acmt27

Have you found out yet?? It's my understanding that it's rare to fail at 75 questions. Since it's looking for you to hold at a minimum competency level, most who are below the level get more than 75 to determine whether they can hit the level.

Completely agree. As long as you're able to get by on the pay cut, your parents should support your mental health above all else.

I joined a big nursing informatics group on facebook (private group called 'Nursing Informatics') with over 8000 members. The discussions there have been super helpful. From what I've gathered, experience is more likely to get you a job in informatics than a Masters with no previous informatics experience. Getting your foot in the door seems to be the main difficulty. I would suggest joining that group- there's tons of people discussing their issues with getting into the field.

No problem. I have even worked at hospitals that publicly announced how many COVID patients were admitted daily.

Nothing confidential about your response. No specific patients were mentioned. No HIPPA violation there.

Interesting information, I have considered trying to get my foot in the door of the informatics/analyst world. Do you think the current pay cuts/hiring freezes in the field are concerning for the future of nursing informatics?

I have been looking into nursing informatics as a career. I'm currently in an outpatient clinic after working 4 years bedside on various floors. If I have learned anything since switching, it's that I want to be even farther removed from patient care and be able to work in a more independent environment. Informatics is something I have soft-landed on. It's something that you can go directly into (although it's a pretty competitive field to get in to), or some positions also only hire if you have a MSN-informatics. After spending lots of time looking ahead into what the job applications look like on LinkedIn, and it looks like most jobs are on site, but there are some hybrid/remote.

Thanks for the advice! I appreciate the insight into the candidates. I guess my only concern is that I have only been at my current job ~7 months. I did 4 years on the floor, between med surg, tele, PCU, and ICU. I had to get away from the bedside due to reasons that most nurses today are leaving the bedside. I've been in an outpatient clinic for 7 months now, and I definitely far prefer it to my time bedside, but I'm just wondering if now is too early to jump away, especially if I decide not to take the time to get a master's before applying into informatics. I work for a massive healthcare system (the largest in my region), so I definitely don't want to burn any bridges if they consider job swapping after 7 months to be too soon.

I have been considering getting into nursing informatics. I'm thinking along the path of a masters in nursing informatics. My question is, would the best path be to jump right into a masters program while working my current ambulatory clinic job, and then apply for an informatics job after completing the program, or would it be worth it to look for an entry bachelor's level informatics job (if those exist) and then go through a masters program? I'd really just appreciate any advice on going into informatics as well.

I did UWorld back when I was preparing for the NCLEX. I remember getting average UWorld scores, that gave me somewhere in the mid chance passing range (don't remember exactly but I don't think I did as well as you). I was so nervous and didn't even feel confident in my chances after taking the NCLEX. Turns out I passed on the first try in 75. You'll do fine if you've done all the prep work. Just stay calm and read every question twice.

I used UWorld and passed first try in 75 questions. It's been a couple years so it's hard to remember but I think I was getting average scores on the UWorld questions. Average enough to be very nervous that I should have been doing better on the questions to feel safe about the NCLEX. I think it was putting me in the 50-60th percentile of test takers. I wouldn't suggest doing random until closer to your exam. I did different categories every day and didn't randomize them until a week or so before the NCLEX. I found the rationales to be super helpful. I took notes on questions and rationales that I consistently missed- not every missed question, but questions covering topics that I seemed to be having a hard time with.

