chuckster

I wonder if myoglobin is on to something with his hypothesis. My NCLEX experience is from quite a while ago but was the full 265 questions. More surprising was the number of calculation questions on my test. I stopped keeping count after 20 but I'd guess it was double that. The calculation questions also became increasingly more elaborate - I can't say more difficult because the math involved for nearly all nursing calculations is generally pretty basic. I was convinced that I'd somehow managed to fail, and so was surprised when a couple of days later, a number of my friends congratulated me on becoming an RN. (An aside: in many states, NCLEX scores must be reported to the BON in 2 business days and you can simply check the state's nursing website to see if you're listed as an RN - without paying Peason Vue extra for early results.) As for the calculation questions, my hypothesis is that I was getting the correct answers and the NCLEX algorithm was simply selecting more challenging questions as the test progressed.

A couple of thoughts. Your age is not a barrier to getting a nursing education, however, your plans should absolutely include the BSN. The overwhelming preference by employers in most parts of the US, despite an alleged nursing shortage, is for BSN candidates. While age is not a barrier to becoming a nurse, age discrimination is rampant in the US, and age can be a significant impediment to finding a job. The Society for Human Resource Management (SHRM) states that "ageism is among the most common forms of employment discrimination." An interesting 2017 study by the Federal Reserve Bank of San Francisco using more than 40,000 dummy job applications, found that job candidates between the ages of 29 and 31 received 35 percent more callbacks than those ages 64 to 66, despite having similar qualifications and skills. Obviously, the job market differs in various parts of the country, and ageism may be more or less of a factor depending on your location. Still, it's something to take into consideration, particularly since the 2009 Supreme Court decision in an age discrimination case. The determination of the Court was basically that age had to be proven to be the principle reason for the discrimination, and not simply one of several factors. That's a very high barrier and essentially allows employers to continue to discriminate on the basis of age if they so choose. And they do: A recent (2018) AARP survey of people age 45 and older (n=3,900) determined that more than nine in 10 older workers perceive age discrimination as common, with 61% indicating they’ve personally seen or experienced it. My suggestion - as others have indicated - is to be very sure that nursing is what you want to do. You will need to invest considerable time, energy and money into getting qualified as an RN. You will also face at least some discrimination in finding a job, taking more time and energy. Neither impediments will be absolute barriers IF you're sure nursing is really your calling.

Thanks for the suggestion. I've looked at finding an employer in the past, but unfortunately without much success. Perhaps the situation has changed of late and it it certainly is worth re-examining, even if it is a relative long shot. After doing some more digging, it seems like the issue is related to my location preference, which for various reasons, is (or at least was) Ontario. From what I can gather, immigration to that province is probably subject to the most restrictions and though I'd like to think otherwise, I'm not a particularly desirable candidate based on their criteria. Quebec seems to be quite a bit more flexible and in many ways is an even more desirable destination for me. The biggest barrier is language. While I am close to basic proficiency, that level will not be nearly sufficient. I'd guess that improving to the point of relative fluidity will take at least a year, probably longer. I also looked into immigration under the AIPP, which is probably the most flexible of the options. While I personally love Newfoundland and the Maritimes, and think I would very much enjoy living there, their relative geographic isolation will make access for our grown children (who will remain in the US) difficult. Probably too tough to make immigration there a viable alternative. I'm going to continue to explore options and plan on an extended trip through Ontario and Quebec in early summer for an on-the-ground assessment. I always knew that it would be difficult to get to Canada but frankly, had no idea of just how hard it would be!

