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I would be very careful with the message you are sending to everyone on the team - and mostly the urologist you are working WITH - as we all know that a MD seeing patients in the same capacity would not be rooming their own patients.

Thank you for such care in preparation. As a NP who has mentored newer NPs, as well myself having sought and gone through a residency training model my first year of practice to have been on the receiving end of pearls of wisdom which made all the difference in my life and practice, I think the most important value set to relay to new NPs is the importance of not pretending one "knows" something if one does not. It is OKAY to not know something. But if one opens their mouth or develops a plan as if they do when they do not - now that's like a dark habit that sadly gets more comfortable with each adoring patient. Share what you've got, and use research/evidence or referral/collaboration if you do not. 1. Develop a "tool-box" of great resources, and quick AI guidelines should be included here, never stop reading and developing, and develop a reputation in the community where you refer and collaborate so you have specialists with whom you can rely on "curb-side" chats if needed. Just keep using what you SOLIDLY know, building upon it, and remember what we personally think (neighborly advice, etc.) does not matter when in the practice mode, but rather using evidence to ACTUALLY help people is the new "kindness" (which is distinct from "nice") now that we are NPs.

I work in a specialty practice where physicians co-sign my notes. This is related to payment, but underlying I have no patient of my own but rather see the physician's patients (there are 7) and then send the note to that patient's physician. I find peace of mind with this, as why not have their input. Every now and then I'll get a message from a MD to ask if we can chat about a patient, and we discuss the plan or the like. Sometimes I'll be given a heads up about a patient before seeing them, often related to an immunosuppressant plan which is an art all itself, ...no algorithm to follow if you know what I mean...I appreciate the collaboration, as the culture on my team involves physicians often openly chatting with each other about difficult cases. I can go through a week of not interacting much, just busy seeing patients, whereas in one day I might have a few patients who deserve discussion, often which I initiate. I have no shame in asking if there is something the MD can add if I am at all with question, and the patients I see seem to be comfortable with seeing me because I am clear about my NP role. I stay up to date and am always learning, so I strongly basically know what I am doing in my specialty and feel strong and empowered. Patients know if I order or advise something it is something I am very sure about, if not, they will know I will be chatting to their doc and the MA or I will give them a call later. Outcomes are good and I am given a lot of respect and kudos from my team, and I sleep well at night. My state does allow independent practice.

I did both. Hollier was more common sense and honestly applied more to the exam. Fitzgerald was full of depth, excellent, but a lucky bit on the exam relative to the extensive info. The MOST helpful, neither, it was Leik book. Summarizes and then you get in depth with areas you may be weak. Do as many questions and read the rationales as you can find. There is a book of questions, the best investment along with Leik.

I am in my second semester of NP school, and from my experiences from a LPN to ADN to BSN, I am finding contacts for clinical rotations for next year. It is really special to have providers who are so proud of me because of my work and education. One of the NPs wrote a letter responding to my request of how she would be honored to precept me. Anyway, I am so thankful for the process of learning and working, as I feel really well prepared in a holistic kind of way and I would not do it over again by going straight for BSN. I would start again at the level of LPN, as every day of those experiences I value. I went from an assisted living, nursing home, sub-acute, and now in a hospital, with each place pretty much matching my level of education. I did not take a break between school, by the way, and that helped with keeping focus.

I am in my first semester of NP school, and I have been trying to get information about how to prepare for my precepting experience. I would value any input about qualities and personal attributes which NP preceptors value in students. I plan to start clinicals in summer 2017. Thank you.

I started the program this summer. I love it. You get out what you put in. I am very grateful for this opportunity. This week I will be taking my final exams in Biostatistics and Pathophysiology; I went down to part-time at work so I could devote to school. Part-time is not necessary, as the program can be done while working full-time. The decision came to me as I see other providers such as PA students and MD students almost never work and go to school, so we'll see. I have As so far, but it's more about learning and being ready to practice which motivates me.

