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TiffyRN has 28 years experience as a ADN, BSN, PhD and specializes in NICU.

Found the promised land of NICU after years of wrangling people much bigger than me!

TiffyRN's Latest Activity

  1. Apparently it is very much dependent on how your department feels. The dean of my PhD program didn't like students to list PhDc so it wouldn't have been in my best interest to go against her. As for ABD, I've never seen that as an official designation and if anything, I always thought it wasn't complimentary. Such as a lot of people out there are ABD but it took special persistence to actually finish the dissertation.
  2. TiffyRN

    Earning a PhD in Nursing after a JD and MSN

    One of my PhD professors was/is a JD as well. I don't know which one came first. I know she's tenured and has now moved into the position of director of the PhD program recently. She's taught special topics on biomedical mediation, legal and ethical leadership. I'm sure there is plenty of room for people with JD and nursing PhD.
  3. hey any help for APRN HESI pharm?


    1. TiffyRN

      TiffyRN, ADN, BSN, PhD

      My husband took it not me. He used study cards to prep. I don't recall his scores but none were terrible. In his program, if your scores weren't at the benchmark you just had to read some supplemental material, no other assignments or questions or follow up tests. He also chose to withdraw from the program early in the 2nd semester. (So many reasons).

  4. TiffyRN

    Cluster Care & Vital Sign Frequency

    Feeders (what I do most): BP once a shift unless on anti-HTN meds. Temps Q3 if eating, can be stretched out further if they kid is ad lib and eats less frequently. For those more stable older kids we aren't likely to wake them up just for a temp unless we're worried about the temp. I've gone up to 6 hours and no one blinked an eye (hourly vitals recorded from the monitor). Sats every hour unless (in rare cases) the pulse ox has been DC'D Only required to record RR/HR every 3 but since our monitors feed into our EMR, most people record this hourly since it's an easy mouse click. Sicker kids usually get q4 temps unless min/stim, then less frequently. BPs twice a shift if the kid is on IVF above KVO. Kids on continuous feeds usually only get hands on cares Q4h. Like I mentioned earlier, we tend to record hourly HR/RR even on feeders since it feeds directly into the EMR. If they have an art line of any kind, at least hourly BPs. Probably a lot more details about the sicker/smaller kids but I don't generally work with them.
  5. TiffyRN

    Critical care RN to PMHNP, am I crazy? Looking for advice

    I know this thread is a few weeks old but I was having some similar questions. My DH is about 1/4 through PMHNP school, he also came from a non-psych background. Whereas he knew most PMHNPs mostly do med management, he had visions of possibly doing some psychotherapy. First semester they only had general family practice practicums and he just started his first psych practicum. He follows a very busy PMHNP who rounds in various LTCs seeing at least 20 patients a day. His concern is, is it reasonable to expect to find employment that is not so fast-paced? He is older and kind of just wanted something to gear it down a bit from hospital work and would be perfectly happy to work part-time but has concerns he would be able to work part-time, or at least go part-time after a year or so. He's open to multiple environments, is not turned off by the LTC-type patients, just wouldn't want to see so many. Would be open to office work, would love to do therapy appointments even if that meant decreased income. Would be open to tele-medicine (is that reasonable for a new grad?). We are in one of the most restrictive practice states so he would have to have an association with an MD, don't know if that makes a difference.
  6. TiffyRN

    What's the least saturated specialty in APRN?

    LOL, but not really. . . (says the NICU nurse who always rearranges her linen and supply drawers as soon as essential cares are completed). I'm not even the most OCD personality in my NICU. Totally agree the specialty cultivates hypervigilence, but that's because hypervigilence has led to catching sepsis in the nick of time cause these kids operate on the narrowest margin of error. I went back and read this and it might come off as harsh, I totally meant this in a humorous self-deprecating tone. But I know you understand as a "babyNP" how fast things change. I literally saw one of my patients go from finishing their 8pm feed well to green residual at 11pm, to being bagged at MN, on the oscillator and paralyzed by 6am, and having care withdrawn at 6pm for NEC totalis.
  7. TiffyRN

    Online PMHNP MSN to DNP cert/program

    I’m still not sure I understand what you’re asking. You have an MSN with PMHNP specialization correct? All you want to do is advance your degree to DNP, and not add another specialty , correct? Are you looking for an exclusively online program? Most DNP programs are post-masters (or add a few extra courses if you are starting from BSN). They aren’t really post-masters’ certificate programs because you won’t just get a certificate but rather a whole new degree.
  8. TiffyRN

    PhD or DNP to become Faculty?