You may be able to do what your want for less than you've budgeted. Like you, I had a previous non-nursing degree and went to CC for my ADN (in my case, DCCC). My cost (less than $6k) was less than you've indicated in your post, mostly because it was a number of years ago and because my undergrad work meant that I did not need as many of the prereqs. After passing the NCLEX, I looked around for the least expensive BSN program offered by an established, regionally accredited college. My BSN wound up only being a bit more than the ADN. All told, my BSN was well under $15k. You should take a close look at the ADN-BSN programs offered by various colleges and universities - the cost varies widely but in general, state-affiliated schools are significantly less than private colleges. One other place I saved money was with textbooks. With only one or two exceptions, I bought the previous edition of whatever text was assigned and almost never paid more than $10. There is some risk in doing this but I found that there was usually very little change between the old and new texts. Most often, the major change was the organization of the chapters. In that case, all you need to do is to see what the chapter headings/descriptions are in the assigned text and then map yours to that. Instructors are often sympathetic and will let you photocopy the table of contents from their text. Failing that, find a rich classmate and beg them for the same thing. On a related note, the state of PA used to grant the CNA to nurses who passed the NCLEX. You just sent your credentialing in, and the state made your a CNA. I could not find a job as a new grad AD-RN, so went this route until I got my BSN, but I don't know if the state still allows it. It's maybe a less than desirable scenario but it's a way to pay the bills, get more experience and do some networking. Just remember to stay within the CNA scope of practice if you do this. Good luck.

When the on-line CRS calculator came up at less than the typically needed points, I then contacted a Canadian immigration attorney. His determination, was also that I was ineligible, though I did not get an explanation of why this was the case.

Hi - for a variety of reasons, I’d like to immigrate to Canada but was recently assessed as not eligible. I'm wondering what, if anything, I can do to change my status. A few words about my situation. I’m a second-career RN (BSN), with a background in primary and emergency care (I’m also a volunteer firefighter and EMT-B; ACLS & PALS). In addition to the BSN, I have a BA an MBA and an associates degree in applied science. My primary career (more than 20 years) was as contracts manager in the aerospace industry. I’m also an honorably discharged veteran. As far as language skills, I’m a native English speaker (born in the USA) and am working on improving my French, which is probably less than basic at this point. While I want to work as an RN in Canada, I have a decent guaranteed pension income and significant retirement savings, so am unlikely to need any kind of outside assistance. I'd also be selling my house in the US, which even in the inflated Canadian real estate market, would go a long way toward a house there. The only negatives I can think of are age (I'm over 47) and that my spouse does not work. Is it pointless for me to continue to pursue Canada or can is there anything I can do to make myself a more desirable candidate? Any advice appreciated.

The least expensive route to becoming an RN is going to be getting your ADN from your local community college. As others have already noted, there is an overwhelming preference for BSN's and depending on your location, you may face considerable difficultly in getting a nursing job. That said, getting your ADN, passing the NCLEX and then going on to get your BSN from a state institution is definitely worth considering and will almost certainly be the lowest cost route. I speak from experience in this, having done precisely that for my BSN. In my case, it was the evening/weekend nursing program at community college, which not only was relatively inexpensive (tuition and fees for the program ran about $6,500, though this was some years back), but also allowed me to continue to work full-time. (An aside: working full-time and completing a nursing program requires commitment, planning and a supportive spouse - it is not for the faint of heart.) Once I passed the nursing boards, I applied to the RN-BSN program at a state university. Not only was the tuition reasonable (about $8,000) but the program was offered via both a traditional classroom or on-line. The total cost, including books, fees, equipment, etc to get a BSN was less than $17,000. Like you, I was a second-degree student when I enrolled in the ADN program, and so had a significant amount of the required coursework out of the way. I'd be surprised then if the total cost for the ADN-RN-BSN wasn't something like 40% less the $35,000 you cite. Your cost is likely to be significantly greater going the ADN-RN-MSN route, but if you can find a state school masters program, may not exceed the $35k figure. Just a guess on my part though.

Bumping this. Curious - is this still the case in 2015?

Ran across this older thread and wondered if things have changed. With the current large surplus of health care personnel in my area, nearly all nursing positions and even most openings for UAPs state that both ACLS & PALS are required to apply. Essentially, employers have now shifted the burden of the cost of certification to applicants which has the benefit of both reducing their expenses and, with many of them also teaching the courses for $300 - $500, also increasing their revenue stream. Unfair perhaps but consistent with the laws of supply and demand.

