wanna_be

I am an experienced FNP and I am considering locum tenens but can't find much information online from other providers about their experiences. Would love to hear the pros, cons, important questions to consider when looking at staffing agencies and contracts, and any other helpful information. Also curious if doing locum tenens will negatively impact my ability to find permanent positions in the future. Thank you very much!

Ugh, I'm sorry this happened to you. I've been nurse for 1.5 years now and still fear getting fired pretty much all the time (my supervisor was recently cut along with a lot of other staff, so it hits close to home). I wasn't there, so who knows what happened, but I will say that you come across as fairly level-headed considering the circumstances. You will bounce back. Getting fired after two weeks as a new nurse has the silver lining of still being able to say you're a new nurse. Being let go, as I've learned, often has a lot to do with the politics of the organization--sometimes moreso than your individual work ethic. That said, one thing to learn (and perhaps you have) is to remain humble and admit your mistakes is one of the best traits you can have as a nurse, because we ALL make mistakes, all the time...but the difference is how you handle it :) I don't know if that applies to your situation or not, but take what you will. As you look for a new job, consider deeply what mistakes you may have made at your last job and learn from them. Best of luck!

I graduated from a BSN program about 1.5 years ago, but have approximately eight years' experience in various outpatient settings (case management, medical assistant, etc.). My passion is ambulatory care, and for the most part, I would be alright if I never worked in acute care. But sometimes I am curious what I am missing. Recently, a Paramedic friend claimed that what I do in the outpatient setting is "just as challenging" as any hospital floor nurse. So, I'm hoping to hear from those of you who have experience in BOTH areas. What do you think? Is one more difficult to than the other, or is it comparing apples to oranges? As an example, as an ambulatory nurse, I do primary care throughout the lifespan, including OB and pediatric patients. I triage by phone and in the clinic, do assessments and work with PCPs on acute visits, administer oral, SQ and IM meds (and the occasional suppository), wound care, I.V. fluids, and urinary catheter insertion among other things. But I still feel quite intimidated by acute care nurses!

I did not realize until after the procedure was completed. You are correct, at a facility where I previously worked it was the clinician's responsibility to obtain both written and verbal consent, which is why it slipped my mind. Discussed with my manger today; will use this to initiate better policies around consent for procedure. Thanks for you input, everyone.

It's the weekend and I haven't been able to sleep since this happened. Looking for some advice, insight, and possibly self-forgiveness? Last week I was asked by one of the UAP to set up for an outpatient procedure that I had not been trained to set up for and had not done previously. It was a standard, low-risk procedure, and I was training another RN. I informed the UAP that I had not done this previously but would be happy to help set out the instruments with assistance. The UAP told me where the instruments were, where to place them, and as I was walking away she said, "don't forget the consent!". We brought the patient back and while rooming the patient discovered the patient had an acute complaint. I stopped the intake for the procedure and took a brief history from the patient regarding their acute issue. The patient was in obvious pain. I advised the patient that addressing their acute complaint took precedence over performing the procedure, and I would inform the provider. Myself and the RN trainee went to the provider and completed an SBAR handoff informing the provider that although the patient was scheduled for a procedure, they were in acute pain and I had informed the patient we would address this issue first. The provider verbalized understanding and stated he would evaluate the patient. I also informed the provider that I was unfamiliar with setting up for the planned procedure and would wait outside the room in case the provider needed further assistance. While waiting outside the room, I received a triage call and advised the RN trainee to continue to wait for the provider and alert me if assistance was needed. A few minutes later, the RN trainee sent me a message and asked for my help getting some supplies. We walked into the room as the provider was initiating the procedure. Soon after the patient left, the provider realized we had not gotten a signed consent from the patient. The provider stated he had reviewed the risks of the procedure with the patient verbally and the patient gave verbal consent. We agreed to call the patient to follow up that afternoon, but prior to doing so the patient called stating their pain had worsened and I triaged the patient and sent them to the ED. Fortunately it was determine their pain was unrelated to the procedure, but we completed an incident report d/t the circumstances and because a consent form was not signed. I have been a nurse for almost a year and I just feel horrible about this. I know mistakes happen, but I feel there were many points in this event where I could have done the right thing and failed to do so--I should have gotten the consent initially, or spoken up and stopped the clinician when I saw the procedure was being initiated without written consent. I informed my manager of the event in great detail along with the incident report. I'm really scared I'm going to lose my job and I feel awful for not following procedure and ensuring this patient received the best quality care.

