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sirI, MSN, APRN, NP Admin 87,234 Views

Joined Jun 24, '05. Posts: 103,244 (17% Liked) Likes: 26,904

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  • Mar 25

    Thank you for returning to post this extremely detailed update of your progress. I am pleased that you seem to have finally found your niche in nursing.

  • Mar 25

    The DNP was a good fit for me because I knew that I had interest in teaching and/or hospital administration in the future. Also it was a point in my life where I could dedicate the extra time to added semesters and I knew in the near future I wouldn't have time to go back for the degree.

    I currently work as an FNP in family practice and I do have patients who appreciate my DNP. Other patients could care less as long as I provide quality and safe care.

    I think you have to look at your end professional goals and make the decision from there!

  • Mar 25

    I think you should consider a few things while making your decision: where do you want to be in 5 or 10 years? What are your other goals- professional @ personal? Also, for me, at least, age is a factor.
    I am 53 years old & have been a nurse for 32 years; nurse practitioner for 16. I really like what I do & hope to remain in my current position for at least 5 more years, but I'm tired! If the opportunity arose, I would probably go part time. Obtaining a DNP at this point is just not something I want to put time, effort & money into. It would not help me in my current position & I would not make any more money.
    You, however, may be much younger & plan to work a lot longer than I will. You may just want to bite the bullet & get it over with. Just another hoop through which you will have to jump...good luck!

  • Mar 25

    I think a doctorate can come in handy for a future role in teaching so I'm considering it but I'm in a state that doesn't offer a great selection of DNP programs that I can attend in person. I'm also considering the cost factor and don't want to spend a lot of money on a degree. I never had loans for my Master's and want to be able to do the same for DNP.

  • Mar 25

    Well Everyone,
    It's been over a year since I posted. The year of my career as LPN was hell, I felt it was over before I even got a footing. I went through a hard termination at a hospital , for which I do take my part and errors. Looking back some of my behavior, was very reactive. In as in the end it was my choices that resulted in the decision.

    That experience lead me to an identity crisis as I didn't know who I really was if I wasn't in a hospital as a nurse. Went through a nasty bought of depression/ anxiety and contemplated suicide. Recently I found out I have hypothyroidism, which could be a reason for my anxiety, which has decreased since synthroid. I still wouldn't go back and change a thing that happened in the hospital as I believe it helped shape me today.

    3 jobs later, one I quit due to moral reasons and one that let go the nurses go because of funding and one I'm still at I have seemed to have a footing finally and regained my confidence. I found my niche in the community/ primary care. I love getting to know the patients that come through and seeing their progression ( I had a young patient with salmonella induced arthritis that could hardly walk using a wheelchair and is now walking without assistance!!!!).

    Life has gotten alot better. I believe I found my niche and I'm looking at doing my LPN to RN bridging program as soon as I get all my hour letters from my employers.
    I have learned to trust my intuition, strive for more and to not be afraid to ask for help when I am unsure of something.

    So in all, hold on as much as you can and don't be afraid to fail. Sometimes failure can lead to future success. I wish the best to all nurses, especially the new nurses. I am here for you if you need someone to listen to you.

    Cheers Everyone!!

  • Mar 24

    I've been a nephrology APRN for 11 years now. Like with any job, there are pros and cons. I am in a large 21 MD, 8 advanced practice providers - we have our own surgical center also. My current job is just rounding on dialysis patients in dialysis units but I also have administrative duties as I'm the supervising APP.


    1. Pay - private practice usually pays more than being hospital-employed. I pay nothing for my healthcare, I have 8 weeks PTO/year, and a completely paid retirement plan.

    2. Flexibility - I make my own hours - as long as I work 40 hours and get my visits done, I'm golden. 3 of our APPs have young children and if they need to rearrange their week, like come in late one day if they are working late, leaving early if they come in early, etc., that is up to them.

    3. Orientation - we offer 3-4 months of orientation depending on prior experience.

    4. Autonomy - I make care decisions on my own. Of course I do have MD back-up (by phone) but at this point, I call MDs only very occasionally.


    1. Biggest con for me (my background is ER/ICU) is the chronicity of nephrology patients. I remain on my rural EMS squad (for the last 18 years) so that I can still get my adrenaline rush.

    2. The complexity of dialysis pts does make you think on your feet - we now have pts in the outpt environment on inotropes, Life Vests, LVADs, trachs, etc. (Personally I view this as a pro because I like learning but some APPs feel that the acuity is getting very high, especially in some of our more rural clinics).

