BritFNP

I am not a CRNA, but my boyfriend is and I have many friends who are (I'm a FNP). You cannot work during CRNA school. This is likely the most difficult APRN program there is. Programs do not allow it, for good reason. You fulfill tons of OR hours and your complete focus must be on anesthesia. After you obtain your bachelors degree in nursing and become a RN, you must work in ICU for 1-3 years before applying for CRNA school, which is an additional something like 28-36 months. For the people I know that are CRNA's, they are very fulfilled in their career choice. The money is good. The work is satisfying and important. Anesthesia providers literally save lives everyday. You must know your anatomy, medication, and skills like second nature. The programs are very competitive and you graduate ready to work. It's a wonderful career choice. Good luck!

You learn everyday. Get your basic processes down. You will see 'new' stuff all the time for a long time. There is no one way to prepare. Just have your resources close by (medscape, apocrates, etc). I just reached my 15 months mark and there are days where I still feel like an imposter and days where I totally feel like I nailed it!

Googling online WHNP program yields many results….drexel university is one that first comes up. Typically for online programs and brick and mortar schools, >600 clinical hours are required. You usually find your own preceptors around your local area. Sometimes your school will help set you up with providers. A hybrid to my knowledge is one that there is some in class work and some online work. For example, you have class once a week and everything else is online with the exception of your clinical hours.

This is a huge issue in the rural clinic I work in too. The meth use is insane out here. Over 50% of people seem to be hooked on pain pills or benzos. It is disheartening. I had one patient come in, on the job a pipe had hit him in the rib cage, negative rib series...treated him acutely with Norco (back when we could rx), flexeril, and some prednisone. He returned 3 weeks later still in pain. I told him he would be sore for a bit - maybe costochondritis - and to take OTC antiinflammatories. He decided to leave me and see one of the doctors in my office who did no further diagnostic testing and rewrote his Norco. Now the patient comes in monthly for a prescription. Many times we do this to the patients ourselves. It is a sad reality.

It's crazy. I too am from Texas and becoming an NP nearly doubled my RN salary. I was only an RN for four years prior though...

I have without a doubt swabbed the cervix and transformation zone and had a report come back saying "transformation zone not present". My docs always say no worries. If there is cell dysplasia it will come up. I think practitioners know what the cervix is AND what it looks like haha

Most people are going to respond saying family NP since you can see patients from birth to geri. The other two limit you.

I agree, that probably means you will be ordering supplies, taking vital signs, doing lab draws, giving injections, all while trying to be the medical provider you went to extra schooling for.

Texas first RN job $22.52/hr, last RN job $28.50/hr first NP job was $40/hr (very low)

This question is a bit confusing. That may be why there are no responses yet. Are you talking about a dual role?

Lots of documenting, but covering yourself means more than ever as a provider, so I don't particularly mind it. I'm a year in as a NP and I've never regretted it once. Can't beat giving orders over taking them. Yes, more responsibility and critical thinking, but certainly worth it. Like BostonFNP, completely different role.

I tell them they scheduled with me, today they would be seeing me. Next time though, as to not waste anyones time, they can schedule with the MD.

I am very direct, many patients have told me, "thanks for not bs'ing me". It's all in your delivery..put it in a way that doesn't say, you're fat - diet and exercise, you've made your cholesterol be out of control - here's this pill. Put it in a way that they understand you want them to live a long time. Figure out what is important to them - hobby - grandkids - their band - whatever. I always give people options …do you want to do this or that? (give it three more months of diet+exercise or take a statin). Commending people for the efforts they HAVE made goes a long way too. My patient tells me they smoke 1/2 ppd, but a year ago they smoked a whole pack…you're getting a high five. Maybe next year we will be down to 3-4 cigs a day, or none. Bottom line - no one wants to come back to you if you sound like their mother every time they come in, telling them what they are OBVIOUSLY doing wrong. Touching on the topic is good, stressing the importance is good, and documenting that the patient understands the risks of xyz is good. Bottom line, you cannot really say everything you are thinking - its bad for business. You will figure it out! Good luck!

