SC ANP

I am a newer NP (~18 months) and I am on my second job. My first position was hectic & chaotic. I went from office to inpatient to nursing home daily. When I was rounding in the hospital, I had as many as 25-30pts, sometimes split with another doc, most times not. My new gig is much better- I'm a dedicated NP on a new specialty unit. Our census is still low, but we have a 16 bed unit that I am responsible for. I also start my day at 7am, reviewing labs & checking with nurses on both shifts. When docs come in, I have already rounded myself and I present the patients and my plans for each. Then we round together, and I write notes. We have interdisciplinary rounds every morning. Then during the afternoon, we take admits or finalize dcs. Right now our census doesn't justify 24hr coverage by NP, so I sign out to hospitalists when I leave. The docs I work with are great, and very, *very* supportive of NP role. I *love* my job!!

This really makes me crazy. I am graduating in 2012, from a program that is an A/GNP program. But if the certification exam for A/GNP is not offered until 2013, where does that leave me? Do I wait a year to certify and practice? Or do I certify as a GNP? ANP? both? And then hope to keep my certifications current? My original plan was to take the GNP from ANCC and the ANP from AANP. I took extra clinical hours to make sure I was qualified to sit for both exams. So... Now what?

apocatastasis- I understand what you are saying re: your worth to a practice- however, as a new NP (or just graduating & looking for a first job, as I will be soon)- how do you research that? I will graduate next year, with a A/GNP MSN. I plan to take both the GNP cert exam (aanp) and A/GNP cert exam (ancc), because I want to be in a geriatric primary care setting. Unrealistic? It wasn't when I *started* my program, but is changing a bit now. :0(

The information I received from AANP stated that the Gero certification would be offered until 2014 for those who wished to add that certification to an existing ANP, but the combined Adult/Gero exam will be starting in 2012. The ANCC information was a bit less detailed, but basically carried the same message without a defined timeline. So for me- I will be taking the A/GNP certification exam, so what would be the point to taking an additional Gero certification? I imagine there are ANP students out there who don't necessarily want to be GNP certified? I understand the theory behind the consensus and LACE models. But that doesn't mean I agree with it! What makes me curious is: why hasn't there been a lot of coverage regarding this change- both in terms of the programs themselves, and the AANP & ANCC websites? If I had not specifically been asking, I never would have found out about it. Do NP students know about it? And if so... does anyone care? (other than me, I mean)- am I just more irritated about this than I should be?

I am currently enrolled in an adult/geriatric NP program. When I started, one of the things that appealed to me most was this program's assurance that by taking extra clinical hours, I could sit for both Adult NP and Gero NP certification exams. Now, I'm told that extra clinical hours won't be necessary, because by next year (when I graduate), the ANP and GNP exams will be combined instead of separate. So in essence, all ANPs will be GNPs - no distinction. This irritates me for several reasons. I want to be a GNP, and treat a geriatric population. I initially planned to be GNP certified, with a secondary ANP cert to make myself more broadly marketable. (When I complained to the director of my program that I wouldn't be considered a geriatric specialist with a combined A/GNP, because everyone would have the same certification, she told me I "couldn't be a specialist at the MSN level anyway, and would have to be DNP for that." But that's another gripe) I will admit, I wanted the prestige of being dual-certified. But I don't think that's a bad thing. (is it?) I do understand that the increase in geriatric population makes it necessary to expand the gero focus for all midlevel providers, but I think that combining the certs is short-sighted. Essentially doing away with the Geriatric NP accomplishes what, exactly? I have contacted both the ANCC and AANP and have confirmed these changes, so I know its' not just a regional thing. I wonder if other GNP hopefuls know about this change, and if I'm in the minority, being irritated by the change. I also know that GNP isn't really a popular specialty- is that the reason for the change? I would think that now more than ever, GNPs would be important, not a diluted A/GNP. Did you know about these changes? How do you feel about them??

