Saifudin

Thanks for your feedback. I can take the exam but will need 150 CEU hours first. I'm still licensed but to practice I have to get certified again. I was certified for 24 years then moved in different directions, all within healthcare and I am now in home care and getting practice skills back. I'm wondering how to set a study program. I'll probably start with a systematic system review, chronic diseases, a pharmacology review, which 25 of the 150 CE requirement must now be pharmacology. I'm thinking to take an NP review course closer to the time I want to take the exam and thinking about taking the board sometime in the fall, and before the ANCC ANP end date of end of Dec, 015. For all my years in healthcare and being an NP since 1982, I continue to consider myself an NP and will now try to get my credentials back and move into practice with wound care an interest but I'm a clinician at heart. At least that's the plan.

Greetings, Has anyone re-certified years after leaving practice? If, so, how did you prepare for the ANP exam? Thanks

If wet to dry dressings are being used less due to removing new granulation tissue, how could 'rough scrubbing' be of benefit? It sounds like a form of sharp debridement. And no prepping the patient with pain meds sounds pretty sadistic.

I am caring for a client with a Stage IV Ischial pressure ulcer who requires a wound vac. My agency is not happy about the amount of care he requires and you do take a beating financially if a patient requires an excessive number of visits, as well as supplies that may or may not be reimbursed. It seems the 'big players' refer to us when they either cannot accept new home care cases do to staffing or do not want to either take the financial hit or believe the complexity of care may result in re-admissions or other problems that may lower their quality scores. I'm also interested in pursuing wound care and am looking for live training in seminars, skill labs or now thinking to see if I can spend a few hours a week in a wound clinic. Even if I don't get certified, the knowledge/experience is a great thing to have, especially for the care of patients in their homes.

I started in home care on October, 2014. No orientation and what followed was a nightmare, that I have nearly recovered from, but it wasn't easy. I lost an inch on my waist, between the adjustment to working in non-clinical environments and the three hours it would take me to complete the OASIS SOC. I have come to appreciate home care for what it is, a highly specialized form of nursing and medical care, perhaps one of the most important when we often serve as the bridge between what is frequnetly highly fragmented care, overwhelmed patients and living environments that often do not support proper care, support and safety of the client. I find it a huge responsibility that I take very seriously. Of course there should be an extensive orientation but given the highly competitive nature of home care and the balancing act many of the 'mom-pop' home care agencies try to maintain by 'beating the bushes' for patients, often with a disregard for available staffing, I have found that you can get stuck with seven day work weeks, long distances and hours of uncompensated documentation time, not to mention how concerns for your patients can get 'into your head', at least, that is my experience. It is unethical and dangerous to not orient nurses to home care.

Sorry, but I wasn't clear from your first post that your business is a non medical home. I don't know much about it but did some reading. No doubt you know much more than me about this. I think as a business it is a great idea. I'm also interested in care of seniors and it seems to have a great future considering our graying society (myself included). Is the RN a Virginia requirement? If your using care givers, they do not have to be nurses from what I understand. Perhaps you need someone to evaluate medical needs clients might have, such as chronic diseases, medications, etc. Sorry I can't provide more but I wish you all success.

I agree with the others that you should build a solid foundation before moving on. I left direct care NP practice in 1995 but in my positions following that as a Director of Nursing and most recently as a Director of Quality Improvement and Patient Safety, and now, as I ponder the direction I want to go in my career, I have and continue to consider myself a clinician. The mix of nursing and being a medical provider was a perfect fit for me. The nursing foundation is far different then medicine. The aspect of patient teaching and the caring element inherent in nursing for me was an excellent foundation for then learning medicine and providing an advanced level of care. I may go back to it. I also think that with healthcare in such flux with the nursing profession losing what many of us once felt was a 'recession proof' profession, I think that given the acute need for primary care providers that will continue to grow, NP practice may also provide more employment stability, but, time will tell. Either way, focus on the rigors of studies that lie ahead.

Ouch...yep..pre-NCLEX for you 'young'ins' means state boards administered their own exams. It was not standardized and of course, not computerized. I might have good news. I wrote the the Michigan Nurses Association and what I was told regarding have to test again might be wrong. They are supposed to get back to me tomorrow. Either way, I don't mind a good review anyway and a refresher course is probably necessary. That's not a bad thing even if I don't return to practice. I haven't worked as a staff nurse since 1983, after completing my NP program. I might try to get back to NP practice which will be another intensive review.

Thanks again for the quick response. I worked overseas for 18 years and now back I may be going back to my roots in nursing...

Thanks ChazzW for the reply. I spoke to someone in the licensing division in Michigan and she said I have to take the NCLEX. Actually, I don't find their website very helpful. If you don't mind, I'd like to ask your opinion on NCLEX prep books. Older versions say 2010 are much cheaper than 2013 books. Do you think there are significant changes in 3 years or so make buying the most recent materials better to purchase?

Has anyone who has been an RN for some years (pre-NCLEX days) had to take the NCLEX in order to get licensed in another state? I'm licensed in New York and now want to get licensed in Michigan. I was informed that I must take the NCLEX first. Is this the case in all states (other than compact states)? I don't mind taking it. The review will be good. Any thoughts on this.

I'm curious how do you break into the field. I've been in healthcare for 35 years. I'm an adult NP, worked as a DON in addiction/mental health and most recently, lead a QI and Pt. Safety department in a community hospital. Last two positions were overseas in the Gulf. Positions advertised usually ask for experience. Will certification potentially open the door?

Great for you for going into business. Your post, however, doesn't provide a great deal of information about the services you provide in order to offer suggestions. I'm not clear on what services you could provide to patients in a nursing home, unless you mean patients in for short term rehab and are expected to eventually go home. What services do you provide, how much competition are you facing, are your services different or the same as your competition, can you provide niche services, etc. Have you defined what the next level is? These are some questions that come to mind in response to your asking for help and suggestions.

My suggestion is go for what interests you the most, what you think will bring you the most satisfaction and then look at the money. For me, despite being out of direct care NP practice since 1995, I still consider myself a clinician. The knowledge and skills I gained while in practice were invaluable as a nursing director and most recently in quality improvement and patient safety. Anesthesia vs. providing direct care are apples and oranges. If your a very people oriented type of person and get satisfaction from not only providing care but the feedback from those whom you provide care for, then I would go with an NP or a PA program. I believe the money is quite good in all three areas with anesthesia likely higher but so is the stress.

Let me take a broader view of this since the story is brief. Perhaps this student has not encountered a patient in this condition before. It can take some time to get use to the more unsavory aspects of nursing care, so perhaps we can go a little easier on this student. In fact, she may never get use to it and eventually seek to work in nursing in an area that does not have to provide this very personal care. What this poster did by taking control and going to the patient is far more instructional than any class room discussion or lecture on culture, etc., could ever provide. There are little things I was taught back in the 70's (1970's that is) that are still with me today. I had a phlebotomy nurse teach me that you can draw blood, and even give blood through a 23g butter-fly. Later, when I was in NP practice, in both the ED and OPD I used 23g butter-flies for nearly all blood draws except trauma cases. 'Back in the day' when I trained in a hospital program, after the the first semester we were allowed to work as aids and orderlies, in fact we provided important staffing and living next to the hospital, they always had enough aid staff. Training and working in the same hospital, you learned all the basics of care and by the time we graduated and went to work as professional nurses, we did it all without question, including what I always felt was one of the worst things we could do to a patient, and that was manual dis-impaction. I suggest patience, compassion and as Tramore35 did, teach by example.