justhink

Wrong. I clearly state that my experience is just that and that others may have had a different experience. And my personal experience, is, by definition, anecdote. I was then replied to by NYCguy that stated that Juan might have have a different experience - an anecdote to counter mine. That's fine, except the implication was that Juan does things that I know he/she doesn't do. There is no need to exagerate one's duties simply to counter my original point. Follow?

Really? They are managing ICU patients??? They are diagnosing coronary artery disease/occlusions based on their caths, and their own readings/interpretations with no MD present in the cath lab??? You do realize that driving a cath and diagnosing CAD are entirely different, right?

I do not "realize the irony," and hope you will comment further. Where I work (anecdotal), we have nothing but Intensivists (4 year MD + 3 year IM residency + 1-2 years pulmonology + 1-2 years intensive care) in the 120-bed ICU. Despite that extensive training, they generally limit themselves to vents/relevant pulmonology, basic electrolytes (K+, mag), basic empiric antibiotics, and simple ICU patient management (foley's, CT's, x-ray, 500 cc boluses, AM labs, nutrition, etc.). If there is any comorbidity (cardiac, neuro, ID, renal, etc.), most is referred/consulted to the relevant specialists (cardiologists, neurologists, urologists, etc.). So maybe there is an APN on this board that handles it all, and is far more prepared to manage patients in the ICU than the Intensivists (with 8-10 years of formal training) that I work with, who is so bright that he/she doesn't need to lean on specialists like the Intensivists (with 8-10 years of formal training) that I work with. If that were true (God help us), then it is an anomaly (I hope).

Yes, me too. Anecdotes, however, mean nothing. Perhaps Juan's area fully uses ACNP's to their fullest capacity. Or perhaps only he is. In my area, they do as I described - glorified RN's. And some may be happy with that. What matters is not what Juan says, and not what I say, but how ACNP's are used in the OP's area. If you have actual evidence (not you or Juan's personal experience that may or may not describe reality) that describes how most ACNP's are used nationwide, please post it and spare us the anecdotal opinions and smiley faces.

Yes, I will read images. There is a second clinic not far away where there will always a physician I can call, and he can also access the x-rays that I shoot. Nonetheless, I share the same concerns you mention.

Several things. First, they are entirely different specialities. FNP does not prepare you for hospital based work, though I see some FNP's in my area working for specialists in the hospital or with the hospitalist service. However, the IOM Future of Nursing report calls for NP's to ONLY work in the speciality area for which they are trained. States have already implemented some of the IOM recommendations, so in the future, I think you will see fewer FNP's working in hospitals. Secondly, if you like problem solving, you get plenty of that in family practice. I can't speak for everywhere, but every ACNP I have ever met does very little problem solving with regard to patient care. Instead, they write very basic admissions orders on behalf of the physician/service for which they work, take call for minor things, round, and write discharge orders. Some work on the floors overnight to handle basic issues that arise when the docs aren't around. They are not heavily involved in developing or adjusting medical treatment plans, so diagnostic reasoning skills are not heavily utilized by the ACNP's that I've seen. If you like diagnosis, family practice/urgent care/ED fast track is the place to be. If you simply like being in the hospital doing physical assessments, taking histories, and writing basic, initial admissions orders and discharging, and don't care too much about using diagnostic skills, then ACNP is a better fit. And, as another noted above, ACNP is rare in the outpatient setting, except maybe for some specialty clinics. The ACNP is not trained to provide primary care, and the FNP is not trained to do inpatient care.

Did you have any NP experience when you started in UC? How long did you train in the clinic before going it alone?

Thanks for the input. Yes, the "sister" clinic is where my preceptor is at and it's about 10 minutes away, and will always have someone there I could reach out too. I like urgent care, and like the group that runs the clinic, and like the idea of 3 12-hour days per week. But, I know how I perform at my first job out of school is extremely important for my career.

I'm about to graduate (FNP) and I think I'm about to get in a job offer in urgent care. Ultimately, they'll want me able to work certain days as the sole provider for the clinic (with a physician always available for call). While they have promised not to leave me alone until I'm ready, neither the physicians nor I know how long this will be. I have about 1,000 hours of experience as an RN in the ER and will have about 2,500 hours of experience in the ICU by graduation. My GPA has been very strong both in undergrad and grad, and I have always had very positive reviews from my FNP preceptors (most of which have been physicians). In fact, one of my preceptors recommended me for this job and he is part of the same practice (but two different clinics). While neither I nor the physician know how long it will take me to get ready to be solo, I don't think they'd hire me if they thought it would take a year, certainly not more than that. If I were to guess, I think they have somewhere between 3-6 months in mind. Anyone here gone solo in urgent care in that time frame after graduation? Is it completely unreasonable to think it could be done?

Another poster on this board (from a few years back) mentioned being given assignments that had nothing to do with advanced nursing (or nursing at all) - did you experience anything like this?

Part-time.

