rhiannonwolf

I passed the AANP FNP boards on December 29, 2016 and graduated from my FNP program in May of 2015, that is a full year and a half after I was done with my program. (Life got in the way with two boys with autism). I only took the exam once and passed, but I will say that if anyone has a weakness in geriatrics, get on that now. I took the online Fitzgerald course which was very helpful, but her questions in her study book are much harder than what was on the exam. I also did ALL of the questions in the APEA Q bank and studied over a four month span of time on and off. Liek is awesome for fast facts and understanding the heart and Fitzgerald also has a great review of heart sounds, S1 and S2 and what is pathologic and what is physiologic. Liek was my bible and I carried that book everywhere. Although outdated with JNC 8 guidelines and some of the USPTF guidelines for cancer screenings, overall it is the best book to study from. I will also say that the APEA Q bank mimics the questions on the AANP test I think the closest. Good luck to all!!

Abby, I just copied some of our discussion onto a word document and am trying to copy the rest and I will send it to you. Allyson But call me first

Hey Abby, what is your phone number really quick? I need to talk to you and then I think we will be done with this discussion.

LOL Brenda, you are already using Tinkerbell in your posts? You are doing well, I can't even do that. I think you are right that we should use the PICO format that you quote on page three, email it everyone else in our group and get it approved and like you said have it to Dr. Sousi by Tuesday so he can read it and hopefully approve it! I will copy the PICO that you wrote down, to a word document, excellent by the way, and who wants to officially submit this to Dr. Sousi?

Brenda, you are quick! Awesome summarization of PICO, I love it! You all are on the ball, I am still in my pajamas and have been doing pharmacology since 9:00 this morning LOL.

So I'm feeling a bit goofy now. Okay, thank you Abby for volunteering for the EBP part, what section is that again? I suggested that we use the Iowa Model because it is nursing based as I discussed on our board this week and there is also a great flow diagram of it in the book. Just a thought, what do you think Abby? :yeah:

Oh okay, LOL, PICO, you mean the articles I haven't read yet because my one hour pharmacology class has me in a tailspin right now. And by the way, I'm venting here, Nursing 731 should be a three hour credit, one hour is crap. Anyway, thank you for the clarification Abby, I am glad you have the syllabus there. I can write section two since I guess I am going to do most of the research for the articles, if that is okay with everyone. And back to the topic of NPO, so we are narrowing this puppy down to: Problem: NPO status in patients may be too long of time and we need to find through research studies what is the shortest critical window of time a patient can go under general anesthetic without eating so that he/she will not be at risk for postoperative complications such as aspiration or fluid deprevation. Once we find this information we should gather data by evaluating patient records to evaluate outcomes. If the outcomes are positive postoperatively, we can change hopsital protocols, or do I have it backwards? I think we should use the Iowa Model for the EBP because there is a great figure of it in our textbook. What do you think?

Right there with you Abby, about how things have been clarified in this class so far :angryfire. Well, I would be willing to write about the research side of the project, I think that is part two. I can do lots of it, although I don't know what PICO form means. What the heck is that? Anyone know? :icon_roll

It says up there that we have three members and three guests, I hope you are there Judith and Kamala. If you want to join the discussion, just log into allnurses.com by registering we would love your input!

Good questions Brenda. I would say that we would be developing new hospital protocols for patients with regards to how many hours and what time a patient should go 'NPO' before surgery. We could look at medical records to audit rates of aspiration and postsurgical complications for patients who have lowered fluid levels who were NPO for longer periods of time, I think that is a good idea. It may be the only way in which we could gather that kind of data.

:yeah:Sorry Abby, I'm having way to much fun with these little icons in my post, I definitely like your idea and thank you for bringing the syllabus along. I do not have it in front of me, how many sections are there to the EBP project and can you list them for us so we can hash out as to who will do what, like someone can write the intro, state the problem, summarize the research, etc. Thanks!

:yeah:Brenda, I would love to do the topic of C-sections, but I think we need to keep it braos enough to where everyone in the group could use this information we are working on since they work in different clinical areas. Most C-section patients do not undergo general anesthesia, they just recieve lumbar spinals and that would open a whole new sac-o-cats.

Abby, could you clarify the patients post operative fluid status to avoid post operative complication? Would it be too simple to state that our topic would be, what is the exact amount of time a patient has to be NPO in order to avoid asperation and complications from surgery so that we as clinical nurses can educate our patients as to the exact amount of time or critical window that they need to stop eating before they go under for anesthetic? Therefore our outcome would be I guess, and this goes along the lines of what you were saying Abby, outcomes would be lowered postsurgical patient complications, and post operative fluid status.

We also talked about who could do the editing and APA checks on our paper and Brenda stated that she is good at this.

Hey Abby!! Just keep hitting your refresh button to see what we are posting. Welcome and glad you found us. Brenda and I are here and are discussing the NPO thing. Do you have any ideas or thoughts are what angle we should approach this?

