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Josh said it was his first day working on a psychiatric floor. This was a psych patient who told him this who was likely in a very vulnerable state of mind. “Why does everything fall onto Josh,” it didn’t have too. He was the one who posted a picture on a Facebook group of 268,000 followers. I’m not even a member of the group and I still saw that picture. I can’t imagine how many people in total saw it. The good news is that Josh has a new job.

I agree with you. I read his original post and I remember thinking to myself that he may get into trouble for it. I wouldn’t imagine that he would be fired though. His post was in bad taste. It was his first day on the job and he quoted his psych patient asking her if he could get her anything and I believe she said, “ you can F off and die.” Anyways he quoted her and it was meant to be cute and funny. I personally didn’t find it funny because it was a psych patient. I’m sure from an administrator’s point of view it was best for them to cut their losses early and fire him. The post went viral, and you can trace him back to his organization. He does have a new job, so he got back on his feet quickly.

I would hesitate if I were you. This will be your first nursing job and it does not have the direct care component to it. Essentially you may have a hard time moving on from this position in the future. I would wonder that if this position doesn't work out, or you choose to leave it in a few years where does that leave you for future nursing employment options? I don't think a nurse manager would want to consider you if you have been practicing in a nurse capacity that has never involved direct patient care. That is up to you if you are willing to take that chance in your career. I would also ask their retention rate for this job. I know of facilities that constantly hire Clinical Liaisons and there has to be a reason for it. I am sure it is stressful job. I would ask you to reach out to someone that has or is currently working in that type of position.

I would say ER if you want to get into critical care. More importantly go with your gut instinct. When you toured the units was there one that you felt more inclined to be at? How was the staff? Did some make eye contact with you? Was the staff running around crazy busy and appear overwhelmed? Did the hiring manager say hello to the staff as he/she passed in the hallway? How did the staff interact to the manager? Are they hiring just one position, or are their multiple positions at once? Your orientation experience will be affected by the preceptor availability. If there are alot of nurses being started at the same time this may cause your orientation to be chaotic. You are looking for a place that you can dig your heels in and grow as a nurse. You can have a long orientation, but be stuck in a terrible unit that you can't wait to leave once on your own.

OP, You said this is your second career, so have you done research before? I would call HR or read the policy online to see if someone in orientation could apply to a different department. I am highly doubtful though. I would stick it out, and since it is an academic hospital I'm sure there will be other research positions that open. Sometimes it is best to wait when the opportunity is right, and right now doesn't seem to be the best time. Lastly, if you find your job intellectually unstimulating it is because you are not seeing the big picture. You are a new nurse, so right now you are very task orientated. You may be too busy worried about passing meds and getting tasks done instead of looking at the greater picture of the patient.

I call out sick for every major holiday that I am scheduled to work. When I return to work everyone greets me with smiles, cookies, and pastries. My boss gives me an apology card and says how wrong she was to schedule me. My boss says she forgot how I am the unit's most special nurse, and I am not needed on the most important days of the year. My coworkers say that they didn't mind having to pick up an extra patient to cover my shift. My coworkers said running around like crazy on the unit to make up coverage for my patients that I didn't have made them miss their families even less. Of course my coworkers really missed me because I am the unit's best teamplayer nurse- just not on Thanksgiving, Christmas, Easter, Labor Day, and 4th of July.

I don't advocate for, "watering down the NP curriculum or making it as easy as possible." Good luck on your journey of starting grad school FutureeascoastNP.

You took patho and pharm in the same semester? That is a very large workload! Is that your school's recommended curriculum plan for your program? Plus the summer semester (atleast in my school) is shorter in length. I would not have recommended you to take both of those courses the same time, work full time, and take it during the shorter length semester. My school had those courses at different semesters during the Fall and Spring. Both patho and pharm take about 30-40 hours a week of studying and reading a piece. I really think you may have overdone your scheduling.

Very interesting. I finally came across the ANCC certification pass rates for 2012. There were 669 that tested for the Family PMHNP and only 553 passed, so actually the pass rate would be 82.6%. http://www.nursecredentialing.org/Certification/FacultyEducators/FacultyCategory/Statistics/2012CertificationStats.pdf

Vanderbilt actually has the pass rates for all the ANCC specialities. The national pass rate is 89% for the family mental health nurse practitioner. https://www.nursing.vanderbilt.edu/msn/examrates.html

AANP posts pass rates on an annual basis, but 2013 is not posted yet. Pass Rates- AANPCP I could not find any posted pass rates for ANCC on any of their specialties.

