ChapterTwo

Hi. A am a nurse practitioner working in general surgery and wound care. My supervisor wants me to attend a wound ostomy continence program and become certified. I have read things about advanced practice CWOCNs, and I'd like to have that distinction. Does anyone know, can I just sit for the advanced practice exam because I am both an NP and will have completed the WOCN program??

Anyone recently take AANP FNP exam? Was wondering if you knew what % of questions you have to get right to pass. Also wondering for input on content.. Did you have a lot of antibiotic questions? Anything in particular that your exam was heavy on? I understand mine can be totally different, but trying to get a range of answers/input. Thanks.

If your MSN is in Family NP, and you go on for DNP, can you complete, say, acute care clinical courses during the DNP, and sit for the acute care NP boards following graduation? Or do the DNP clinicals have to be within the specialty you chose during the masters?

I am graduating from an FNP program this August. I have a feeling I want to specialize in something, or just do something more specific with my degree rather than work in a primary care office. However, I am worried about the recertification process I will eventually face. Does anyone know which credentialing body is more lenient towards accepting hours that are not strictly primary care - ANCC or AANP? I like the idea of AANP more right now, because I like the credentials NP-C if I were to do something that's not really "Family" medicine. For example, if I work purely in geriatrics, will the AANP still recertify me since my education is in Family? Another interest of mine (but I'm sure I'd just have to be lucky to get into) is dermatology. If I worked in dermatology, would I get recertified as an FNP? I'm sure there are NPs in this field... so how do they go about the recert process if they're in a specialty?

For my capstone project, I need to choose a theoretical framework to guide my literature review. I've taken multiple research classes, written a handful of comprehensive research papers and reviews, but I have never come across instructions to include theoretical framework until now. This is new to me and I am struggling with finding appropriate framework. All nursing theorist framework seem like a stretch for my paper because my topic has nothing to do with nursing - it's about inappropriate prescribing in the elderly. Sure, I would like to incorporate the role of the APN in solving this issue, but the content of the paper is really just not nursing related. My advisor threw some words out there like "systems outcomes process" and "systems theory" but when I google, nothing really clicks with me. Everything's so abstract and I feel like I'm BS-ing the theory into my paper. I wish there was a list of conceptual framework, with definitions, so I could choose one. Does any one have any ideas for a theoretical or conceptual framework? Something along the lines of medication safety, improving outcomes, etc? Where can I find framework? And how do I know if its like, real? Like, how do I know if it's legitimate framework? Or just one person who is suggesting some framework? I am really confused and wish one of my research courses covered this in any way. Anything advice would help. Thanks.

I just found remembered I'm eligible to take to test for certification in rehabilitation nursing (CRRN). This is something I wanted to do since I started in Rehab. I recently went per diem at my hospital to make room for NP clinicals, and when I'm an NP I'm not sure if I will be working in that setting. It would be cool someday to do something in a rehab hospital, but I'm wondering if it is worth it to go for the CRRN certification if I will be a Family NP in a year. By worth it, I'm thinking financially -- $350! Anyone have thoughts on this?? One more thing. I also picked up a per diem job at an inpatient acute hospice. They like the nurses to get certified in hospice/palliative care (CHPN). Would this make me more any more marketable as an FNP? Does anyone get dual RN certifications? I'm not just letter-happy I promise. I'm think in terms of job market when I get out of NP school, as well as the route I'd like to take my career. I'd appreciate any comments!

Thank you so much! That was exactly the kind of answer I was looking for!

Hi. I am starting my final year in a Family NP program and will begin working on my Capstone/Thesis project this fall. I want to choose a really good topic. The two qualifications for "really good", to me, are: 1) Interesting, and 2) I will learn something valuable that I will go on to use in practice. I would like to pick something that I may find challenging as a new NP (so that I'll have a head start!) I have some non-mainstream interests such as integrative pain management and alternative medicine. But, I have no idea if my career will take me in that direction, or at what point (may be far down the road). It seems safer to choose a topic related to conventional primary care or internal medicine. I am a rehab nurse so I was thinking of something along the lines of stroke prevention. One topic idea is cardioembolic stroke management. In other words, management of A-fib and related disorders. My question to practicing primary care NPs is, do you manage a lot of A-fib? Or are these patients mostly managed by cardiologists? I guess an even safer route would be hypertension management as that is definitely a primary care topic... but can anyone think of an interesting focus for that topic? I would appreciate any ideas. Even if you could just tell me what you see a lot of in practice or what you may not have been prepared for as a new grad, and find quite often... that would be great. Thanks for your time!

