EricJRN

What I'm wondering about is the motivation for going into mental health. If you haven't gotten much exposure to people with mental health concerns, I wonder if there are volunteer opportunities in your area where you could do so - before you make major life changes. I understand the need to find meaning in your work. I would just consider that there are a ton of healthcare jobs that you might find meaningful. U.S. healthcare is a mess in a lot of ways, and it's pretty eye-opening how often patients fall through the cracks in mental health specifically. I still like what I do in inpatient psych, but sometimes it feels like a revolving door and at times I wonder how much I'm really helping anyone. I worked in a different specialty for years and never felt quite this sense of futility. Looking at the timeline you lay out for becoming a PMHNP, I think you should make sure to add some time working as an RN. PMHNP programs are doing a disservice to people by admitting a lot of applicants with minimal psych nursing experience. I know a number of nurses who went through the PMHNP education only to discover that they really don't like working full-time with people suffering from mental illness. I hope this gives you a few more things to think about, though I'm sure you've considered some of this already. Good luck to you!

If I just took the exam and it stopped at 119, looking at the table would lead me to conclude that I almost certainly passed. But if I got a single question more than that, now I'm thinking I basically have no hope of passing? But then if my exam lasted a few more questions (to get to 125, for example), it's almost a sure bet that I passed. It seems like we might be able to admit that this data set is too small to make any meaningful connections between the number of questions and the pass/fail result. Based on the format of the exam, it seems like both passing and failing candidates would commonly feel unsure, overwhelmed or unprepared. I'm sure there are some good points that can be taken from this, but it seems like it's worded too strongly.

Sometimes in other nursing specialties, there are interesting ways that nurses work with imaging. Some nurses, for example, are trained to use ultrasound technology to facilitate placement of an IV line. It's the exception, not the rule, and it all depends on the nurse's employer, unit, and nursing role. And even those rare nurses are not credentialed to perform ultrasounds for other purposes such as ruling out blood clots. In my role as a bedside neonatal ICU nurse, I'm expected to go into the computer and pull up my patient's chest X-ray image and then collaborate with the respiratory therapist to make sure that the patient's endotracheal tube (breathing tube) is located at the appropriate depth in the airway. I'm not qualified to use that image for other purposes, so the X-ray will be reviewed later by a radiologist and the patient's physician. (But an experienced nurse can often recognize certain obvious things like a collapsed lung and that can help them anticipate what the physician is going to ask for next.) Like others have said, as far as actually taking the X-ray, we don't do that. When the radiology tech comes to take the X-ray, my nursing responsibilities are to continue to monitor the baby, to make sure that they are lying in bed straight so we get a good X-ray image, and to move certain wires (like EKG leads) so they are not running across the patient's body. This can be very important, as a rotated chest X-ray can make the patient's heart look bigger than it really is.

I think if you really want to assess whether a specialty change is going to do the trick, I would give it at least six months off of orientation. At three weeks on your own, you are probably still trying to figure out some basics like getting to know your coworkers. NICU nurses are pretty protective of their patients, and on some units that comes out in the form of not being super welcoming to new people at first. I know it's uncomfortable to be new to a specialty but not new to nursing. (I had a midlife crisis a few months ago ? and left the NICU for an adult specialty after 16 years of only NICU.) If uncertainty about patient care is part of your struggle, I think there is good news. There are like five newborn disease processes that constitute most of your care - maybe a handful more in a Level IV unit - so after a few months I bet you'll feel more confident as far as knowing what to anticipate for your patients. My other thought is that if you come up with an end goal at 2.5 years, that would be way faster than average! I'm hoping you'll stick it out for a bit, but I hope you do what you need to do to maintain your mental health.

I agree with the previous poster. It sounds like your sandwich shop boss would be able to write a more personal and specific letter that would show qualities like leadership that would probably look good. Good luck to you!

Hey Kamilah - I got my AS and MS (nursing education focus) at Excelsior. I finished the master's more than seven years ago, which is probably too long ago to be helpful to you, but I wanted to wish you good luck.

Almost all of them do in my experience, and I think it would be reasonable if an NNP program said they didn't count the orientation period as experience. (In the longer Vizient-type residencies, they'll probably be taking independent assignments long before the nurse residency program ends.) I know that nurse residency requirements can be time-consuming, but no matter how difficult it is to succeed as a nurse resident, I think it would be harder to learn those essential things without the structure of the residency. When I think about units that might hire a new grad without a nurse residency program, I'm thinking of small, low-acuity units that wouldn't exactly be great preparation for an aspiring NP.

I've never worked in the role, but I think you're right to be concerned about the experience. I'm surprised they're not requiring teaching experience in allied health. I know a couple of people in similar roles; one was RT faculty for several years, and the other taught in an EMS program for a long time.

To clarify, are you thinking about becoming a hospital unit-based educator? Or something more along the lines of a clinical instructor for a nursing program? A clinical instructor job can be a good way to try out teaching because it's usually once a week. Most people do it as a side job, and a lot of programs let you skip a semester if you have other things going on in life. To me, it's fulfilling to hear from past students who have become nurses. A lot of schools require a master's degree though. Unit-based educators (the educators that track unit competencies and plan the orientation schedules for new hires) are often salaried based on 40 hours per week. If you work on a unit where the educators are very involved in QI or you have a lot of nurses on orientation, it can be hard to get everything done in 40 hours. It's also worth thinking about the fact that you would likely be going from three days a week to five days a week. Good luck to you! I hope you're able to find a good fit.

I'm late to the discussion, but I'm just echoing that that's an odd "no nurse residencies" requirement. A nurse residency program should make it easier to succeed as a new grad, not harder.

I'm in a similar place in my program as saheckler. I have felt supported in my program, but it can be a struggle to perform well without sacrificing important family and personal things. I would just add one career option to the above: Some hospitals or health systems hire nurse scientists to help nurses start EBP projects, publish articles and the like. I know a handful of people in these roles, all PhD-prepared. I don't think there are a ton of openings for the role though; in my current hospital system, there is one nurse scientist for 12 hospitals.

I realize this is an old thread, but it’s a good question and might help somebody else. If you have any work or clinical experience, you have probably run into a time when you disagreed with someone. (When I’m conducting an interview, I ask this as “Tell me about a time you disagreed with a coworker” - not “How would you … ?”) If you have had a work or clinical disagreement, even if it wasn’t a nursing job, giving that example (and explaining what you did) can be a great way to answer. Privacy and a calm, gentle approach are good things (good job there), but I would like to hear you mention something about listening to the other person’s point of view. Many times a disagreement arises just because two people aren’t listening to each other well enough.

I’m another EC grad here. I finished back in 2005, so I’m not going to be much help to you, but I wanted to say good luck!

Good luck to you. It’s a little disconcerting to think that students in the second program will wash out so frequently, but it sounds like you would be an above-average student in that program. Something you might check into: Do these programs have full approval from your state board of nursing? In my state, we can go to the board’s website and see whether a school has full approval or whether it must continue to meet certain conditions because of concerns noted by the board.

Mine uses pass/fail, but the student has to achieve certain numeric scores (like a minimum numeric grade on care plans) in order to pass.