Wildschmidt

Thank you all for the input! I definitely would believe that the neuro symptoms were secondary to the heart arrhythmia. The reason we thought stroke initially was because his wife was a nurse and that's what she called it in as. She described it as a sudden onset, collapse, drooling, etc, and of course we tend to trust nurses... That said, the neuro stuff improved so quickly (30-45 min) it must have been secondary to something else or a massive TIA. It seems he's lucky to be alive - AMI going on for multiple days leading to a non-perfusing rhythm which resolved itself within a minute. He was far enough out in the middle of nowhere that we couldn't have converted him if it didn't happen on its own.

Thanks for the info! Do you mean the "seizure" activity that the family noticed was just an electrolyte issue in the muscles, or that the electrolytes can cause actual seizure EEGs? It makes me wonder if the "stroke" the family witnessed was actually a non-perfusing rhythm... He was in the middle of nowhere, so it was 30 min before first responders got vitals on him and 45 before we got there and looked at a 3-lead.

So during school I've been working as an EMT, and I'm super confused about a patient I just saw. Here's the scoop: * family witnessed a sudden "fit" - briefly unresponsive, snoring, drooling, incontinent followed by "jerking motions" with arms for a couple seconds * on arrival he's A+O to everything but events, neuro all checks out (grip strength, pupils, droop, speech) * pt's c/c is "tight" chest, substernal and left with SOB, low exercise tolerance and nausea - This has been going on for 3 days. * pt is also dehydrated ("about 1 cup over a couple days" and slow IV flash) * O2 15 L is maintaining sats at 100% (they dropped below 95 within a minute so we put him back on...) * BGL 125, all other vitals normal/stable, lungs clear and equal * ECG (we only have lead II) shows large Q's (1/3 of R), every T is inverted, and a few PJCs and PVCs * med control advised O2, IV fluid (no change with 800 mL), nitro (no improvement) and no aspirin Help! I'm running calls to learn but now I'm just super confused. It seems to me, he's been having an AMI for a few days (or possible PE since he was traveling) but then presented with a stroke and maybe a small seizure thrown in. We took him to a specialty center where we can't really follow up specifically. SO...any insight? I'm humbled by this patient and appreciate any clues/tips! Thanks!

Check out Edukan.org. They have microbio which is 5 credits including a lab for 625. However, some sections have only a "virtual lab" and some sections require you to find a physical lab with instructor that you can use for exercises. I would be super cautious doing micro without any sort of actual lab experience and it may not be accepted by your program. That said it is cheap and convenient...

There's a good summary of the bill on the AANP website: http://www.aanp.org/NR/rdonlyres/D0BC1356-E320-420E-B9C2-D98E266DF280/3898/finalhcrsummary.pdf It's still long and complicated, but only 13 pages instead of 2000! As an FNP student, I'm hopeful about this bill, since it does seem like much of the money is targeted to primary care and underserved places. Some highlights that I picked out: More loan repayment program, via states, national and service corps Medicaid rates get bumped up to Medicare rates for primary care Increase in Medicare federal funding for primary care Health plans have to spend at least 85% of their $ on health care costs There's other provisions that we'll have to wait and see how they play out, such as the comparative effectiveness research that might control costs. They're also starting a pilot program reimbursing for Medicare "episodes" of service rather than each procedure. And yes, there's definitely some benefits for insurance corps and pharmaceuticals (like extended time before generic meds can be introduced.) Overall, I think the biggest difference will be that many more patients will have coverage, and the coverage will be more similar across the board. This should eliminate some of the confusion and incentives that exist now. (Like patients without coverage going for a "free" ER visit that they'll never pay for instead of preventive services.) This is all focused towards primary care so I don't know what the impact will be for the ACNPs out there. It's not perfect, and it will definitely change incentives, but it seems better than the s$#%show we have now!

