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BostonFNP Guide 49,521 Views

Joined: Apr 4, '11; Posts: 5,169 (63% Liked) ; Likes: 13,179

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  • Mar 16

    Quote from Cjaco90
    Auto immune mediated anemia and asthma (secondary) and celiac disease. My system is just too fragile for vaccines and I thought I would just be able to wear a mask instead. but the laws have changed now
    Autoimmune diseases are not a reason to avoid influenza vaccinations, they are actually a known subgroup for whom influenza vaccinations are even more important than in the general population.

  • Mar 14

    Who left the gate open? You have lost your weekend passes till June!

  • Mar 6

    Quote from pmcgrady
    Who is to decide the metrics for adequate patient care if it isn't management?
    Do sports team coaches attend the games, and witness the plays, and intervene in an attempt to win or do they sit in their office and wait until the game is over, analyze the data, and then provide policies and mandates to initiate for the next game? Herein is your answer.

  • Mar 3

    I'm confused. Genuinely.

    When I entered clinical practice as a paramedic 25 years ago, I was told that my patients would now be "writing my tuition check going forward", and the cost of that tuition was now going to be paid with their life if I really messed up - yep, that motivated me to WORK harder post licensure than in college then and later as a new RN and with every new role since. That tuition they may pay is a privilege, I take seriously and I give it everything I have.

    Yeah, I think that speech might apply here. Pass it on.

    When did clinical mentorship or high standards of clinical practice for any provider become a bad thing? Why would it be surprising that inexperienced providers with high case loads have worse outcomes?

    Any wheel you come up with will still need to be round to roll, eh?

    Since it is a life and death business (high stakes environment), why is that entry into clinical practice such a vicious environment that punishes unsuspecting patients and can literally kill them - pointlessly, needlessly.

    Do these patients gave a right to know how "new" their providers are? Would you want to know?

    Medical error is the 3rd leading cause of death.

    Overworked, under-supported is not a badge of honor.

    Some tuition really can be just too high.

  • Feb 27

    Quote from BostonFNP
    Which studies have you read that you find lack value? Is that based on your professional practice experience as an APN?

    The truth is that the vast majority of people that weigh in on this issue: 1. have never read any of the extant data on the topic as their minds were already made up and 2. have little to no experience with NP education or advanced practice experience.
    Agree-it's all about "feelings" or "perceptions". Keep in mind that the plural of anecdote does not equal data. Aren't we an evidence based profession? The personal biases of many here, including those who have not practiced as a NP, really have little correlation with how DE grads perform in practice. No one is saying DE grads are superior, so not sure why djmatte chose that phrase.

    buttercup9-you are still in school and have not practiced as a NP, yet you seem pretty sure that you're going to be much better than a DE grad. That seems pretty self congratulatory. My guess is that you will likely be at a similar level as a new grad DE NP when you graduate. You will both be novices, regardless of how much nursing experience you have, and how much life experience and other skills the DE grad has. I've seen seasoned nurses flounder as NPs and DE grads turn into rock stars. The reverse is also true.

    Having "feelings" or "opinions" about something doesn't necessarily make it so.

  • Feb 22

    I'm curious, since no one has asked, what did the child's parents say? I would think if they know their kid weighs 44 lbs, they'd question it if a practitioner said "OMG, your child has lost 1/3 of her body weight, she's down to 30 lb and has fallen off the growth chart!"

  • Feb 22

    I can see not noticing a 14 pound discrepancy on a 200 pound adult but 14 pounds is almost 50% of the weight of a 30 pound child. Not something any observant healthcare practitioner would overlook.

    I would think anyone working in pediatrics would be better at estimating weights.

  • Feb 22

    Quote from NHGN
    You're a genius if your subject line was deliberate.
    I am very interested in eros for nurses

  • Feb 7

    Quote from EGspirit
    For the record, I hope my patient was able to hear me. I doubt it, but I hope so. I did my best for him and his family, and my best is something I have always had a very good reputation for as a nurse, even among people who didn't like me. Keep in mind, the reason I did all that I did for him was because a bunch of lazy nurses before me never did--probably atheists.

    So, my best comes with my religious convictions. The only reason I'm a nurse and not an accountant is because of my religious convictions. I have had so many dying patients. I have been on so many codes. When you've walked a mile in my shoes then I might listen to you. I loved my patient as I love myself. I did unto him, as I would have it done unto me. That's what my best comes with. And I can tell you right now, he was lucky I was his nurse. He never regained consciousness. He died. But when his family came to see him, he looked dignified instead of disheveled. He was clean, orderly, smelled good, and looking at peace.

    Judge me? Go judge yourself.

    I was his nurse. He was my patient. He couldn't do for himself, so I did for him. And if the worst thing he had to endure was my statement of faith meant to encourage him and give him strength, then he got off pretty easy. He was an old man, a vet, he raised a family. I doubt he was offended by my comments--and I hope that he did hear them.
    Your religious convictions should never come into play when caring for a patient. You've made it about you, and not the patient. Your intentions may be good, but it's insensitive, selfish, and plain unprofessional to start whispering your convictions in a comatose patient's ear behind a closed door. Would you do this in front of family or other staff? My guess would be no. You may say it's because you don't want to be judged, but I would guess that you know it's wrong, and you don't want witnesses.