I have had a good experience with UC, and am so excited because I just learned yesterday that I have been accepted into the 2016 Summer AGNP program!

I worked about 3 months on a med-surg unit where I made a decision to leave. The unit had all the elements you described and more. I wrote my 2-week notice and hand-delivered it, with certainty. I had the opportunity to talk with managers, and I was honest. I have been a nurse and manager in a sub-acute care center for years prior, and so I had developed my standards for my own professional practice. My situation is a little different because I was able to rely on a very solid nursing work history and I have great references from those years, so I felt more confident about speaking about the unsafe environment. My heart goes out to newer nurses who feel they need to put up with the abuses put upon them in some settings. It is horrible. I commend you if you can stay for the experience, but make sure to protect your heart and soul for your personal nursing passion and profession. My current hospital is a completely different experience. My interview was amazing, as I was interviewing them, truly. I think they saw my dedication to nursing, and thankfully, I fit in with the culture. My advice is to somehow stand your ground and look for a better position and get out of that toxic environment as soon as possible.

I work a contingent job as a telephone triage nurse. My primary job is on a med/surg unit in a hospital. The phone triage, comparably, does not even seem like a job. I love it. I don't want to lose my skills, or I would do it full-time. I do have to say, it is important to be experienced with assessment skills and dealing with stressed-out family members, as most of the nurses in triage have been nurses in the hospital for many years so they don't get too excited about many things. My vote for the least-stressful actual nursing job is phone triage nursing!

It shows your commitment if you apply and offer to work in the role of a nursing assistant until you pass your boards. I think this investment is valuable time spent for you, as well, for all the obvious reasons. Just be clear about your role change when it occurs, that is the only risk. But, if you handle it right, you will earn respect and will learn the culture and expectations before having to take it all in as a nurse. Good luck!

The group of sub-acute care practitioners (of which I dream of joining one day as a NP!) state they are looking for ACNP-trained NPs because the acuity of care is increasing in their setting. I have sub-acute care and med-surg in-patient experience, but most of the ACNP programs require ICU RN experience of at least 2 years. I have applied and am still waiting to hear from the few programs to which I applied that do not require ICU or other high-acuity experience. I anticipate completing a primary care NP program (I have been admitted), and then go on for my acute care post-grad certificate. My concern and question for anyone who is informed about this detail, do the post-grad ACNP programs also require ICU experience? I have applied to ICU and other high-acuity jobs, but I seem stuck in the med-surg identity when it comes to hospital hiring. ICU managers seem to hire new grads at my hospital system, or very experienced ICU-trained nurses. Thanks.

Thank you all so much for sharing! I am set up to begin the March residency, and I am getting really excited but even more nervous. I am waiting to hear from University of Cincinnati for a May start. It seems like the Cincinnati program is more impersonal, but it is more traditional in that it is full-time 2 years and there are fewer courses (humanities, as well I don't have to retake a higher-level statistics like I would at Spring Arbor). Spring Arbor just feels more comfortable, and I like the idea of the residencies, plus how kind everyone I've dealt with has been. Cincinnati is definitely distant and purely professional in their style, so I am leaning toward Spring Arbor.

Thank you, MiNurse and applesxoranges! I am concerned about working and attending school. Do you find that you are able to study as much as you need? I hear so much about "what you put into online programs is what you get out," so I am just wondering if you feel you're able to put in what you need?

Exactly, it is about patient-centered appropriate care. Just as the medical model of specialization targets specific populations for physicians, NP preparation is trying to target training according to patient population. Lol, the lingo is so funny here, as in-patient vs out-patient generally does dictate level of acuity, but it seems when professional nursing attempts to improve educational preparation in response to changing times is always attacked with petty hang-ups. Thanks for the reminder. Nobody here is saying Primary or Acute is better. Myself, I am trying to decide upon the best preparation for my targeted interest, which is sub-acute care. The medical director of the program where I hope to one day be a NP said they are trying to hire Acute NPs, as he even brought up the consensus model and the acuity of patients, etc. And simply that.