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Cococure

Cococure

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Reputation Activity by Cococure

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Like 5

Reactions Received

Like 4

  1. Like
    Cococure got a reaction from Dodongo, APRN, NP in Why don't more NPs advocate for better training?   
    To make matters worse, students and prospective students don't seem to have any qualms about sitting in front of junk professors because these students want the advanced degree and they go to whatever junk school will accept them with the minimal amount of effort/cost _<<----- 100% true I have co-workers asking me how hard is my program, because they want an easy school. When I try to tell them about why it is hard they are like... "I will get trained on the job, I just need the degree"  The education needs to be standardized and everyone is on the same playing field...but people will always try for the shorter easier programs no matter the cost. My school is a state school and it is not perfect by any means...but there is always room for improvement. 
  2. Like
    Cococure got a reaction from Dodongo, APRN, NP in Why don't more NPs advocate for better training?   
    To make matters worse, students and prospective students don't seem to have any qualms about sitting in front of junk professors because these students want the advanced degree and they go to whatever junk school will accept them with the minimal amount of effort/cost _<<----- 100% true I have co-workers asking me how hard is my program, because they want an easy school. When I try to tell them about why it is hard they are like... "I will get trained on the job, I just need the degree"  The education needs to be standardized and everyone is on the same playing field...but people will always try for the shorter easier programs no matter the cost. My school is a state school and it is not perfect by any means...but there is always room for improvement. 
  3. Like
    Cococure reacted to traumaRUs, MSN, APRN in Why don't more NPs advocate for better training?   
    I'm on the bandwagon of the need for more APRN residency programs. I know that when I graduated (2006) there were none at least in my area. I entered a specialty practice with no experience in that specialty. However, I was afforded a 4-5 month orientation with both didactic education provided by the physicians as well as clinical education provided by very experienced APRNs. 
  4. Like
    Cococure reacted to djmatte, ADN, MSN, RN, NP in Why don't more NPs advocate for better training?   
    While I don't disagree that involvement in our local organization is important, I don't find they (mine specifically) are particularly interested in the quality of NP education programs.  Certainly not enough to potentially hold back the profession on the stage of legislation and improving NP autonomy.  If they ever suggested that NP education was lacking, the AMA would be all over that and two decades of progress would be a wash (appropriate or not).
    IMO improving education starts at the either the school accreditation or the two organizations that certify NPs.  The problem with both is there are too many organizations in the pot.  There are multiple school accrediting agencies ranging from national to regional and all are generally accepted by certifying bodies.  And as evidence by some of those schools with accreditation, many of the "low performing" schools still maintain high level accreditation.  AANP and AACN specifically are in competition (especially since they don't allow cross certifications anymore) and their bread and butter is adding new members and ensuring those members continue to pay dues.  They sure as F aren't going to risk a steady increase of members by adding additional restrictions.
    A good area they could start is by certification bodies forcing new nurse practitioner graduates to complete residencies prior to certification.  This could at least slow down the flood of new NPs and provide a more structured hands on education that those bodies control and have a vested interest in.  But as previously mentioned, it slows down numbers (money) and increases their work (cost) by adding more programs to manage.
  5. Like
    Cococure reacted to Ohm108 in How did your program teach physical assessment?   
    I’m in a B&M program and this is how they teach us physical assessment, everything is done live and in person:
    We have a 2 semester class devoted to Advanced Health Assessment.  We are lectured on a different topic or body system each week and how to perform the physical assessment.  Then we also have lab each week where our TAs go through the physical assessment again and then we have to perform the body system assessment on our lab partner.  Then we have 2 sets of checks off for a set of body systems plus a final comphrehensive check off across all the body systems.  Then we have a final oral exam where we need to put everything together.  We are given a patient case study and we have to verbally explain the signs and symptoms, how we will complete the physical assessment, the types of labs and diagnostic tests we need to do to confirm our findings etc.  We have to know all of the different body system check offs but we randomly draw a body system when we get checked off so we need to know all of them because we don’t know which one we will get.  We only get 15 mins to perform the check off; if we go over we get points deducted.  If we go over by 5 mins it is an automatic fail.
    This is further reinforced in our med surg rotations where we have to perform it on the patients that we see along with taking a HPI and identify their Chief Complaint.
    Then we are again reinforced on the landmarks for physical assessment in our anatomy class with cadavers i.e we need to know that the Angle of Louis is the landmark that we use to find and to best listen for the aortic valve (right sternal border second intercostal space) or where the right middle lobe is in relation to the ribs (4th rib RSB, 5th rib MAL, 6th rib MCL) and why we need to include it in our physical assessment for lungs because that is where pneumonia is likely to develop.
    Then we are reinforced again during small group practice with the med students and the PA students in interprofessional group practice.  We also practice on our own time to prepare for the check offs as well.
    Edit: For the pelvic, breast, and male genital exams we used plastic models to learn how to place the speculum and to check for masses.  We will have live actors next year when we focus on the body systems that pertain to our specialty.
    Hope that helps!
  6. Like
    Cococure reacted to MSNrunner in How did your program teach physical assessment?   
    I went to a B&M school that had a lab where we practiced our skills. Then we went to a med school close by that had volunteer patients. We were checked off on a full head to toe assessment, a sick patient visit, a pelvic exam, and a DRE with a doctor watching us. They gave us feedback at the end. 
  7. Like
    Cococure got a reaction from mtnNurse., BSN in Nurse Gives Lethal Dose of Vecuronium Instead of Versed   
    THANK YOU, THANK YOU!! For making this statement, it is crazy how we are expected to float and work anywhere because we are RN's. Mgmt is quick to say patient abandonment if you are not a ''team player''. Yes, nurses are overworked and unreasonable expectations placed on us. I am not excusing the major mistakes she made but she obviously not from that unit and unfamiliar with the med. and it played a role...that issue needs to be addressed.
  8. Like
    Cococure reacted to ToFNPandBeyond in What made your first year of NP difficult?   
    I'll respond to both your and my original question as I'm nearing 6 mos in primary care as an FNP. I started seeing a full panel of patient in 2 mos, which was quicker than what we had negotiated. However, in the end it worked out and I was better for it. Turns out, I was ready to see a full load. You really do move with the tide and pick up pretty quickly once you're thrown out there. I remember feeling the same way after I completed my final semester. Even though I opted for more clinical hours, I still didn't feel ready and feared I'd flop and get fired. But as long as your program is rigorous, accredited, and has great placements, you should do fine. Oh, and support! The support you have from your supervisor and colleagues at the job you choose is critical! 
  9. Like
    Cococure got a reaction from ToFNPandBeyond in What made your first year of NP difficult?   
    Hello all, 
    Yes can we please revive this thread and get some more input I know there are lots of experienced and new NP's out there. I am in my last semester and I feel like I know nothing and I am still super nervous at clinical and my MD aks great questions but I just don't know the answers...ugh. When did you start to feel some assembleance of confidence? Did you feel confident in your last semester? I am all shambles...any advice...
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