Ptrv12

Congrats on the new job! Working in an oncology floor can be tough.. You see many patients in different phases of their grief, some are angry and can be bossy as well as their families but always try and put yourself in their place and be empathetic. I can also tell you that working on an oncology floor can be very rewarding especially if they see you really care patients and their families really open up to you and I utterly grateful to you. These patients appreciate you more than other patients do, or at least they show it more. What makes a good CNA is someone who really cares about the patient. I have some awesome CNA's on my floor that always make sure the patients are bathed and clean, they take the time to get to know the patient and make them feel important. Being on this type if floor can be very hectic and I understand sometimes you will be short handed and may not have time to give every patient a bath but always try n do your best and not leave a patient soiled in thier diaper. No one likes cleaning people's diaper but believe me the patients are more embarrassed by it than you. I have had many patients cry while I was changing them and tell me I'm sorry I have to clean them, so I don't look at it as a chore, I look at it as helping a person do something they can no longer do and praying that if I ever get sick God will re-pay me and look out for me and send me a good cna and nurse. Time managment is key... A good CNA should not have to be told to get a fingers tick or vitals but again if you are busy we as nurses should understand. Be honest with the nurse if you feel overwhelmed because they may not realize 3 other nurses asked you to do something at the same time, so instead of saying you'll do it, explain you are doing so and so and will do what they are asking when your done, most people will understand and often offer to help you out. I believe a patient is a reflection of the nurse and CNA so try to look at it that way. If you patient looks dirty and soiled that looks poorly on the nurse and CNA especially to the family. The CNA's at my work are awesome because I rarely have to tell them to do anything and report any abnormal vitals to me which is extremely important because we may not see the vitals until later. Be a team player and learn from each team member. I have learned things from CNA and I teach them things too. I would advice you to look into the ONS website and there is stuff on there you can learn about oncology. Well best of luck to you and I hope you like it.

I am not sure if this is the correct place to post but had to vent about work today. I still remember my very first patient to pass away on my floor like it was yesterday. I can tell you what room number she was in and the look in her daughters eyes as she took her last breaths. The daughter looking helplessly at me to bring her mother back but unable to do so due to a DNR order. I started as a new grad in an Oncology floor and found myself unable to cope with so much death at first. Seeing a 31 year old woman and mother of 5 kids leave her children behind, or the 21 year old newly wed man with a child on the way, was just too painful for me to see. I often thought of these patients and thier families and it would just break my heart. Months and months have passed and although I still am saddened by the deaths that occur on my floor I somehow am able to see it in a way that I can handle it better. I see so much pain and suffering from the patient and sometimes when they are gone I console myself by thinking they are in a better place and no longer in pain. But there are still some that really get to me like the one I had today. There is something about caring for oncology patients and thier families that I just can't explain. You see some that are angry at the world and can be really mean, you see the ones that are full of hope, the ones that are depressed, and some that just want to give up. Today, as I prepared to change the dressing of my patient he looked at me and said, " what's the use of doing anything for him? Cause he was dying anyway." The look in his eyes was an all too familiar one, one that I have seen many times. I leaned towards him holding the knot in my throat and said for him not to think that way. Then I excused myself for a minute locked myself in the restroom and just cried for a good 2 minutes. There I was crying for a man and his wife I just met 2 days ago. These moments are the ones that get to me and this man will go in my filed memory of all the ones that have come and gone. So many I have had the pleasure of taking care of but the sadness of realizing they are gone. These strangers that let me in thier life and share thier beautiful family stories with me. I guess I am writing this because I want to know how other nurses can hold thier tears back at work. I often feel unprofessional because when I have cried at work even though it is not in front of patients or their families some of the nurses can probably tell from my face being red. It hasn't happened at work that often but thier are just some cases that get to me the most. Not saying that any of patients where more important than others but tht somewhat made a bigger impact in my career. Is it wrong for me to cry for a patient I just met? Does it somehow make me unprofessional? If there are any oncology nurses out there hoe do you deal with this and do you respond to a patient that says these things without giving false hope? I really do love my job, no, I do not like to see anyone suffer but I enjoy the fact that if I can make my patient have at least one good day then it was all worth it. No matter how many times I have to clean them, or thier throw up, or give them pain medicine, or simply help them get dressed because they can no longer do it. Some people will thank me for doing these things and cry when I have to change thier diaper and really appreciate it, but the truth is, it is an honor to do these things for them because It humbles me each time I do it. I as an RN am not any better than a CNA and can help my patients with these things. If I can at least make them have one good day then all of it is worth it. There are so many memories that I have of my terminal patients that will forever be embedded in my head. Does it ever get any easier to deal with at work? Will I ever be able to contain my tears till I get home? How do any of you all out there deal with terminal patients? How do you encourage your patients to fight the cancer without giving false hope?

