adult gerontology primary care nurse practitioner

[redsnapper19]

Hey guys! Finally back on here. Use to get on here awhile back when I first started nursing school for my associates. Forgot my username and password. I recently got accepted to a nurse practitioner program from a very good school. I'm excited but scared at the same time. It is a lot of information to take in. There are also a lot of responsibilities that comes with a new degree. Also hoping another nurse practitioner will accept to be my preceptor.

I just wanted to ask you guys that went into nurse practitioner school if your work experience helped with your nurse practitioner specialty? I didn't choose family nurse practitioner as rather not work with children. Didn't choose acute care because I don't want to work in ICU or ER. My work experience have been nursing home, med surg, and acute rehab. Spent majority of my career in acute rehab. Went to orientation, and other students are in bigger hospitals or in specialty floor. I just feel like I'm lacking in experience prior to getting into the nurse practitioner program. The good thing is that some of those students only have one year of nursing experience. I will have to cut back on working full time so I can focus on school for the next two years.

[db2xs]

Yes and no my RN work experience helped with my nurse practitioner specialty, which was adult-gero primary care. My only experience as an RN was in an acute care hematology-oncology unit, which I chose because I wanted to work in palliative care and hospice. The unit I worked on for five years had people of different ages but they were mostly in their 50s-70s, because that is the average age of cancer patients in general. (Acute care is not just ICU and ED, btw.)

In hospice and palliative care, the majority of my patients are in their 70s-100s. The focus is much different than curative inpatient, so many of the things I learned or did in inpatient, I don't use in the community. No IVs pumps, no endless supplies on hand, no constant scrutinizing of patients' BPs, labs, etc. When I worked inpatient, I would say at least 75%-85% of all of our major meds were IV with central lines. It was an adjustment learning about PO meds

If you've worked as a nurse in acute rehab, I doubt you are lacking experience. The things you don't know, you'll learn at school and on the job. And you probably know a lot more than you realize that you do.

[time2go, MSN, RN, NP]

Agreed. I was a CHPN, hospice RN before I finished my NP. Now I'm a hospice NP. Knowing the role of the hospice NP was a comfort to me because I knew that if I got through the education and credentialing process, I could absolutely do the job! I agree also with the previous poster that you likely know more than you realize. Don't minimize your knowledge by comparing to someone else's. I never wanted to work in a hospital and never have. I still know how to do my job. If you're motivated to learn, you'll be fine.

[IMOKAY, BSN]

Hi @time2go. 

I'm also interested in becoming a hospice NP.

Did you have a difficult time finding hospice NPs to precept you in school? 

What is a typical day/duties expected for you as a hospice NP?

Thanks!

 

[time2go, MSN, RN, NP]

You don't need a hospice NP as preceptor.  Whatever your NP designation is going to be is who needs to precept.  For example, if you're heading toward Adult/Geriatric Primary Care, you need a primary care preceptor.  Hospice NP is not a licensed designation, it's a specialty after all your licensing stuff is done.  You need experience once you are an NP if you want to be certified by HPNA.  There are NPs who work hospice who are not certified in the specialty. Many will just find per diem work doing face-to-face visits required by CMS prior to the RN recertifying a patient from benefit period 3-infinity, however long the patient stays on service. 

The other part of hospice as an NP other than the regulatory requirements is symptom palliation.  There is always an MD/DO available to run things by if you are uncertain since an NP cannot be Medical Director in hospice based on CMS rules. Symptom control knowledge is a needed skill in hospice but there are usually less than 20 meds you should be familiar with in that regard in order to take care of the majority of symptoms you'll run into in hospice.  

I was a certified hospice RN prior to being an NP and, if you want to be involved in the nuts and bolts of hospice work, the RN role is much more involved with patients than the NP.  If your main goal is to be involved daily with patients as an NP, you may want to look into being on staff at a hospital in the palliative department.

[IMOKAY, BSN]

@time2go. 

Very helpful. Thanks for taking time to reply.