JaimeeG

Kelly - Excellent post with very valid comments! I am currently in the first semester of a DNP program, and I am seriously considering dropping out and finding another truly clinical path. This is my fourth theory class, and I am learning nothing new, other than how much I loathe nursing theory. As others have stated, we are one of a very few professions who has chosen to become mired down in theory. I NEVER use nursing theory in my daily practice as an NP, much to the dismay of my current theory professor. When I am with a patient and have a problem to solve, I have never scratched my head and thought to myself, "Hmmm...what would Orem/Rogers/Roy/Watson/(insert theorist of your choice) do in this situation?" Although the powers-that-be in nursing academia would like to convince us otherwise, we CAN be a legitimate and respected profession without years of nursing theory crammed down our throats. We CAN provide good patient care without years of nursing theory classes. Nursing theory, in my opinion, has done nothing to advance our profession; instead, I feel that it has been a serious detriment. I know of many nurses who stopped their education at the Associate's or Bachelor's level because they so dreaded the thought of more theory. Very sad.... In the early postings of this thread, someone commented that in their NP program they had a few hours of cardiology instruction but an entire semester on theory. That was something I questioned when I looked at the curriculum of my NP program as well. We had ONE class in adult health in which we went over cardio AND respiratory. Our neuro talk consisted of a neuro NP (who does only sleep medicine) came in and talked about MS and migraines. But, I did have an entire semester of theory and research. Yes, we must make sure we have the classes important to patient care! I believe my rant is over for now. I have built-up issues because I am trying to do discussion posts in my class without saying the things I have said above!!! Jaimee

You don't get any documentation after you test. At the end of the test, a screen will come up telling you if you passed or not, and that's pretty much it until you get your stuff in the mail. I read my results and it said something like "You have passed..." I left and got all panicked and said to my husband, "What if it really said 'You have NOT passed' and I just missed the NOT???" Jaimee

I took the AANP boards in January and had very few peds questions (thankfully!!). As a couple of others have mentioned here, I used Amelie Hollier's review. I found her review to be MUCH better than Fitzgerald's. Amelie says what needs to be said and then moves on, where Fitzgerald goes on and on and on. Sure, it's good info, but I felt like I was listening to a review of my entire FNP program. I got more out of the "just the facts, ma'am" that Amelie uses! Good luck to all getting ready to take boards. They really aren't that bad...they just seem that way Jaimee

I work in a retail clinic, and I have been out of school since December 2008. I started in a horribly hectic rural health clinic, where I saw everything and anything. I left each and every day feeling stressed beyond belief. In the retail clinic, I feel very relaxed and much more at ease. Granted, I am not seeing much challenging stuff, but that's okay for the time being. I do have a collaborating physician always available by phone so I feel very comfortable in what I do here. I probably wouldn't have guessed I would be in a retail clinic so soon after graduating, but I think it's a good place for me at this point in my career. Someone mentioned the things that are "lost" in the retail clinic setting, such as doing labs, follow-up, etc. While we don't do blood draws, we still have to think critically and know when a patient is appropriate for us to treat here and which patients need to be sent on. It's probably not for everyone, but it's great for me for now! Jaimee

I know someone going there now. We were just talking about the school a few days ago, and she said she is "marginally satisfied." There was apparently some faculty changes, and things seem to be smoothing out now. I have applied for the spring start there. Jaimee

Are there any NPs floating around here who do median nerve blocks? I have been talking to a local chiropractor about a position, but I am just not entirely sure about the legality and other issues. I would have a collaborating physician, but he/she would not be on-site. The collaborating doc is going to be hired by the chiropractor to be the official "chart signer" and not much more than that. I know there are NPs working in pain management who do median nerve blocks, but I wondered about being the only person in the office able to do them, with no on-site backup. The chiropractor is doing a one million dollar office add-on, with three OR rooms and fluoroscopy, and I think the potential is there for a really cool job, if it were all legit. Any ideas/thoughts/comments? Jaimee G

I just took the AANP FNP exam yesterday..and passed! I didn't attend any live review courses, but I did purchase the CDs from Fitzgerald's and Amelie Hollier. I personally liked Amelie's CDs better because she didn't ramble on and on and on about little meaningless things. I also did the Mosby's online review and found it to be quite the waste of money. I think what helped me the most was doing hundreds and hundreds of practice questions. During the exam yesterday, I had several questions that were nearly word-for-word out of the review books. Good luck! Jaimee

I just celebrated being done with FNP school by getting a new Corvette!