Link to full article (via Medscape): Medscape: Medscape Access The ADN vs BSN topic has been beaten almost to death, but there has not been a lot of objectivity in many of the arguments. This recent article in Nursing Economics is a dispassionate look on the ADN-BSN debate and is worth reading. Among its observations: There has been a rapid increase in ADN educational programs over the last 10 years. ADN-prepared RNs appear to be experiencing diverging labor market outcomes from BSN-prepared RNs - 82% of new BSN graduates were employed in hospitals within 18 months of graduation compared to 67% of ADN graduates. It is unclear whether ADNs are shifting away from hospital settings out of necessity because hospital jobs are unavailable, or if their skill set is better suited for less-acute nonhospital patients. ADN programs may find it in their interest to specialize in, and focus on, the kinds of skills increasingly critical to enhanced ambulatory settings such as care coordination, communication, teamwork, population health, and education and prevention.

I sympathize, but while it may unethical for your employer to effectively require you to put in uncompensated time, as seems to be the case here, it is probably not a violation of the Fair Labor Standards Act (FLSA) as has been suggested. The FLSA specifically exempts "executives, administrative, professional and outside sales employees." Registered Nurses, but not LPN's, generally fall into the the professional category, as this quote from the US Department of Labor (http://www.dol.gov/whd/overtime/fs17n_nurses.pdf) website shows: Moreover, the definition of "professional' has eroded considerably from the time (1938) when the FLSA was enacted. As a recent piece in Politico "Whatever Happened to Overtime" pointed out, "By 2013, just 11 percent of salaried workers qualified for overtime pay, according to a report published by the Economic Policy Institute. And so business owners like me have been able to make the other 89 percent of you work unlimited overtime hours for no additional pay at all." (Whatever Happened to Overtime? - Nick Hanauer - POLITICO Magazine) The sad truth unfortunately is that if you are a salaried RN, making more than $23,660 per year, under Federal law, your employer does not have to pay you extra for work done in excess of 40 hours per week. Welcome to the new America, where corporations have almost all of the rights - but none of the obligations - of individuals.

Not sure why you think the LPN will shorten your path to ADN by a year and half. Things vary from one Community College to the next but LPN's at my CC only skipped one semester of the nominal five semester (two year) AAS-Nursing program. Most nursing programs require quite a few classes for the associates degree over and above those in the nursing program, which could easily make things 3 or more years long.It sounds like you need most of the associate degree pre-reqs. For nursing, these typically include Bio, Micro, Psych (usually Intro, Abnormal and Developmental), Stats, Math, Chem at least two semesters of A&P and possibly Nutrition. You may also need a couple of semesters of other social science courses (Soc, Anthro), probably English and perhaps other Humanities (History,Philosophy, Art, Music, etc) to be eligible for the degree. It will take some time to get these out of the way, so why not apply and get accepted to the nursing program and in the interim, take care of all your pre-reqs?

Thanks Cauliflower. I'm not bothered by the self-study aspect of the program - this seems to be the trend and in any event, is something I'm familiar with from my RN-BSN program a few years back. I used to be bothered by having to handle all the aspects of the clinicals but it seems that this too is the trend, even with traditional programs such as the one offered at my alma mater. I presently volunteer at two different nurse-managed clinics and will be looking to personnel there for help with clinicals.Ball State meets all of my important criteria: It is a brick-and-mortar institution, is nationally ranked, is a major research facility and has reasonable tuition. A couple of questions for you: How are you familiar with the Ball State program? Are (or were) you in it or associated with it? Thanks in advance.

Both ADN's and Diploma nurses are anachronisms that are likely to disappear in the not-too-distant future, with the active support of the ANA abetted by a poor job market all but ensuring that extinction.The nursing job market is glutted in most (though not all) parts of the country. At the same time, nursing school enrollment - and the supply of new grad RN's - is at record highs and increasing, exacerbating an already bad situation. Employers have taken advantage of this and increasingly demand the BSN, really just because they can. Either demand for nurses has to increase, or the supply decrease, for this to change. Demand is probably growing (albeit slowly) now that more folks have health insurance. I admit that I don't have the data to back up this assertion, but the anecdotal evidence I see seems to indicate that hiring has not picked up appreciably in the face of increased demand. On the supply side, things look to me to be static with increases in the rate of retirement of RN's probably evened out by the increase in new grads (I do have data showing the number of new RN's increasing but nothing on RN's leaving the work force). My guess is that tomorrow looks much the same as today . . . so you are likely to face the same poor job market in which your odds of finding a job are long but seem to be better as with BSN after your name than with ADN there.

