LLLovely

I am close to completing my MSN in midwifery and am looking for practice tests. I have the candidate handbook and Kelsey's Midwifery newest edition, but am unsure of what other practice resources are truly useful. My school does not provide prep materials. Since I learn best by answering practice questions more than any other form of review, I want a resource with as many questions as possible.

I don't know your life circumstances, but there are options to get where you are going without incurring more debt. While I think the PHN certificate is great, I think many certificates are not valuable if they aren't required and tied to a specialty that only hired those with certificates. I don't know enough about PHN to know of the certificate does that. However, it certainly makes you more competitive for graduate school. You could do some travel nursing and pay off debt and save up for grad school, or you could work at a university medical center where employees get free tuition. There are probably schools with great grant programs and other options for free schooling. I was in the military for 20 years and know many who joined to get their schooling free or paid off after the fact. However, the military is not for everyone, grants are not guaranteed. Graduate assistantships are another way. Those students generally get tuition free and a stipend, plus better parking. Of course, not everyone lives near a university medical center or a good grad school with widely available grants, so then you have to decide if you are willing and able to move. There are a lot of moving parts and it can be an enormous burden. I moved half way across the country to go to a grad school that works for me. I'd start with finding a nurse who does what you want to do. Whatever nurse role is embedded in the foster system, find one and shadow them. Find out what the options are for doing what they do, what the pay and hours are like, what job satisfaction is like, etc. Maybe work is the way you want to be involved in the foster system and maybe it isn't. I know many people who became foster parents, and they felt that was one of their callings in life, but it wasn't career-related for any of them. Remember, there are *** in every crowd. Sometimes one bad apple spoils the bunch. It's okay to move on if your floor or the facility is a crap environment. If you are miserable, move on. Good luck in contemplating changes.

You are definitely being too hard on yourself. I get wanting to leave the ED if people were jerks to you, and I'm not suggesting you should have stayed and subjected yourself to such treatment. At the same time, if the ED is your dream, don't be put off by a week of not catching on. A week is no time at all. With experience under your belt, you could easily go to the ED again later and be successful. Also, don't let those ED turds intimidate you. They get scared and clueless too. You should see them (and the ICU nurses) get flushed and panicky when one of our OB or postpartum preeclampsia patients end up there. The fear is palpable, also funny and delicious! ?

I've never heard of them until just now. I think they would not have been useful for me. The dilation boards are useful because you can actually put your fingers inside the holes and compare to how the cervix felt. For me, this is better than a chart or beads, which are essentially like a ruler. It just doesn't feel the same. The basic boards are usually floating around hospitals because they are supplied by companies that make OB related products. For example, the ones we have at my current facility were made by a company that makes fetal fibronectin tests. Belly beads might be useful, but I hate having extra stuff hanging from my badge. I do have a belly balls teaching tool. When I first started nursing, we had a supply of them that we gave to all breastfeeding mothers. I kept one and found that most hospitals do not supply these as an educational tool for parents, so I use my own. You can make a kit of your own easily by printing off a PDF from online and buying your own shooter marble, ping pong ball, and plastic Easter egg, then putting it all inside of a ziploc to use to teach parents. Sometimes, the midwives where I've worked have brought in a bag of shooter marbles to give one to new breastfeeding families, so that they can keep touching it to remind themselves that baby's tummy is small. Those are inexpensive and could be great as I find that families learn better when they can touch and keep things. Just my two cents.

I am in an MSN program for midwifery and will be taking advanced pharmacology this Spring. We will be lumped in with physical therapists and all other MSN and BSN to DNP tracks for this class. Pharm is challenging for me, so I asked a friend who is a pharmacologist what he recommends to help me internalize a ton of material in a short time. He recommended Sketchy Pharm. He said a lot of medical students use it and the residents where I work confirmed this and said it is good. On their website, they have different focuses: medical, MCAT, PA, pharmacy, and nursing. However, the nursing focus is for undergrads who will be taking the NCLEX. So, has anyone used Sketchy Pharm for their pharm class or boards? If so, which focus did you do? I feel like PA might work, but have no idea how their school or licensing exams actually work. I think medical is probably overkill and nursing is definitely not going to work for advanced pharm. I like the idea of the way they teach the concepts. Hopefully somebody here has personal experience with this tool and can offer some insight. TIA!

