ROLO

What do you mean by “difficult?” I think I would want to explore the origin of this difficulty. The DNP sounds great. I am an ACNP with an MSN, and I hope to be working on my DNP within the next year, but I wonder if your getting your DNP is going to solve this problem.

I am not in the DNP program yet, but, having done the MSN ACNP track (class of 2011), and holding four other degrees, I am thinking school is what you make it. I would encourage prospective students to be realistic. Grad school WILL require work. If you do not want to work, then do not do it. Do as much research about the school and specific program as you can, which is what people on this discussion board are doing, but do not stop here. Contact USA instructors by phone and email. USA staff were great in talking to me and answering my questions during my research process. I even asked instructors to give my email address to students who were getting ready to graduate, so that I could ask them questions --I got to talk to several graduating students who shared their thoughts on the USA experience, which I found very helpful. I have seen comments about USA being "self-taught," which I translate as "little help from instructors." If you are looking for a spoon-fed graduate nursing program, it is not USA, and I would be leery of any program described as such. Not that I think it should be mandatory, but I think nursing grad students working towards ADVANCED PRACTICE NURSING (NP, CNS, CRNA, MIDWIFE, etc.) specializations should be seasoned and have a good knowledge base. Be realistic. Be prepared. Do NOT give up.

One of the best all-around nurses (emergency nurse) I know took her boards, I think, FIVE times. Not only is she very knowledgeable, but she can get along with anyone --not only difficult patients, but difficult nurses, and difficult physicians. She is just a great person. So, my advice to you is DO NOT GIVE UP!

OH, and I needed to add, I used/use research and theory every day. I am sort of scared of those who do not (or think they do not). Evidence based practice, best practice guidelines, new treatment modalities, patients perceptions of their caregivers, spirituality in breast cancer, the theory of caring...as an advanced practice nurse, SERIOUSLY, how can you not use research or theory to some degree?! The parts of research and theory (mostly research) that I do not care for are the parts that I did not truly master. One of these days I will re-visit those areas that I did not entirely grasp, and I am thinking I will find them interesting and even helpful.

To "8mpg": I would venture to say that no one is excited about taking research and theory, but those courses are required by the "powers that be," and so every NP program has to have them. If you find a program that does not have research and theory, turn and run in the opposite direction, as I am thinking it is probably not "legit"/accredited. Individually, a school can add to the required courses. I started out at a school that had two research courses, instead of the usual 1. I think they went on to add a leadership course, too, that was not required by the "powers that be," but just a course that they thought would benefit their students (whatever, right?). I did great in my courses, even got a decent score in that first research course, BUT I DID NOT PASS IT BECAUSE I DID NOT GET ENOUGH POINTS IN THE INDIVIDUAL PART OF THE COURSE (there were group projects AND individual projects). So, even though I had enough points for a grade of B, I received a C in the course and was told that I had to retake the FIRST research course again.... I transferred. Though I had finished a year of grad school, I saw this as a HUGE "red flag" against this program. I transferred to my first choice of schools --the University of South Alabama (GO JAGUARS!). Ironically, the first course I had to take (or re-take) was research. Research was not easy, and historically it was not known for being easy, BUT MY GROUP AND I ACED IT! The instructor, on our last paper, which was a group paper, wrote, "CONGRATULATIONS, YOU UNDERSTAND RESEARCH!" It was so cool. Chances are you are going to have to take research and theory. Spend your time finding out which school "fits" you. Like me, you might hate research (and/or theory) at one school, but LOVE it at another school. Start asking "why did you like/dislike your research course" at the University of South Alabama, or USC, or Indiana Wesleyan University, or whatever. When a program/school sounds good, then research it a little more. You WILL find your school.

After graduation, I kept the part-time emergency staff nurse job, a position that I had for the last 10 years, and this past June, I added a part-time hospice/palliative care NP job (love it!). Last Friday, I put the 2-wk notice in for the staff nurse job, and I am going to be picking up more time with my NP job. The company is great. I told them that I did not want to abandon emergency nursing, that I would like to pick up enough time to get insurance through them, and then I would like to do some part-time emergency NP work. They totally understood and were supportive. As long as I put in at least 30 hours of hospice/palliative time, then I get my insurance/benefits, and they are good with me working in the emergency department. I did, by the way, secure an emergency NP job a couple of weeks ago. I am going through the dreaded credentialing process. It is a wonder that there are any NPs with what one has to do in order to get credentialed (wish me luck!). I do not check out the discussion boards like I used, so I apologize for the delay.

Forgot to mention: Sign-up ASAP...you can get his CDs...I wish I had had them while I was still in school.

Took Barkley (ACNP) last December (2011) in Mobile, Alabama. I love him. I want to marry him. He is fantastic, and knows his stuff. I studied (off and on) until March (2012) when I took and passed the exam. His study guide is great, too. I take it to work with me (I have a bag of resources that I cannot live without). Good luck!

Beautiful policy/procedure/guideline! I am just "tuning in" and have not seen all of the other posts, but I might remind us of the Emergency Nurses Association (ENA) (check out their web site). The ENA has position statements on various topics and concerns (advanced practice nurses in the ED...difficult IV access...violent patients...etc.). Also, the National Guideline Clearinghouse is a great source of information regarding standards of care (see their web site). I am an ED nurse, and when I was working on the management of the adult psychiatric patient in the ED, the Clearinghouse had already addressed it, and so I was able to find some good information. You may have already talked about these things, but I just wanted to throw them out there:)

BARKLEY = AWESOME!

I just wanted to throw this out there for the student. As you know, there are several types of assessments, and the one you choose is ultimately up to you. I work in a busy ER, but I almost always include the heart and lung with my assessments. They only take a moment to assess. Mind you, I am not talking about measuring JVD, finding the point of maximal impulse, and grading dependent edema. Your question was sort of general, but I can just hear my program director from school telling me, “If you have a little old lady, with CHF and COPD, YOU BETTER LISTEN TO HER HEART AND LUNGS!"

If I understand your question, you want to know if you HAVE to (as in “required”) listen to heart and lungs, and then include them in your H&P when dealing with a possible UTI (or something or low acuity), for example.... 1) YES 2) YES 3) YES

Graduated 12/14/2011 from USA. Did their ACNP track. I LIVED that program! It was not easy, but I liked the format. I recommend USA. If grad school were easy, everyone would be doing it.

Thank you!

I am waiting for the OK to take my exam... Studying Barkley’s review book and listening to his CDs. Wish me luck!