    3. Little interaction with other APPs - we talk/text but for the most part you are on your own.

  • Mar 24

    I chose a beautiful spot outside on this 72 degree day to write about this nurse innovator. It seemed fitting to be surrounded by blooming azaleas, periwinkle, dogwood trees and to hear the birds chirping while I introduce Clifton Joullian RN, BSN. His story is just plain cool! Clifton was a home health case manager for 20 years before transitioning into home health intake nurse recently. He has always had an interest in gardening, starting small with flower beds. Throughout the years his interest expanded to backyard farming and he began connecting this passion of farming into his nursing career and goals. If you are like me, you are wondering how the two passions fit together, read on!

    Clifton Joullian is “The Nurse Farmer”. He connects his love of farming and nursing in a blog called The Farmdamentals of Nursing. “My mission as a nurse and a backyard farmer is to advocate and teach how farming and gardening are a means of health promotion and disease prevention from a holistic perspective, bodies, mind, and spirit.”

    Healthy Bodies

    Farming promotes healthy bodies in a few ways. It increases physical activity and exercise and it also increases vegetable consumption. Evidence has shown that people who grow their own fruits and vegetables have a tendency to eat more fruits and vegetables. This is particularly true for children. Research has shown that children who grow their own vegetables are 5 times more likely to eat them! Clifton has been helping with his sons’ high school vegetable garden, teaching the students about the link between the foods we grow, how we grow them, and how they can have a positive impact on our health.

    The Centers for Disease Control says, “Gardening is an excellent way to get physical activity. Active people are less likely than inactive people to be obese or have high blood pressure, type 2 diabetes, osteoporosis, heart disease, stroke, depression, colon cancer, and premature death.” Gardening has been used in nursing and assisted living facilities as part of a physical rehab and stroke recovery program. For the elderly, it also increases hand strength and joint mobility.

    Healthy Minds

    Clifton refers to the emotional and mental benefits of gardening/ farming as a” natural antidepressant”. There have been studies to support this as well. Gardening leads to decreased cortisol levels and positive moods which can promote relief from acute stress. Being out of doors and working with the earth can provide mental clarity. There is also a boost in positive self-esteem and a feeling of reward that comes from seeing the literal fruits of your labor. Gardens have been used in communities to get people to work together for a cause. They have also been used in nursing homes to decrease aggression in patients with dementia and mental impairments. Clifton has been stretching outside of the virtual world to volunteer his services at a local church that needs his help with their garden. He is helping them grow vegetables that are being donated to an organization that feeds the homeless.

    Spiritual Health

    Clifton sees gardening as a means to promote spiritual health by helping us connect with others or even feel closer to God. Clifton read an article quoted some individuals who viewed their time working in their garden as their church time with God!

    When asked about what has lead Clifton toward his innovative idea as The Nurse Farmer, he credits advancing his degree from ASN to BSN a few years ago. He learned how to research and write using evidence -based information which further advances his career goals as a nurse blogger and potential growth in his business. Clifton believes that one of the most important issues professional nurses must address in the next few years is to increase the number of baccalaureate-educated nurses. He argues that having a BSN “opens so many doors and exposes us to so many sides of nursing that maybe we didn’t know existed. Having a BSN is a tool that makes navigation in innovation that much easier!”

    Clifton says he was also exposed to a whole new world of professional organizations, through his BSN, such as holistic nurses. His search for like-minded nurses who ‘think outside the box’ led him to The National Nurses in Business Association (NNBA). He attended the national conference last year and was able to meet one of his career role models and fellow nurse innovator, Donna Cardillo RN, CSP. She has been very supportive of Clifton’s role as The Nurse Farmer. She stresses to him the power of publicity as a means to separate yourself from competitors in your business.

    Clifton’s long-term goal is to further integrate farming into his nursing career. He advises that nurses need to think outside the box when it comes to their career and license. As a nurse who wants to branch out of their current career, Clifton recommends asking yourself this question that may steer you in the right direction. “If I could throw a sign up in my driveway that read REGISTERED NURSE FOR HIRE, what could I do for financial compensation using my nursing license that did not require a physician or employer directing or controlling me?” He says, “before answering the question remember the definition of nursing (abridged) is the promotion of health and the prevention of disease”. For Clifton, that means teaching and advocacy. He can teach and advocate farming, gardening, and nutrition.