Hello, thank you for the offer to help! I was just accepted to a DNP/FNP program and although this has been a career goal for many years, I am already getting nervous about job prospects after graduation as a new APRN. Background: I have about eight years' experience working in FQCHCs and look-alike clinics, first as case manager and later a medical assistant. I hold an undergraduate degree in public health and graduated in July 2016 with a BSN. My current (and first) job as a nurse is in a FQCHC; I work as a floor nurse, take triage calls, and participate in leadership activities at the clinic. I am a HRSA NURSE Corps scholar. The DNP is approximately three years and does not confer a MSN as part of the program. I will continue to work at my current position and the clinic is very supportive of furthering my education while working. My question is, what are the job prospects for a DNP/FNP upon graduation? Would my previous experience appeal to employers in primary care, or would being a relatively new nurse prior to starting my APRN degree negate that? Since many of the clinics where I've worked have employed APRNs I assumed the job market was good, but in doing more research I see that there are few openings for mid-level providers and many requires 3-5 years experience. Thank you so much for your insight!

I agree with the above post. My husband is a paramedic; I wish I'd fully understood the paramedic role before going to nursing school. I love being a nurse, but my ultimate goal, like yours, is to become a midlevel provider. I went through a lot of heartache trying to find a nursing school I could afford, then spent two years in school, and am now getting the experience I need (or feel is appropriate) before jumping into a graduate program. That's a lot of hoops if your ultimate goal is a midlevel provider, and you can get there with less time and money as a paramedic, plus still get a great education and great patient experience.

Thanks for the helpful advice, friends! Yes, I knew my original post would ruffle some feathers but I hope everyone can agree we're in the business of helping all people live full, dignified, and healthy lives, and the current administration seems to be fundamentally opposed to that goal. Anyway, fortunately my current employer (outpatient, not hospital) is VERY politically active and encourages us to participate in activism via legislative involvement. Attended a peaceful rally yesterday, it was great. I think my line is drawn when there's a risk of arrest; as much as I can appreciate certain acts of civil disobedience in the face of injustice, I also know my license is a valuable way of fighting the good fight and I don't want to lose it :) Appreciate the conversation!

Community health nursing. You get a very broad base of experience and also work closely with midlevel providers as part of a team. There are also a lot of FNP programs that require community health nursing experience, or favor it. Programs also look favorably upon applicants who have worked with vulnerable populations.

I will have one year of nursing experience come June. I currently working in community health, which is also what I did prior to obtaining my nursing license. My role in the clinic includes triaging patients and assisting in procedures (including EKGs, catheterizations, neb treatments, wound care, etc.) and managing the care of the occasional emergent patient who walks in the door (e.g. respiratory distress, severe burns, HELLP syndrome) until EMS arrives. I know that the emergency department is very competitive, and typically requires experience in the ICU or at least a Med/Surg unit. I'm curious if there's any crossover between community health nursing and the ED. From what I've seen (in clinicals), the ED is 90% what I do in the clinic (cough/cold/minor injuries) and 10% fast-paced, highly skilled critical care. I have my ACLS/PALS cert and am looking into TNCC. I enjoy my job but am just curious if I do someday want a change of pace if it would be feasible to apply straight to the ED or if I would need to pay my dues in Med/Surg first. Thanks!

If you're interested in activism, National Nurses United is very involved politically.

I will have one year of nursing experience come June. I currently working in community health, which is also what I did prior to obtaining my nursing license. My role in the clinic includes triaging patients and assisting in procedures (including EKGs, catheterizations, neb treatments, wound care, etc.) and managing the care of the occasional emergent patient who walks in the door (e.g. respiratory distress, severe burns, HELLP syndrome) until EMS arrives. I know that the emergency department is very competitive, and typically requires experience in the ICU or at least a Med/Surg unit. I'm curious if there's any crossover between community health nursing and the ED. From what I've seen (in clinicals), the ED is 90% what I do in the clinic (cough/cold/minor injuries) and 10% fast-paced, highly skilled critical care. I have my ACLS/PALS cert and am looking into TNCC. I enjoy my job but am just curious if I do someday want a change of pace if it would be feasible to apply straight to the ED or if I would need to pay my dues in Med/Surg first. Thanks!