I took a similar route to what you are planning. I graduated from an ADN program and then did my BSN. While working on my BSN, I worked full-time so that I could gain some clinical experience. We relocated to another state about halfway through my BSN, and I started thinking about advanced practice nursing after we moved. So, I went back to school, again! I just graduated from an FNP program in December 2008 and am now waiting to take my boards. I chose the Family specialization because I figured it would give me the most options for work. I actually work in neurology now, and that is where I will be staying. Good luck to you! Jaimee

I have no idea about Osage Beach, but I can comment on Branson. I worked for a short-time at Skaggs and hated every minute. It's a very nice, modern facility, but it just wasn't the place for me. The pay there was low, but that is just how it is in Missouri. The nurses here are willing to accept low wages so nothing will change. Anyway, off my soap-box now! The ER at Skaggs is busy because they serve a large area. I don't believe they have any kind of trauma designation, but I could be wrong about that. If you want to work in a trauma center, there are two in Springfield (Cox and St. John's). Depending on where you live in Branson, and where you are going in Springfield, it's about a 45-minute drive. Good luck on your search! Jaimee

I did my BSN online and am now doing a "live" MSN program. I have never had anyone ask where I went to school or what type of program I attended.

I had to take the GRE for my FNP program at Missouri State. Funny thing about that....we were told not to worry about our GRE scores and to just take it because it was a "formality" for the graduate college and wouldn't count toward our application points to the program. I studied some for the GRE but didn't stress over it too much because of the advice I was given by the program coordinator. Thankfully, I did fine and got into the program easily. But, I have two friends who were admitted part-time because of their application points. They were told that if they would have scored higher on the GRE, that would have made a difference!

I did my ADN-BSN through Oklahoma Panhandle State University. It was entirely online, except for your clinical experiences, of course. The cost was VERY reasonable, compared to most other online schools. I believe I was paying around $250/credit hour when I went, but I am not sure of the current tuition. They do list all tuition and fees on their website though. http://www.opsu.edu I could be mistaken, but I think that all BSN programs have a community component. For the OPSU program, I had to do clinical hours in my assessment course and the community course. The clinical hours were very easy to accomplish though, and I was actually able to meet most of the requirements during my work time or through just a few extra hours per week. Good luck! Jaimee

My BSN program was cake. I currently attend a state university FNP program, and it's not bad. Research was a bit tough and time consuming, and the thesis work is extremely detailed. I have found the biggest difference to be that in grad school we are expected to be very self-motivated and self-sufficient. There is little direction given for papers and such, and we are expected to be APA experts by this point. Every instructor I have had so far has been super picky about APA. I have discovered that what I thought was correct APA, from my BSN program, was totally wrong! Of my ADN, BSN, and now grad school, the ADN program was probably the toughest. My instructors were the most demanding and rigid. Grad school is probably the most time-consuming and definitely has the most hoops to jump through. Jaimee

Does your program not have specific courses for each semester? If so, you will probably have to make sure you are in the appropriate type of setting for that course. In my program, we had an advanced assessment first semester. This had to be done in either family practice or internal medicine. I did mine in a very busy family practice office that sees mostly Medicaid patients. I was with an FNP and had a good experience. For women's health, I was at Ft. Leonard Wood, a large army post in Missouri. This was by far my most beneficial clinical time. I was able to do almost 200 well-woman exams and also did many prenatal and postpartum visits. Some in my class had really poor preceptors and did under 5 exams total. I just finished my adult course. For this semester, I was with an FNP in a family practice office. We had the choice of doing either family practice or internal medicine again. Summer will be my peds course, and (of course) I will be in a pediatrics office. I will be with two different PNPs here. Practium is my final semester, in the fall of this year. For practicum, we have to do 80% of our time in a primary care setting and then we are free to do 20% wherever we choose. I am going to be working with a local neurologist when I am done with school so I plan on doing my 20% with him and the other 80% with a local FNP. Like I said in another thread, be sure that you choose GOOD preceptors. Some are not so willing to let you get in and actually do things. I spent a short amount of time with a local family practice doc, and I basically followed him around all day and watched. I learned some stuff from him, but I think it's much more beneficial to do the exam yourself and come up with your differentials, labs, treatments, etc. Good luck, and have fun! Jaimee