There was a nurse at my hospital that moved from New York to South Texas because she was not able to find a job. I think that this is a problem everyone faces at first. Where I live either you had to know someone to get in a hospital or be lucky enough to get into a GN program. Many hospitals now a days are not hiring new grads unless they go through a GN program ( well at least around here). Like the other post said try other states many offer relocation benefits.

Heliconiabay, great post! Very informative! I completely agree with you that in clinically there are some students that put in more effort than others and that was the point I was trying to get across, that you get what you put in to your education.

Slyfox RN, I do agree with you that an online NP student can succeed and be an excellent NP but still have to disagree that online programs make it easy for someone to become a bad NP. I don't think it's the school that makes them a bad NP but the person chooses to become a bad one. You see this from regular nurses as well. Someone could have gone to the best nursing school but lack the willingness to continue to grow and learn as a nurse that they will miss critical things that could help save a life. They can miss crucial information that should have been reported to the doctor simply because of their lack of effort and willingness to do the bare minimum at work. You also see this with MD's. Just last week, I had a patient that showed a HR of 174, 14 beat run with a wide QRS, symptomatic with SOB and Chest pain, and when I reported it to him, he just walked off and said okay. I had to go above him to the shift supervisor to call a code in order to get an EKG, cardiac enzymes, and so forth. He might not have found it pertinent to get these test but I would rather be safe than sorry. I guess my point is, in any profession, regardless of where you went to school, what really matters is your willingness to go above and beyond your duties and continue to grow and learn. Another time when I had to take my pediatric home health patient to the ER due to her mic-key button having blood in her residual and tarry stools, the resident that came in the room had no idea what a G-button (mic-key button) was and didn't know what it was and he graduated medical school. My point with that example is that you can not learn everything in school and even though you do learn a lot I feel you learn with your experiences. I could have judged him and thought he was dumb or he went to a bad medical school but I didn't because I am fully aware that no one can retain all the information they are taught at school and if he had never been exposed to a mic-key button, how would he have known what it was. What I am saying again is that what make you a great NP is the amount of time you apply yourself and dedicate in your learning. I guess we will just have to agree to disagree about the fact that you think online schools are the problem, it is not the schools in my opinion but the person itself. They give you the materials to learn and you do with them what you choose to do. I am glad to see that if you do decide to go to an online university you will seek out every opportunity to learn and practice skills. That is going above and beyond in your learning experiences. If you feel this way you would do just fine in an online program and you would be the type of person to prove that you can be as equally or more prepared as a B&M FNP student, but I guess based on how you feel about online programs that will not happen. But anyway best of luck to you in whatever you decide to do.