    I've just completed my dissertation and am applying for faculty positions. . I've always been told I'm in a PhD program in nursing. The only detail being that since I came in with a BSN, I was required to complete a handful of MSN-education courses. Now I've noticed how my degree is listed within the "Academic progress" area of my student account: PhD: Doctor of Philosophy in Nursing Education. I feel like this only helps my case for future faculty positions because while I completed all the same courses as my MSN cohorts seeking PhD, I also have 18 hours education hours (and a 180 hour teaching practicum). But, I feel a little surprised at how my degree is listed on my account page. I won't have a degree conferral until the end of the semester though my dissertation was completed in early September.
  9. TiffyRN

    Lpn to Rn online school

    I may be wrong but I think the only places offering online LPN/VN to RN are Excelsior and Indiana State University (and I'm not sure on that one). I'm a fan of Excelsior but a lot of states have a problem with their competency based education therefore check carefully if your state accepts their graduates. Several states require certification of preceptor hours, requirement you be licensed in another state first with many hours of practice completed first, or in the case of CA, it's just a no go if you graduated after 2003 or so (appeals are possible but unlikely).
  10. TiffyRN

    Easiest/quickest online MSN-DNP program

    I guess the exception makes the rule. I truly felt my RN to BSN was the most influential educational and professional journey I ever experienced. Well, until I completed this latest "journey" which was 100% inspired by the coursework I encountered in the RN to BSN (ok, I admit, Informatics did nothing for me). But then maybe it's because I would have gotten a lot more from a pre-licensure BSN if that had even been an option for me where I lived and with zero money at the time.
  11. TiffyRN

    PhD Nursing... thinking about it

    My chair contends that a PhD is above everything else a degree in persistence. The last couple of years are a real exercise in patience as you feel you are so so close for so long and then all of a sudden, it's done.
  12. TiffyRN

    Online Certification Courses

    I'm still unsure what you are asking about. Is it to become a certified nurse for example Certified neonatal or oncology nurse? Or do you mean certifications like PALS or ACLS? My previous experience has been that nurse certifications are never tested online, always in testing centers (similar to Prometric or Pearson). Certifications like CPR or PALS can be done online partly but if there is no skill demonstration, the different entities (AAP & AHA) will not recognize them. In fact, my hospital uses an online Healthstream version of the NRP to do the written exam part. But you don't get the card unless you show up and do the skill demo and super-code.
  13. First of all, I don't know the answer to your question. What I do know is that most people I know who work in Nursing Informatics have an MSN in informatics and none of them had previous college work other than nursing. Might be helpful to know which accrediting bodies they mention and while certification exams are required. I'd guess the accrediting bodies are the standard nursing ones (CCNE, ACEN), and the certification is through AACN to become an RN-BC in informatics. I'd be interested in hearing from others more familiar with informatics work.
  14. I'm personally not a huge fan of Walden. WGU has a great reputation though they famously only grade pass/fail that is usually counted as a 3.0 for graduate admissions. If your GPA is already borderline, this may not be a good move. I believe you can go to many all or mostly online MSN-Informatics programs which are from not-for-profit or State universities. They would save you some money compared to private, for-profits, and allow you to raise your GPA to where you can get into the DNP program you want. Also, I looked at your original post and it says your DNP program requires 3.2 GPA in undergrad. Are MSN-Informatics courses going to count toward your undergrad GPA? Worth finding out before you dive into a graduate program.
  15. TiffyRN

    Why are FNP paid less than Psychiatric NP?

    I'm going to have to go with market forces. Market forces affect several aspects. One thing is that (it seems) that about 80% of new RN (or at least BSN) grads are already picking out their FNP program when they get their first job. Surveys seem to confirm this perception in that there were twice as many NPs in the market in 2018 as there were 10 years before and at least 2/3 are FNPs. While the market does appear to be strong, primary care has never paid like specialities have in any field of healthcare. Just go compare the homes of your average CT surgeon to that of the average family practice MD even in the same urban/suburban area. Other market factors include the increase in the psychiatric field. There is still a lot of stigma around psychiatric care, but much less than in years past so people are more willing to seek treatment. Another factor that increases the market of psych patients is the availability of telehealth. While some telehealth services are available with many specialties, psychiatric services are very well suited to this form of care delivery. A PHMNP can video chat with a patient then electronically send medication adjustments to the patient's local pharmacy. This allows patients in more rural areas to access psychiatric care that was not previously available to them. https://www.aanp.org/news-feed/nurse-practitioner-role-continues-to-grow-to-meet-primary-care-provider-shortages-and-patient-demands
  16. I had someone close who is an RN have to be hospitalized for the same thing. I was helping them through the admission process and I specifically asked the PMHNP if there was a concern with the BON. The PMHNP stated it was not a problem though I did my due diligence and checked things out on the board's site. My reading was that depression is not a concern. Having said that, if your employer or management know, then watch your back. They SHOULDN'T do anything but there is certainly still a lot of stigma attached to mental health as we all well know.