Vanillanut

Have you considered Women's Health NP? (WHNP) This would give you the women's side of things and the nurse practitioner side of things, as opposed to CNM. Alternatively you could go FNP, but I suspect you might need another cert or so to be competent in L&D.

Hi there, I am/was an ER nurse who went back for BSN-DNP, specializing in Family practice. I understand the anxiety around choosing a specialty, especially coming from an acute area of practice (and from what I'm gathering, likely wanting to stay there?) I should also mention I am a spouse of active duty navy x 15 years, and am using the GI bill myself. I chose FNP because it's the most marketable, I can treat across the lifespan. In my program, there are at least 50-75% of the FNP program are ER/ICU nurses, who chose FNP for the same reasons as I did. If we want to pursue a post-grad certificate in acute care, it'll be short and sweet and I can work virtually anywhere. I say: If you are undecided which clinical area you want to work in: FNP If you are 100% certain you never want to treat kids, and you mentioned you want to stay in an acute setting- take ACNP If you're 100% certain you don't want to treat kids, but aren't sure of your desired area of clinical practice: FNP (as opposed to AGNP) ACNP really ties you to a hospital or outpatient center. For myself, I was tired of working all hours of the day/night and was looking forward to getting on "normal" hours (or at least daylight hours). I would also consider where you want to live. Larger cities require more site-specific quals whereas the more rural towns flex a bit more (FNP's often work as hospitalists, for example). I am now 8 months away from finishing with my DNP- I write my AANP exam next month. Considering you're a single guy without dependents, get your DNP. It doesn't matter all that much in terms of clinical practice, but as more and more DNP's enter circulation you're quals will be somewhat lesser then others (if only on paper). If you don't want to get the DNP, then I'd go after PA instead of NP. Shorter, you'd likely stay in acute if you wanted to, less liability as no independent practice, etc. Lastly- go to a brick and mortar school, not online. I did, and I am very glad I chose this way. Some people elect for online for cost or convenience, but if you can afford the brick and mortar (thank you GI Bill, and thank YOU sir for your service) then do it. Happy studying! PS- 80K a year is way, way low even for a new grad NP. Average is at least 90-100 for starters. I purposefully omitted CRNA info, as I know you said no to that one- those guys make 120-150K.

I also agree on the study space. Having your own space to work, where others know "she's doing her schoolwork, and not just surfing the net" is priceless. Set it up really nice because you will be spending a LOT of time there! My program is very paper-heavy and I spend a lot of time writing. I invested in a $300 office chair designed for high use (5-10 hrs/day sitting) and it's been the BEST. I'm also considering other ergonomic supplies (foot rests etc). It sounds somewhat lame- I didn't even realize office chairs had sit ratings until I bought one- but SO worth it when you are comfortable. Background music helps with ambient lighting. In terms of other stuff, I got myself a Samsung galaxy note 10.1 and LOVE it. I have a laptop and a smart phone and let me tell you, it makes life a lot easier. Taking notes is a breeze! I just pull out my S pen, bring up the powerpoint the professor is teaching, and make notes directly on the slide. Then, I just shoot up my files to the cloud, for later use on my laptop if needed. I also use PERRLA and although it has some quirks, I'd say its worth the money. I've heard Refworks is good also.

I am interested in this too, as I am a mil spouse heading that way later in the year. I've read horror stories and will be taking a massive pay cut (-$16 less then I currently make)...... I'm almost contemplating doing something other then nursing for the time we are there. Although Florida is a beautiful state and I am looking forward to the warmer climate, this is really going to axe our budget and lifestyle. Any difficulties for experienced nurses finding work?

I was actually strongly considering that school myself, but I don't think I will apply there as I am funding my education through the GI Bill (military resource). The GI bill doesn't include the DNP in their list of included programs, so I will skip it.

"Nursing: If others knew what we did, they'd see us differently..."

I am an ED nurse and I see wait times anywhere between 1-2 hrs on a not-busy day to around 4-6hrs (to see a RN, not a doctor- about a 2-3 hr triage time). Our hospital is crazy busy, and there simply isn't enough rooms at the inn for everyone. I've seen patients being held in the ED for days- yes, DAYS- waiting for a bed. Also, not everyone who thinks they need a bed really does. I read the post about the woman who miscarried, and often I see the exact same case in my ED. A woman, PV bleed and known early weeks preg, abdo pain, etc. The truth is as long as they are & remain hemodynamically stable (we reassess), there's not a heck of a lot that can be changed about their situation if they were to be seen ASAP vs in 1 hr. I do feel bad for the women who miscarry and come in crying, knowing, or fearing the worst- but my hands are tied when I have 1 bed, they are stable (or more stable) compared to an MI or hot stroke. Yes, bleeding and being in pain is not fun. But neither is being yelled at, cursed at, spat at, threatened, etc when all you're trying to do is prioritize patients based on acuity. And last of all..... having chest pain does not mean you are sicker then someone else. I wish people would understand this. Chest pain can be a lot of things and when first investigated should be ruled out as being cardiac in origin. If your chest pain is cardiac in origin, and something acute is actually happening, believe me you will be seen quicker. I tell patients to feel free to use 911 services or come to the ED if they think it's a true emergency. But then I follow that up by saying if it's not a true emergency, be prepared for a bit of a wait, because an ambulance ride does not ensure you get bumped to the front of the line. If they can see their GP/a walk in, to do so.