I did not go to school for NP, but I went to an online nursing graduate program. Flexibility does not equate to easiness. It is hard. It is time consuming. It is challenging. I am proud that I am a nurse. I am proud that nursing education allows fellow nurses to go back to school and work. Some nurses don't mind moving to campus, not working, and taking a huge student loan debt. That is fine if it works for them. I am proud though that it does not have to be that way. There are nurses who have been practicing for years and have kids in college. Maybe some of them would like to become an NP and not sell the house, be jobless, and hours away on campus. There are single mothers or fathers that can go to NP school and still work part time. I hear a lot on these threads that many in NP school start full time at their jobs and then go part time or per diem for their clinicals. People that attend online and work do make sacrifices. I hope when you do become an NP that you are proud of your degree and your are proud of your profession.

I wish more hospitals were like yours! Congrats on going back to school!

I don't think the OP was complaining. She stated UAB is an excellent program, but there were things that did not work for her. This is an informative post for people considering UAB. The strict adherence to the plan of study would be problematic for me. I went to USA and decided for my spring semester to add a class, so I would not have to take 2 classes and my practicum in the following fall semester. I was so glad that I did that! I think it is hard to estimate how time consuming grad school is until you actually start the program. I know I was not sure if I would be able to be in the full time program or the part time program. I was able to stick with the full time program. If I had to switch to part time I would have liked to be able to do that. I think there should be some flexibility to the program, so I get what the OP was saying.

I have searched for positions nationwide and there are many traditional CNS positions. These jobs are speciality based. I see a lot for critical care, oncology, ER, and OR. If you don't practice these specialities or are unwilling to relocate then you may want to reconsider. SteveDE- I saw one position for a clinical nurse specialist specific for diabetes at UNC Health Care- Chapel Hill. The CNS degree provides you with a general background in research, direct care expertise, patient education, staff education, consultation, system leadership, and collaboration. You can go for jobs that are not labeled CNS such as management, staff development, quality improvement, and such. The broadness of the role is a double edged sword. It makes it hard to define what the role is but on the other hand you can make a role fit for you. I love this role because it is broad and it is practicing nursing at an advanced level. That is why I got the degree. I would advise anyone that wants to diagnose and prescribe that they can with the CNS in some states, however just go to NP school. Good luck.

There is a lot of content. Some of the test questions are very specific. Like I said before there will be questions that aren't even on the study guide. There will also be points in the study guide that you won't even have questions on. Should you focus on the study guide? Yes. Should you only worry about what is on the study guide? No. It is a hard class and is very time consuming. I don't know how you learn best. Everyone has their own learning style. I never paid much attention to the powerpoints because I did not learn anything from them. I am the kind of person that can't learn with index cards or powerpoints. I need to see the, "whole picture." There are alot of tables and illustrations in the McCance book that helped me with that. Again the powerpoints did not give me the, "whole picture," so I render them useless for my learning style. You may find them useful. I learned alot more from reading through the chapters. I learn by repetition and looking at the tables/illustrations that were in the book. I also learned by reading the chapter summaries because they gave me the good overview of the content. You need to be aware how you learn best and make it work for you. Good Luck.

That happens every once in a while. It happened to me with two of my classes if I remembered correctly.

What do you mean by your section of patho? You have to read the whole entire book. If you want a head start then just start reading chapter one and keep pushing forward. I don't think there are any recorded lectures for patho.

Pharmacology and Pathophysiology are open book- not health assessment. The best thing is to tab your book. Tab the study guide points and tab the beginning of the chapters. Really there are so many questions to answer in a limited amount of time that you really can't use your book except maybe on one or two questions. You can not use your book for health assessment. I really don't think the book made much difference grade wise because all my final grades were the same for patho (open book test), pharm (open book test), and health assessment (closed book test). There were recorded lectures for Pharm, Nursing theory, Nursing Leadership, and I think Patho (not entirely sure). There are only a handful of lectures that were recorded for these classes though. Maybe about two or three lectures- that is it. The university used an old database system that was not compatible with my MAC- only a PC. I had a PC available the first two semesters and then with my third semester I didn't have a PC anymore. The lectures were nice but they were old. Not that the content changes (theory, path, pharm) so I guess it doesn't matter. Now they may have changed/updated the database they used for these lectures. I graduated May 2013. Honestly though if you prefer a university that has lectures online USA is not the university for you. You will have to write a lot of papers at USA. I found that the writing assignments helped me best with learning the content anyways. You had to apply what you learned. I loved writing and researching so I didn't mind this. I prefer to write a paper then to take another test. The most challenging semester was summer- health assessment and research. Thankfully I did not have to take a third class. Remember the summer semester is shorter compared to the other semesters by a few weeks. If I were you I would try and take research during the fall or spring semester. You had to write a research paper every two weeks. There was no lecture. It was unfortunate because I was really looking forward to that class. I felt swamped the whole semester. You had to read the content and put a paper together every two weeks. I felt that was completely unreasonable. I learned very little and just did what I could to prevent myself from drowning. I hope this helps.

