Rural NP

I thought ANCC was the only game in town for PMHNP. When did AANP get in that game?

Hello. I am very interested in the Duke PMHNP program and am interested in enrolling. I was wondering if you had any insights/observations. Thanks.

Hang in there. I also flunked on my first try, but passed on my second try, at 75 questions. I also was a little embarrassed after my first attempt, as my classmates, family and friends think of me as academically talented and assumed I would pass. Ultimately, it was no big deal though. I carved out some uninterrupted study time, learned the material much better than I had before and took it again. In all honesty, I now view flunking the first time as a blessing; I will be a better nurse as a result of having to dig into the material deeper.

One more thing: on Youtube, SarahRegisteredNurseRN has many short, clear lectures on a variety of topics. I highly recommend them. I watched dozens of them.

I wish you well on your preparations. I just passed the NCLEX, in 75 questions, on the second attempt. On my first attempt, I failed in 145 questions. I used the Mark Klimek lectures and UWorld on the first attempt, and the same two resources plus Archer on the second attempt. I attribute my failure the first time around to trying to squeeze my prep into the two and a half weeks before the exam. For the second exam, I devoted almost four full weeks before the exam. Bottom line: I recommend that you allow yourself plenty of time to prepare. I also recommend that you purchase UWorld (which is pretty expensive) and the Archer QBank (which is considerably cheaper), but do not buy the Archer lectures. I think UWorld is a very high-quality educational product. It is much better than Archer at actually teaching the substance that will be on the NCLEX. The UWorld questions are carefully written and the explanatory rationales are clear, detailed and well thought out. UWorld explains in detail why the correct answer is correct and why each of the wrong answers is wrong. In contrast, the Archer QBank is sloppy. The explanatory rationales tend to be perfunctory; sometimes the "rationales" for wrong answers are little more than a statement that the answer is wrong. In addition, some of the questions are poorly drafted; I think a handful of allegedly "correct" Archer answers are simply wrong; and some of the stated rationales contain obvious errors. Although Archer claims that its questions are designed to be short and mimic the NCLEX, I found the NCLEX questions to be much clearer and better written. (I agree, however, that the UWorld questions tend to be longer than the NCLEX questions.) Archer has at least one very attractive feature that UWorld does not. My UWorld package included only two 100-question practice test assessments, which are supposed to tell you your approximate chances of passing the NCLEX (low, borderline, high, or very high). These practice exams are offered with some UWorld packages, in addition to the QBank. I suggest that you take these assessment tests after you have completed a fair amount of study. In contrast, Archer lets you use the QBank questions to make up as many 75-question practice tests as you want, which are then evaluated as low, borderline, high, or very high. This was a great feature, which increased my confidence as I improved, ultimately testing consistently at the "very high" level. Archer claims in their advertising that four straight tests at the high or very high level indicates a 99% of passing the NCLEX. (I confess to being skeptical; I do not understand how Archer can access their customers' NCLEX test results to accurately correlate the NCLEX test results with the Archer assessment tests.) I also purchased the Archer video lectures, which I did not find particularly helpful. I gave up after listening to about 10 hours, which was only a small fraction of the lectures. The lectures are long, presumably more comprehensive than the Klimek lectures, but much less interesting and lacking in the helpful mnemonics and other memory aids at which the Klimek lectures excel. One irritating feature about UWorld is that, with study packages of 6 months or less, you cannot reset the questions. This is a hindrance after you have gone through the QBank and want to start over again. (You can keep having the computer feed you question sets to answer, but there is no way to tell the computer that you only want to see "new questions.") Presumably this is because UWorld wants customers who want a reset to bite the bullet and buy a new product. I believe Archer similarly will not let you reset the QBank but I am not sure of that as I did not exhaust the Archer QBank.

I graduated with the Fall 2020 ABSN cohort in August 2021. I had also been accepted in the GWU ABSN program. I am glad I chose GMU over GWU. GMU is a huge cost savings, especially for VA residents. And GMU is a 12-month program as compared to 15 months for GWU. Interestingly, admission to the GMU program is more competitive than GWU (as stated to me by a GWU admissions officer when I toured GWU's facility). I thought my fellow students were very high quality: smart, hardworking and mature. The program was disorganized but showed some improvement over the course of the program, based in part on some administrative personnel changes. As a general rule, faculty varied from good to outstanding, with only one professor being what I would consider poor-to-bad. Overall, I think students who work hard will get a very good education there.

