Isabel-ANP-BC

My MSN program required 720 hours of clinical. I had 967. If I had realized I was so close to 1000, I would have done the last 33. We had to meet the minimum number of hours, but we were encouraged to go over. Now I'm in a DNP program and we have to do a minimum of 720 hours again, so by the time I'm done I'll have about 2,000 hours. It's all clinical and every class I'm taking is related to what I'm doing because even the non-clinical classes teach critical thinking and how to evaluate new studies, etc. I agree, some graduate work is fluff, but I don't agree that every MSN or DNP program is full of it.

I've had the "I'm writing everything down" thing happen as an NP when I worked in a hospital. I just started leaving my name, my bosses name, and her phone number for the scribe. I found that if you act as if you have nothing to hide (which I never did, but hey...) then the scribe loses a lot of umph behind the threat to turn you in. Yeah, well, go ahead, here's my bosses name and number, I'll be happy to discuss this with her and you if needed... Only had one person turn me in, but she turned everyone in and my boss just shrugged it off. The rest sent thank you cards.

I'm working on my DNP. I'm an Adult Nurse Practitioner. I'm also Board Certified in Adult Health. When I finally get the DNP, I will introduce myself as "Dr. ANP, a Nurse Practitioner specializing in adult health. I am your healthcare provider. Please call me Isabel." I do not think it is confusing to patients as long as we a clear about who we are and what our professional license is. I think it is demeaning to patients and the general public to assume that they won't ever be able to understand the differences between NP and MD, etc. I object to the term mid-level provider. I do not provide mid-level care. In NYS we still must have a collaborating physician, but hopefully that will change soon. Regardless, I provide high quality, holistic healthcare.

I took the ANCC ANP exam 2 years ago. Didn't think it was bad, passed on the first go round. I used their online review lectures and powerpoints, did it the week before the exam. Didn't do anything else. Thought the review was good because the lecturer would say, "And this is a great exam question". About half of those types of questions were on my exam. I'm not sure if I did well because I tend to be a good multiple guess test taker or just was at the point where I was like, "I know this stuff..." and refusing to stress walking into the exam. That said, the woman who came out at the same time I did failed the FNP exam. Maybe FNP is harder because it includes pediatrics?

I'm enrolled in Loyola University New Orleans' DNP program as an NP (there is also an Executive Leadership Track). I'm finding that the critical thinking skills we are learning is what is setting the program apart. Look for a program that you think will meet your needs and is within your budget. No DNP program will be a perfect fit, but neither would PhD, DNS, etc, programs. Also, remember that DNP is a relatively new nursing degree and is still growing into itself. I like that--gives me a chance to shape what I want to learn and how I want to learn it. Fortunately, I'm a program that allows that.

Heh....I just tell them the truth: No kids, engaged, now how are you doing? Let's see what I do to help you feel better/get out of here/blah blah blah (ok not quite like that, but still). once I did tell someone it was none of his business after he didn't take the hint and the "I would prefer not to discuss my personal life" as an indication that it was none of his business. If they persist I tell them one child is about 91 in people years a loves to chase balls and the other one is about 71 in people years and loves cans of tuna. Usually that stops them.

I have a BSN from SUNY Stonybrook. Program was all online. My degree merely says, "BSN". I got into an online MSN/ANP program and am now doing the DNP the same way. No issues as long as the program is properly accredited.

I know I'm probably going to annoy some people, but....And before I go too far I want to say that I am an ASN RN originally and that I'm currently working on the DNP-- 1) LPNs should continue to be a 1 year full time program. Scope of practice limited things such as passing PO/PR/Otic/Optic/SL/SQ/IM meds, observations, taking histories, confirming allergies, doing dressing changes on pressure ulcers, and other duties along those lines. Still the backbone of LTC and where needed outpatient offices/clinics. 2) RN--2 year full time associates degree. Can do assessments, hang IVs, handle central lines, but not educated for clinical leadership, management, or as a way to transition into advance practice roles. Strictly direct line patient care. AKA Registered Nurse. 3) RPN-4 year full time BSN. Can do all of what an RN can do, plus entry level management, precept, charge nurse. AKA Registered Professional Nurse. All three of the above take different licensing exams and all three have very distinct scopes of practice, with the higher level building on the previous level(s). Advanced practice nurses: MSN, PhD, DNP, DNS, etc. MSN is the entry level to advanced practice nursing. Good for clinical nurse leaders, educators teaching at the LPN, RN, and RPN levels. Also entry level for clinical nurse specialists. PhD or DNP or other equivalent doctorate required to teach MSNs and doctorate level students. Prescriptive advanced practice nurses should be required to have a doctorate. Nursing wants to be considered a true profession, lets set it up so looks like one.

Yup, Elmira itself is boring. I lived there. But Corning has museums and interesting shopping and dining because of Corning, Inc. That's 17 miles down the road. Ithaca is a great college town, 30 miles north of Elmira. Some of the areas up 17 may be problematic because of the number of nursing schools graduating RNs. True upstate (Syracuse, Albany, Binghamton, Elmira, Utica, Rochester, Buffalo, etc) may offer more entry level opportunities. Pay won't be as high as in NYC or the immediate surrounding areas, but rent is lower, as is car insurance and a number of other cost of living indexes. I liked Binghamton, but I really love the Syracuse area. Close to the Adirondacks and the Finger Lakes, easy access to a lot of wine country, lots of interesting little towns to explore. And Albany, Syracuse, Rochester, and Binghamton do have cultural events, fairs, theater, opera, and museums. No, none of it is NYC, but upstate New York is a good place to live and work.

Yup, in most states as long as you don't clock in and don't take report, it's not patient abandonment. The facility can fire you, but the BON doesn't get involved. I live in NYS. I worked a hospital where I walked in one night and found out I had 13 patients (normal load was 7 - 9) and that the other nurse had 14. We had one nurse call in and the hospital refused to float a nurse from another unit (turns out the other big med-surg unit had 5 nurses and 5 patients each). The other RN on my floor and I were there for 17 hours. I refused to come back in for my next shift (which was 7 hours from the time I left). I got written up. A few weeks later, when in and refused an assignment because it was the same 13/14 patient deal. They sent us another nurse. A few months later I quit. Wasn't worth it. Maybe more nurses need to start saying, "No, not doing it." As a group we might lose jobs initially, but if enough of us say it, someone will have to start listening.

No, people don't like a snitch, but then again, snitching would not have been required if the nurse had behaved professionally and taken care of the residents appropriately... So, the right answer was to report it. The facility has an obligation to help prevent retaliation.

You won't get paid as much as downstate, but the cost of living is a fair amount lower...

I used to live in Elmira, and I agree...not a great place in and of itself but Ithaca and Corning and a lot of great sight seeing areas are right near there. You can also look into places like Utica/Rome, which is between Syracuse and Albany; Syracuse itself is good, and I like it here. UHS hospitals in Binghamton own the hospital in Norwich. Norwich itself isn't great, but its close to Binghamton. Syracuse and the surrounding areas are good places to live. You could also look at communities around Albany/Cooperstown/Oneonta. I'm not sure about communities further west or North... Isabel

I had the same thing happen to me in my first job, but I stuck with it and learned a lot. You're a new NP....you're low man on the totem pole. You can leave but sometimes it's just better to suck it up and stay for awhile, then go...

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