I am an emergency RN who recently moved to the states. I have all of my experience in emergency, although I am very comfortable with ICU patients as often I have taken care of ICU patients for days (in Canada, the system is more backed up then it is in the US). In any case, I would like to eventually apply to CRNA school in the future. I have received 2 job offers: Job A: Small outreach hospital, working in Emergency. Almost outpost nursing but with a few more resources thrown in. No support staff, no birthing unit to send people to. I (and another nurse or two on shift with me) are essentially "IT". Also I would be oriented and floating up to ICU at times- although the bulk of my work would be Emergency. Job B: Larger hospital, has cath lab, higher acuity (level 3). Emergency, with no floating up to ICU. Other factors like pay and distance from home are the same. I already have acute care experience at a level 3 hospital which is much busier & more acute then Job B.... so essentially, Job B looks very much the same on paper as my previous experience. I decided to go with Job A, to diversify my experience and also potentially spend more time in the ICU, despite being an outreach hospital. Is this a wise choice for me, or did I just make a big mistake here (bearing in mind CRNA school is the future goal).

Hurst covered a lot of what was on the actual exam. without going into too much detail just know your calcium/parathyroid/all that jazz. And I agree with infection control, I think thats the only part where hurst sort of skimped over compared to what I dealt with. But I mean its common sense... at least for most people who wouldn't dare to perform _____ skill without protecting their ___ (eyes, whatever). I was super prepped in the patho department when it came to resp, ortho, maternity, peds, etc. Looking back I would of probably paid more to infection control and mental health. But yes, with what was presented in Hurst I felt ready, and I guess I was, because that is the only thing I did. :) Hurst has an infection control hand out too you can go over if I recall, it's more of a memorization thing vs something she lectures about.

All I have to say is, THANK YOU HURST REVIEW! Now I went about this totally unconventionally. I *hate* studying. I can not sit still for hours and hours and stare at paper. I am a tactile & visual learner. I just can not shove a square peg (me) into a round hole (the typical way people study). So, I got the online review from Hurst, and sat and watched the videos while following through with the notes (all provided with the online package). Thats IT. No pressure on myself to answer hundreds of questions every day. Because I started off that way, and all it got me was stressed out and beating myself up about not getting enough correct. I took a different approach: to just be mentally relaxed. Marlene (in the hurst review) is right. If I haven't heard of something, well chances are neither have you and they're meaning to try to be sneaky to both of us, trying to freak us out. I did buy a box of Saunders flash cards but barely used them.... again once you feel defeated about something you tend not to want to go and pick it up. :) So if you're like me, you don't mind watching a funny video but hate reading/writing then Hurst review is for you. That, and DONT STRESS, you have all the time in the world to answer questions. Chill, trust yourself and you'll be fine.

I used Hurst alone, honestly I barely studied apart from that review (I did the online one). Passed first try. Would highly recommend it. I didn't do thousands and thousands of questions. I think I would have gone mental. But kudos to those who learn that way. :)

Yup. I know exactly what you mean. In every facility I've ever worked at, all meds are documented in RED ink. So in one instance, I was documenting in red. I have one of those pens with 4 ink colors in them. This nurse comes up to me, and says "WHAT DO YOU THINK YOUR DOING??! BLACK INK!!"..... I turned to her and said, oh, ok, calm down. And click, switched it to black. I had all of 2 letters written before switching it. *Not* a big deal. Then there's the million different discrepencies about how to do something, each person is "right", and therefore I get a similar response to above when I go about doing something a different way. This is especially challenging when you have just gone through facility orientations/workshops and I *know* the latest, correct way to perform a skill. Try telling this to some of these nurses. I think it's just personality. Not to say that it's right or professional. But you can choose how you respond to it.

I wrote it last June. It was the easiest exam ever. As long as you're educated in Canada, then you "think" the same way. If you're educated in another country it might be more difficult. Just for every response, think from more of a psychosocial aspect vs an ABC aspect.