I've heard that you don't need RN CEUs if you are working on, say, your masters degree in nursing. Does anyone know this to be true? In other words, your continuing education in the form of a degree program qualifies as CEUs.... ? Either way, do you need to present proof of your CEUs to renew your license?

I guess that as an RN in the particular facility I work, I worry about liability with regard to unavoidable mistakes... we are very understaffed and I really feel it's damned if I do, damned if I don't... I just hope that as an NP, though I will be accountable for what I diagnose and treat, I won't be worried about unavoidable mistakes due to lack of time to complete things or disorganization. In other words, if I am in control, I will feel comfortable. Thanks for your feedback.

I need some encouragement to continue in the direction I'm going. I've been a registered nurse for almost a year now and I'm currently in a family NP program - which was my reason for going into to nursing in the first place. I work at a rehab hospital and I'm so jealous of the therapists- PT,OT,SLP... it seems like their job is so much better than mine (less stress, less liability, more satisfaction, more respect). At first I kept telling myself "just wait, you'll be an NP in a couple years", but as an NP I will have yet even more liability than a therapist, and stress... I don't think changing careers entirely is an option (nursing was already a second degree for me), but maybe I should go into something non-clinical since I can't seem to handle the stress of being liable for people's lives. Are there other RNs or NPs out there that have had an unreasonable fear of liability, and gotten over it so that they enjoy their job?? I need to hear that. Or, if the truth is NPs worry about their license or doing harm on a daily basis I need to hear that too so I can change directions. Thanks.

You asked how I found the NP classes-- I was accepted into my NP program when I was accepted into the BSN. It was a second degree + master's. My school is a university-medical school and health sciences/nursing... most of the classes for the NP are offered both in class and online, so I'm just taking the online versions when I can. Since you didn't start the NP thing yet and you're interested in holistic medicine, maybe you could look into other holistic degrees/certification. I'm going to follow through with the NP because I'm about 15 credits in, and at $900 a credit... yeah..not going to throw that away. But, in doing my research.. I've found a lot of alternatives to the NP that would allow me to practice holistic health care w/out the liability of an NP.. Massage therapy, Reflexology, Craniosacral therapy, Health/nutrition counselor. I mean, combining these with an RN or BSN could be pretty cool - and marketable. But either way, take your time.. no sense in rushing the NP (like I'm doing) haha.. I get a lot of remarks about it from co-workers. Lack of experience, etc. The more years you work as an RN, the better off you'll be when you're done the NP. I chose this path before I knew all that, and I'm going to stick with it because I don't want to regret not doing it while I can. Everyone is entitled to their opinion, and I'm going to give it a try I guess!

Roses-- I feel like we have a lot in common.. I feel like my personal life is on hold because I am living at home (w/ my parents, im 23) to make up for the cost of all this schooling and I'm working full time.. I have no life!! One thing that's nice is I'm doing the NP program online mostly, except for clinicals and select courses. Some programs you can do completely at distance.. and just schedule your clinicals on your own - so keep that in mind. It's not like adding 2 more years.. you could move on from where you are and be in school purusing the NP at the same time. I also don't feel right about giving patients a cup of meds. It took me a while to figure out why I felt guilty.. I was like "I'm doing my job.. carrying out orders.. I checked for allergies/contraindications, etc".. And finally I figured out that I just didn't agree with treating just symptoms! I mean I've known for a while I was interested in holistic medicine, but I never realized working as an RN would evoke a moral conflict. I just really hope I'll find what I'm looking to do some day, and really feel good about my job. Maybe I'll even apply for the U and A fellowship. Good luck to you!

I've actually looked into that program since before I started nursing school! I went into nursing with the long-term goal of becoming an NP and practicing integrative medicine. I will definitely look back into it. Good to know that fellowship is well-known/respected.

I heard that new research says aspirating is not necessary. But, I never got a chance to check it out myself... maybe I will.