My situation a year ago was almost exactly like yours- a year and a half on a tele unit, working nights. I absolutely hated nights but day nurses on tele were always swamped so I put up with the disruption to my circadian rhythm. I've always wanted to be a CRNA but wasn't able to get a spot in an ICU new grad program, so tele was my closest option. I was fed up with the patients and hated going to work but loved my coworkers, so I felt guilty about making the transition. I, like you, felt like I lost all of my medical knowledge (pharm, pathophys, etc.) due to how busy I was on tele. I barely had time to pass meds and draw labs. I hated giving my patients their meds but not having the time to look up why I was giving them the meds. I finally decided I had enough and started applying to various ICU units at other level 1 trauma centers in my city (I was interviewed for every position I applied for, most positions I made it to second and third round interviews and but always passed over for someone with previous ICU experience?). I had to eventually tell my manager that I was applying to other places, since I had to get them to fill a recommendation survey. They understood why I wanted to leave; I've always preferred the sicker patients who were acutely ill, and our tele unit had mostly chronic illness and psych patients waiting for placement. My manager also supported by ambition to become a CRNA, so she recommended me for our own hospital's MICU, although I wasn't sure about staying at the hospital. I was so grateful I talked to her about where I wanted to be, because she's the reason I've now been in my hospital's MICU for almost a year (and day shift- normal life ?). Since I've been working days on the MICU, my attitude and motivation has improved drastically. I love listening to rounds in the morning on my patients, so I'm finally starting to relearn things I learned in pathophys and pharm. I just got my TNCC (my hospital requires it in ED/ICU) and once I've been here a little longer I'll work to get my CCRN so I can start thinking about CRNA school. Finally, to answer your question at the end, I was super worried when I made the transition to ICU that I wouldn't know how to respond in critical situations, especially with rapidly deteriorating patients. I feel fortunate to have an awesome team of nurses with me. They understand that everyone has to start somewhere, and they help me when I don't know what to do. I've surprised myself with how I've adapted to learn how to respond in critical moments. In just a few months of being in the ICU, I started to feel more and more competent and I don't freeze up when things go south like I used to. Good luck! I'd be happy to share more of my experience!

I float around the ICUs at my hospital, but mostly stick to our SICU and MICU. We are a level I trauma center in a large urban area. We also have a CCU and PCU, 10 beds for each unit. We are a very trauma heavy hospital so even when I'm in the MICU I tend to have surgical patients. We go through waves of high and low acuities. Sometimes we're completely full and every nurse has 2 intubated patients, sometimes we have more downgraded patients (waiting for a bed on the floor) than actual ICU patients. We usually have at least 2 patients on CRRT at any given time. We get post cath swans frequently. Occasionally we get craniotomies with ICP monitoring and EVD drains. We don't do open hearts or ECMO, although I heard our hospital is trying to initiate an ECMO program. Lots of STEMIs, overdoses, and post arrest hypothermia. Our CCU is dedicated to COVID ICU and PCU patients. Most of them are vented. Lots of them who are vented end up getting paralyzed with nimbex.

At my hospital, they use pain parameters for IV pain meds (ex: fentanyl 50mcg q1h PRN for pain 7-10). If I rated the pt's pain as a 3 and gave that med, I'd be flagged by pharmacy. That's crazy that they expect you to give IV for a pain of 3.

Long post but skip to the last paragraph for the main jist of my issues. I have been considering quitting my current position for a while now (like, since before COVID was a thing in every hospital). I work in telemetry, where we are chronically understaffed. I usually have 5 patients (and these are not med surg level people) and rarely ever have a tech to help the unit (we are supposed to have 2 per unit). Add to that the anxiety I have been facing as I am sometimes floated to the COVID tele unit, and I live with a roommate who would be at high risk if I expose her to COVID. Now here's the kinda complicated web of entanglements making me unsure of whether I should stick it out. I want to work in an ICU. That's always been my goal since I have always wanted to be a CRNA. I've only been a nurse for about a year and a half. I was trying to apply to level one hospitals in my area, but then COVID happened and it seemed like no one was hiring. Now people are hiring again so I've been sending out applications. I interviewed with the head of a major level one hospital's medical transplant ICU. I should be hearing back from them late this week or next week, since they have a few more people to interview. When I told my nurse manager about my applications to other hospitals (I initially didn't want to tell her until I got an offer but I needed a manager's reference), she got in touch with our director about getting me a position in our level one SICU, since she wants me to stay with the hospital. I greatly appreciate her for this. But I'm not sure if I want to stay with this hospital. We are a safety net level one working in a major urban area. We get the patients no one else wants to deal with, many do not have any health insurance, some are abusive to staff- it's incredibly stressful. Here's my main pickle- do I stay in case my director can help secure a spot at my current hospital's SICU, which I'm not even confident I want to work in, or do I pull the plug and resign, hoping I can get a spot in another ICU? I'm afraid that if I resign now and don't get the offer for the medical transplant ICU, I'll be stuck and resigning will reflect badly on me in future applications. Or will it? I have never resigned before. I have the funds to lose my income for quite a while, but I don't want to experience trouble finding another job when I only want to be in an ICU. Any input is appreciated, thanks!