Looking for some info on the CSU-DU MSN-FNP program. The website provides a great deal of data but is a bit lacking in useful information however. A quick search here on AN did not turn up much, so I thought I'd post the questions directly. The most basic is: Does the program accept out of state students? It is on-line but many of the requirements appear to limit it to not just California residents but also to only those located in SoCal. For example, there are 2 specific classes (Adv Roles in Nursing and Adv Pathophys) that you are required to take first and these classes have an in-person orientation. If that's really the case, its obviously a significant barrier for those who are not local. It also looks like the school determines the appropriate clinical sites and maintains a list of affiliated and directs the student there. This is also something that would be a barrier to non-locals. I have a much longer list of specific questions but wanted to see if I could get answers to these basic questions before contacting the school directly.

A very big second to this. IMHO, it is one of the best shows on television and the blackest of black comedies. Doctors, nurses, patients and family are equally skewered, but the writers do an excellent job of in keeping things reasonably realistic, if a bit OTT.

If you enjoy interaction with patients and want to get a bit more "hands on" experience with patient care, you could consider getting your EMT cert and volunteering. This option will depend largely on where you live but in many parts of the country, Fire and EMS are staffed by volunteers (though many are now a combination of paid and volunteer personnel). Running with an ambulance crew gives you the opportunity to provide some level of care and gets you comfortable with more intense patient interaction. Your local fire department may even pay for your EMT training. As to nursing itself, becoming an RN was a late attempted career change for me. Nursing school itself is fairly demanding, but very doable for most. I attended an evening/weekend program at my local CC to get my RN and then completed a RN-BSN program on-line. My path was a bit shorter than for many others however as I already had both bachelor's and master's degrees and so had many of the tougher pre-reqs (Chem, Bio, Stats, etc) out of the way. I worked full-time though, which meant a busy life with clinicals all day every weekend for the first two years. I'll add that this was a very low cost way to the BSN - the total cost in my case was less than $15k, including books, uniforms & equipment. Getting the degree and the license is the easy part however: In my opinion, the biggest challenge to those contemplating a career change to nursing is age. There is presently a significant surplus of RN's in most parts of the US (rural areas tend to be the exception) and new nursing grads face a tough time getting that first job after graduation. This seems to be compounded in the case of older grads. For whatever reason, employers at least in the areas I've surveyed, appears to be very reluctant to hire older new grads. Bottom line is that the career change you're contemplating is eminently doable but before making the considerable commitment required, I'd be sure that it's really what you want to do and that you have a reasonable shot at getting employed after graduation.

I don't really have any info on the facility per se, but can tell you about my experience with them. Some years ago, I went to the facility to drop off an application in response to their advertisement for RN's. I could not find a name for anyone in my on-line searches and asked the receptionist if I could speak to either the nursing or hiring manager. That request was declined. I then asked if they could provide me with a name or some way to contact one of the managers. Again the answer was no. At that point, I gave the receptionist my application and asked if it would be possible for someone to phone me. The answer was something on the order of "someone will call you if they like what they see in your resume." I was a bit taken aback by this treatment, especially since I was in a business suit and tie when stopped at the place. After handing the application in, I waited a week or so and phoned but got the same runaround as when I was there in person. Never heard anything at all from them. YMMV but needless to say, I am less than impressed. Good luck.

I would look for a program with both regional (e. g., Mid-Atlantic, New England, Western States) and national (CCNE, ANCC) accreditation. There are many such on-line programs and many are also run by colleges and universities that also offer a traditional classroom program. The next thing I would look for is reasonable tuition. This narrows things down quite a bit.The overwhelming majority of schools meeting both the accreditation and tuition criteria will be state-supported colleges/universities. Examples include U Texas-Arlington, SUNY-Dephi (NY), Ohio U, Ft Hays State (KS), U Wyoming - there are a lot out there. Not sure what each now charges for tuition but as of a few years ago, none of them were more than about $10k for their complete RN-BSN program. There's nothing wrong with many of the on-line programs offered through private colleges such as GWU (DC), Drexel (PA) or USC (CA) but they will be much, much more expensive. The same is true for the "For-profit" schools such as Univer of Phoenix. Keep in mind that many for-profits are not regionally accredited either, which could make going on for a masters or even simply transferring schools, difficult or impossible.

