Aymese

Thank you so much!

Lol, agreed.

]Ditto to above. I encourage you to reach your goal of ACNP if that is what you desire. However I really think you should get some ICU nursing experience for 1-2 years before entering grad school. I don't think it's really necessary to have floor experience beforehand. Others have different opinions about that too, I'm sure you will fid. In ICU, you will find it very fast paced, challenging, and sometimes even scary as you first start. Just food for thought...Do you know how to troubleshoot or analyze PA catheter waveform? Do you know the differences between assist control, pressure control, pressure support ventilation and when a patient should begin weaning trials? Have you been involved in codes? These are just a small example of valuable experiences that you will gain as an ICU nurse. To have a basic foundation in critical care before becoming an ACNP will be very valuable to you. I believe you will feel much more confident as a new ACNP.

OP, Glad you finally got your letter!! I found the red tape associated with the NP hiring and credentialing process to be stressful myself.

I agree with the above poster. My BON processed by APRN license in about one week.

I think it's crazy that they are giving you nursing students already!

Also keep your ears open for job fairs in your community or colleges. I highly recommend getting the business card of the HR or nursing representative. Follow up with an email to them the next day, thanking them for meeting you. This is also how my resume got through HR to the nurse manager for the position I had applied for. Sometimes all you need is to get through HR!

I agree with the above poster. Apply everywhere you can. My first nursing job 6 years ago was to a CCU that had one year experience as the desired minimum to apply. You never know how much action a job posting is getting and they may just be willing to spend the extra time training you if they need the position filled but have few applicants. I'm sorry you and other new grads are having a tough time in this market :\ If possible for your life situation, seriously consider relocating for a job. New grad hiring varies on the region. Congrats on passing boards, Don't give up!

STEMI (ST segment elevated myocardial infarction) patients can be very unstable or can quickly become unstable. If you think about the pathophysiology of what is going on in this clinical condition, the patient is demonstrating ST segment elevation because a coronary artery is completely obstructed with thrombus. This typically results from a nonobstructive plaque inside the wall of artery that ruptures. The clotting cascade is initiated and a blood clot (thrombus) forms which may completely block the artery (STEMI) or cause an incomplete blockage (usually NSTEMI). In the case of your patient (STEMI), this complete lack of blood flow deprives the heart muscle of oxygen, causing the tissue to begin dying within minutes of the blood clot forming...causing associated clinical symptoms (hypotension, Chest pain, dyspnea, N/V, diaphoresis, etc). This ischemia in turn leads to many dysrhythmias including PVCs, vtach, vfib. Oftentimes depending on which artery is blocked (Right coronary artery or a dominant circumflex either of which may feed the SA Node) you may see bradycardic arhythmias like 2nd degree type II or 3rd degree AV blocks. However another possibility can occur when reperfusion of blood flow to the heart muscle is established (either by angioplasty or administering a thrombolytic drug such as TPA, TNK). This is called reperfusion arrhythmia. It can be any number of abnormal rhythms. Usually transient but can be life threatening. The nurse should always be vigilant of the patient and the bedside cardiac monitor when administering a thrombolytic agent to a AMI patient in the ED or ICU. Sorry to hear about the loss of your patient. Hope this response helps in your learning.

STEMI (ST segment elevated myocardial infarction) patients can be very unstable or can quickly become unstable. If you think about the pathophysiology of what is going on in this clinical condition, the patient is demonstrating ST segment elevation because a coronary artery is completely obstructed with thrombus. This typically results from a nonobstructive plaque inside the wall of artery that ruptures. The clotting cascade is initiated and a blood clot (thrombus) forms which may completely block the artery (STEMI) or cause an incomplete blockage (usually NSTEMI). In the case of your patient (STEMI), this complete lack of blood flow deprives the heart muscle of oxygen, causing the tissue to begin dying within minutes of the blood clot forming...causing associated clinical symptoms (hypotension, Chest pain, dyspnea, N/V, diaphoresis, etc). This ischemia in turn leads to many dysrhythmias including PVCs, vtach, vfib. Oftentimes depending on which artery is blocked (Right coronary artery or a dominant circumflex either of which may feed the SA Node) you may see bradycardic arhythmias like 2nd degree type II or 3rd degree AV blocks. However another possibility can occur when reperfusion of blood flow to the heart muscle is established (either by angioplasty or administering a thrombolytic drug such as TPA, TNK). This is called reperfusion arrhythmia. It can be any number of abnormal rhythms. Usually transient but can be life threatening. The nurse should always be vigilant of the patient and the bedside cardiac monitor when administering a thrombolytic agent to a AMI patient in the ED or ICU. Sorry to hear about the loss of your patient. Hope this response helps in your learning.

Goofeegirl, This link to UAB's RNFA may be an example of what you are looking for. One of the prereqs if you do not have previous OR experience is a MSN degree: http://www.uab.edu/nursing/images/stories/info_sa/msn_flyer_rn_first_assist_post_baccalaureate.pdf

no advice here, just congrats!

Don't change your answers! Don't even go back over the questions after answering. Usually your first instinct is correct. Do you have any outside stressors that are interfering with studying or test-taking day that could be adjusted for the semester?

In interviews with 2 separate practices, I have been directly asked what I am looking for in salary. I did some research beforehand into each specialty within the region. NP/PA Advance has some good salary survey info. Also have been asked about my interest in NP run clinic in certain area of the practice (pacemaker, lipids, etc). If in school you were able to electronically log your clinical encounters, find out if it can generate a summary/graph of the types of patient you saw. The practice I was hired by was impressed that I provided them with that data as a large majority of my patients as a student fell within their patient population. Good luck!

Advance NP/PA recently released their salary survey results. Maybe it will be helpful to you: http://nurse-practitioners-and-physician-assistants.advanceweb.com/Features/Articles/National-Salary-Report-2011.aspx