    Clifton admits his concept is still in its infancy. He is constantly rethinking and developing his skill set and knowledge base. Through The Farmdamentals of Nursing and his role as The Nurse Farmer, Clifton is able to reach out to his community and affect the mind, body and spiritual health of those whom he is in contact with. I am so glad to have connected with Clifton Joullian, nurse innovator. He has inspired me to think of how I can reach people through my own passions. Connecting, caring, advocating, helping others to achieve health and wellness is what we all as nurses hope to achieve. We all need to be encouraged to step out into the world and “get our hands dirty” to make a difference!

  • Mar 23

    Today’s post is a two for one special! This week I decided to take a weekend getaway to Charlottesville, VA. But there’s one major problem. I’m still in grad school! One great thing about being in an online FNP program is that I can attend class anywhere there’s wi-fi. The bad thing about having such flexibility is that it requires you to be more disciplined. Is there a way to balance travel and grad school?

    This week I share some travel study tips and see what Charlottesville has to offer!

    Some highlight include:

    • Travel study tips:
    • Be strategic
    • Be organized
    • Be disciplined
    • Yes grad school is tough, but remember the sacrifices you make today will benefit you tomorrow!
    • A peek at local establishments and wineries around Charlottesville, Virginia

    I hope you enjoy Follow Me Through Grad School Episode 105 part 1 and 2! Let me know in the comment section, if you think it was a good or bad idea to go on a weekend getaway while in grad school? Also, have you taken a trip while in school?

    Until next time,

    Bizzy Bee

    Fuel your passions. Fulfill your purpose.

    Episode: Charlottesville, VA Pt 1

    Episode: Charlottesville, VA Pt 2

    Be sure to see the journey from the beginning. Don't miss the first 4 episodes:

    Follow Me Through Grad School Episode 101 - Journey Before the Storm
    Follow Me Through Grad School Episode 102 - First Week of Classes
    Follow Me Through Grad School Episode 103 - Going Stir Crazy
    Follow Me Through Grad School Episode 104 - My First Grad School Fail

  • Mar 23

    Failure is a normal part of life. It serves as an important step in one’s personal growth, learning, and future success.

    I’ve always said sometimes a setback provides an opportunity for us to step up! In this week's episode, I discuss my first grad school fail! Although, this did come as a shock. It did not deter me from my ultimate goal of becoming an FNP!

    Some highlights include:

    • There will be bumps on your journey to becoming an FNP, but it’s what you do in those instances that will determine success!
    • It’s not about perfection. It’s about progression.
    • Life’s greatest lessons are usually learned at the worse time, from the worse mistakes.
    • Grad school is more difficult than I could have ever imagined.

    I hope you enjoy Follow Me Through Grad School Episode 104: First Grad School Fail. Let me know in the comment section if you have ever failed in nursing and/or grad school, and if so what did you do to rebound from it?

    Until next time,

    Bizzy Bee

    Fuel your passion. Fulfill your purpose.

    Episode 4: My First Grad School Fail

    See the journey from the beginning. Don't miss the first 3 episodes:

    Follow Me Through Grad School Episode 101 - Journey Before the Storm
    Follow Me Through Grad School Episode 102 - First Week of Classes
    Follow Me Through Grad School Episode 103 - Going Stir Crazy

  • Mar 23


    I am the author of this article and I hope I didn't offend you...but it sounds like I did. I did this article not to ever say I am smarter than any patient, but to the fact that these remarks always throw me for a lopp.

    That being said, I agree with the others that laughter is the best medicine. If you haven't laughed about what a patient has said, and in turn laughed about things you have said, then you aren't having fun at work, in my opinion.

    I absolutely love what I do. I absolutely love my patients, but need a good laugh.

    Quote from NotFakingit
    This question has already been answered, but - plug your nose - let's try again. The OP rants about what a burden it is to be the smartest person in the room, and having to deal with those who she deems intellectually inferior. This is narcissistic.

    So I'll ask - for the fourth time - where is this so-called humor I keep reading about? There is no attempt at comedy in this rant. Don't misunderstand - I am not suggesting that the humor is mean-spirited and therefore not funny. There is no humor, no attempt at humor, and nothing that could be considered humor by anyone, anywhere, ever. Yet you seem to think that erroneously applying the phrase "gallows humor" makes the OP's statements defensible.

    Anyone want to answer the question this time? How about an example?

  • Mar 22

    1. Are you glad you got your DNP? Why?

    I am glad I got it out of the way, it makes me more comfortable for whatever future lies ahead. The way I see it, it is never going to hurt me and may help me in some form or another down the road, either in practice or in academia.

    I also "just like" having a terminal degree. There is a feeling of completion there in a job where otherwise you can never stop learning.

