hmatthewcooper

Update: It took a while but I found a job. I'm doing gerontology and podiatry in a number of long-term care facilities in my area. I'm still learning, but so far it's going well.

OP, The previous posters bring up some valid points, but reading your narrative, I couldn't help but think about my own introduction to nursing which had some similarities to your own. You do have to have single-minded devotion to get through a nursing program. That part is definitely true. I was originally an associate prepared RN. My class started as 93 people. We graduated 33. For two years, we lost classmates every time we took a big exam. Some of my closest friends, with whom I had struggled and studied since the beginning of the program, flunked out on the last exam of the last course. It was very difficult mentally, emotionally, and at times physically...and that's just school. It gets much more stressful when you begin practicing. I literally didnt know what a nurse did until I was in my first med-surg clinical. I had researched it online and asked friends that were in nursing what their day consisted of, but I had never been hospitalized or privy to the inner sanctum of healthcare. I had no context for the explanations that were being offered. It wasn't until my first clinical instructor pulled my struggling first semester group into a room to obtain a stool specimen from a man with dementia that I figured it out. We log rolled him, changed his brief, cleaned him up, cut off a small piece of stool with a popsicle stick, put it in a little plastic jar, made up the patients bed, gave him some medicine, something to drink, and fluffed his pillow. The whole time we were working with him he was giggling and making these hooting sounds like he was being tickled. When we left he was so much more comfortable, and he had a big grin across his rosy cheeks. It was hard physical work, hilariously absurd, a little disgusting, and the nicest thing I had ever done for anybody....that's nursing. I looked at my instructor and chuckled, "that's it?" She looked back at me grinning and said, "that's it." Nursing is the spirit of rolling up your sleeves to do hard unheralded work that nobody else wants to do on behalf of someone you don't know with little reward-indeed maybe even at great personal cost. The scene that I described is an example of basic bedside nursing, and you'll do your share of that, but nursing today is engaged in the directed use of that spirit of compassionate work in many different arenas. We're an ancient trade and a young science, but even dating back to Flo (that's Florence Nightingale to non-nurses) nurses were using their brains to address health disparities, research clinical issues, study the health of populations, and increase the safety of interacting with the healthcare apparatus. In critical care settings like the ones you've experienced you're going to find an abundance of direct concrete thinking type A personalities. If you work in psychiatry you might find much more mild easy going abstract thinking type B personalities. It really just depends. Nursing is a huge field. There's something for everyone that shares that same spirit of compassionate service to others. If the idea of performing unpleasant tasks for long hard hours on an understaffed unit for not that much money all while having more positive impact in the lives of strangers in a single day than most people have in a lifetime of volunteerism (and maybe earning a wicked adrenaline rush in the process) doesn't sound appealing to you, then do yourself a favor and consider a different career. Nursing seems to be everybody's parachute from unpleasant circumstances these days. What they don't realize is that nursing is so in demand because most people don't want to work so hard for someone else for so little compensation. It takes a special kind of person to stick with it. If it does pique your interest then try it out, but your going to to have to become friends with science if you go that route. Nursing is a science itself, but you'll need a background in traditional "hard" sciences to understand it. Try some prerequisites courses at a community college. Take some advanced math courses, statistics, chemistry, biology, and see how you feel about it. My whole life I thought I was bad at math until I went back to school at 23 (10+ years ago) as a grownup to do nursing. It turns out I'm really good at math. I had just never really applied myself to it. If you struggle with math you'll struggle in the hard sciences and in nursing, but it's not string theory. It can be learned. Believe it or not, one day as a nursing student you may gleefully anticipate exams that contain math because they can be solved with correct answers, which is not always the case in nursing. They joke that nursing multiple choice is the only exam format where the choices offer four correct answers, yet they're ALL wrong! One day you may understand... Anyway... best of luck in whatever you decide. If you would like to ask any specific questions feel free to message me. I am a veritibal wealth of useless trivia and nursing stories. Just sayin...