That all depends on if you can find a clinic that is open saturdays. Will be difficult. I did clinicals in Austin and when I couldn't find preceptors I went to Abilene and Albany, tx. Working full time will be fine if you are doing school part time. Hopefully you are in no hurry to finish because part time is a looong process. (full time = 2 years).

What I don't understand is we as FNP's learn nothing about laser hair removal in our programs. These big chains promote RN's and NP's as if we have extensive training in aesthetics.

Practicing as a NP is nothing like practicing like a RN, so yes, you will feel like a novice again once you land your first position. You will take an advanced health assessment, advanced pharmacology, and advanced pathophysiology again in your program. You will fulfill many clinical hours. If you are lucky you will have a lab to practice PAPS, suturing, I&D's, casting, etc. There are STILL some fluff glasses in these MSN programs. If these programs didn't adequately prepare us for practice no one would be passing their national exams that say we can practice as entry level NP's. You get out of your program what you put in. If you love to learn and never let a word, concept, or procedure pass you by that you are unfamiliar with, you will excel.

CRNA school is VERY tough. I would be surprised if a 3.0 would even be enough with all the qualified applicants.

It's easy to get burnt out in this area. Why wouldn't we be subject to it?

The only problem I have had are the ones who finally catch me and want to go in depth about their new study when I am busy. If you want to talk for more than 2 minutes a meeting should be scheduled, a lunch, something. My doc has been less than polite back to them when they don't have new things to say, for example: "Consider the epi pen for children who have asthma and eczema"...his response being something along the lines of "Uh, yea, I already went to med school". However, overall all most reps are very nice, polite, and respectful of the schedule.

You cannot prescribe as a student. In texas, even as a "graduate NP", you cannot Rx. We actually don't even have that status anymore. (Do still have graduate RN). You have to have everything cosigned as a student and again, cannot prescribe (you are not licensed). Most doctors offices do not have RN's. They can hire a medical assistant to do the small tasks that the office needs (RN not necessary). Unless of course you want to work for $10/hr, I'm sure they would be thrilled! I agree with backtoschoolmurse, now is not the time to think about getting in with any providers. If you are doing a RN-MSN, you likely wouldn't have clinical for literally years. I also agree with LauRN that ER will pay exponentially better, but hours will probably be 12 hours shifts/occasional weekends as with nursing.

Except Austin, Tx! :)

I've posted this before, but there is a study out there somewhere that I read while I was in my program on the transition from RN to NP. The study showed the transition is actually smoother if you have no RN experience; you don't have to turn your brain from thinking like a RN to thinking like a NP. To my knowledge there is no proof or data that shows more experienced RN's make better NP's. I will say for me though (was a RN for 4 years) it definitely helps to work to become comfortable talking to patients, learn medications, and see disease processes first hand. It really is what makes us different from PA's (among many other attributes).

I have heard it is not easy to switch program to program. Most grad programs will only accept a certain number of graduate level course/hours. If it is same school, I don't think its too big of an issue. Your core courses are the same usually until you branch off into your separate specialties. For example, my entire first year was filled with classes that the MSN educator students did too. Every school varies.

Would have to know your state? It's totally doable to work full time during your first year. End of second year, clinical hours are increased with heavy didactic. I went on campus 2-3x (skills labs, comprehensive exam, etc) and had two site visits. Site visits were toward the end of the program.

Hi! I have been a NP for 6 months! RN for 2 years prior to NP school. I always look things up! There are so many different disease processes and medication options, you have to use your resources. I often know what they patient is coming in for generally…although CC: Abdominal pain (for example) doesn't offer you much direction until you've spoke with the patient. There are a lot of medications I can Rx off the top of my head, but there are a lot that I can't. It takes time. In general, patient's haven't minded my saying,"You know what? I want to double check something right quick on this med." With that said, my family practice MD asks me questions too and asks me to look up stuff for him often. Guidelines change, we have to stay relevant :)