    What you are doing is a fireable offense. Worse than that, it is taking advantage of someone who does not have the ability to refuse your proselytizing. I would certainly report you or anyone else doing this, regardless of religion.

  • Feb 7

    I'm a Direct Entry grad, and have no regrets about going this route. I've never had any issues obtaining jobs as a NP, and never had an employer that was concerned about my lack of RN experience. I'm an FNP, and work in a specialty outpatient practice.

    I did a brick and mortar program at Boston College. I learn better face to face than online, and I felt it was valuable to know and spend time with my cohort. We studied together and were a good support for each other. The program was pretty intense and you needed to be be motivated and take initiative to search out information on your own. Still, I never felt it was unmanageable, but school was my entire life while I was in the program.

    You will find a lot of naysayers on this forum. It's frustrating, but I see that I have been successful and my cohort have been successful as NPs. I let my patient outcomes and peer/supervisor reviews speak for my abilities and competence-not someone who has never met me or might not even have a good understanding of DE programs. Choose your program wisely. Go to the best program you can afford, and pick one that will help you find preceptors for your clinicals.

    Best of luck to you. Feel free to PM me if you have further questions.

  • Feb 7

    How has nursing changed me? Hmm... I'm certainly more jaded and cynical than I was prior to getting into nursing. Now as a psychiatric NP, I find myself trying to diagnose Axis I and II disorders in almost everyone I run into. I also seem to have this odd dent in my forehead; it may or may not be from repetitively banging my head into walls.

    Aaaand on to the main subsection of this post: EGSpirit

    I consider myself pretty religious. I believe in God and follow His commandments as well as I can in my day to day life. However, even as a fellow Christian, you have made some remarks here that deeply trouble me. Number one: It is not your place to be telling a patient on his or her deathbed that s/he must endure for anything. The patient was old, tired, in pain, and dying. He should have been allowed to pass into whatever afterlife (or lack thereof) he believed in without you telling him that he needed to endure another second in this world for any reason, and this includes seeing family, religious conversion, or anything else.
    Number two: I echo everyone else's sentiments regarding proselytizing to an unconscious person; it is not your job to try to convert a dying patient if he cannot participate and tell you whether or not your ministry is even wanted. I agree that bringing God into the fold as a healthcare worker when having not been asked to do so by patient or family is inappropriate. For some, religion is peace, for others, traumatic, and for any number of reasons. How would it make you feel to be on your deathbed and have a nurse praying over you in the name of Allah? Please keep things like this in mind.
    Number three: I have known many Atheists in my career and, funny enough, they all seem to be capable of providing proficient and compassionate care. It would probably also do you well to remember that we Christians haven't yet cornered the market in compassion, and some of the most hypocritical people I have ever had the displeasure of meeting claimed to be of faith. It was lovely that you prepared your patient for family visitation, but the nurses before you may simply have not had the time to do so; when I worked in the ER, it was all I could do to get my work done and make sure my patients were quasi-comfortable. I'm sure it had absolutely nothing to do with the previous nurses being Atheists.
    Number four: I will pray with my patients and attempt to comfort in a religious way if AND ONLY IF the patient (and any family present) has asked me to do so, or have made it known that it is okay. To do it at any other time is very presumptuous, and a violation of the therapeutic relationship I share with my patients.
    Finally, I do not believe that anyone here has addressed you in such a way that has necessitated you responding with the venom and name calling that you have. Please do not continue to give us of faith a bad reputation; it is bad enough as is anymore.

  • Feb 7

    Quote from EGspirit

    So, I closed his door; I cleaned his room, and I whispered into his ear: "You may not be here much longer, but you will look presentable and respectable for your family. I will not let you be seen without your dignity and honor. You must endure this for them. We are men; we put our faith in God.".....
    So you knew for a certain your patient was a christian?

    Because if you didnt, thats a violation of the nurse patient relationship on the deepest level

  • Feb 7

    Quote from EGspirit
    It's why God called you to it--to change you.
    Before I read anything else on this thread, I feel the need to point out that not everyone feels called by god or even believes in god yet you always seem to push that onto many of your threads. Awesome for you whatever you believe, but not everyone believes the same way and that's ok.

    ETA: Nevermind, I read the rest of the thread and am gonna go hit my head against the wall repeatedly.

  • Feb 7

    Quote from EGspirit
    He was comatose. Nothing hurt or offended him. ...
    That is by far the worst argument I have ever seen.

  • Feb 7

    Quote from EGspirit
    So, I closed his door; I cleaned his room, and I whispered into his ear: "You may not be here much longer, but you will look presentable and respectable for your family. I will not let you be seen without your dignity and honor. You must endure this for them. We are men; we put our faith in God."
    I cannot even begin to express to you how distressed this would have made me if I was your patient. I don't share your religious beliefs and if you had proselytized to me when I was in such a vulnerable state, you would have made my final moments on this earth some of the most upsetting and anxiety provoking of my life. I hope, for your patient's sake, that he did share your beliefs and found comfort in your words, but I also hope you come to realize that not everyone does and it's not your place to impose on them without their consent.