At our rural hospital, there are usually 1 or 2 nurses in the ER, a couple more on the floor, and a physician on call but not always present. No "teams" to do any skills - they have to get every IV stick, know every drug, every procedure, and be able to stabilize any patient by themselves! It's a tall order and I know they have a hard time finding nurses who have that level of experience. I'm still just a student but it's intimidating to watch the level that is required. Oh yeah, and they pay less than any urban hospital and the hours are less flexible. Then policy makers wonder why we have a shortage of nurses in rural areas!!

Chender, thanks for the info about Yale! It's a good point that the BSN from Penn might be useful, since I can imagine wanting to take time as an RN, either during or after the program. The Yale staff have been super nice and helpful, but I think it will come down to flexibility and $ for me. Lunchbox and eazye - I am not looking at UVM, but I have lived in the Burlington area before. So if you have questions just about the city and lifestyle I can answer those. It's definitely more rural and much less diverse than New Haven. You'd more be treating folks who are underserved due to location rather than $ and other factors.

I'm also choosing between Yale and Penn for FNP. I think it's going to be Penn as long as they accept my transfer credit. I really liked the campus and area and it sounds like they're usually better with financial aid. They also seem a bit more flexible with taking time off, going part time, or changing specialties, which is good cause I'm scared of commitment! I've been to New Haven before but I haven't specifically visited the school. What are your thoughts?

Still nothing, and she didn't return email or phone calls today. I'm going to trust I will get it on Monday, but I'm starting to get anxious and frustrated. I need to figure out my job and lease and moving to Philly if I'm going to do the program. And the fact that they told us definitively we would hear today makes me question their organization. Still hoping it all works out...

Me too! FNP! The waiting is over!

It depends how much time you want to spend in schooling, but I would recommend some sort of accelerated program, given that you already have a bachelor's degree. If you go back for an ADN or BSN, not only will you have to take all the nursing and science classes, but you have to retake things like writing and history. Most accelerated programs require some prerequisites, and you can do just your RN or go straight into the MSN. There are also programs where you stay in the same program but they require or encourage you to take some time and work as an RN in between. With these programs your timeline would look like: take prerequ's (usually A+P, biology, chemistry, nutrition, etc.) for 1-2 years, enter program, get RN (1-2 years), work as an RN (can skip or take years if you want, depending on program), finish MSN and become FNP (1-2 years). You can also combine taking your prerequisites with working as a CNA or tech, getting some patient care experience. This helps a lot with admissions and making sure this is what you want to be doing! Obviously, you can spend as much time in school as you want, but this way more of your time will be learning new things and it is more directed towards the FNP which is what you want.

I still haven't heard anything! I'm going to wait a little longer and then try to contact her directly. I don't want to be pushy but it seems like a long time to wait after already being "accepted" into the program.

Is anyone else still waiting to get their plan of study? I'm really excited to go to penn but I need to know if I can do the summer start. And I'm getting more anxious since I need to give notice to my employers here, figure out leases, and move across the country?! I thought we were supposed to hear by today at the latest. I'm tempted to email her and ask, but I know that's probably just more work for her right now. Anyone else in the same boat?

Just got an email saying decisions will be emailed out today!! Try to focus on your Friday work now!! Good luck to everyone...

Whew! I have my pennplan posted with financial aid info and I'm very excited. They have an even smaller contribution than I was expecting - although they also want me to do work study. That sounds like a lot for the first year so perhaps I'll take out a little more in loans or something. Thanks for the link to that admitted students chat from last year. I'm hoping to go to the one tomorrow night as well, although I might still be at work. In terms of the admitted students day - I won't be able to go since I live in Utah (and 4 hours from a big airport!) I was already very impressed by the school this fall and I'll probably just arrive in the city earlier in June or visit sometime this spring to get more settled. Still waiting to hear about prerequs transferring but I've got a good feeling so far... Good luck to everyone else including the waitlist folks! I remember her saying that they admit about 70-80 students and about 60 start each fall, so there seems like a good chance they'll pull some from the waitlist.

