Chronicles of a VA APRN Resident

Specialties Advanced Nursing Q/A

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I interviewed today and was offered one of six resident positions. I lost it. The panel laughed and said my reaction was the best one so far. ?

I was asked nine questions. They were along the lines of "Tell me about yourself; How will you contribute to VA care; Flexibility and describe a time when it was required; Career goals; Rate yourself 0 - 10 in the following aspects, etc.". I was sweating the whole time, but displayed a cool (I think) exterior.

It starts towards the end of September, so plenty of time for me to go over all my material from school and beef up my knowledge so I don't look like a total dunce.

I will periodically update this thread with all my trials and tribulations for those who are interested in applying for a spot in the future and want to know what the year will look like.

Specializes in FNP.

I heard HR is so backed up which is slowing things down, plus everything is a process at the VA. It sounds like it maybe closer to October. Yes fingerprints have to be done, the background investigation, preemployment physical etc.., there are some TMS trainings, CPRS trainings, and the onboarding that have to be completed before starting. 

Specializes in hospice, HH, LTC, ER,OR.

I got my letter about 1 hour after I posted about not receiving it. I briefly skimmed it. But we so have to report at 0745 to the education building, so far the start date is still 9/26.

Specializes in hospice, HH, LTC, ER,OR.
1 hour ago, Freckledkorican said:

UPDATE:

Hello all!

Last week, I received the official HR job offer and accepted it. Today, my program coordinator emailed a schedule of phase one of the residency, up to end of October. It is now feeling real and I cannot wait to start on Monday?

I hope everyone else is doing well!

Very nice! Can you tell us what your schedule is like for those of us, left in the dark about what we will be doing?

Specializes in hospice, HH, LTC, ER,OR.
28 minutes ago, Freckledkorican said:

Of course?. Mileage will vary per program, of course, and as always, subject to change.

Week 1: Mon and Tue is dedicated to finishing up loose ends with HR, presentations on benefits, leave, Privacy/HIPPA, etc.. I will be with my cohort in person at the hospital for these days. Wed is new provider training (virtual). Thu is home site orientation and observation of clinical experience. Fri is syllabus review, general housekeeping rules, and weekly reflection at one of the outpatient community clinics (not mine).

Week 2: Monday morning is clinical experience at our respective home site and afternoon is TMS Travel training. Tuesday morning is clinical experience and afternoon is some more TMS training along with one hour of didactic (Whole Health). The rest of the week is essentially the same. Clinical experience in the a.m. and then some type of orientation classes in the p.m..

Week 3: This is when the orientation hours start to slowly drop off and we will start ramping up clinical and didactic hours. I thought didactic would be on Fridays all day. Instead, it is split into half-days on Tuesday and Friday afternoons.

So far, I am pleased with the schedule.

Thank you so much for sharing

Specializes in FNP.

What is the dress code can you wear scrubs?

Specializes in hospice, HH, LTC, ER,OR.

I am so nervous for orientation tomorrow! They told us to come business casual; I haven't had to pick out an outfit since clinicals. 

Specializes in FNP.

Happy for you guys let us know how it goes. It is taking so long not sure if I want to continue with this or just get a regular job. I just completed my finger prints Friday.

Specializes in hospice, HH, LTC, ER,OR.

The first day for me was all policies, benefits, who to call and and when. I fell asleep twice I was so bored. I hope I don't do this tommorrow. We are still with everyone that was hired, so nothing specific to NPs or nursing.

For those of you who chose to do this residency instead of just going straight into a non-residency job:  Did you decide on this route because you felt your school did not give you the best training?  Or you felt "okay" but wanted to go into your first non-residency job, after the VA, more confident?

It's my understanding everybody comes out of FNP school feeling less than prepared for the most part.  I guess I'm just wondering the pros and cons of going through a residency, such as the VA, versus getting employment (less practice) right away and "hoping for the best?" 

Specializes in Psychiatry.
Mergirlc said:

For those of you who chose to do this residency instead of just going straight into a non-residency job:  Did you decide on this route because you felt your school did not give you the best training?  Or you felt "okay" but wanted to go into your first non-residency job, after the VA, more confident?

It's my understanding everybody comes out of FNP school feeling less than prepared for the most part.  I guess I'm just wondering the pros and cons of going through a residency, such as the VA, versus getting employment (less practice) right away and "hoping for the best?" 

It's a totally different experience. No, NP school does not do a good job preparing students for practice - PAs and Medical Students are terrified and fumble for months in residency/first jobs and they have 2,000-4000 hours of clinical. The requirement for NPs is 500 hours, much of it ends up being set up by the student and can be as simple as "shadowing." The first job for many NPs has no support and they are just expected to learn on the job, despite having no mentor or someone to tell them when they are doing something correctly. 

A residency is NOT like a first job- there is no "quota" they are trying to hit or make sure you are profitable out of the gate. In my VA residency program, I was assigned an MD and worked with him everyday, 9am to 4pm, seeing patients. At first, I shadowed him and asked questions. After a 2 weeks or so I began seeing his patients while he watched and corrected. After a few more weeks I saw patients alone, then presented to him the findings and my plan, he would then go see the patient and verify and we would talk it out. He helped me learn when to order tests, how to read them. Eventually I started to have my own "roster" of patients and by the end of the full-year residency I had acquired an almost additional 2,000 hours of directly supervised clinical hours and was working independently with my own roster of patients but given 45-60 mins per client so I could take my time and learn and full access to an MD who had signed up to teach and was not at all concerned with profitability. I also got to rotate to different specialities for a while. On top of all of this was didactic experience with experts explaining common pitfalls, treatment algorithms, etc. I learned 10x as much during my residency as my entire NP Program.

Freckledkorican said:

Everything MentalKlarity pointed out. An NP Program barely prepares one to be a provider. In my opinion, a strong residency is what I need (heck, all NP graduates) before I practice on my own. For example, my first specialty rotation will be with pharmacy for two weeks at the beginning of November. Sure, we all took advanced pharmacology and learned whatever amount during clinicals, but this will be in-depth learning with a pharmacologist. I'll have another specialty rotation with a radiologist and the list goes on. That is precious knowledge I wouldn't get if I just started working somewhere as a new grad and hoped for the best. 

Thank you both @Freckledkorican and @MentalKlarity.  I appreciate the insight.  Next semester, I'm about to start my FNP clinicals.  It will be for the entire 2023 year and will get close to 700 hours in, possibly more. I know, still not enough. I like to start weighing the possibilities now, to see which road will be the best for me to go down.

I do like the idea of rotating through the various specialities at the VA; especially w/ the pharmacist!  That's golden!  I do agree, as new NPs we definitely need guidance along the way in some way.  

Thanks!?

Congrats on your success! May I ask what your background consisted of?

I desperately want to do a residency before practice. My only concern is my mediocre resume; limited RN experience, "diploma mill" grad school, no publications or direct experience in leadership... feeling discouraged and unsure of where to look. I can't seem to find much on the discussion of NP residency, either. 

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