I'm from Columbus, but haven't lived here since I graduated from high school. My background is mostly maternal-child health and I'm considering going back to working on the floor. Currently, I work in a private OB office and at OSU doing biometric screenings. The private practice pays poorly and OSU keeps cutting my hours, and I really need the money. I'm considering applying to both RMH and OSU. I'd love to hear your experiences of L&D in one or both of those hospitals. My points of consideration are as follows. Pay Environment or practice, treatment of patients, and management Autonomy vs. lots of residents Call requirements for part-time/PRN Type of providers: OB, FP, CNM Float requirements Time to wait to work on days Thanks for any input you may have!

Generally, an employee is held liable for the highest licensure that they have regardless of what position they are working. For example, some registered nurses take positions that are coded for LPNs or even CNAs because that is all that is available at a given time or all that fits with their child care options. However, being licensed as an RN means that if you do something wrong that an RN should have known how to do, you can be disciplined as an RN. However, facilities may still restrict your scope to the position you are working in and may report you to the state licensing board for violating hospital policy, or discipline you internally. If you were my employee, I would likely not discipline you unless hospital policy required it. However, I think it is essential that you clarify with your manager what you are allowed to do and provide your manager and HR a copy of your nursing license if you haven’t already. Remember, once is a mistake. Twice is neglect.

I’m sorry this has happened to anyone. Did you know that even physicians are treated poorly in maternal child settings when they are women who say they feel something is wrong? Stuff happens. However, we aren’t really talking about either of those things. Your anecdotal experience does not negate the fact that this happens at an alarmingly higher rate to blacks (not POC in general) and an even higher rate to black women. I’m not saying you shouldn’t be pissed about what happened to you, but your experience doesn’t speak to the bigger picture here.

You are assuming that she is saying that all of the prejudice exists in the hospital. Statistically, black women ARE treated differently with regard to pain especially in both hospitals and medical office settings. That is not to say that every single nurse and doctor is a prejudiced. Again, implicit bias does exist and many don’t realize when that is happening, but that is not all that is happening In addition to implicit and outright bias, there is also systemic racism, everyday interactions with those who have implicit biases, microaggressions that happen over and over even by friends and family of black women who are not POC and don’t necessarily realize they are doing and saying things that are offensive. Ultimately, most studies show that it is the cumulation of racism that black women face that causes poor outcomes. Imagine living in a society where you are just EXHAUSTED by the continuous onslaught of oppression, bias, judgement, disproportionately higher incarceration and murder rate of people who look like you, and then add sexism on top of it. There are long term health effects from that sort of stress, and yes it is a direct result of racism. Whether you are interested in voting for Warren or not, this is an opportunity to sit with this uncomfortable truth and do some introspection about how you and your colleagues can do better. We can all do better. Also, while Warren is not my first choice for President, I give her big kudos for bringing the health outcomes of black women to the national stage. It would not occur to most other politicians to give a second look to poor maternal morbidity and mortality at all (and it is piss poor in this country given how much we collectively spend on it), let alone the even poorer outcomes of black women and to even begin to speculate why it is happening, and that includes other politicians who are women. Very few politicians in the history of this country would bring such an issue to light knowing that they are implicating themselves as partially responsible. This is a bold and brave move on her part and it may even bring about funding, research, and change that will benefit black women. I thinking sitting for a moment with the question of why so many nurses seem automatically offended at this is important as well. This wasn’t a flip comment about playing cards on shift. This was a call to action to make things better. Why wouldn’t we want that?

I agree that DNP is not necessarily worth more money, but that part of it doesn't add much time. I am interested in the DNP because eventually it will be the standard, and because I would like the option to be able to teach without having to go through any more schooling later. I think if I am going to get an MSN that the DNP is within easy grasp, so I might as well finish it in one fell swoop. Thanks for your thoughts!

