16BitSalt

VISN 4 here (Pittsburgh). I am part of the provider group for a couple of rural CBOCs in Western PA but we are stationed at one of the main healthcare system campuses. I find it strange that they don't do the same for you guys. We are teleworking temporarily because office space is an issue (two RNs and an LPN with one dedicated cubicle). There is one of us onsite to triage any walk-in patients and the other two telework, it adds up to 2.5-3 weeks of telework per nurse per month. It doesn't affect me too much because I don't have children and the main campus is only 12 minutes from my house, but it has been tremendously beneficial to the other two nurses. Do you have an actual walk-in clinic at your site? We work at the campus that has primary care clinics but no dedicated BH clinic, so it doesn't make sense to have three BH nurses to triage one or two patients seeking first-time BH care every 1-2 weeks or so. The other campus, our main hospital, has a dedicated BH clinic and the nurses there do not telework, but they do get to work 10-hour shifts. I'm not sure how busy you are in your VISN, but I myself have maybe 2-3 calls and a couple secure messages daily, so we can definitely get away with one nurse on site at a time. Ours is supposedly temporary but they may make it permanent if we want to continue to do it and the on site triage stays slow.

I'm a senior nursing student, and our classes were moved online. We only had one week of class left (the final exam), and it was moved to online for this Monday. We had two clinicals left and they will be sims, followed by a Zoom meeting with our instructor. Our last lab will also be a Zoom meeting. We will have to do our ATI Comprehensive exam online as well, but there is no date yet. We were supposed to come to campus, and just be split into small groups, but here in Pittsburgh and all of PA non life-sustaining businesses were ordered to close for two weeks. Thankfully, we have three clinical sites who will take us for preceptorship. Our pinning ceremony was postponed, but it looks like we'll be able to graduate at least. I feel terrible for the other classes missing out on all of their clinical opportunities. I'm devastated that I won't get to celebrate the two years of hard work put into graduating with my friends and family, but so grateful we can still finish our program on time.

I'm not much for reading, but I do skim our powerpoints from class and flip through the book if I need more in depth information. Most of my learning comes from clinicals where I'm actually working with a patient and seeing what I need to learn face to face. I'm a big fan of practice questions, too ?

A lot of people have already mentioned not doing nursing if you're in it for the money, and I'm inclined to agree, BUT I'll add some of my two cents just because you're already in the program and presumably doing well: There are TONS of different types of nursing fields, many of which either don't actually require a ton of patient/coworker interaction or involve people that may be more your type. My clinical instructor worked in IT as a nurse, doing things like looking at how charting systems function from a nurse's perspective. Clinical research nursing involves specific groups of patients and often involves more data-driven stuff. Clinic nurses work more of a traditional 9-5 healthcare role deoending on where you work. There's a lot of different types of nursing with different types of people (and a nice wage regardless). Every place is different and so are its employees. I wouldn't give up on nursing just yet, you may just meed to find your niche. I'm a very social person and I know how hard it is to feel alone in a large group. If you continue, you may have to survive bedside nursing for a couple years until you find a field you enjoy and further your education, but in my opinion you could still have your "a-ha!" moment and find what you like ?

I was hoping I could get some input from nurses who stayed in psych or made the transition to any form of medical nursing (med surg, ER, ICU, etc). I am a psychiatric nursing assistant and have worked in psych for 10 years in some capacity. The main emphasis of my job is to run groups and use therapeutic communication as it pertains to mental health issues. I currently work for the VA (inpatient psych) and my floor specializes in schizophrenia/psychotic disorders/depression with acute suicide attempts. Psych is all I know and it's what I'm good at; the transition to psych nursing would be relatively easy for me as the scope of practice for psych nurses is very familiar to me (mental health admission assessments and psychiatric med administration). I graduate with my ADN in May and am contracted to work for the VA as a nurse for three years. I've started to enjoy bedside nursing and I'm starting to really think I'd like to work on a neuro floor, either the ICU or a stroke floor (my current clinical floor is neuro-telemetry). My bosses at work would really like me to stay in psych, and I know I'd be good at it (I can't choose where the VA puts me due to my contract but they can request I stay at my request). My school has offered us the opportunity to precept on a psych floor, and this is our ONLY opportunity to choose exactly where we precept. However, I'm really torn because I think I'd like to precept in med surg nursing or something medical, even though my skills aren't as strong by a long shot, and I DO love psych too. I am also planning to work on my BSN in the fall and then choose a BSN-DNP program after that. I don't know if I'll want to specialize as a psychiatric NP or do something like adult-gerontology acute care, and part of me thinks I'm doing myself a disservice by staying in psych. Do any psych nurses have some input? Have any of you transitioned from psych to medical?

This is kind of late for your test, but for what it's worth: 100mL ÷ 60min = 1.6666 mL/min 1.666mL/min x 10gtt/mL = 33.333 gtt/min Round to 33gtt/min Convert cc to mL first. Convert hours to minutes. The 250mg is not relevant to this question, they sometimes do this to test how well you can pick out the important details. Do not round until you have your answer, and drops are always calculated to the nearest whole number.