Despite potentially possibly being legally allowed to work, I would caution against it, because should (God forbid) anything go wrong during that shift at the nurses' fault, it won't really matter. They'll go after your license anyways.

I have a BSN that I borrowed approx $33,000 for. I worked on average 30 hrs/week as a care aid (19$/hr) throughout my entire degree. It was *hard* but the city I lived in had a really high cost of living. It irritates me when the assumption is made that people have the option to either cruise through on loans, or buckle down and work. Sometimes, you have no choice but to do both, and you still end up in debt. I'm on my way to paying it off quickly though.

I declared my specialty after doing a post-grad certification in ER (which came in the form of 6 months more school, after my BSN). From what I know you can declare your specialty after you've passed this exam (same as KTlitz said). Being special and having a specialty are two different things

I would research travel agencies, get set up with a good one, and go on a couple assignments before leaving your current position. You really want to make sure you're stepping out on to firm ground if you're leaving a guarenteed position. On the other hand I have less experience then you and am making much more then you per hr. So if you're looking to travel, or at least relocate, I know a few hosp's/agencies around my area that are hiring. For an ER nurse with exp you are looking around $35/hr to start.

Are you on any medication? I don't mean for this, I mean in general. Sometimes that can alter your thought processes. If you have always been this way, I would suggest speaking with a Speech Language Pathologist. There are conditions out there that alter and effect a persons ability to express speech, writing, etc.

For certificate-level courses, no. For anything from an educational institution (specialty certifications, etc) yes. My employer reimburses us for certificate-level course fees (ACLS, etc). Regardless of what the institution requires I get what they require and sometimes more, just to cover my butt.

I am doing Hurst now. I haven't done Kaplan so I can't say much about it other then comparatively speaking it's more expensive. I can say that I am really enjoying the Hurst online review- Marlene makes it funny & easy to remember key points. I don't regret purchasing Hurst and I would purchase it again, knowing what I know now. My learning style is very visual, so the videos are right up my alley. All the little "extras" are also included (vaccination tables, etc misc stuff for memorizing). Quick & easy, I feel like I'm getting through a lot of material fast and not missing anything. I really don't have anything negative to say about it.

Our vents/ICU patients are 1:1..... only ever 2:1 if they're right beside eachother (within eyeshot) and stable. But typically 1:1.

A huge part of nursing is exposing your patient, and to me it sounds like this was missed. Patients can be talked in to assessments, although they might not exactly enjoy it. I've had patients initially refuse but once spoken to they reluctantly concede. I hope you are getting that I'm not approaching the patient in a nice, sweet, "please miss patient may I" nice tone. I'm somewhat direct/honest by nature and don't hold back much. Often I will be able to get patients to cooperate even if they don't like me at the end of the day. What's more important, that they like me or they survive? And 99% of the time they turn around later and like me, and respect me, and ultimately trust me more for looking out for their best interest. I'm not hanging the OP out to dry, because obviously a lot of other people were involved with her care- it just seemed that perhaps an attempt to examine her appropriately wasn't really done all that great.

Not that I know of. I'm Canadian, from BC and as far as I know, ANY BSN program must be an actual brick & mortar school. We don't have an ADN for nursing. You're either an LPN, or an RN (in Canada, all RN's are BSN degree holders, except for some older nurses who were grandfathered in, and I think perhaps 2 hospital programs in Quebec that are still running hospital-based diploma programs). Keep in mind when you do your BSN, some of it might be online but it's still through a physical campus, and the online portions are always in conjunction with on-campus/clinical time.... so you can't do your schooling from anywhere, you always need to be somewhat close to your school.

In addition to the above, I would also leave a paper trail..... document. Not sure what types of forms you might have for something like this... but if you state things objectively (one CNA working etc) then later on when something (hopefully doesn't) happen, and it's due to poor staffing, the facility will at least have evidence that it had staffing problems long before & should have addressed it.

Typically here's how it works: You can get into a specialty one of two ways: 1. Get hired onto a specialty unit at a hospital, and they will send you/pay for you to go get your specialty (ie, ER, Peds, ICU, whatever). In return, you will most likely owe them some time working for them, approx a year. 2. Pick a school that offers specialties, and pay for it yourself. Keep in mind though it would be best to do this before you found a job, because jobs might be suspicious of you if you meet them, start working, but are hesitant to commit for that year. So I would suggest if you want a bit more personal freedom/not having to commit to any hospital, get your CRNE and AB license, then enrol in a school ASAP. Then if you don't like your hospital you DO find a job at, you can find another hospital to work at, without owing them anything.