speaking to greater than thou NP, understand that bedside nursing provides the FOUNDATION from which NPs learn and grow. NP students were expected to already have a strong knowledge. As the bedside nurse, I need to feel confident in the APNs abilities and education because when SHTF, I am calling you (general you, of course).

    If NPs feel that bedside nursing experience is no longer needed, then NP training should divorce itself from nursing altogether and just be called "practitioners."