I worked full time for my first year of nursing school, I'm in my last semester now. It's very doable, but it's extremely difficult and stressful. I was fortunate enough to have an employer that has a policy of "school schedule over work schedule" so I was able to arrange my hours accordingly. For my first semester I worked nights and then went to my evening classes, and for my second semester I did early mornings (6a-2:30p) and then class (4p-9p), did evening shifts on the weekend, and I scheduled my day off work when I had clinical. I only had one day off from both work and class every week, so studying was difficult unless my unit was quiet (inpatient psych) and I could get some studying done at work. If you need to work for financial reasons like many students, you can absolutely do it, but I won't lie, it's not fun.

If you don't want to wear a turtleneck or something on your neck, Kat Von D Lock It foundation is a very heavy foundation that will cover anything, and it doesn't smudge easily. It's a little pricey, but it lasts a while. You can get it at a Sephora or directly on her site.

That's correct. You would still be expected to work while receiving NNEI funds so you would be paid your normal salary while working. The VA does offer some pretty helpful residency options if you decide to pursue CRNA while employed there, but I don't know enough about it to provide any info unfortunately.

There's a separate program for CRNAs; they send you out to Texas for two years to complete a residency and your clinical hours as well as classes. It's on the VA's dime and there is a service obligation after. I was looking into it for my grad school plans but two years in Texas isn't really feasible for me. You could use NNEI funds to pay for schooling if you don't want to travel to Texas, but you'd still have to work during that time and there's also a service obligation (from what I understand it's hard for CRNAs to work during school). NNEI is for advanced nursing degrees (post-BSN).

We get time and a half for actually working on the holiday, we only get an "H" day if we take the day off, which is a normal day's pay (essentially an AL day without using AL time). I'm VISN 4 if that makes a difference. I've never gotten the time and a half for working the day before or after.

I work with amazing nurses who failed programs at one point, and they're my best mentors now. Someone who is struggling might find comfort in knowing that you were once in their position, and you were able to develop better studying techniques and have previous knowledge. It's hard to fail out of a program and start from scratch, and you're a better person for it. Anyone who judges anybody for wanting to better themselves has major issues, anyway. You deserve to be proud of the hard work you've put in.

Just like AnnieNP said, take a moment to relax and collect yourself. If something is against protocol, just don't do it. Not only for the sake of your patient, but yourself. It sounds like you learned that lesson and your resident is going to be alright. Nursing programs are intensely competitive, and you HAVE to be smart in order to earn a spot, which means you ARE smart. We're all learning while we're in school, and it's scary to be in a position where you don't always know what to do when there's a living, breathing person involved. It's especially daunting when you're a CNA, because in a couple years you'll suddenly be in a position where you're expected to know what to do and delegate tasks to CNAs and LPNs as a brand new nurse. We're all dealing with "impostor syndrome" through school and it's a normal feeling. None of us are going to know how to assess everything right away, that's what clinicals and seasoned nurses are for. Don't be afraid to ask questions and try to take in as much as you can. If it makes you feel better, I had a test question my first semester that asked what were PREVENTABLE risk factors for an illness, and I selected "being female". My instructor said after the test that "one of your peers doesn't know how to read questions". I felt like an idiot, learned from it, and I'm now six months away from graduating. Trust me, we all have our moments.

1. It was the cheapest and the most convenient for me. 2. August 2018. I graduate in May if all goes well. 3. No. 4. We have two international students, one is from Africa and I'm not sure where the other is from. 5. Allegheny. Keep in mind that you can choose a preference but they can put you wherever they want to. 6. We don't see many other students. We get a lot of transfers from other campuses so probably Allegheny. 7. I don't know the cutoff but I had a 3.2 gpa and an 80 on the TEAS. I got my first choice of campus (Allegheny, evening). 8. Our instructor told us there were eight applicants per seat, but I don't know anyone personally who didn't get in. We've had about 1/3 of our original class (40 students) fail at least one class, and I know four that dropped the program. One is working on going to Shadyside. 9. I am transferring to Cal U for my BSN after I graduate, and then I'm going straight to grad school after, but I don't know which graduate program yet. I work for the VA and have a scholarship through them, so I will continue working there for at least 3 years.

I would talk about it with your scholarship coordinator first, I was under the impression that VANEEP was available nationally. I know my VISN (4, Pittsburgh/Western PA) uses the program pretty heavily and we get a mass email every application cycle. If you look at the Sharepoint under Nursing Education there should be scholarship info as well.