I got in as well! It's wierd that we have to wait to hear about the MSN part, transfer credit, and financial aid. But yay! Also, is everyone FNP? That's what I am and anxious to hear about that piece! Congrats to everyone!

Trying to focus on work... Aahh! Good luck to all!

I just got an email saying they'll be posted next friday at 3 pm EST! https://www.admissions.upenn.edu/decisions/mydecision.php with the same username and password as the portal. AAHHH! Good luck to everyone!

Hey Taco, Sorry to hear that you were hoping to apply to UW. At least they left you hanging while you can still apply elsewhere! In terms of getting experience, I've heard it definitely does help to have some experience in the general field, as much for learning everything during a fast program as for finding a job afterwards. I'm sure in this economy it doesn't hurt for finding jobs either since everything is a little more tight right now. For instance, I've been working as an EMT and volunteering at a free clinic which is similar to the setting I'd like to practice in (FNP). Maybe working or volunteering in some mental health setting would strengthen your application, like a special needs program, prison, group home, etc. (I'm not sure how relevant those actually are, but you get the idea.) Good luck with the process! I think there may also be a sticky thread about this issue on the NP board.

Hey qwerty, I'm also on the waitlist (FNP) and somewhat freaked out. However, I think the issue with new grads not being able to find jobs is mostly a concern about the direct entry NP grads, meaning new NP's who have no RN experience. I know the job market for all RN's is tight, but I can't see why it would be harder after the first part of GEPN (as compared to any other new RN grad.) It actually sounds like it makes a lot of sense to take that time off to get some RN experience and be a more marketable NP grad. Of course then there's the whole issue of finances - they just changed the program this year so it's not eligible for a lot of tuition exemptions and grants. This means it's very expensive without a lot of support. Right now I'm hopeful that I might get in off the waitlist, but planning to go somewhere else. It just seems like the program is going through a lot of changes (best case scenario) or is being sacrificed/jettisoned by the school. And they already have made so many last minute changes to the admissions process, it makes me wonder how supportive they would be to us as students... I'm definitely interested to hear other thoughts since we're all in the same boat!

I went through a VERY similar thought process. I think if you truly want to be an MD you can - just check out "post-bac" pre med programs which are designed to walk you through the whole process and prerequisites. On the other hand, I decided to go the NP route based on the recommendations of both MD's and NP's. They said the only reason to be an MD is if I wanted to do a specific specialty (surgery, ortho, etc.). Since I want to do primary care, the NP's I talked to were much happier with the whole experience including hours, student loans, and time with patients. Also, remember that in addition to having to take prerequisites and go to 4 years of med school, you'll also have to do a residency once you graduate. Long hours, little pay, little control...

Thanks for the info! I applied to GEPN (FNP) and we didn't get any sort of ranking. It just says we meet the criteria but don't have a place at this time. I'll just hope to hear in the next month or so, which is when I thought we got our letters anyway. Since I have applications in to other schools, I probably won't wait around on the wait list for too long before committing to another program. Thanks again for the info and good luck getting off the waitlist!

Waitlisted...yargh. Does anyone know when accepted people have to commit to the program? I'm wondering when we might find out about the waitlist, like is it worth it to wait or will I be in another program by then.... Thanks!

I got an interview, but I have to do it by phone since I'm working full time that week (1/28). Is anyone else doing a phone interview? I've already seen campus but I wonder if it will negatively affect their decision. Also, for UW applicants, there is another thread going: https://allnurses.com/post-graduate-nursing/university-washington-gepn-444945.html Good luck to everyone in interviews!

I've been traveling but my roommate says I haven't gotten a letter yet! Could be because I live in the middle of nowhere, but I'm still nervous. I'm also glad I applied other places, since UW raised their tuition and all that. Rot - what did you mean by they're suspending the GEPN program? It seems like they are putting fewer resources into it, but are they suspending it completely? I assume that would be for 2011 since they already let us apply for 2010... Good luck to all!