i am 7 months from graduating from the fnp program at missouri state university. i started last summer and was pretty overwhelmed in the beginning. i think i went into the program with some unreal expectations though. i have found graduate school to be extremely self-directed. my biggest piece of advice to you is figure out a system of organization that works well for you. if you are not organized, you will sink...quickly. one cool thing that we did in our roles class last year was to write a paper about why we wanted to be nurse practitioners. this has been really helpful when i have been down in the dumps and ready to throw in the towel. you will undoubtedly hit some low points during your studies. just find something that keeps you going and allows you to remember why you are putting youself through such misery preceptors: as for preceptors, i have had to find my own for each semester except for women's health. the preceptor situation can be tough around here because there are several np programs in the area and also a pa program. i lined up my preceptors before i even started the program (after i knew i had been accepted) and then remained in contact with them periodically until time to do my clinicals. if you have to find your own preceptors, be sure that you get people who are willing to actually let you do things. if you end up with preceptors that just have you shadow them, you will not learn much of anything and will end up with a very poor clinical experience. work: if you have to work and are going full-time, work as few hours as possible. i started out working full-time but rapidly discovered that was not going to work. you are entirely too busy with your class time, clinicals, and studying. i have had to write a ton of papers in my program also. once you start working on your thesis or project, your time will be even less. i think there are only 2 in my class who still work full-time. they are single with no committments, and they work weekend option jobs. they both have really struggled though with getting things done on time. online courses: for the most part, i like online courses. i did my entire bsn online, which was great. it's super cool to be able to go to class in your pajamas! in the fnp program, i have also had several online courses. some are good...some are not so good. i am currently finishing my advanced research course online, and i think that one might have been better live. there are just so many tough concepts that i think might have been better understood in a live setting. also, we work on three chapters of our thesis during this course so to have live time with the professor would have made the thesis work much easier. i know some mentioned using a pda. i have an hp ipaq that i use daily. i have epocrates essentials installed. you can get a 35% student discount from epocrates, by the way, if your school has a discount code. if they don't, it's very easy to do. i set it up for my school in just a few minutes. it just requires finding a faculty liason and sending them a form to fill out and resubmit. good luck to you in your studies! just remember to take deep breaths often and don't ever forget why you are doing what you are doing!!! jaimee

Been a while since this thread was started, but I thought I would play too I am rather new to Missouri. We moved to Rogersville in February 2006 from Northern California. For those that don't know, Rogersville is about 20 minutes east of Springfield. It's a tiny little hole in the wall town, but we have a nice little furniture store and a Dollar General. What more does one need?? I started in nursing as an A.D.N....then right on to my B.S.N....now in my third semester of FNP school. I will be done with my FNP program in December of next year and hope to work either in women's health or neuro. I know...strange choices! I currently work in surgery at a small local hospital in Springfield. When in California, I worked OR and neuro. Jaimee

The pay in Springfield is not necessarily better than Branson. I actually made more at Skaggs in Branson than at St. John's in Springfield. If you are relocating here from out of the area, be prepared for a huge drop in pay. It is insulting what they pay nurses in this area. We moved here from California 1-1/2 years ago but almost changed our minds when we found out what the pay was like. Granted, I came from one of the highest paying states, but there is just no justification for the low wages in SW MO. Natives of the area try to argue the "cost of living" issue, but that is pretty much a mute point now. The cost of living is only different in property values now, with most everything else being fairly comparable to what we paid in California. I would take a long look at the area and what is available for jobs before you decide to move. I am now in an FNP program and will most likely leave the area when I am done with school. There doesn't seem to be any motivation to change here, and I would really like to make more than $24-$30/hr as an FNP! With all the negatives, I have mentioned, I guess I should throw in a positive or two! The area is beautiful, and there is a lot to do here. You are only a days' drive from Nashville, parts of Kentucky, etc. There are many fun fall festivals, and the holiday season brings some really pretty decorations in Branson. Jaimee