Again, you are missing the point slyfoxrn, what I am saying is that while yes you do learn the proper techniques from a lab that does not make you any better at suturing by having multiple days of "training" in a skills lab. Of course, I am aware that the skills for an NP are more advanced than that of an RN, it would be ridiculous of me to think otherwise. But, my point is what makes you think you would be better at suturing a patient than an online student? Just because you practiced in a lab? Everyone is exposed to different things in clinicals and the more exposure you have to things like suturing a patient that is where you are going to get your expertise from. I am not an online student, in fact, the only reason why I have debated whether to go to an online school or campus is because of narrow minded people like yourself. If you have researched as much as you say you have you would see that schools such as San Angelo University and other major universities require you to attend the university once a semester for a skills lab. Do you really think 1 day of practice would make you more advanced and capable if performing a skill? Yes, I think it is important to have a skills component but I do not find it necessary. Everyone gets what they put into a program. Like I have said in other posts, you can have a student from a major university and one from a community college and sometimes the community college student seems more knowledgeable and vise versa. To hear nurses say one nurse is better than other simply because you graduated from this university and that university is ridiculous! And please don't try and compare an Ivy league university to any of the ones I am referring to because of course I think an IVy league education is a lot better. If I were to ask many RN how many questions they had on NCLEX and some responded 130, 110, 80, 90 questions, and I myself passed at 75 questions do you really think that makes me a better nurse? No! It does not. A person becomes a well rounded knowledgeable nurse by the experiences they face at work and how much they apply to their learning. I can not tell you how many things nurses that have been nurses for years do not take the time to learn new skills or about new procedures, and I myself as a novice nurse have taught them the correct protocol and way to do these skills because I take the time to research things and learn. I seek out every opportunity to continue learning and growing as a nurse, and some people do not they just go to work do their job and go home. Even on my days off of work I research things that I was unfamiliar with at work so that next time I can be more knowledgeable. We as nurses can learn from eah other because we are all exposed to different things and instead of trying to put each other down because this person went to that school or this school we should learn from each other. You seem like a type if nurse that would think someone is inferior to you because of where they went to school and that is just simply sad and this type if thinking is why we have so many new grads that feel like they are mistreated because they are looked at as inferior to the seasoned nurses. Does it make your ego feel better to call yourself or think of yourself as a more competent nurse just because you went to a better school? In order to be a great nurse, you must be compassionate, understanding, empathetic, and really enjoy your profession and that patients you care for. You could have gone to the best university and lack those things and I for one would prefer one of these nurses over a nurse with a huge ego. Your type if thinking is what gets a nurse in trouble. No nurse will ever know everything and I bet a nursing student that went to an online university can teach you something and you could learn a few things from them and vice versa. So instead of trying to worry about whether you are better or they are better you should try and help eah other and learn from each other. Everyone passed the same NCLEX exam whether you did it at 80, 100,200, or 75 questions. Just as a person from an online school passes the same boards for FNP school.

[Quote from SlyFoxRN I don't recommend an online program. You tend to lack preparation in lab skills when you attend an online program.] While I do somewhat agree that you might get more skills practice being taught in person by a professor in a skills lab, My opinion is that you will get a lot of practice while doing your clinical hours. I am not really sure how they practice skills at an FNP level but if it is like nursing school I don't think working on a mannequin or SIMS stimulation lab makes you more competent in your skills. Yes, you learn the basics and proper procedures on doing things sutures and stuff but I don't think it's comparable to what you learn in clinicals on an actual person. Just like how in nursing school they teach you how to put in an NG tube on a mannequin it is nothing like doing on an actual person. In order to master skills like putting in IV's or Foley catheters or any procedures is by actual practice on a real human being not in a skills lab. No one would ever be great at starting IV by working on a mannequin, you have to gain that experience in clinicals. Again, I do think that you can learn the basics of how to perform the procedure by an instructor and practicing in a skills lab but I think it's unfair to say an online student would lack the skills needed just because they didn't have a skills lab component. Everyone had different learning styles, some are visual, auditory, and kinesthetic learners. My second job is Pediatric Private duty nursing and some skills I never learned in nursing school I had to perform at this job and I learned to master these skills on the job. I also read up and watched videos on performing these skills so that I can have a better understanding on the correct way to do them. Like you would in clinicals, I was taught by a nurse preceptor on the job. I think when it comes down to doing you clinical hours you will learn your skills from clinicals and your preceptor rather than in a lab.

BritFNP, thank you so much for all your input as well as everyone else who responded. You all have been a huge help!

I worked full time when I got my BS in psychology and when I attended nursing school. I worked full-time worked w-sun and had Mon tues off for clinical days. I would attended school from 8-4 and work 5-11 or 12am and on weekends worked long shifts. Needless to say I didn't get much sleep and sacrificed family time. Like another post said I too would study in the living room so I could at least be close to my 3 children and husband. But when you want something you do what you have to do to accomplish it. Instead of looking at it like I was exhausted and I had a long way to go to graduate I took it a day at a time, and time flew by. My advice is don't over stress, the key is being well organized and plan out study times. In psychology we learned that research shows if you study in small increments at a time each day rather than trying to cram for an exam you retain more information.