There is more to being a good nurse than starting IVs. I work in LTACH and most patients have PICCS/midlines for a reason. They are difficult to stick. The procedural things like starting IVs and blood draws- you will get with time. It took me a long time to finally get decent with starting IVs and I am decent at most. I was a mess with it in the beginning. Believe me you will be surrounded by a lot of nurses that are great at it and love doing it! Watch them do it and notice their technique. The LTACH population is challenging but please don't downgrade your nursing abilities because you can't start an IV or draw blood. There are greater things to stress about like picking up when a patient is about to crash and burn. I would put the phlebotomy/IV as a skill set that is needed but in the grander scheme of things it is not a top priority. I know on nights you have the majority of labs to do so if I were you I would follow a nurse that is good at it and watch her technique.

There is a lot of reading. I read everything at least once. They would give you a test guide. This was just a guide though. Some of the points on the guide you would see on the test and some questions were found that were not on the guide. Of course the guide was really general anyways. I would review what was on the guide. I read the chapter summary also. I made an auditory recording of the material on the test guide and also the chapter summary key points. I listened to my recordings over and over again. All I can say is you have to put a lot of time in reading and studying. Taking patho, pharm, and health assessment is like having a full time job. There is a lot of material to cover in a short period of time. You have to be organized. I am a numbers person. I would calculate the number of pages that need to be read for the test. I forget if there was a test every other week or every three weeks?? Anyways I broke down and calculated how many pages had to be read, and did my recordings while reading. I then spent the last week before the test listening to my recordings. I would listen to my recordings while commuting to work in my car and walking my dog. Really these little blocks of time add up!!

Thanks for this reference! How are you doing? Are you finished with school?

Being on the fence- I would say if your primary goal is to provide direct care to patients and to prescribe medicine than go with the FNP. Job opportunities- I think since the CNS is broad you can look at many jobs that are not CNS specific like professional development, quality improvement, or managerial. However there are plenty of CNS advertised jobs throughout the US. You just have to be willing to relocate. The role is broad and is very difficult to articulate. I need to practice my articulation of the role because when people ask me this I always stumble on my words. I know there are alot of healthcare workers not aware of the CNS role. Yes it is scary and I find the closing of CNS programs even more discouraging. Healthcare is in a major transition. Now more than ever healthcare is demanding quality outcomes and this is a time of necessity for CNSs. This is an opportunity for CNSs to utilize their skills. Unfortunately the CNS jobs are found only in the healthcare organizations who use them. They are not a necessity. However I found at the organization where I complete my clinicals at, that this organization is very supportive of their CNSs. There are many of them throughout the different hospitals. I have also noticed that this organization has a passion for quality of patient care and this has renewed my faith in hospital administration. Politics- I am a student. However I feel if you are in a leadership role in an organization there is no way to avoid politics. Goodluck with your studies. I know I responded late to your post. Are you still in the CNS program or did you switch to the FNP?

MyelinSheath. Congrats on finishing your ADN. I enlisted in the ANG at the age of 17. I went through the medic program and when I went home I started my four year BSN program. I also worked as a CNA in nursing school. I guess once I graduated school and I cashed in on my big fat ticket to ride--- woohooo!! The red carpet was pulled out for me at my first medical-surgical job. Definitely it was not smart to have that military experience. Bloody heck it takes up too much space on the resume! I also was not smart to join the military because I regret all the GI bill assistance I had through nursing school and the same GI bill assistance I had in completing my MSN now. I also had a scholarship for community service at the private college I attended too for my BSN. I wish I could take that back too! I also purchased my house recently using a VA loan. I know medics I have worked with too that are now doctors and nurses! I guess we were all so stupid to get that medic training and to be in the service. What a waste of time! Be proud of your accomplishment! Congratulations!

Right now I would say No. I can't speak for the future though. I always wanted my MSN, however I never thought of a doctorate degree. I am the kind of person that will take one day at a time and baby steps. I want to complete my MSN and enjoy having a life again. Then in another couple of years I may be ready and willing to go back. I want to begin my career as a CNS and get comfortable with the APN role before stepping a foot further into academics :). However I need to have a plan. What would I do with a DNP? Better yet, "What would my project be about?" Maybe when I can answer myself some of these questions I may go back.