    2. Are you glad you didn't get your DNP? Why?

    I wouldn't have done it if I had to pay for it.

    3. Does it really matter?! Why?

    It matters but not in many significant ways. It opens doors to academia. It prepares for the future. It engages practicing NPs in a number of different ways. I think it is good for the profession moving into independent practice from a purely superficial standpoint.

  • Mar 22

    Almost as if on queue, the professors of my MSN FNP/AG-ACNP program are pushing for DNP. I understand the push for terminal degrees. It looks good on paper, woo hoos, hugs, and high fives. But realistically, it will be *at least* 2 more semesters for me.
    Should I delay graduation and providing for my family for another year? It seems like 10 years down the road I would be thankful for getting a terminal degree (i guess?), but the short-term seems pretty terrible. I realize there will always be an opportunity to go back to obtain the DNP, but would it be wise to just get it while my hand is on the plow?

    My question for actual, practicing NPs -

    1. Are you glad you got your DNP? Why?
    2. Are you glad you didn't get your DNP? Why?
    3. Does it really matter?! Why?

    Sirl and Trauma, please leave this in this group! I want to hear from licensed NPs, not from MSN/DNP students. Thanks!

  • Mar 22

    My first day as a nursing assistant, I arrive in my pretty new scrubs and meet the nursing assistant who will be training me. I greatly enjoyed everything we did that day and was perfecting things I had learned in nursing school-taking vitals, checking blood sugar, I/Os, ambulating patients and so much more. Towards the end of the day my trainer asks me to go get a plastic spoon after my lunch break. Confused, I hunted down the plastic spoon and she then proceeded to tell me we would be using this to scoop poop from a bed pan to send to the lab. Grossed out I move forward and dived into the beginning of my career and one of my many encounters with poop. I also brought my own spoons to work after that for lunch!

    The other #2. Crap, poop, ****, poo, doo-doo, poop emoji, the runs, and so many more I have not listed. As a health care provider, one of the most common complaints people have is about poop and it is one of the most common things I see every day at work . If you think about it everyone poops… you hope.

    People are funny about poop, I have seen grown men cry about not pooping every 12 hours, teenage girls claiming they only poop every 18 days and do not need a bowel regimen, people wondering why their constipated but refuse to believe you when you explain side effects of the narcotics they are prescribed, not understanding why you need to wash your hands post poop. Poop is a funny thing.

    One of the many life lessons I had in nursing involved poop and one of the many names for it. I was working in an inner city hospital in the ICU, I had just come in on night shift and was told to immediately transfer a 3 year old to the general care floor so I could admit an intubated baby. I take report, call the accepting nurse and go to see the patient in question. I walk in the room and he is screaming at the top of his lungs. I go up to him and put the crib rail down and ask him what was wrong. He screams at me “I gotta boo-boo”. I’m thinking “Crap, how did he get hurt? Filling out an incident report is going to take so much time!” I start examine him looking for this boo-boo and cannot find anything. While I’m doing this, his mom is giving me the look that translates into “you’re an idiot”. I then ask her if she wants to try and calm her son down and I may have been making it worse being a stranger. His mom then says “he’s trying to poop, boo-boo means poop”

    Imagine me turning bright red and stuttering I’ll be back. I rush out of the room embarrassed to my co-workers who all burst out laughing when I explained what was going on and then proceeded to tell me their first “boo-boo” stories with patients.

    Pooping is essential to health and way too many people in this world are constipated. Think about peoples diets, sedentary life styles, narcotic use, lack of water intake which all leads to constipation and then a miserable person. Pooping is a good thing, please don’t ignore constipation in yourself or your patients and you will probably need to educate your patient one day (if you haven’t already) it is not normal to be screaming in pain with poop, miralax will not give you the runs seconds after drinking it, our grandparents got it right with prune juice- that stuff is magic for constipation, it’s not normal to poop once every 18 days and most people don’t drink enough water (I’m so guilty of this one).

    Nurses know much more about poop than the general population and we should be educating all of our patients and their families about this. Even though I’m not a bedside nurse anymore, I’m sure I will always be able to smell a GI bleed and C-diff from a mile away and I was always immediately send a sample to the lab if a bedside nurse tells me the poop has the dreaded smell (way worse than typical poop smell). Health care providers are probably the only people you will meet who will be more excited about your farting and pooping than yourself.

    Peace, love and happy pooping

  • Mar 21

    Thank you sirI, MSN, APRN, NP for your kind words. My cousin definitely tight me a valuable lesson!