I'm sure nobody has actually done the research, but if this is true doesn't that just mean that hospitals are cost-sharing new grad training? I mean if hospital A hires new grads and hospital B hires new grads, and after a couple months all the new grads leave both hospitals A and B, and then apply for jobs at the other hospital doesn't it just all come out in the wash? When you hire an experienced nurse from elsewhere you are hiring a nurse that some institution paid to train. Those experienced nurses also bring their old unit cultures and practice habits, for better or worse, with them when they come. At least with a new grad they're a relatively blank slate. I think hospitals are at least contributing to this phenomenon by trying to poach experienced nurses off of each other. Maybe a new nurse really wanted to work in a particular care setting at hospitals A, but they could only get a job as an experienced nurse there, so they settled for the new grad program at hospital B. Does that mean that nurse shouldn't pursue their dreams? I agree that leaving prior to at least a year during your first hospital job is pretty rude and may reflect poorly on a new grad, but I can see why some new grads do it. In nearly all American industries these days there is no more agreement between management and the workforce. Companies do what's best for their bottom lines, and nurses do too.

I work, teach, and attend school in one of the largest NP programs in the country. So yeah...oversaturated. I can't relocate because my family has put down roots here. I guess I'm playing the waiting game.

Seriously!? 3:1 and 4:1 for med-surg? When I worked med-surg we had a 6:1 or a 7:1 with one tech covering the front of the unit, and the other covering the back half. With those kinds of ratios I never would have left.

Thank you! I'll start looking immediately.

Nursing is trying to find an equilibrium at the moment. Medicine did the same thing 100+ years ago. They finally settled on the current model when the European style of medical education came to John Hopkins. It'll even out. It's a trend. Everybody is going to nursing school because they think it's a way out of the undesirable career they currently have. When they hit the floor they realize its a ton of uncelebrated work. Then they try to educate their way out of it. For profit and non-profit universities alike are taking advantage of this trend, and some are better than others. I think the real solution to this problem would be the establishment of a mandatory residency for NPs. Perhaps the minimum education should be increased to DNP as well just so that there is some parity with other clinical disciplines that require a doctorate to practice (pharmacy, PT, etc). It's hard to argue for more autonomy and compensation when the bar for entry is lower.

Thanks for the response! I have acute care experience it's just from early in my career, but you're right. They may not even consider that. A lot of ACNPs here are critical care nurses. I would be fine rounding in nursing homes. I don't know exactly how to go about that. It seems like most of the nursing homes have a contract with a physicians service. I've considered trying to contact a physicians service about this, but I don't know who has the contracts. There are only really two true gerontology practices here; the one that turned me down, and one that I emailed my resume to that hasn't responded. I'll have to do some more research on that. Thank you very much.

Although it is considered a clinical doctorate, the DNP does not offer more in the way of advanced pharmacology or diagnostic reasoning than an MSN. It's essentially the same as the MSN with another two years of health disparity and statistical research methods with a capstone project which is basically a paper that you publish about your chosen population. it really just depends on what you want to do. If you want to be an associate/assistant professor at a university you'll need a DNP or a phd. The phd is like 5 years of statistics classes while you write a book. DNP is pretty much as outlined above (to my understanding). If you just want to practice as an NP and maybe teach at a community college or as an instructor at a university the MSN is currently plenty. Of the the two choices all things being equal I'd go university DNP because it sounds like a better program. Also, these days a lot of your didactic courses should be distance accessible anyway.

I can relate to the OPs frustration, but I've met my share of competent/incompetent people in every profession. In the hospital people quickly flock together into "good" and "bad" interdisciplinary groups. It doesn't take long for doctors to figure out who the good nurses are, and for the nurses to figure out who the good people providers are. Often, credentials don't matter at all. Some people get it and others simply don't. There absolutely is a global shortage of nurses and healthcare providers. The fastest growing segment of the population is people over the age of 65, and they have medical issues. The only reason the NP role exists is to extend the coverage of providers in light of this shortage. I can provide a citation for that if you like. The problem seems to be that the university medical centers where people are getting advanced practice nursing degrees are not the places experiencing provider shortages. I think you have to either relocate or wait for the right opportunity. As far as the pay, I don't think any of us expected to get rich in nursing. Nursing is an ancient trade and a very young science (profession). One of our main virtues from an employer perspective is the lower cost vs hiring another physician. The NP role was created to fill the gaps where medical school graduates weren't going -mostly primary care.

