sweetmissdixie

Agreed!

Every single nurse, whether they're aware of it or not, has made a med error at least once (Amelie Hollier, DNP, FNP-BC said something to that effect). We're human! I have missed a med before and had to give it late then adjust the treatment schedule - I don't know any nurses who haven't. Earlier in my career I also gave 2 norcos instead of 1 because I wasn't reading the order carefully. Luckily, everything was still kosher with both of my patients. But I definitely understand that feeling of guilt and remember feeling absolutely sick when it happened. Frankly, I think that's a good sign - you understand the potential ramifications of a serious med error. The most important thing you can do is use this as a learning experience. It seems like you are aware of the circumstances that led to the error - so now you must plan ways to try to avoid that again (e.g., asking for help earlier before you get overwhelmed). Also, learn from other nurses' mistakes - I am thankful my errors were relatively harmless, as I knew nurses who incorrectly calculated Lasix and Heparin drips, gave the wrong insulin, etc., and harm did come to the patient. Reevaluating my practices (taking time to slow down and read carefully), holding other nurses accountable for double checks (no "I trust you"), getting enough sleep (I was a night-shifter), and asking for help (whether it was from the CNAs, pharmacist, other nurses, etc.) were all changes I had to make when I was new to try to prevent more, potentially serious errors. The bottom line is don't beat yourself up too much. Learn and grow from this. To paraphrase Dr. Hollier again: There's a reason they call it nursing practice - you have to practice every day.

I posted this answer in another similar blog post: "...passed my FNP certification exam from AANP - I graduated on 11/1 and took my cert exam at 9AM on 11/14. .... I gave myself a break from studying for 9 days after graduation. It is a totally arbitrary number but I felt like a mental cool-down period was essential. Throughout my courses, I would use the Fitzgerald practice exam book - I did questions that corresponded to the unit I was studying to guage whether or not I was ready to take an exam. I did not pick up that book again, though, and did not use it to review prior to boards. I did, however, purchase an online practice test from Fitzgerald that I took maybe 3-4 days before the exam and made a 67% I think. I typically do worse on Fitzgerald questions than any other resource. I also attended a live Hollier review literally the weekend before my exam (11/11-11/13). I wanted the information to be fresh in my brain. Dr. Hollier recommends making > or = 70 on the APEA predictor exam before testing. I had the benefit of my school requiring us to take one prior to entering clinicals after all of our didactic coursework was complete - I made a 74 at that time. I took another APEA practice exam 2 days before boards and made a 78 (not going to lie, I cried because I am a perfectionist and I just KNEW I was going to blow it out of the water and thought I should have made in the high 80s). I told Dr. Hollier this and she told me to go take my exam. Good thing, because I already had it scheduled. Her review was fantastic and I highly recommend it. I think reading Liek would have made me *feel* better prepared and have less anxiety. I got this book late and didn't have time to go through everything but it looks like an excellent resource. I skimmed through the test taking strategies and then did 150 of the questions the day before the exam. I scored this myself as if it were a practice exam and made an 88% or something like that. I made sure to eat well, get daily light exerise, and stay well hydrated prior to the exam. The night before the exam, my friend and I made each other stop studying at 8pm to take a mental break, have a glass of wine (just 1!), and go to bed early - rest is important! I ate a light breakfast the morning of the exam, even though I am not a breakfast person. There were very few things on the exam that I felt like I had no idea what they were talking about. In fact, only 1 or 2 questions come to mind. Less than 1/4 of the questions were ones I was in-between answers. The rest was very straightforward. I agree, don't go looking for zebras. Honestly, I felt like this exam was easier than NCLEX or any of the practice exams I took, and my friend who took it with me said the same thing. But I agree that you know yourself best. I killed myself studying in school, so by the time I graduated, it was like, "If I don't know this by now then I will never know it." If you slacked off a little (or a lot), then you may want to spend some more time studying. My mantra: 'You have passed so many exams up to this point. You'll pass this one, too!' Stay positive - you can do this!" Good luck!

Believe it, because we exist. Your beliefs are your own but please don't discredit us for not subscribing to them. Kindness, compassion, love, living in the service of others... all values I hold dear that are not mutually exclusive to belief in a deity.

We had a nurse on the floor doing this and she was told by management that it was a HIPAA violation. Subsequently, we were told in a staff meeting not to do this and not to keep our "brains" (paper sheets used for notes during each shift). If you really want to do it, maybe talk with your manager and see what the policy is. In order not to violate HIPAA, you can't keep dates or room numbers or ANYTHING that could be identifiable. Our managers told us that our charting should be detailed enough to cover us legally, so that keeping those notes wouldn't be necessary.

