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Joined Oct 28, '12 - from 'Denver, CO, US'. heartlover is a BSN, RN, CNOR. She has '9' year(s) of experience and specializes in 'Cardiovascular and thoracic surgery'. Posts: 44 (23% Liked) Likes: 15

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  • May 8

    Hi,

    I haven't seen lots of posts about people taking the new ANCC-FNP exam as of February 2016, so I decided to write one because I know I went looking here for advice and on what to expect several times throughout my process. I just got home and I passed the exam.

    So as far as study advice I would say really really really really DO NOT SKIP OR GLOSS OVER epidemiology, all the technical jargon about nursing roles, standards of practice, quality improvement programs, risk management programs, sentinel events, root cause analysis, outcomes analysis, malpractice, CPT, ICD-10, incident to billing.

    Learn these definitions so well you can repeat them back including, if applicable, their precise names (International Classification for Diseases, Budget Reconciliation Act). If there are stated steps to the "risk management review process"- know them by name and in order. If you get these type of questions wrong on your practice exams, pay A LOT of attention and review, retest, try to fix. Don't think "ugh, whatever, I know what 'leadership' is"... they will ask it in strange ways.

    Really improve your literal test-taking skills at closely reading questions. I am someone who is generally naturally good at this (I had a near perfect score on GRE verbal and I'm a voracious reader), but I actually realized I needed to do work on this. There are many questions where the line between the right answer or wrong are things.

    I used lots of things to study over time, Leik is very good for streamlining and making things feel manageable, but there are also mistakes and exclusions and its organized not very well. There were some nights where all that made me pretty aggravated. All that said, I used her a lot. She does talk about professional issues, but you NEED to supplement-- go everywhere looking for supplements on the topics I suggested above, no one source covers it all. Check ANCC's book.

    I took Barkley review ages ago, so the live review didn't factor in to my success (but could have), but the book I got from it was very good-- his outline for peds really helped me feel like it was manageable where other books were too bogged down in info. But of course, none of that was on the exam.

    Fitzgerald is great, but she really lays on surplus info you don't need- she's focused on making great clinicians with her book, not getting people to focus on only passing the exam. But good supplement. I took Fitzgerald's practice online questions (many repeats from book, but some new), I bought Barkley's DRT exams (annoyingly expensive and overthinking it I think), the ANCC practice tests (they only sell 2 which together make up a little less than 1 whole exam), and I took APEA predictor exams the last few days before my exam, which I liked and also boosted my sense of confidence. Really none of these provided the mix I got on my exam, they were all much more clinical, and the test wasn't. But you need to just start testing and getting some sense, so just choose whichever budget wise works for you. But, if you had to only buy two for instance, I would choose two tests from two different sources rather than from one. Just having the experience of doing questions on the computer is valuable.

    I also took Fitzgerald's review (again a long time ago) it was very thorough... it had a less relaxed feeling than Barkley's... I felt I liked hers better, but again... they are all focused on clinical...I also have lots of other resources that I didn't use much (Fitzgerald's CD's for instance) and I am happy I didn't use to study in retrospect... although I will for my general knowledge.

    So, that's it. Hope it's helpful. I had agonized way past the point of return because I was so nervous about this test.... Oh, also, normally I take tests VERY quickly. On practice exams of 150 questions, I am done in an hour and 15. I needed every minute of 4 hours and 30 minutes on this test. I didn't even get through reviewing all of my marked questions when the computer shut off and I only took one short bathroom/ drink break.

    OH and another thing, the computer DID NOT tell me if I passed. I sat there thinking it would given what others have said. And then I thought something went horribly wrong, or I failed. In fact, the proctor outside the room after checking me out, printed out a sheet, silently folded it and then handed it to me. THIS had if I passed or failed on it.

    Additionally there were two features available to help you on the exam, which I have never heard anyone mention before. 1. You can strike out answers to help you visualize and cut down on the data. When you go back to a question, your strike outs remain. 2. You can also highlight parts of the question and your highlights remain.

    Also everything, but your ID And key to your locked has to be put away, but at my testing center people were allowed to access food and drink they left on top of the lockers. A lady actually told me that I could even go into my locker as long as I didn't check my phone or other prohibited behaviors, so although I left my water and juice out, I left my snack bars in. It turns out my proctor made me leave my key on the desk, so she was misinformed. But I had access to my liquids, I would have put out my bar too if I had known. I took the test in NYC- Manhattan at Prometric and I am sure there could be variation between centers, but just putting it out there....

    Good luck!

  • Sep 28 '14

    I worked in PACU with a nurse like this. The directors loved her. She was charming and evil. She did the schedule, never had on call, came in late and left early almost every day. Sound familiar?

