BenjaminV

***Crossposted from AAENP Sig "Student" Forums. 10/11/2021: Okay everyone! First week! My time as a fellow actually started two weeks ago with a last minute invitation to an ED MD resident Webex regarding 'diversity, equity, and inclusion in healthcare', 'disability rights' w/ a staff attorney, 'sickle cell disease', and case scenarios. It was super interesting, and definitely fun to listen/observe the group dynamic of the ED residents. Last week the APP fellows were invited to the ED Resident journal club, the articles all involved pharmaceutical treatment of agitation in the ED and covered haldol, droperidol, olanzipine, ziprasidone midazolam, and lorazepam. The APP fellows (including me) sort of just listened in on the Webex, as a lot of the practice changing (or not changing) knowledge was regarding the specific psych populations encountered in the AMC ED. Being that we haven't physically started yet, we had little to offer. However it was extremely interesting listening to the attendings discuss their experience with droperidol, as I "came up" as providers were looking to other medications to manage patients due both (at different times) a black box warning and national shortage. Most of my knowledge of droperidol came second hand through stories from my medic friends. Hospital virtual orientation today and tomorrow (benefits, disaster preparedness, hand hygiene, etc). ATLS course in two weeks, (they provided the book about 1 month ago). We received our schedule and will be on the floor this week, potentially beginning to see patients on Friday! An APP fellow at AMC needs to join SEMPA as a member so that AMC can enroll the fellows into the ROSH EM review, so I did that as well. We have our first SEMPA grand rounds this week on Wednesday. Benefits seem like they are OK, nothing to write home about but not horrible. Cheers! 11/6/2021 Well, as you can tell it's almost a month since my last post and things are super busy. The first two weeks I was paired with an outgoing fellow (Senior Fellow) that was transitioning to employment within the department. First day was a general orientation to the hospital in person - at the time I felt the hospital was a huge maze. I've since become more comfortable, thankfully! There is an underlying level of stress (at least I have), if I can't position myself within a building, easily find the bathroom/locker room/cafeteria/exit etc. I have been riding my bicycle to work, there is a dedicated bike cage that is badge access only which is nice. We started seeing patients during our first week, bouncing between the "E-zone", which is sort of like a fast track when it is open, pediatrics, and the adult A and B zones. Getting used to the EMR here and all the extras that you need to use it well has been a challenge. They use Soarian, which in itself is a mediocre EHR, but all other hospitals in the area are on EPIC so that data doesn't merge with Soarian. The outpatient clinics that are within the AMC network use an allscripts derivative which also doesn't populate into Soarian - so you really need to use two different applications to gather patient records. It is really tedious. On the bright side of this - you have to go on what the patient tells you ( or nothing if they can't) with very little background. Not the best way to do medicine this day and age with all the information available, but definitely leaves plenty open for differentials and such. I have been on my own (away from preceptor) for a week now and have been seeing patients, running them by the attending, and implementing my plan. The patients here are really sick, I am admitting most of them actually. I was initially surprised, but when I look at who actually makes it back to a room here, they are mostly ESI 2's with a few 3's and the occasional 1. In that respect, I suppose it's not that surprising they are getting admitted. Lots of transfers from outside hospitals. The admission process here isn't too bad, there are actually two different processes depending on what time of day but I have gotten pretty good at getting patients admitted with orders to get them by until the hospitalist can see them. Staff is really friendly here, and because I spent so much time as an ER RN I'll go ahead and put in a line and get labs when I can if I'm not too busy and the staff is slammed. There is a big staffing issue in Albany in general, with a limited pool of nursing talent moving between hospitals (Whoever is paying the highest contracts). Additionally, the AMC RN staff just joined NYSNA (which I support, as I have historically been a member of some strong and active nursing unions) - and predictably the new union contract has quite a bit of breadth between what is in writing and what is in reality. I passed my ATLS course the week before last, I also just attended a full day toxicology conference hosted by SUNY Upstate which was awesome. It was so inspiring at the end of the day I jumped online and ordered a used current edition of Golfranks. My EM book collection is growing nicely! I start my weeklong optho rotation on Monday. I spend the morning in the clinics, and the afternoon seeing consults with the optho resident in the hospital. On my final day, I take the optho consults in the ED (with resident backup). I'm pretty excited about that, and even found the slit lamp and another willing fellow to practice with last week because I feel rusty since graduating! End of November is the two week U/S rotation. They want us to have ~300 documented U/S upon completing the fellowship, and if I do a certain amount of ultrasounds in several different categories throughout my year here I can obtain some type of certification or credential though it may be limited to just this hospital system. Oh! We also had our first simulation lab experience this past week - we went through 3 iterations of a fun megacode type scenario with SIM-man and a live actor family member. There are three fellows, so we all swapped out being team lead and refining our approach after a quick debrief following each session. Details wise for the fellowship, we are required to wear maroon scrubs and are dressed exactly the same as the residents. The nursing staff pretty much assume we are all residents. The attendings and resident staff are generally very respectful and all very intelligent. Some are more helpful than others, and overall I don't know how well versed the residents are with the fellowship but I imagine the 2nd and especially the 3rd years are pretty familiar with the role and scope (which is essentially wide open) of the APP fellows within the department. One thing I noticed though, and sort of knew before going in, this is traditionally a PA fellow program. Now there are plenty of NP's that work in the department and APP's have the same role regardless of NP or PA. However, when people see I am an NP (my badge), or I introduce myself as an NP fellow sometimes I get a comment from the other person along the lines of thinking I might be the first one or the first one in a long time. Hopefully I make a decent enough impression on the hospital here that it becomes more commonplace, as a seasoned ED trauma nurse/now NP in an ED APP fellowship should be a high performer, and that is what I am striving for. The PA component is reinforced by my mandatory membership in SEMPA (reimbursed by the department). Also, we are supposed be doing at least 10 ROSH EM questions per week. We will occasionally be assigned materials that sync up with our rotations on the ROSH dashboard as well. There is supposed to be an initial assessment, mid-term, and final assessment during the fellowship and it is arranged through SEMPA somehow. Just as an FYI, an NP can join SEMPA and they are of course welcome - but are non-voting members. Semantics for me, but just in case you were curious. I think our cohort will benefit from the decreased number of fellows (3 vs 5) in terms of having more exposure within the department. In part due to staffing, and also due to a return in pre-covid numbers, the flow is SLOW. Some days I cannot pick up more than 2 or 3 patients because there are so many boarders and not much movement. APP fellows do not currently take sign out from residents on boarders, which is good (we will later on in the program, though, or at least sign these patients out to eachother). We do sign them out to residents though. I'd say on any given day 50% of the department is boarders, and that doesn't count our ED OBS beds or the psych area. Anyhow, that's all for now. I hope someone is reading this!