Colorado as a new nurse in community health--->$60,000/year. It's expensive to live here but the job market is great and so is the quality of life.

I am a nurse and therefore believe in human rights, which naturally means that I do not support the actions of the current administration to dehumanize women, poor people, minorities, the LGBTQ community, and basically everyone who is not wealthy and white. I have always been an activist, but now that I have a professional license I also understand the added responsibility of maintaining my professionalism in my person life. I want to participate in demonstrations, marches, and protests, but also know that my most valuable contribution is as a nurse caring for the aforementioned groups without bias. My question is: is there any information on how to participate in demonstrations legally and to make sure I am not crossing any professional boundaries? Thanks for understanding--I know you all are a good group of folks :)

All I can say is be honest. There are situations in which the past is the past, but applying to school, your license, and ultimately employment are not the place for that. I had a few very minor brushes with the legal system as a youth (no actual charges) but having to put all that out on the table, frankly and not sugar-coated, when applying to my state BON was heartbreaking. Be truthful and upfront, and demonstrate what you have learned and how you have changed. It's a scary process, but there are many, many RNs who don't have a perfect record--hopefully all have learned and grown from it.

I haven't read through all the comments so I imagine this may have been underlined previously. I hate to say it, OP, but even though this is a personal--not professional--situation, you as a nurse are a mandatory reporter. By law, you must report this. In fact, with enough information given you would also implicate all of us as mandatory reporters. I work with a lot of teens and mandatory reporting is an every day part of my job. It is never easy to break the news to someone that you have to report--and I have a lot of compassion for you right now, because you and your daughter did not ask for this awful situation. The bottom line is that not only does mandatory reporting serve to protect, it also provides structure: if these things occur, then by law, this action must be taken. Our job as nurses is to ensure the safety of our patients (and by extension, all people); it is not our job, nor are we equipped, to decide how to exercise the law. We must follow it. Set an example that this behavior is not tolerated. Non-consensual contact should ALWAYS be taken seriously, and reporting this demonstrates that you are taking a stand for your daughter.

Don't think too much about percentiles. Focus on the logic behind the questions and even your own strategy about why you chose an answer. The percentiles really don't matter. Also don't feel that you have to know everything about every topic--it won't help you, because chances are you might not even see 99% of it on the test. Be confident in what you know, continue to practice every day but in the day or two before the test DON'T study; take a break, let your brain breathe, and do something nice for yourself. And, if you really must stress about it, those scores are quite good by NCLEX standards.

So funny. I took the test 6/28 as well; same experience. From the first question (which was a SATA, as were what seemed like 99% of the questions) I was thinking, "there's NO WAY I'm going to pass" and just kept telling myself to get through it, brush myself off, and take it again in 45 days. I did Kaplan and I think it helped with the way I thought about questions but still did not prepare me for how incredibly difficult and bizarre the test was! I had my head in my hands at question 75, hoping that the test would go easy on me and give me a chance to prove I know something about nursing, and not shut off...but it did. I walked out of the test center more sure that I failed than I've ever been about just about anything in life. Not, "poor me, I think I failed", but truly and logically and rationally sure that there was absolutely no way that I could have passed that test. But, I passed! I still don't believe it. Congratulations to you!

You're asking a thoughtful question, OP--I just passed the NCLEX and may be in the same boat depending on when the BON gives me a license. One thing to consider (and another poster pointed out): you said you passed your NCLEX yesterday. You likely already know this, but just to clarify, you must actually have an active license with your BON to be considered an RN--even after you pass the NCLEX, you are not licensed to practice as an RN until your license shows up as active. Good luck!

I'm in Colorado. Took the NCLEX yesterday morning. After the test yesterday--up until this morning--my BON status was pending status item "NCLEX Passing Submitted". Then this morning it's changed to "Final Review". I hadn't checked my status between receiving the ATT and taking the test, so I'm not sure what it said in that timeframe, but I'm curious if this status change is good news or bad news. My fiancé also did the PVT (against my advice!) and got the "good" pop up twice yesterday. I know I'll have my results in the morning, anyway, but was wondering if anyone can weigh in on the status change on the BON site. Thanks!