I was just accepted to UMKC's FNP program and was looking for feedback from anyone currently in the program or has graduated from it. Are you/were you satisfied with the quality of the program? Do you feel it has/is preparing you well? What is your opinion of the faculty and textbooks? Any feedback on what's good, what's bad, etc. would be much appreciated!

Short story - left a lucrative and successful career solely to become an APN (specifically an FNP). I'm now about to graduate with my BSN and could really use some guidance on selecting a school and specialty as I begin to apply. Biggest concern is the right school. Here are my questions/concerns: 1) Does distance matter, i.e. will I be viewed differently by potential employers if my MSN is distance vs. brick and mortar? 2) I would love to have ACNP and FNP certifications both. In my geographic area, I can realistically only get the ACNP "brick and mortar" and will have to do distance FNP. I really only want to do primary care, but love the idea of the additional knowledge the ACNP would offer and it could be done "brick and mortar." Which should I do first? Should I only worry about the FNP? Thanks!

I'm currently in the program and would be happy to answer any questions you have. Here's my overall take on my experience so far. There are a number of good things about the program, and a lot of things that aren't. However, what I've learned is that some of the things that drive me nuts about the program are the same things you'll find at any nursing school, so keep that in mind with what I write below. First for you is getting admitted. As I'm sure you already know, it's very competive (as with any school). Minimum GPA ranges from 3.4 to 3.8 depending on the semester. That may change some, however, as they've changed the way they calculate GPA, which may hurt or help you. Before, every class you ever took was calculated in the GPA, now only the prerequisite courses are. Get the best grades you possibly can, focusing mostly on the prereqs. The admission comittee admits purely on GPA off a "blind" list, though you get .1 in bonus if you already have a degree (I assume you don't at 20). NWA has great medical facilities, and the clinical facilities I have in been have been very good. They currently use Washington Regional, Northwest (Springdale and Bentonville) and Mercy as your main locations. They plan to double the size of the program in 2012, and I hear that Gravette (not good) and Siloam Springs (OK) hospitals may be brought in too. The UA is opening a whole new building dedicated to health sciences in 2012 to accomodate their doubling in size, which is cool. The plans look awesome. As a side note, if your GPA is not quite where it needs to be, your chances of getting in will increase significantly when they double their size as twice the number of seats will be available (about 180 per year vs. 90 now). The quality of your clinicals is based almost exclusively on the preceptor you happen to get on any particular day. The school does fine getting you into good facilities, but what you learn depends on 1) you and 2) your preceptor. There are some excellent faculty members and some that are, well, not so much. That's typical for any nursing school. The school has a new director as of a couple of years ago, and all the changes she has made seem positive. The latest faculty members brought in seem to be very good. NCLEX pass rates were low for several years, but have recently been in the 90's. As for curriculum, assignments and testing. Curriculum is similar to any nursing school in that nationally recognized publishers are used (mostly Mosby, some Lippincott). Assignments are mostly pure busy work and eat up all of your time - again, that's true at any nursing school, but it does vary by instructor. Testing here drives me nuts. It's all designed to supposedly mimic the NCLEX, which is fine, but the quality of the questions leave something to be desired and they pull them from various sources. Many are poorly written and vague. You'll hear ad nauseam that the questions are supposed test "critical thinking" using various scenarios, like the NCLEX does. However, all of the true NCLEX questions I've seen are written much more clearly. Furthermore, it's not unusual to see several questions on any given test asking things that have not been covered in class or the in assigned reading. Finally, many of the instructors believe in a "bell curve" approach to testing, believing that most test scores should be a B or C with a few A's, D's and F's. If a particular test yields too many A's, they'll make the next test harder. On the other hand, if a test yield's too many F's, D's and C's, they'll curve it up. I won't go into how ridiculous that approach is, but considering how all those in the program had 3.4+ GPA's coming in, I'm not sure why they feel that these students should start getting C's and D's all of the sudden - and the faculty will actually work to make it happen. Imagine taking incredibly simply material and making it insanely difficult - that'll give you an idea of how some of the classes are (e.g. the Health Promotion class). I have a high GPA still, so it is doable, just be ready. From what I understand, though, a lot of nursing programs are like this. First semester is a nightmare. You will feel like you are way behind (and you are) in your first week. Just trying to figure out where to be when, what is due when, and how to conquer the insane amount of reading and work you are assigned terrifies many new students. Then you learn that you have to average 70% on exams to pass the class (other work excluded from the average) and that you have med calculation exams each semester that you have to get 100% on (in three tries). However, no one in my class has dropped out over grades and very few students (out of 45) have gotten held back a semster due to grades. Everyone has passed the math calc tests (they're not that hard). So there you go. Hope that helps.

Looking at the KUMC FNP program. Anyone know if it can be completed at a distance? The program director is out right now, and no one else there seems to know for sure. Looks like most (if not all) of the didactics are on the Internet, but I'm not sure if clinicals can be arranged in one's home area. Any info would be appreciated!