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My work is developing a preceptor training course. Here are the resources I am reviewing right now to see if they can help us to have better preceptorships and orientations. Core Concepts for Clinical Preceptors and Faculty - John Hopkins School of Nursing, $10/module including CE, bundle of 9 save you $10 Core Concepts for Clinical Preceptors & Faculty | School of Nursing at Johns Hopkins University Preceptor Education Program *FREE* http://www.preceptor.ca

I did an ABSN/MSN program. The lack of experience had it challenges with no nursing experience when you are applying for NP jobs. A lot of large corporate employers will automatically kick you application out because they want some form of experience but there are plenty of people who will hire you without. I found that employers would had more ability to chose applicants they liked best over strict institutional requirements were easier. For examples, private practices are willing to hire new grads if they interested in training someone up. Government agencies and hospital systems were a no go directly out of school. It is important to make up for your lack of existing clinical knowledge by studying hard and absorbing as much as you can in clinicals. At the end of the day, if you want to have a good NP brain and skills, you are going to work to achieve it regardless of your previous experience. The pursuit of excellence is what determines the quality of NP you are going to be. I have precepted and oriented APRNs with no experience to 20 years experience as an RN. Your mind, motivation, and desire to learn is what make you into a good NP. Previous RN experience is a small help but only if it directly related to what your APRN practice site does. After 5 years of practice, people misunderstand me when I explain my nursing pathway. They often think I am joking when I explain I had no nursing experience prior to being an NP. Today I am a resource person and known for being the person who knows a lot about everything. My fellow NPs says they would never know I had not worked as a nurse prior to being an APRN.

Every 5 years is with HPV DNA testing for over 30 years. Cytology alone is different.

The current guidelines are slowly being accepted. At this point insurances are still paying for annual pap smear, so some offices continue to do them annually for money and patient preference. The reason that guidelines are do not reccomend younger than 21 and less frequently is that most healthy individuals will clear the infection. Cervical cancer is usually slow growing, so it should be detect if screen for every few years. Studies showed that frequent more screening led to excessive invasive treatment without waiting to see if mild cases would resolve on their own. Cone procedures and multiple leeps affect the cervix structure and can result in future high risk pregnancy related to incompetent cervix. Convincing the patients can be the hardest part. Sorry I do not have specific references for the research but that is what we learned in school was the reason behind the changes in the guidelines. I just started at a practice that requires that everyone get a pregnancy test to recieve birth control. At Contraceptive Techonology, I learned the research shows you only need a good history and BP. No pelvics either. There was an article just published about the fact pelvics may be overly used as an annual screen and provide patient with false reassurance. There have been some studies I believe in other countries that show COC used as an OTC are safe but I do not think that is going to happen in the US anytime soon. Chlamydia screening is reccomended to be done on everyone sexually active under 25 due to the high risk of undiagnosed infections and the long term consequences (infertility and PID). If you can do urine screen, there is no need to do a speculum exam to do the swab. Hope this help :)

Some states require you to have a BSN to participate in MSN programs. An example would the GA. I am not sure how this would affect your job prospects though.

I have struggled with a similar problem. One of my friends in an FNP program chose to attend several of the WHNP lecture to expand her knowledge but I don't know if your current school has that option. Depending on your school, you could try to arrange an extra clinical rotation in gynecology if you have the time in your program and that way you have more experience than the typical FNP new graduate. FNPs do get jobs in women's health but the learning curve might be steeper when they first start depending on how their program content. As WHNP student, half of the appointments are gyn and the others are prenatal/postpartum. The FNP program at my school only has 40 hours of women's health clinical versus the WHNP 600. To me its a calculated risk between the chance you will get the job you want vs when the loan payments start. Look into the market where you plan to practice. I know that the market I am looking out has few WHNP jobs, so I have decided to finish the ANP portion of my program. Unfortunately the WHNP/ANP is no longer being offered at Emory. It is hard to choose and to stick to your choice but you could get a post masters in either specialty or just expand your own skill set through self education (learn more gyn as an FNP). While WHNP scope usually include the primary care of women, it has been suggested in some discussions at school that a WHNP practicing in a primary care practice including the treatment of non-gyn conditions could create some legal risks.