I previously lived in Colorado Springs and applied for and was offered several different positions when I retired from the military myself. All of them had astonishingly low pay rates. I ended up applying to jobs in the Denver area and got offered one position. The pay rate was significantly better than anything I was offered in Colorado Springs, so I commuted for a time. Ultimately, I moved to Denver and took a different job, which was how I realized that my first job in Denver actually payed really crappy wages as well. Live and learn. But that meant too that wages in Colorado Springs were even worse than I thought they had been. If there is a different explanation other than retirees, I'm not aware of it. If you have seen some of the Army towns in the lower 48, you'd realize what a dream location Colorado Springs is. It has beautiful mountains, fresh air, 300 days a year of sunshine, tons of trails, lots of dog friendly places, and more. Most military towns are known by the fact that they are the armpit of whatever state they happen to be in, so towns like Colorado Springs, Honolulu, and Tacoma, WA are jam packed with retirees because they are decent places to live that also happen to have access to military facilities such as health care and shopping. You can't swing a cat without hitting a retiree, but contrary to popular belief, most people don't live solely off of their retirement checks. The retirement checks aren't big enough for most to do that, but they do make a difference in what sort of wage you are able to accept and still make ends meet. So, while I don't do economic assessments and can't speak to other market factors with any authority, I would say that the basis for this assumption is valid, though I can't say what else might be at play. Thank you for bringing up the autonomy piece! Pay is an important factor, but I know I would prefer the ability to have more autonomy in the long term.

I've just been accepted to a DNP-FNP program. At the same time, my husband has two job offers pending, one in Tampa, FL and one in Colorado Springs, CO. I am a bit hesitant about moving to Colorado Springs. We previously lived there and I found that RN pay was dismally low due to the number of military retirees in the area who were willing to accept low pay because they already were getting retirement pay. I'm not sure if the same is true of NP pay. I recognize that job trends go up and down, but I would appreciate any insight into one area vs. the other. I don't want my husband to take a job, then find out after graduation that I'm screwed trying to find a job with a decent paycheck that makes it worth it to have a DNP. I'm also interested in personal perspectives regarding hiring for first jobs in those areas. Again, trends are cyclical, but also tend to vary by region. I wonder if it is easy to get a job right out of school or especially difficult. Thanks for your thoughts!

If one is already good at vocabulary and writing, and one needs some brushing up, but was always very good at math, what is the shortest amount of time one could student and expect a decent score? I realize that sounds shitty, but I realized that the school I'm applying to has clinical requirements that I may not be able to meet. Now I am beginning to apply to some alternate schools, at least one of which requires the GRE and has a deadline that is approaching very quickly. Does anyone have great resources that really helped you study? Anything I shouldn't bother with because it is just mediocre or the material can be sourced elsewhere in a better format? I'm open to all tricks and tips, but I really need to be able to take the GRE within four weeks to meet the application deadline.

It can be so hard to tell from a visit/interview. I would ask about staffing ratios, like whether they follow AWHONN standards. I would ask how often they have requirements outside of your shifts like meetings, classes, online work, annual trainings, on call, etc. I would ask how shifts and on call are scheduled like first come, first serve, by seniority, on a rotating basis. I would ask about their relationship with the postpartum/Mom-Baby floor. I would ask about their relationships with physicians/practices, whether they teach there, whether they have Family Practice docs delivering, whether there is a midwife practice. If they teach there, I would ask how that modifies the RN role. I'd ask what the acuity is and if they have a lot of antepartum patients (not my scene at all). As an example, I work at a place now that I really love, but they do a lot of teaching, so I mostly do not check patient's cervixes. I have to ask before I make any moves. It took me a while to get used to that as before I worked where I am now, I had worked at places with little to no teaching going on and I was very independent, physicians primarily just showed up to catch. Overall, I have found that I can make just about any L&D job work except LDRP (hated it with a white hot passion), a hospital with no midwives, or a manager who doesn't support the nurses well. When you see people there, see if they look happy or if they look like they have been dragged a few miles by a horse. Look to see how clean the place is and whether stuff is just shoved in any available corner. All of that may not matter to you, but sometimes I think it is a very good indicator of the overall quality of a facility and what sort of support you can expect from upper management.

I think you will be fine if you pass the second time and have a good GPA overall. I do also think it is worth discussing with your instructor. Let them know that you really want to be a nurse and do well in this class and ask what you can do to improve your skills.