I think it is wise to get realistic expectations about the profession before entering it. Seeing nursing as "glamorous" or through rose-colored glasses is, in my opinion, how people get burned out quickly. Because the reality is that it is not glamorous. It is hard and demanding work - mentally, emotionally, physically, and, depending on the type of person you are, spiritually. There is so much more that affects your success and happiness in nursing than caring for patients. Everyone will have a little different perspective, but in general, most people I've talked with share complaints about the financial/billing side, the pressure from the "higher ups" to chart a certain way, to hit core measures, to round hourly, to meet satisfaction scores - all while short-staffed. You'll find that many patients and family members are NOT appreciative of what you do and some are outright abusive. You may also face abuse from physicians and even other nurses. I say all this not to scare you away from nursing - we need more fabulous nurses. But I want you to prepare yourself for the possibilities that my colleagues and I lived through but weren't ready for when we graduated. I don't feel this way, but I have heard colleagues saying they would not have gone into nursing if they knew "it would be like this." On the flip side, I have helped many patients the way I envisioned when I was a new nurse. I have had many wonderful, appreciative patients and family members. I've worked beside fantastic nurses and doctors that lifted my spirits and made me a better nurse and individual. I've done good and life-changing work despite the barriers. I know my fellow nurses have done the same. It's those moments that keep many of us in the profession. I'm not going to lie - most of the time it is a ****-show (excuse my language). It took about a year before I felt like I knew what I was doing, even though I graduated top of my class. I cried a lot in the beginning. But I love being a nurse. I love my patients. You'll learn to laugh about the hard things. I've worked in many different areas, perhaps to help with burnout. I went back to school and became an NP (again, perhaps to help with burnout). That is one nice thing - you can move pretty much anywhere and have a job. If you don't like one area of nursing (or your coworkers, or you commute, or whatever), you can try something new. And you can keep advancing your degree if you like school (I do). And that brings me around to your original question (gee, I talk a lot): No, I didn't feel called to nursing. I chose it for those reasons - job security, decent pay, flexibility. I was good at the sciences, like a challenge, and wanted to help people. If you have the opportunity, I would see if there is a program where you can shadow a nurse or maybe volunteer at the hospital and get to know the nursing staff. See what it is like in the "real world." I hope some of this was helpful and didn't completely run you off :)

Yes! The final certification results come in quickly - I had mine the next day. The license... well, that is a different story. Still waiting! Congrats again and good luck on all your endeavors!

Hi Nursing girl28, sorry I am so late to respond - I never got notification of this post. If you are still having difficulty, please PM me. Hope all is going well in your program!

Congratulations! I, too, passed my FNP certification exam from AANP - I graduated on 11/1 and took my cert exam at 9AM on 11/14. You did a lot more preparing than I did - kudos to you! Your advice is spot on. I'll share mine in case others are interested: I gave myself a break from studying for 9 days after graduation. It is a totally arbitrary number but I felt like a mental cool-down period was essential. Throughout my courses, I would use the Fitzgerald practice exam book - I did questions that corresponded to the unit I was studying to guage whether or not I was ready to take an exam. I did not pick up that book again, though, and did not use it to review prior to boards. I did, however, purchase an online practice test from Fitzgerald that I took maybe 3-4 days before the exam and made a 67% I think. I typically do worse on Fitzgerald questions than any other resource. I also attended a live Hollier review literally the weekend before my exam (11/11-11/13). I wanted the information to be fresh in my brain. Dr. Hollier recommends making > or = 70 on the APEA predictor exam before testing. I had the benefit of my school requiring us to take one prior to entering clinicals after all of our didactic coursework was complete - I made a 74 at that time. I took another APEA practice exam 2 days before boards and made a 78 (not going to lie, I cried because I am a perfectionist and I just KNEW I was going to blow it out of the water and thought I should have made in the high 80s). I told Dr. Hollier this and she told me to go take my exam. Good thing, because I already had it scheduled. Her review was fantastic and I highly recommend it. I think reading Liek would have made me *feel* better prepared and have less anxiety. I got this book late and didn't have time to go through everything but it looks like an excellent resource. I skimmed through the test taking strategies and then did 150 of the questions the day before the exam. I scored this myself as if it were a practice exam and made an 88% or something like that. I made sure to eat well, get daily light exerise, and stay well hydrated prior to the exam. The night before the exam, my friend and I made each other stop studying at 8pm to take a mental break, have a glass of wine (just 1!), and go to bed early - rest is important! I ate a light breakfast the morning of the exam, even though I am not a breakfast person. There were very few things on the exam that I felt like I had no idea what they were talking about. In fact, only 1 or 2 questions come to mind. Less than 1/4 of the questions were ones I was in-between answers. The rest was very straightforward. I agree, don't go looking for zebras. Honestly, I felt like this exam was easier than NCLEX or any of the practice exams I took, and my friend who took it with me said the same thing. But I agree that you know yourself best. I killed myself studying in school, so by the time I graduated, it was like, "If I don't know this by now then I will never know it." If you slacked off a little (or a lot), then you may want to spend some more time studying. My mantra: "You have passed so many exams up to this point. You'll pass this one, too!" Stay positive - you can do this!