I've got three degrees and two of them are from top 10 nursing schools (at the time). My MSN was challenging. It wasn't unobtainable, but I certainly had to put in the work. I breezed through undergrad deans list honors society and all that. I would put my graduate education at slightly above some of the more difficult hard sciences and maths I took in undergrad. It's a little concerning that some people report it being so easy. There are definitely some NP factories out there pumping out providers left and right.

I think every nurse feels like this sometimes. It's the byproduct of trying to put 20lbs of stuff into a 10lbs bag day in and day out while dealing with vicarious trauma. It also sounds like you're dealing with your share of abuse and maybe lateral violence in your workplace. Something has got to give. Have you ever ever worked at a different facility? I've worked in hospitals in a couple different regions, and some are better than others. I've worked in some that filled me with the same kind of dread you describe here. The great thing about nursing is how wide open the field is. Try something else. 1. Try a different hospital. Nursing units often come with their own culture that reflects he boss or the attitudes of the people who have been there for a while. Try something else. It can make a world of difference. Try and find an academic medical center if you can. Every one I've ever worked in has had a nursing practice congress. It makes things better when the nurses are empowered to change things. 2. Up your self-care game. Whatever is the healthy thing you do to get rid of stress spend more time doing that if possible. Emphasis here on healthy coping mechanisms because often the unhealthy ones cause more long-term stress than they relieve. I'm an adrenaline junky (like a lot of nurses) so I like to do dangerous stuff. Go jump out of an airplane, whitewater rafting, hit up a shooting range and destroy some stuff. You'll feel better next time you work a shift. 3. Try a different care setting. Nursing is everything from clinical research to school nursing to pharmaceutical sales to case management. Try a change of pace, different things to be stressed out about 4. Go back to school. With a BS in biology and an associates in nursing you can probably get into an accelerated masters pathway or like an RN to MSN. UAB has one (I teach clinical in it.) MSN is kind of the sweet spot in nursing. Maximum return on investment. Being a provider is stressful, but it pays better, and has more status. You'll be treated differently. It's more like 20lbs of stuff in an 18lbs bag. You can teach, put people to sleep, prescribe, run clinical trials, run a unit or anything else you can think of in the field. Might be worth looking into. Good luck.

Greetings all, I have been a nurse for about 7 years, and I recently completed my MSN as an adult-gero primary care NP. I finished in August and had some family issues that kept me from searching the job market in earnest for about a month after graduation. I have a diverse clinical background which includes med-surg, neuro, ortho, and for the last couple years I've been working at an academic medical center in psychiatry. A lot of my experience has been with agitated neuro/psych patients. I didn't feel particularly called to do the PMHNP program so I did adult-gero instead. I enjoy the patient population, did fairly well in my program, joined sigma theta tau, and expected to quickly land a job after graduation. That hasn't exactly happened... I've applied for so many jobs I've lost count, had two promising interviews that quickly moved into second interviews, and then they kind of fizzled out. I'm learning that this can be typical for new grad NPs, but I'm only working flexi, and as an adjunct for my local SON st the moment. My wife is able to float the cost of living, but it's time for me find gainful employment once again. I can't relocate permanently, but I'm open to the idea of doing locum tenens on a temporary basis, but hate the idea of being away from my kids. I've got a couple ideas, and I thought I might bounce them off the knowledgeable folks here. 1. Keep applying and wait it out. 2. Make a lateral move and apply for some FT MSN type RN jobs. (Worried that this could be career suicide). Considering working as an RN in something that supports my resume more than psychiatry (geriatrics, palliative, hospice). 3. Return to school for a second MSN. Considering ACNP or PMHNP. It would only take a year, my employer would pay for school if I went back to work as an RN for them full time. Which would be the more desirable degree given current market conditions and my primary care AGNP degree? 4. Get a DNP. Would only take a couple years and would probably land me a full time teaching gig. Might make me stand out in the job market a little more. 5. Your advice. Im in uncharted territory here. Any and all suggestions are welcome. Thanks, HMC

I will be attending school for nursing in the fall. One of the programs I have been accepted to offers an AASN. How does this differ from an LPN program? Which program is superior? What seperates an AASN from a standard LPN program?? thanks so much Coop