I have been struggling in clinicals with a lack of confidence. I feel that even if we went over the information in class I have trouble remembering it until we do it in a case study or I have a patient with the condition. I can remember most information from discussion based classes, but struggle with powerpoint dependent teaching style. I can read the same chapter three times and barely retain anything in long term memory. I am entering my third semester as WHNP and just now learning about abortions and infertility (so frustrating!). I got two case study question books that have helped but am looking for other good study tips. My grades are fine despite the way I feel about my knowledge base. While I understand how seeing patients at the same time as learning can be beneficial, i believe it comes with some short comings. Due to medical and family issues, i have fallen behind in clinical hours but am continuing full time in the program with supervision. I am working with the school to schedule enough clinicals to catch up. My preceptor is very supportive and says I need to trust myself. Just not sure how to go about it.

My specialty is women and adult health, but I really would prefer to practice women's health. I will only be working in primary care. Many of the local hospital refuse to hire full time students and they require a two year contract full time (most likely nights) after their new grad program (3 to 12 months depending on unit). My program is less than two years, and I have heard it is impossible to work full time later on in the program. I am also planning to move out of state to my bf and get married as soon as I finish. I would love to work in a primary care clinic but the market where my school is located is already flooded and clinics do not hire new grads. Half of the incoming class is new grads (5 out of 9) and the school has a 100% pass rate. My concern is just about the stress of life. My relationship is long distance, so not having weekends and working evening makes it even harder. The chronic stress has just been overhelming in addition to be cut off from my support system. I am just hoping grad school won't be as crazy especially since I will be working clinic hours. Thank you for the advice.

Thank you so much for your comments. The school had us take the graduate level research, ethics, and health policy classes, so there might be a few less papers. We have to take elective to make those credit hours up though. I have talked to the program director. Graduates from other program said their friends switched specialties because this particular degree because of the clinical hours (1000 hours total). Maybe there will be grad students at the orientation. Thank you again.

Hello, I am graduating with my B.S.N on friday and start my NP program two weeks later. My program is acclelerated so this spring semester we had to take 18 credit hours, which was almost too much for me. This past month (part of summer semester) I have been doing about 40 hours of clinical a week and have classes one day a week. I can't wait for my week of vacation. I was wondering how diffucult juggling all the readings and clinical is during an NP program. I have two days of classes and 1.5 days of clinical for the first semester. Later in the program we have 2 half days of class and 3 days of clinicals. I have heard several times that there is a ton of reading during NP programs. I was wondering if anyone could estimate this as equal, less, or more than my current workload. I am all set to go, but I just want to have accurate expectations for the next 17 months of my life. If you have any tips on NP school vs nursing school or biology degree please feel free to give. Thanks in advance.

The National Association of Nurse Practitioner's in Women's Health lists all the programs available and you should be able to filter by state. I am am about to start WHNP/ANP program and have yet to find any type of ranking. It is such a specialized field I guess. Most of the curriculums are similar and 600 hours of clinical are required by NCC to sit the board. I think it is what program fits your needs. Talking with past students and the program coordinator can be very helpful.

I do live in very backward state when it comes to nursing that does require a BSN to pursue an MSN in Advance Practice (NP, CMN, ect). If i had gone to the CNL program, I would have had to move to another state to pursue my MSN. Just be sure to look at the nurse practice acts to see what is in the scope of practice and education requirements for each role in your state. This information is usually found on the state's board of nursing website.

Thanks for clarifying the certification thing. I did not mean to imply that certification was needed to bill. I was trying to highlight possible business economic reasons for using a PA or NP as first assist rather than an a RN. Is there any evidence to support using one type versus the other?

We had someone talk about this in a lecture. FNP can train as first assist with training. If I remember correctly, there are programs to get certified as a first assist. It is actually a financial benefit, because the FNP can bill for their time as compared to nurse. The other alternative is to go to PA school. At my school, there are a number of nurses in the PA program. According to some sources, PA program gives more procedural training and would be more likely to include surgical related stuff like a rotation in general surgery. I have no idea if PA need additional training to be a first assist. PA can also bill as a first assist. With an mid-level role, you have the scope of practice to round on the patient afterward the surgery and write orders for the patients. The speaker stated some physician enjoyed this additional benefit, because it allows them to see more patients. I would guess this is dependent on experience and the relationship with the physician. If you are really interested, you might want to talk to someone who does this type of work and get their opinion.

I looked at doing a CNL program, but ended up in ABSN/MSN due to my career goals. Making it a Master's changes your federal financial status to graduate student. If you already have a bachleor's, you are not eligible for certain federal aid programs. If you do a second-degree BSN program, you might be less financial aid. You can get more aid if you are a graduate student if you have a previous bachelors. Check out federal aid websites and talk to school administrators about this stuff if you have questions. I have not idea about the market for CNL. But if you want to pursue an advance degree (Advance Practice Role, ect) at some point in time, SOME states require a BSN. An MSN cannot be used to fulfill the requirement.