:yeah:Hey Brenda, so glad your on the site and found the forum, I hope everyone else does, do you think Dr. Sousa would be receptive to how many hours it takes for people to truly be NPO before the rates of aspiration increase? This would help us in our practice as clinical nurses with regards to what we tell our patients if they are to have a surgical procedure the next day and we could definitely find information on this. This may also help patient satisfaction rates so they wouldn't be starving. I know with my patients who are in labor or having a c-section the next morning, they are told NPO at midnight, although their procedure may be scheduled for 9:00 a.m. the next day and then after the procedure they are on clear liquids advanced as tolerated or even stay on ice chips. Allyson:heartbeat:smokin: Just having fun with these little guys:angryfire

How about the idea of either number of hours it takes to be NPO before risk of aspiration is lowered in preoperative patients, or with regards to patients who have been educated to what NPO actually means and patients who have not, how long did they fast before the surgery, or we could do compliance rates of patients who are supposed to NPO. Just some suggestions

Hello everyone, I am here. I am going to see if I can find this post through the search option. Allyson

Hello to all you Frontier people out there on this Forum! I have a question, I am applying for next year's class and was wondering, do they really mean its 30 hours a week of studying if you go part time? How many papers do you write? Are there alot of online tests? Just trying to get an idea of what this would be like for the CNM program. Thanks! Rhiannon

AMEN!! Perhaps it is just the midwest that seems to be void of midwives with only a select few hired and they must have experience. Oh well, my husband and I are looking at moving to Seattle in 2011 after I graduate, so we will see, I think I will have a much better chance at getting a job out there than here in Kansas.

I hope you are right about the field of CNM's. It seems like all I read are articles of hospitals firing their CNM's and OBGYN"s not wanting to collaborate with them because of liability issues. Insurance coverage ranges from 20,000 to 25,000 a year! It just seems scary to me, however, if I find the right job I am willing to pay the price because it is the only thing that I want to do or see myself doing the rest of my life. As far as family obligations, my children will be in gradeschool by the time I have a thriving practice so those 3:00 a.m. in the morning phonecalls won't be as difficult to answer since they won't be babies.

Hi Mom2Michael, I moved from Missouri to Kansas a year ago because my five year old son has autism and there are much better services for him across the stateline. However, I know that in St. Louis there are alot of midwives that practice and I know in Central Missouri there are lay midwives still doing homebirths under the guises of a physician. Good luck with your endeavors of becoming a midwife, I think what I will do is I am going to do a post-master's FNP after my CNM. I have to go really slow through school though because of my family situation. Missouri has alot of restrictions against advanced practice nursing. It is really sad. Here in Kansas its like the wild west compared to Missouri as far as scope of practice and FNP's and CNM's. I know they are practicing where I am located, there are just not alot of them. However, I know that in a few years my husband and I are moving to the west coast so I know I can practice out there. Take care! Sincerely, Rhiannon

Hello, I just got into the midwifery program at the University of Kansas Medical center which I know now is ranked 12th in the nation. I have always wanted to be a midwife. It is exactly what I have wanted to do since the first day of nursing school. However, after doing extensive research, I am finding that there is a possibility that this career field is dying. What do you all think? I am scared that I made the wrong choice. Otherwise I think I will also get me FNP so that I am more marketable for my family. Rhiannon

I am shocked and mortified that the clinic that you work in does not have a chaperone for their patients during gynecologic exams performed by male docs or nurses. I know that at my clinic and my hospital, it is MANDATORY that a female is present for all cervical checks and breast exams. If not, there is a huge liability for our institution. What about all of the patients who have been sexually abused? Is the doctor and male nurse that you work with sensitive to this dominating issue? The patient can always come back and slap a lawsuit against us if we do not do this. It is a violation of patients' rights and we as nurses or in your case a student nurse should be advocates for the people we care for. I am an OB nurse and I know firsthand that about 30% of all of our clientele have some past history of sexual abuse or domestic violence. I hope that you can go to a superior of your clinic and express your concerns. It just burns me up when I hear abou cases like this because, in your situation, if it is a free clinic, the patients are probably on the lower end of the socioeconomic ladder and this egomaniac doctor probably feels like they have no rights, they are just lucky to be recieving his services. Him and this male nurse need to be taken down a few notches. Just ranting!! Rhiannon:angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire

I need help from anyone who has experience with the HESI test. I have already passed my boards, but my friend, who I am trying to help study took a HESI E2 today and scored a 711. Her test is in a week and a half and she is scared as heck about taking them. Apparently this score on the HESI is not good, but if she doesn't take the test by August 6, her 90 days runs out as a GN and she will lose her job. I know she has the knowledge, she has been scoring in the 60's on Kaplan tests. Does anyone know about the accuracy of HESI in predicting whether or not someone will pass NCLEX? Any input would be appreciated! Thanks! Rhiannon