Help, please! New grad here. After reading WAY too many threads on allnurses I convinced myself I had committed some kind of fraud by not putting two minor legal issues from many years ago (one as a juvenile) that never came of anything on my licensure application. After frantically calling the BON and leaving a way too detailed message that probably did more harm than good, I went back and read the application again and it said to only list convictions. I found this to be odd, because the checklist said something like, "all complaints, charges, arrests, deferrals, etc." that was really vague and then said that if you failed to disclose this information it was considered fraud and your application would be denied and you could never get a license in Colorado. Well, now I feel like I'm in limbo. I have no problem explaining in whatever way necessary why something appears in my background check that was later dismissed, but I also don't want to go to great lengths to dig up the past if the BON doesn't care. I tried calling but no reply and I read here that sometimes you never hear back--they're very hard to get a hold of. Please, someone with a Colorado license, what and how should I disclose this to the BON? I want to be as honest and straightforward as possible, and do things the right way. Just very confused about what that entails. Tried searching online without much luck.

What should I do? I'm a prospective nursing grad and got a call back about my dream job. I was so excited, I blocked the time out for the interview in Google calendar during the call, and am fairly certain I wrote it down for the correct time...but....since it's Google calendar, what if it was at (e.g.) 10:30 instead of 11am? I don't trust myself to have entered the time correctly. Should I call the hiring manager back just to "confirm"? I don't have their email address; just the phone number. Gah! I feel like an idiot! I desperately want the job!

If this student has had SI in the past, the first thing you need to do is ensure her safety. That means counseling her, and determining if she has a plan in place if she is, indeed, pregnant. Assist her in developing some coping skills. Secondly, I'd assess her knowledge. Sounds like there's been some hearsay. It's near impossible that the student or her teacher "know" she's pregnant if the "incident" occurred two weeks ago! Does she know how pregnancy occurs, and how to prevent it? Does she understand consent? At the very least, I'd make sure she's safe, that she isn't being coerced into sex, and that she understands the physical/emotional components of becoming sexually active (not a lecture, just the facts). Then I'd give her resources. Let her know what her options are. She can (at least here), legally, get pregnancy and STD testing, and acquire birth control, without involving her parent. So, if she can't do those things at your school, let her know where she can go to do it. In some states, PP or other providers offer those services for free to adolescents. If she is pregnant, give her reliable sources to counsel her about her options. Just make sure it's not some fake pregnancy crisis center. There's a lot of support services out there. *Edit: I just saw the update. So, this is the part I think is really, really important--even with her dad involved and a GYN appointment scheduled: Finally, I'd definitely consider possible pregnancy in an eighth grader a red flag. Maybe it was consensual sex with another minor, but at that age, and combined with a hx of SI, I'd be weary that something else is going on.

I'm graduating with a BSN in about eight months. For the past two years I've worked as a clinic assistant, and depending on the week, working back-to-back ten to twelve hour daytime shifts. That is to say, it's not out of laziness that I am terrified of working a night shift. I have heard that it is every new nurse's dues to work at least six months to a year on the night shift on the Med/Surg unit. I am committed to nursing, and I'm not trying to get out of paying those dues. However, I have severe anxiety and a history of depression. Staying up late exacerbates my symptoms--my ability to cope quickly deteriorates the later it gets. I know the night shift is difficult for anyone, but I seriously question my ability to safely care for patients, make rational decisions, and stay sane if I alter my sleep schedule. Please, any advice is appreciated--do all new nurses start out on the night shift? Is the any way to communicate my fears to my advisor without sounding like a slacker? I am good at my current job, and I don't doubt my ability as a nurse, but I'm really worried about this.

Thank you, vintagemother. I actually have many years of patient/client experience (beginning as a massage therapist, then as a case manager, and now as a clinic assistant). I think what tripped me up about this situation was how subtle it was, and it made me question whether or not I was "making a big deal of nothing". I've had patients who were WAY out of line, and I've had no qualms about either ending the interaction, or firmly telling them that they were being inappropriate. But the asking about the female anatomy didn't seem weird until the other thing happened, and that was so subtle it was like, maybe the patient didn't hear me? Maybe the patient is just nervous about getting a fingerstick (people get funny all the time about getting a fingerstick)? As for positioning myself in a different way, there's really no other way I could've positioned myself that would've prevented it from happening, since I needed to access the patient's finger. Please understand that even with my own experience, this caught me off guard. I think it can be easy for us to question our own gut feeling when we don't want to "overreact". From what I'm hearing, though, this gut feeling that the patient was being inappropriate was enough for me to take action (set boundaries, possibly let my supervisor know). That's the question I had. Thank you!