From what I understand most students in current nursing programs (at least in my area) are using the 2016 ATIs still for Practice A and Practice B. Do your practice exams and remediate if your school requires it (we have to fill out study templates for B and meet with an ATI instructor before doing our proctored exams). After I remediate, I flip through problem chapters daily, and then 2-3 days before an exam, I take ALL of the Nursing 3.0 quiz questions on whatever area my proctored exam is on (there's a lot for med surg so you may need to allow more time!). The questions aren't exactly what'll be on your exam, but they're a great study tool and they help you get comfortable with how ATI wants you to answer certain questions. The rationales will help you think through the questions, do NOT skip reading them ? The day before your proctored exam, do not study (trust me on this), just take the day to yourself and relax as much as your schedule will allow. Get 8-10 hours of sleep if you can that night. Then, the day of, grab a nice cup of coffee or tea and just skim through your problem areas and maybe re-do some practice questions. I have earned level 2 or 3 on all of my exams so far (med-surg, mental health, leadership, and maternal/newborn) using this method. The most important thing, though, is not to let ATI intimidate you with their questions. Just think of it as a valuable study tool, and use everything they have to offer to help you succeed. Good luck!

From my own experience, I had a 3.2 and got into my ADN program. I scored an 80 on the TEAS. I have 9 years of experience as a nursing assistant, but I don't recall them asking about my employment. There were eight applicants per seat for our class. I was pretty surprised to be honest, because everyone else seemed to have a higher GPA than me. As for school now, I get Bs and Cs. I've never been in danger of failing and I'm at a 97% likelihood of passing my NCLEX according to ATI. I'm not the best student, but I can assess my patients, prioritize, and respond in an emergency. I know how to coordinate with my peers and the nursing staff on my clinical floors. I may not be a stellar student, but I'll continue to put forth the effort and walk across that stage in May to get my pin and degree. The whole process of nursing school from start to finish has been a mystery! I would love a little more transparency in regards to expectations. The unknown creates an unnecessary amount of stress!

Right now it's 2.5 but there's a rumor it may bump up to 3.0 in the future. I don't think anything has been set in stone with that, though.

You're correct--the downstairs unit is out substance use/mood/personality disorder floor and we typically specialize in schizophrenia/acute (but we get a lot of substance abuse overflow). It's very frustrating to feel like I'm not helping much, but that seems to be psych in general (I'm moving to med-surg after I graduate most likely). The real, genuine veterans are the most wonderful out of the bunch but you're right, you get the "veterans" that didn't survive boot camp who come in and out of our facility for three hots and a cot every two months. Many VA employees are lazy and incompetent, but un-fireable because of AFGE. I like having the union in case something happens to me, but it's frustrating that bad employees are pretty much impossible to fire. I also deal with a direct supervisor who was originally a staff RN when I started--so she has her clique of nurses that can do no wrong and, without making a wall of text for you to read, this has created a conflict of interest/all-around miserable experience for work. I don't want it to sound all bad, though, I'm extremely grateful for the opportunity I've been afforded and I'll make these next three years I owe to the VA work to the best of my ability. Who knows, I may end up staying :)

It's hard to say without knowing exactly how you explained it to your nurses, but for what it's worth I can tell you how my nurse manager explained it to us (keep in mind I'm just a student and NA, but my supervisor wrote us a great email about the pay scales) I'm in the VANEEP program. I'm in a two year ASN program for nursing, and I will begin at the VA after graduating next May and passing my boards at a Nurse I. This makes sense, I will only have a two year degree and I have NO prior nursing experience outside of being a CNA. I am a shiny new nurse that will require a lot of help and supervision for at least a few months. Nurse II is a little more of a gray area: From what I understand you usually need to have a BSN, for starters. You're also expected to show leadership, and create/improve on plans of care for patients, as well as hospital operations. Some examples I was given are: properly adjusting staff based on patient acuity (if you're a charge nurse), recognizing subtle patient cues that a new nurse may not pick up on (such as a comatose patient with improper pain management), or identifying unit/department performance deficiencies. It's not very clear cut and I'm not sure who the decision ultimately falls on, but those were some examples I was given.

Hi there, I'm only a nursing assistant so this is anectodal, but I hope it helps: I work in inpatient psych and an RN who is a close friend of mine developed a program for opioid addiction as part of her masters program. Unfortunately I don't know the full details as it only just launched and I've been on leave for VANEEP for two months. I know that for a nurse III you typically need at least an MSN (she earned in May) and you need to develop a program that benefits your floor. The only other way to really secure it is to earn an MSN/ DNP and work as an NP or some type of managerial position. Unfortunately, part of this program implementation seems to be playing the politics game and getting your superiors on board, so that's a hurdle for some.

What do you mean? Are you saying your staff are underperforming, or they don't understand the qualifications for a Nurse II?

Honestly the more I'm doing clinicals at private hospitals (UPMC and AHN) the more I'm becoming jaded by the VA. But I'm at a good age to utilize federal retirement benefits (I'm 28, started at the VA at 26), so if I play my financial cards right I can retire at 57. I'm not a big fan of the the stereotypical "federal employee syndrome" that seems to hold true, though.

That's correct ? Our MSA was really on top of it so I continued to get my paychecks right on time every pay period. If you work second or third shift, you will not get shift differential, so just be prepared for that.

It's not income based. For me there was a hard cap of about 34000 for the VANEEP program, and that was universal for all of us. I don't know if that figure goes by VISN or if that's national. I'm a GS-5 currently. They appear to be lifetime funds, and then there's a separate pool of funds for people who pursue NNEI down the road. You do not need to be full time, you just need to have a year of service to the VA before applying.