I have a slightly different take. Your job and salary prospects are considerably enhanced if your degree is from one of the Ivy's (Penn, Yale, etc), Ivy-equivalents (e. g. Stanford, Johns Hopkins) or some of the "state Ivy's" (UVA, maybe UMich). These schools, perhaps numbering 30 in total, are perceived as top-tier by many and in my experience, grads from them typically find getting jobs and moving up the ladder much easier. Again in my experience, it doesn't seem to much matter if your degree is from elsewhere - OU, Ball State or any of the hundreds of schools not in the categories above. I readily admit that I have no hard data to back these assertions up. So the answer to your question about whether it matters where your degree is from is a heavily qualified "yes." If you can go to one of the perceived elite schools, you should certainly do it, if for no other reason than the robust alumni network they offer. If, like thousands of us, you can't, then pretty much any school with both regional (Middle States, North Central States, etc) and national (e. g., CCNE) accreditation is as good as any other. Full disclosure: Bobcat BSN.

Considering the Ball State program and looking for feedback from anyone familiar with it.

Nearly all employers in the US have moved from defined benefit plans (pensions) to defined contribution plans (401k). Since your odds of having an employer-provided pension are already low and likely to go even lower, you should expect to fund your retirement mostly on your own (you will get a little from Social Security). If your employer offers a 401k plan, the best advice I can give is to fund it to the maximum extent possible. Current IRS rules allow for a max employee tax-deferred contribution of $18k in 2015 (it was $17,500 last year). You can of course contribute more but it will be on an after-tax basis. The combined limit for total (employee + employer) 401k contributions is presently $52,000 ($56,500 if your are over 50). Employer matches vary widely but they are typically something like 50% of the employee contribution up to a max of 6% of your salary. My employer is a bit more generous and matches 75% up to a max of 8%. You can make a determination of how much retirement savings you will need based on the age you want to retire, how much income you want in retirement and the number of years your funding will need to last. If you want to retire at age 60 with $50k per year and think you will live to 85, you nominally need to have $1.25 million available. Since the total will be comprised of your savings plus compounded interest, the actual amount you need to put aside will be less than the full $1.25m you need at age 60. This is a bit harder to estimate since you need to make assumptions about the rate of return you are likely to get. There are on-line calculators like this one from BankRate that can help with this. I did a quick calculation for you and if you want to retire at 60 - giving you 37 years to save - with $1.25 million in your retirement account, you need to put roughly $1,000 per month in your 401k, including your employer match, assuming a 5% annual return. The amount you need to contribute depends on your employer match but it's going be something on the $750 a month. YMMV and you will need to work through the numbers on your own. You will also have something from Social Security available to you, but you should consider that a minor component of your retirement nest egg. If all of this sounds daunting, it is, especially considering that you also need to figure out which of the funds in your 401k to invest in (your employer will determine which funds will make up your 401k). Hopefully, you will have some low-cost index funds (for example, exchange-traded funds - ETF's) to choose from along with the higher-cost mutual funds. Fees are important and you need to pay attention to them because they can have a great impact on the overall rate of return. This seems unfair - you are making 100% of the investment and taking 100% of the risk but getting a lot less than 100% of the return - and it is. Welcome to modern capitalism. In sum, save as much as you can for as long as you can. Save prudently by diversifing your investments (I can't emphasize this enough). If you need help, go to an advisor who is a fiduciary - someone who is ethically bound to make financial decisions that are in your best interests (many financial advisors are little more than salesman for mutual funds). Good luck and hope this helps a little.