Hi everyone, I've been an AllNurses student member for a couple years here and have had my education at Washington State University culminate in the award of a DNP earlier this year in May. I applied to about 12 ED NP fellowships/residencies across the country, and interviewed at several including Albany Medical Center, Northshore, NY Presbyterian, NYU Langone, TeamHealth OK, Northwell Health NYC, Vituity Riverside, and Vituity Kaweah Delta. I was accepted at Albany Medical Center, in Albany NY. I wanted to start this post for any AllNurses members or those who are browsing who might be interested in a fellowship, or interested in AMC's fellowship in particular. As I have not started just yet I only have a few tidbits to offer, but as time goes on I will be updating this topic with my experience as an ED NP Fellow at this facility. First lessons in transitioning to practice (having nothing to do with AMC)... New York State took a very long time to process my NP certification application despite having all of the materials. I actually applied before taking my ANCC certification examination on the basis of graduating from an approved educational program in May. I then updated my application in very early June when I took the ANCC exam (I also directed ANCC to provide my results to NYS). Nonetheless, I spent a lot of time on hold on the phone (thinking about 10 hours between several phone calls) and was finally granted NY licensure on August 13th. Go figure. Once awarded licensure, obviously you can then apply for an NPI which was super quick and a DEA number (also quick). Then you must apply to NYSDOH again for prescriptive privilege and access to the health providers network (also gives individual access to PDMP), for out of staters like me this requires a signature in front of a notary. Also, a collaboration agreement needs to be submitted to the state within 90 days of beginning practice. Just a few of the hurdles necessary to be ready for my fellowship here in NY! I was already a New York State Registered Professional Nurse with an active license prior to applying as an NP by the way. As I have practiced as an RN in NYC before and actually applied for initial RN licensure after graduation from nursing school in 2013. Looking forward to the fellowship and telling you all about it, I start October 11th.