I did my RN-BSN through Oklahoma Panhandle State University. I found this school after hours and hours of research, looking for an accredited, reputable, and somewhat inexpensive option! I believe I was paying $285/ch for my courses, and everything was online. There were some clinical components that you had to complete locally, but they were no big deal. The only course I was not happy with was Advanced Assessment. I don't recommend doing an assessment course online. When I started in the FNP program, I felt pretty clueless about assessment. One of the really nice things about OPSU is that the director will review your transcripts and work with you on setting up a schedule that works for you. There were no fees for reviewing the transcripts. I found all of my instructors very helpful and knowledgable. The website is http://www.opsu.edu Jaimee

1. I entered the nursing profession after working for 20 years in the medical field in other capacities. I went back and forth between nursing school and PA school but opted for nursing school due to time constraints, travel issues, etc. 2. I love to educate patients and families. 3. Working in Missouri, I don't like the backward ways that things are done, and I certainly don't like the pay!! 4. See #3. The pay in Missouri is insulting to nurses. 5. Where I work, most of our doctors are pretty respectful. As with anywhere, we have a few who are nasty, but we also have some nasty nurses! You get respect when you give respect. 6. I felt prepared to enter the real world of nursing. My preceptorship really allowed me time to adjust and see what it was like to work on the floor. 7. I spent some time working in neurotrauma ICU. The challenges were interesting, but the emotional toll was just more than I could stand. 8. To me, the most rewarding thing about being a nurse is that moment when you feel you have really made a difference in the life of your patient and/or their family. 9. I guess that would depend on the ER and the new grad. Generally, I would say that new grads could really benefit from some floor time. On the floor, you get to practice your skills and learn how to effectively prioritize and delegate. I was 100% against working on the floor right out of school, but I spent a year working neuro step-down, which was a wonderfully valuable experience! 10. I am starting an FNP program next month so I guess I am leaving bedside nursing for the time being. I will be working as a grad assistant, teaching clinical skills to new BSN students, so I won't be doing any hospital work during the next several months or years! I am a 40-year-old female working in the surgery department now. I have been an RN for 2 years - completed an ADN program, immediately started a BSN program, now starting MSN program in May.

I live in SW Missouri and am starting an FNP program next month. I already know that nursing wages, in general, suck in Missouri, but I was VERY upset when I found out what NPs are making in my area. One of the major hospitals in Springfield, MO, starts new NPs at $24/hr. That isn't a typo...it really does say $24/hr. :angryfire When I met with my advisor earlier this month, she told me that a great thing to do is get my FNP schooling done and then move to another state to practice. I am quite dismayed by the fact that I am spending yet more money to further my education and skills and am going to make an insulting wage when done. Grrrrrr Jaimee

I guess I should rephrase what I said about our aide taking vitals pre and post op. The aide can hook them up to the machine and record preop vitals. Postop, they hook them up, but the nurse is responsible for recording all vitals. Jaimee

My first OR job was in one of the busiest free-standing surgical hospitals in the U.S. We had 12 ORs and stayed busy constantly. I currently work in a small, 20-bed hospital with only 3 ORs. I like the feel of the small hospital because it's quieter and we have more of a team environment than I experienced in the bigger facilities. I often times find myself wanting a bit more excitement though! We do a lot of general surgery and foot cases, and we don't see a lot of variety. I have been spending a lot of time in outpatient lately though, and I enjoy doing something a bit different and interacting with the patients more. Jaimee

Can you keep a piece of hard candy or something in your pocket that could be helpful if your sugar drops? As a circulating nurse, you don't stand in one place for very long so the standing probably wouldn't be any more than you are used to as a med/surg nurse. Jaimee

Where I work, in surgical services in a 20-bed hospital with 3 ORs, we currently don't have aides in our outpatient department. We do a lot of outpatient/ambulatory surgeries and used to have an aide, but budget cuts did away with that position. When we had an aide, she would do preop vitals, postop vitals, help patients dress after surgery, clean/make beds, wheel patients out to their vehicles, etc. It was a great help because we often times get slammed and could really use an extra hand. On busy days, we are usually admitting and discharging the scope patients also, and that can make for a lot of patients. Most ambulatory surgery centers are only open Monday-Friday, day shift. I am sure there are a few open on weekends and evenings, but most are not. We do ambulatory surgeries Monday-Friday only. Jaimee