Hi all- I am a relatively new RN- graduated in Dec 08, just passed my 6 months on the floor. I work a cardiac step-down, with telemetry. I used to get 4 pts, but now regularly get 5 - including active CP & post-cath. On our floor, RNs have to take our own vitals Q4, in addition to all our other duties. My preceptors and my managers have said I'm doing well, but I feel like I'm just not putting everything together. I feel like a fraud when I'm doing my assessment, passing meds, giving report... I have the degree and the title, but most of the time I still feel like I don't know what's going on. I know that critical thinking takes a while to develop, but I thought by 6 months I'd feel a bit more confident. I think I'm still too task-focused instead of seeing the whole picture. I know I need more work on meds (knowing effects off the top of my head, and what/when to hold or give). I'm not shy about asking questions or advice from other RNs, and I don't mind working hard. I don't know if I'm looking for advice, or commisseration, or what- I haven't told anyone about feeling like this, so it feels good to just admit it. Maybe you can tell me about *your* first year. How long did it take before you felt like you had it all together?? Thanks! S

I have been wanting to do a Geriatric NP since I started NS. I like seniors, feel like I work well with them and have more patience with them than some others. However, I have had a lot of ppl tell me that a Geriatric NP is a waste of time, and all I'd be doing is working in a nursing home. I have no interest in working with young adults, so I don't want to pursue a FNP. But I also don't want to be confined to a nursing home! Faculty from one of the schools in my area said that most of their grads are being asked to round in hospitals, at nursing homes, and work in an office (all about equally) - does this sound plausible? Is a GNP in demand? or even marketable? I'd like to hear any & all opinions! Thanks!

Not an early acceptance, but a graduate. Did you have some questions?

You might want to look into Munson Medical Center. The main campus is in Traverse City, which *is* (obviously) a city- but rural areas are not too far away. I think their website also has a listing of affiliated hospitals in the area. http://www.munsonhealthcare.org/ GL! S

U of M is also on a hiring freeze. & you're right- not many jobs were posted, but they were talked up at job fairs. I think that some nurses that are already working are transitioning from contingent or PT to FT in order to get benefits - especially in this economy. Maybe that explains the lack of FT jobs available. I think the month of December isn't a good one for job-seekers. End-of-the-(calendar) year financial statements have to be evaluated before hospitals can tell whether they can afford to hire more staff. Also- if you think about it, the holidays are a bad time to hire new people. When can you schedule orientation? Do people take more time off during this time? How can you schedule a preceptor? etc. As usual, though- just my S

Those will be fine. When they say no scrubs, they mean your standard scrub top with one pocket at the top- the pants are fine. And they will tell you (several times) not to wear colored underwear- but ppl still do. It *does* suck to be wearing white scrubs all the time. Especially at 6:30 a.m. when you're walking into the clinical site- looking like a ghost! The only break from the whites is Peds. s

No problem! A year ago, I was in your shoes... s

No PDA here. I know a classmate or two who have them, but they're certainly not required. Or necessary, really. There are a few pocket guides which are probably good enough. HTH! S

Malenurse: Commute. By all means. As long as you have a car, I would say live free and spend your $$ on gas instead of rent. Katie- I can't really think of any great advice, other than keep yourself organized, make friends with your clinical groups, and remember that all of these semesters build on each other. Sort of like 4 semesters of cumulative exams. Oh, and don't procrastinate. :imbar Now, back to work for me!! LOL s

Hey Israfeel- If you've already got those classes under our belt, the first semester should be smooth sailing for you. 2050 is the only course with a clinical, so you should have lots of time for preparing care plans. As far as how much time you'd need to put in- that I can't answer for you. You know how you learn best- in groups, on your own, reading the text vs not, whether you pick things up the first time around or need repetition. I know that's not a very satisfying answer, but it really has a lot to do with you and your learning style. One thing you can be sure of- you'll have a lot more time on your hands than your classmates. Use it wisely, otherwise your second semester will come as quite a shock to you. In general, lectures are on Weds., and clinicals on M/T or Th/F. I had all 5 classes first semester, and I was on campus every day. It all depends on how they schedule you- you really don't have much say in which class you take when. HTH! s