I recently completed my FNP program (MSN) and am continuing with the companion DNP starting January 2017. I don't know anything about Simmons but here are some things to consider when choosing a graduate program: 1. Most programs require at least 1 year of experience as an RN. If the program doesn't, I would still recommend you work as an RN for at least a year. You will learn and practice critical thinking, leadership skills, interpersonal communication, time management, and so on - all very important for the foundation of an advanced practice degree. You will learn important professional skills that you just do not get while in nursing school, which will benefit you later when pursuing an advanced degree. 2. As someone else pointed out, most programs require you to obtain the MSN first and then continue with the DNP. Which is fine - this will enable you to begin working and gaining experience as an APRN while you are working toward your doctorate. 3. Most NPs are prepared at the Master's level and this is an acceptable degree for the vast majority of NP positions you will come across. The DNP will be helpful if you decide to teach or take on administrative roles but it does not expand your scope of practice; therefore, most employers do not offer higher salaries for DNPs. If you are truly interested in this degree, I'd highly recommend you research the purpose of the DNP and its roots in quality improvement and translating evidence-based research into improved population and system-wide outcomes. There are several short books available on the topic. American Association of Colleges of Nursing | DNP Fact Sheet also has some quick info. 4. Again, as someone else mentioned, many online programs require you to find your own preceptors. This was true of my program and was incredibly difficult and daunting. My program had very specific preceptor requirements (e.g., no more than 20% of hours with a physician, could only use NPs - no CNSs, PAs, etc. Could not do clinicals in specialty areas, primary care only) that posed a significant barrier to finding preceptors, so I would look into this before committing to a program to make sure it is feasible. I ended up having to drive 2 hours to a clinical site to complete my requirements. 5. What is your end goal? Understanding this and the degrees/programs for which you are applying is the best way to avoid wasting valuable time or money. Really develop an understanding of the role of the NP in general. As an APRN, you will be transitioning from the RN role to the provider role, which have different functions in practice. Develop an understanding of what the different NP degrees offer - as an FNP, you will be expected to learn to care for patients across the age continuum - from newborn to geriatrics. If you are truly only interested in geriatrics, there are specialty programs designed for geriatric NPs and this would likely be a better fit for you. Again, it all depends on your end goal and what you want to DO. Not the title, but how you want to be practicing every day and who you want to care for. I hope some of this was helpful. Congratulations on your imminent graduation and good luck on the NCLEX!

Seeking some advice/resources from any EP NPs (or PAs) I recently graduated from my FNP program and have been offered a job in cardiac EP. I was a nurse in the EP doc's office for about a year and a half before I was approached for the position, so I know more about the specialty than a typical FNP would, but definitely could use more information in regards to a provider role. I will be trained, of course, but want to get a head start on building my knowledge base. I am looking for good resources directed toward APRN management of EP patients if they are out there, or something close. Any texts or online resources you have found to be particularly helpful? I appreciate any tips you can give me :)

I will be entering my full-time clinical practicum around April 2016 and am seeking FNP preceptors in Austin, TX and surrounding areas. My school requires a minimum of 675 clinical hours and also requires the following minimum number of experiences:  5 Newborn exams  15- two weeks to 5 years well exams  15- two weeks to 5 years episodic exams  15- six to 12 years well exams  15- six to 12 years episodic exams  5- 13 to 19 years well exams  5- 13 to 19 years episodic exams  300 Adult episodic or wellness care  50 Speculum/bi-manual exams  150 client visits for chronic illness care  10 New antepartum  30 Return antepartum My university does offer monetary reimbursement and continuing education to preceptors. Please let me know if you would be interested. I appreciate your time and consideration -- do not hesitate to contact me with questions or concerns. Please note: I have already contacted available preceptors from the TNP membership site. The Austin APN membership site allows you to see if there are people interested in precepting, but requires a $90 payment to be able to contact preceptors (this privilege is also only good for 90 days, then you have to pay again). If you have additional thoughts on ways to find preceptors, I am all ears!

Hi all, I am applying for a new job after a little over a year at my current hospital. I had no problems nabbing my first job and I felt like my graduate RN resume was a cinch -- i had tons of activites in college, was active in SNA and was a chair member, did tons of volunteer work and made great grades... blah blah blah. Now, I am applying for an endoscopy nurse position at a new facility. Of course, I have been at the bottom of the food chain at my current position. I havent had the opportunity to charge or precept or any of those things because they have strict timelines as to when they allow people to do these activities. My resume now looks very bland. Anyone have any ideas on how to spice it up? They also require a cover letter and I am just at a complete loss on what to talk about. I would love to hear your thoughts. Thanks!!

I'm in the Versant RN residency... it's awesome! Clients shows cities that have Versant programs... good luck!

This is so awesome... thank you for this! I am proud of you just reading this!! :) I can't wait to come into my own, I have only been orienting for a month. I really appreciate this encouraging story!