Let's address the BSN question first. As others have already pointed out, it is an increasingly essential requirement to work in nursing and I second those who suggest that is the route you take. That said, there are several ways to get there. Folks have suggested the ABSN, which would certainly be the quickest route for someone with a non-nursing baccalaureate. The more problematic issue with the ABSN is likely to be cost. I'm not sure what your options are relative to schools in the LI area, but I suspect all are likely to be fairly expensive. With PMHNP as your ultimate goal, another option is an acceleratedBSN/MSN program. Again I don't know if this available locally to you but Jefferson in Phila offers such a program. It is basically and ABSN combined with the MSN and offers some savings in the total number of classes required. I was accepted to the Jeff program when I started nursing but eventually declined to enter due to its high cost and because the BSN portion was not o ffered on an evening/weekend basis (I needed to continue working full-time while in nursing schook). Another option as you yourself suggested to first get the ADN at your local CC. This is the route that I chose because, as I said above, I needed to keep working while in school. It also turned out that it was a reasonably quick route, about which more later. I was in their evening/weekend program and it was a bit of a challenge with classes at least 2 nights each week and clinicals all day every Saturday and Sunday. While this is a low-cost, high value-for-money option, it is not without its drawbacks. In my case, I already had both a BS and masters degree prior to starting and so had nearly all of the pre-reqs (chem, bio, A&P, etc) out of the way. If you need those courses, the ADN will take significantly longer than the typically advertised 2 years. The other is that when you graduate and pass the boards, you will face long odds in being hired as an ADN-RN. Like you, I planned to go on for a higher nursing degree. My thought originally was to enroll directly into an MSN program - an option available at some grad schools to RN's with non-nursing bachelor's degrees. The drawback is that several (3 to as many as 5 depending on the school) MSN bridge courses are required for non-BSN holders. These classes are billed at grad tuition rates, so they are quite expensive. In fact, for me it turned out they would cost more than than the tuition needed to simply get my BSN. I decided instead to enroll in a RN-BSN program and apply to grad school later (I'm now in the process of looking for an appropriate MSN-FNP program). The big advantage of the ADN-RN-BSN route is cost. My ADN at CC was very inexpensive and I chose a state school for the RN-BSN. In total, I paid something less than $15k for everything, including books (I always bought used texts of the previous edition and rarely paid more than $10). This may not be everyone's experience - as indicated, I already had other degrees and so either got transfer credit or was exempted from a lot of classes. As I also indicated, I was able to work full-time, at least 50 hours a week, throughout nursing school, which may not be possible for everyone (my spouse was a stay-at-home mom for example). It can be done however. A quick word about PMHNP that you may want to take into account. As a psych minor in undergrad, this was the specialty I thought I wanted until I started looking at programs. In the dozen or so schools I looked into however, the overwhelming emphasis was on psychopharmacologic patient management, to the near total exclusion of any other form of therapy. I do not want to be solely a medication manager as an NP and have altered ultimate my goal slightly as a result. YMMV however.

Greetings all. Looking for a general idea of the job prospects in upstate NY - the Adirondack region particularly and even more specifically, in and near Essex County.

I think that what Smartnurse is hinting at above is that the the BSN debate is a distraction from a more basic issue, namely that it's hard to circumvent the laws of supply and demand.For some time now, anecdotal (and some preliminary) evidence has hinted that the supply of new RN's has exceeded demand, in stark contrast to the rosy employment predictions of the BLS. It is also the case that enrollment in nursing programs has increased significantly and in fact continues to grow. On the demand side, with the exception of a handful of places like CA with mandated nurse to patient ratios, healthcare institutions seem to get by with minimal RN staffing, helping to keep nursing employment levels low. At the same time, many institutions also seem to be moving toward increasing the role of UAP's - who are paid significantly less than RN's - in patient care. Given the oversupply of nurses at the same time demand is static (or more likely decreasing) it should not be a surprise to see RN wages decrease. There is some data indicating that this is in fact the case. The BLS reports that average 2009 RN wages were about $32/hr, nominally rising to just over $34 by 2014. Even in this time of relatively low inflation, this represents a decrease in real terms, albeit relatively small. Keep in mind though that these figures are for average RN hourly wages - starting wages are significantly lower and I suspect show both a nominal and real decrease over the same period. My cynical conclusion is healthcare institutions are simply taking advantage of the situation and demanding the BSN because the oversupply of nurses allows them to. BSN or not, there will be continued downward pressure on nursing wages that will not change until the supply of RN's decreases or demand for RN's increases. In my opinion, neither is likely in the short to medium term.