    The lies and vicious gossip made me cringe. She destroyed a few reputations and careers. She particularly picked on the housekeeping staff. She lived to fight with and dominate others and the whole crew went along with it because they were afraid for their jobs. I think this is the definition of a sociopath. Her ex was in jail for embezzlement or something.

    To make a long story short, I stood up for myself and became the target of her rage and the management believed her. I resigned. I really loved that job, I had great relationships with the OR team surgeons and anesthesiologists.

    This PACU played fast and loose with ASPAN standards. Their version of level one recovery from anesthesia was totally unsafe. Their were major incidents, nothing changed.

    Every PACU seems to have one of these self appointed charge nurse women who makes a nice job into a hornet's nest. Oddly, they put her in charge of their mandatory anti-bullying education. After I resigned the staff had a mandatory meeting and identified her as the main source of conflict and the reason that no one would work there.

    If I could go back in time, I would have left after the first month of working in that PACU and found a more congenial work environment. I could have stayed in that job forever except for her. I enjoyed it that much.

    You will not be treated fairly in a unit with weak management. IF YOU CONFRONT THIS PERSON ALONE YOU WILL BE TARGETED I was left alone in PACU with three patients, two of which needed ICU care. Some people thrive on making others miserable. This kind of person will delight in sabotaging you any way that she can just because she can. Especially if you are in a non union facility. After six months of positive performance evals she wrote one that was a huge pack of lies. They believed her. It is best to leave.


    If you have absolutely no other options, walk away when the nasty gossip and complaining starts. Go help in the back, in ASU or discharge, ask the pread missions nurse if she needs help, get a drink, make up stretchers, fill the blanket warmer etc. Do not listen or participate. Smile, talk to her only about the weather, the red sox, and the schedule for the day, keep on trucking.

    There is a book called The Sociopath next Door, written by a psychologist, which you might find helpful, at least in terms of maintaining your own sanity. It addresses the spectrum of people who are born without a conscience.

  • Sep 18 '14

    The big issue many employers see is that whether you are employed in your full scope or not, you will be held accountable to your highest license- the same would be true of an LPN working as a CNA, an RN working as an LPN, an NP working as a floor RN, or any other combination you can think of. My guess is that it is a facility-specific policy, and that they have had something happen in the past. I don't think it's tied so much to your degree as to the license. I also agree with the previous poster- if a BSN is required to work there, just go straight for the BSN. It isn't just your hospital that has such a requirement; it's the nature of the current employment environment. Having that BSN off the bat enables you to work as a nurse immediately and also means you can apply to facilities other than the one you currently work for.

  • Sep 17 '14

    Omg the paper is awesome, u r a blessing. This def gives me ideas. Was there other topics u know of hand besides autonomy. I want to keep my options open n do it on the topic that yields the best results. Btw the website for the article is not working. Thank you again

  • Sep 17 '14

    Be ready to work at a fast pace. Many day surgery procedures are short, and the goal is to get 'em in, get 'em out! and get the next one in.

    Be ready to do homework. If you know what your cases are for the next day, see if you can get copies of the preference cards to go over at home the night before.

    Keep a little notebook. This can contain notes that are "common knowledge" that aren't on the preference cards, such as where to find certain supplies or that Dr. X likes this radio station.

    Take a look around the OR forum. This is a question that is often asked by those new to the specialty, and others have given numerous tips that I can't recall off the top of my head. You may find those threads beneficial.

  • Sep 17 '14

    Pls do. I will really appreciate it. Of course I can't plagiarize unless I want to get kick out of the program, I just need something so I can have an idea of what i should write on . Thank you for helping a stranger out

  • Sep 16 '14

    Quote from Nola009
    Nurse Practitioners, what activities does a day at work consist of? As we often hear from nurses working at the bedside, did you find your first year of practice to be most challenging? Was there a certain 'defining moment' which prompted you to pursue your NP? Please explain your stories. I am intrigued by you NPs...
    For me:

    I get to the hospital at 745AM and round on whatever patients my office has admitted, normally 3-4, put in orders, discharge them if needed.

    Arrive at my office/clinic by 9-930 and a mix of acute and chronic parents until 12-1215. Break an hour for lunch. Start up seeing patients again at 115-130 until 4.

    Follow up on phone calls. Go back to the hospital if there is an admission pending or go home.

    In the office I see acute visits, follow ups, new patients. I do whatever procedures need to be done and are safe to do in a primary care setting.

    I also handle all of our INR monitoring, VNA orders, skilled care orders.

    The first year is a learning experience. It can be wonderful or horrible, just like the first year of RN with some added pressure.



    Sent from my iPhone.



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