BostonFNP, I do agree that it depends on where you live and your network of contacts. I am aware of how many people have a bias against online schools but the fact of the matter is that many B/M universities are now doing online programs. I have looked into University of Texas Arlington and they offer the FNP program is online and you are required to find your own preceptors just like the online for profit schools. The only difference if I attend UTA or San Angelo is that whomever I get hired with will not know I attended an online program. I am aware no program is strictly online because you have to do the same number of clinical hours and I feel that this is where you get a lot of your experience from. I have taken many classes online and know I can handle an online program. In fact when I went to the university classes, there were many classes where the professors just read from the PowerPoint that they would later post online, so I would just not attend class sometimes because I felt I could learn this information at home. There were a few classes where I literally just showed up for class to take the tests and still managed to get A’s in them, because I was disciplined and studied at home. Thanks for your input though. I have not decided where I want to go yet but wherever I go I know I need to build up my network of contacts. I was just wondering if anyone that has graduated from an online university has had trouble securing a job.

Thank you all for your responses. FNPstudent15 thank for all the input, I would private message you but I believe I am unable to due to the fact that am new to this website and need 15 posts. I will definitely look into San Angelo University. I do agree that it is definitely about whom you know and that is for all jobs so I appreciate you re-confirming that. How soon do you think a person should start looking for preceptors because I have found that many people have problems in this area. I have talked with several doctors and they have all agreed that as long as you pass boards they do not care where you graduate from. A lot have said your experience as a nurse is what they look at when they are hiring. For instance there is a local oncology doctor in my area that is looking to hire an FNP or PA and he stated that if I had graduated FNP school no matter where I attended whether I be an online for profit school or the local university he would hire me because I have nursing experience in Oncology and have shown him through my work experience that I am a competent knowledgeable nurse. I was just wanting some input from FNP's, prospective student FNP's and current students in FNP programs. I really do feel you get what you put into from a program. I have another question... Would you recommend for me to work at a physician's office or continue working at the hospital? Thank you all so much for responding.

I posted on another forum but don't know if you saw it. I used Kaplan and my scores on the tests were always around 50-60's and I passed with 75 questions the first time and had about 50 select all that apply questions ( which meant I stayed in the hard questions) and Im not exaggerating, I kept count in the white erase board they give you. I also studied the hurst review. How I studied for NCLEX was with both Kaplan book and Hurst notes and combined important information on a notebook. I personally feel Kaplan was harder than NCLEX only because I always felt Kaplan questions were always trying to trick you (in my opinion). My advice when taking NCLEX is that remember when testing you are in a perfect clinical world and don't confuse information with things you have seen out in clinical. Best of luck to you! Hope this helps.

Thanks. Atom2013. I don't really remember if I could see the rationale for the Diagnostic test but in all the other tests I did. I also remember thinking that if I had watched the videos before taking the diagnostic test I would have scored higher because some of the answers to the questions where on the videos. For NCLEX I literally would study using the Kaplan book and Hurst review notes open and I combined important info on both on a notepad I took notes on. Hope that helps. Good luck on NCLEX!

I took Kaplan review when I was in school and my scores where always in 50's 60's range. The videos are very helpful and I would suggest doing as many questions as possible. I don't know why it does not let you see the rationales but it should. I passed NCLEX with 75 questions and got around 50 multiple choice (select all that apply) questions which meant I was in the hard questions most of the test. I actually found Kaplan to be harder in a way than the actual NCLEX. I also did the HURST review.

I was wondering if there are any FNP out there that experienced trouble finding a job due to the fact that they attended an online for profit school. I have been debating whether to attend an online for profit school or attend an online program from a traditional university. I have read a lot of negative comments towards for profit schools but often wonder if they are so bad why do hospitals promote them? I work at a large hospital and they offer discount tuition to Chamberlain, university of Phoenix, and Capella university. I plan on being an FNP and was wondering if there are any out there that attended these universities and if you all had trouble securing a job after graduation. I have mixed feelings about it but I also feel like if you pass the same certification test as anyone who attended a regular university it really shouldn't matter. I also want to know how long the FNP program took online and how hard finding a preceptor for clinicals was. I live in Texas. Any advice would be greatly appreciated. Thanks!