I agree that state income taxation rules are complicated and that it is wise to get advice from a tax accountant or tax lawyer. I would be particularly leery about relying on a one year rule, as I am not aware of any state that has such a rule. In fact, depending on the state and the specific facts, state income tax liability could attach much quicker than one year. Forty one states and the District of Columbia tax income of residents. One universal trigger of state income tax liability in these states is if the individual is "domiciled" in the state, meaning that the person maintains a residence within the state with an intent to remain indefinitely or, if the individual is absent from that residence, intends to return to that residence in the future. I am not aware of any state where domicile depends on the passage of any particular time period; rather, in most and maybe all states, someone who establishes a residence in a new state with the intent to remain in that state indefinitely is immediately domiciled in the new state. Some states also find an individual who is not domiciled in the state nevertheless to be a “statutory resident” of the state (and therefore liable for state income taxes) if they spend a certain amount of time in the state during a particular tax year. 183 days is a common trigger but some states have different thresholds (e.g., 6 months, 200 days, 9 months.) Some states have other rules for when an individual becomes liable for state income taxes. Although there are exceptions, a worker normally must pay non-resident income taxes for the state in which they work (assuming that the state imposes such taxes) and resident income taxes for the state in which they live. Fortunately, many states treat taxes paid to one state as a "credit" for taxes owed to the other state. But it is important to know the law and claim the credit. You don't want to be in the situation where you pay one state and then a different state subsequently makes a claim for its taxes.

Hello. Interesting post. But can you please elaborate on your statement that "legally, you can't continue to be a travel nurse in the same region for longer than a year." To what law are you referring? Also, why would the IRS care where you work, as long as you pay your taxes? Thanks.

Thank you for your reply. Yes, I am a new NP student, in a combined MSN/DNP program. I plan to deliver primary care in an underserved rural community where I have some ties. In addition, after I graduate in four years, I may want to look into doing a residency. Further down the road, I may also want to teach as an adjunct faculty member in a NP Program at a university a couple hours away. But I am not emotionally committed to either idea at this time. I want to do well in my NP Program and am used to working hard. I had a 4.0 in my BSN program, which helped get me in to my NP Program, which is among the very most competitive in the US. But I am older and must decide how I will balance the competing demands on my time. Aiming for an A in every class would mean allocating hours towards school and away from other activities--including family time, volunteer work and community activities--that are also important to me. So I am seeking clear-eyed assessments of exactly how important stellar grades in a very well regarded NP Program are. Since I am already in the combined MSN/DNP program--and these definitely will be my last degrees for my lifetime--I don't need to worry about how a grad school will view my transcript. I also have no interest in a tenure track academic position. Thanks to all for any insights.

Typo: I meant to say residency, not internship

So I am curious how important, if at all, NP school grades are? I assume that they have some importance for NPs that want to get into a competitive DNP program. And also for DNP graduates that want to pursue tenure track appointments in academia. But how about for NPs that may want to work as an adjunct at some point in their career: do grades matter at all? How about for any other purpose? Do they matter for certain NP internships? What about for other jobs? Although I am asking generally about NP school grades, I am particularly interested in FNP program grades, if that affects the answers. Thanks.

Interesting. Do you have any theories as to why you would be waitlisted at Maryland and accepted at JHU? I realize that Maryland has a very good reputation but if I am not mistaken, has a much larger program. It also requires in-person attendance one day each week, at least in non-Covid times. Maybe it is a result of all the Maryland residents applying to get in-state tutition?

I am curious if anyone has any thoughts about the relative strengths/weaknesses of these two programs? Thanks.

Hello, I just posted this question in the Specialities section, but then realized that it may be more applicable here. I have researched both of these programs pretty thoroughly, using their websites and email questions with the respective admissions offices. Both offer distance-based DNP--Family Practice programs, with periodic on-campus visits. Tuition is almost identical (very expensive) at both schools. I am having difficulty seeing many significant distinctions. I think I already have a pretty good handle on Durham vs. Baltimore. I was curious if anyone had insights/opinions regarding Duke's and JHU's respective pluses and minuses? I am particularly interested in any comments regarding the quality of their offerings, educational experiences and reputations with students and employers. Thank you.

Hello, I have researched both of these programs pretty thoroughly, using their websites and email questions with the respective admissions offices. Both offer distance-based DNP--Family Practice programs, with periodic on-campus visits. Tuition is almost identical (very expensive) at both schools. I am having difficulty seeing many significant distinctions. I think I already have a pretty good handle on Durham vs. Baltimore. I was curious if anyone had insights/opinions regarding their respective pluses and minuses? I am particularly interested in any comments regarding the quality of their offerings, educational experiences and reputations with students and employers. Thank you.