rprn2009

I'm set to graduate from the St. Joseph's Program in December. I'm not gonna beat around the bush - the amount of work assignments will continue to be tedious and won't get any less time consuming. I had to sacrifice a lot of time and effort to get through this program and I can tell you it will be worth it when you make it. Stick with it and good luck to you.

So today I saw a patient, late 60s, history of IV drug use when younger, depressive symptoms, crying spells, Hep C positive, has had some issues with dementia lately (dx as Alzheimer's per PCP) and is on aricept and namenda. Has had HH for about 4 weeks for debility and fall hx. Patient recently has had some decline with memory and functionality. UA performed and was negative. The patient's spouse that lives with him and is primary caregiver calls me last night stating, "He's been hiding knives under his pillow and scissors in places." I go there to see the patient today and ask him, "Do you have any thoughts of hurting yourself or others?" He tells me that he wants to stab someone in the neck at his church he attends every Sunday with a little pocket knife - next time he sees that man because he is flirting with his wife. He gives me a name, the spouse states "but that's the Deacon and he and I have to talk to one another because we work close together." I check the patient's orientation. He is able to tell me who he is, where he is (city and home), who the president is, what day of the week it is, but can't tell me what year it is. Speaking in clear sentences. Flat affect. I see this as mild to moderate dementia (disoriented to time). So what do I do? The man has a plan to hurt someone else, I have to report this. Long story short, the patient is willing to go to the hospital. I tell the wife to take him to a local ED with a psych unit to be worked up for a psych evaluation. Earlier tonight I get a call from an ED doc stating, "The patient you sent here has Alzheimer's, sometimes they say things they don't mean. That patient is not appropriate for inpatient psychiatric care. I wanted to call you to educate you about the Alzheimer's disease process." I tell the doc that I'm very well aware of what Alzheimer's disease is and the patient has a history that involves potential for mental health issues. I tell the doc I don't need him to educate me, but thanks anyway. He hangs up on me. Am I supposed to ignore the patient's threats and assume "the patient doesn't mean them" just because he has dementia? What kind of logic is that? I have my patient and family to protect AND license to protect, thank you. What are your thoughts on this situation? Any similar experiences?

Hi everyone, I'm about to start clinicals soon in an FNP program and since beginning my fledgling script writing career I've come across some issues of bioequivalency of generic vs. trade brands. Of course, some medications (i.e. coumadin) are best to start generic, but I have been unable to find a resource that really compares generic versus trade brands in terms of efficacy, pharmacokinetics, etc. As we all know, no-name generics are mostly cheaper than the marketed brand versions so I was wondering if anyone had any good web-based, iPhone app, or print resources that give you that sort of information as a quick reference for what products should or shouldn't be prescribed as generics based on differences. Again I am new to this, so any input is appreciated! Thanks in advance.

Hi everyone, I'm enrolled in a graduate-level policy course and was looking to get a few nurse opinions regarding nursing policy in general. They are as follows: 1. How do you do think the public perceives nursing political activism versus how the nursing community views it? 2. What has been your own role in and contribution to nursing political activism? 3. Do you believe that the nursing role as a patient caregiver and political activist are intertwined or independent of each other? Please include any other demographic information such as pertinent work history and educational background that could give an overview of your experience as a nurse. Thanks! and I appreciate your help! Ray, RN in Oregon

LJames13, You can overlap courses once you complete the first two courses with a "B" or better and then are matriculated into the FNP program. I started my first course back in June of this year. I will hopefully be able to start clinicals in summer 2012.

core34, Hi I got your PM but I can't reply because I haven't posted at least 15 posts yet. I live in Louisiana and find the program manageable while working, but I am on my third core course and plan to be in clinicals by at most next summer. I plan on dropping my work hours to part-time soon so that I can focus 100% on the course load, though. I am trying to overlap courses, i.e. complete one course halfway then start another at that time. Hope this helps.

Cookie, Yes it does allow for it. Since St. Joseph's College of Maine has an accreditation from the CCNE, you can get certified through the ANCC or the AANP, which in turn allows prescriptive authority depending on which state you live in. You can find out the rules for APRN scope of practice through your state's board of nursing web site. See links below: http://www.nursecredentialing.org/FamilyNP-Eligibility.aspx http://www.aanpcertification.org

A program is only as good as the person enrolled in it... A lot of the best practitioners out there make their way just as well through supplementing what they've learned through self-study.. sometimes its not what you learn, but how well you are at learning it. So different people will have different perspectives on this program. Self-study is not for everyone.

thbos, I'm actually 32, started nursing as a second career. I have been an RN for three years and I'm ready for FNP school. I'm still with no kids (not for long, probably) and now is the perfect opportunity to begin the next step for me before life throws any more obstacles in my way.

Its hard not to get discouraged when you know you'd make an excellent practitioner. I know I would do well in the program. CCRNdiva, that doesn't give me much hope. I applied to USA back in December and still waiting on reply. I'm hoping it comes in the mail soon, either way so I just know an answer. Its hard to believe with your experience, GPA and certifications that you wouldn't be a shoe-in.

I just received a rejection letter from Rush University.. I too graduated from nursing school with a 3.5, cum laude, have both ER and ICU experience, and even experience as a nurse case manager. I am keeping my fingers crossed that the University of South Alabama accepts me, even though after a call to the graduate office they told me that they have an "unusually large amount" of applications this year. Amazing.