Howdy, I'll be graduating from my DNP FNP program here in May and I have spent a lot of time researching and applying to Emergency Department Fellowships throughout several states in the US. I have done a decent amount of due diligence on researching the medical centers I have applied to and also have about as clear of an idea of the content of the fellowships as the descriptions allow. I was wondering if anyone on here had experience with any of the following ED NP fellowships or has maybe worked as an NP in one of these departments...; University of Rochester Medicine Strong Memorial Hospital ED Albany Medical Center ED Northwell Health ED Nurse Practitioner Fellowship New York Presbyterian Weill-Cornell Medical Center Nurse Practitioner Residency in Emergency Medicine New York University Emergency Medicine Advanced Practice Provider Fellowship Mayo Clinic Emergency Medicine Nurse Practitioner Fellowship (Rochester, MN) Northshore University Health System Nurse Practitioner Fellowship in Emergency Medicine (Evanston-Chicago, IL) TeamHealth Mid America Nurse Practitioner Fellowship in Emergency Medicine (Norman, OK) Vituity Riverside Fellowship in Emergency Medicine (Moreno Valley, CA) St. Lukes University Health Network Advance Practice Fellowship in Emergency Medicine (Bethlehem, PA) If so, could you let me know what your thoughts of the fellowship program were? Or maybe just your general thoughts about the department if you didn't do a the fellowship?

I was actually going to post a question similar to yours, under the auspices that your NP program is probably not as heavy in Pathology as you would like (as many NP programs are not, including mine). I perused around allnurses and even a few MD/PA groups lurking for suggestions. What I have found so far are some med school books that seem like they are studied pretty universally. One is Rapid Review Pathology by Edward Goljian MD, and one is Robbins and Cotran Pathologic Basis of Disease.. Some people might say the Robbins is overboard, but I am a traditional guy when it comes to studying - and I don't mind reading a lot if the information comes in a structure I can make sense of with plenty of resources. I hope there are some more out there that people can suggest. I would also suggest brushing up on your A & P, Chem, Biochem if you have the time or doing it concurrently. I went as far as to hang 4 or 5 anatomy posters around my office.

I just finished the program. I'll be happy to let any of you know about my recent experiences at this school - as far as the TEAS goes If your TEAS scores are high, and your GPA from an undergrad degree or associates is not too great they will favor the TEAS. If your GPA is high from an undergrad or associates and your TEAS is okay (meaning not in the toilet) they will favor your GPA. If all you have is a High School Degree/GED and a GPA from prerequisite classes, they will 100% weigh heavily on the TEAS.

Can someone who has the link to the financial aid page please send me the link. I was looking through the thread and unable to find it (maybe it was removed)? The contact information at BHSN would be much appreciated as well!

Hey everyone! Just got back from a great vacation in AZ to find out some even better news! I got my acceptance letter last week while I was gone, yippeeeeeeeeee! Looks like I'll be seeing you all in the Fall!

Thanks for all the support guys! I've got my fingers crossed too - I would be ecstatic to be in the program with all of you. I figured about a month to hear back either way, I already have a friend that got in and she said that is about how long it took. I will most definitely post what happens either way :-)

Hey! My name is Ben and I have applied to BHSN for the fall 2012 start. They have had my application for a while but I just took my TEAS V this past Saturday. Got an 85.3%, I feel pretty good about that. My undergraduate GPA isn't the best, here is how I have done on the prereq course list. I am a CNA and I do have some really great references. English Composition: B Chemistry, 4 credits, with lab: B Co-Requisites Anatomy & Physiology I, 4 credits, with lab: B General Psychology: B+ Anatomy & Physiology II, 4 credits, with lab: In progress Child Psychology & Development: in progress (Lifespan) Microbiology, 4 credits with lab A- Principles of Sociology: C+ Public Speaking or Human Communications: C Elective: Navajo Language Class A I'm wondering what you guys think about my chances of getting in? Someone mentioned that only 31 spots have been filled as of yet? I would be really surprised if that was the case, I mean the lions share of applicants have already applied and gotten all their stuff in. I'm going to fax them over a copy of my unofficial transcript with my most recent grades and courses in progress tomorrow just to make sure they have it.