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Hi everyone, I'm a FNP looking to start my own business. I'm curious what experiences any of you have had or are currently involved in. I've researched some different options and feel a bit "stuck". It would be great to network and hear some of your stories! Like what inspired you? Did you use a non profit model? Any other insights would be great. Thank You in advance for sharing your stories!

Hi there! One site I have had good luck on is Indeed. There are lots of positions available in underserved areas that tend to pay more. Often these positions offer tuition reimbursement, sign on bonus, relocation costs, etc. Good luck!

Thank you all for your personal experiences and advice. I do not check these posts as often as I should. I am back at work...negotiated part time for a month and then ft after. I let them know forthright that I may request parttime down the road after my coworker is back from maternity leave and they are ok with that. It is great to work in an environment that supports work-family balance. Thanks again and good luck to u all in your endeavors,

Also researching NPs and different specialties that you can go into may help with your decision.

Hi! I have been a NP for over 3 years now and a RN 7 before. I think that it is such a personal choice. You would want to consider where you are located and what your goals are. Does your hospital welcome NPs in women's health? Will you mind working mond-Frid with poss call? You say you are tired of drama and nights but consider the business of days. There are pros and cons on both sides. I am glad I became a NP as it was always a personal goal of mine, however, there are days when I miss nights (quieter and less bustle) and yearn for my prior 3 12's a week. From a professional standpoint there is definitely more autonomy. When I come to a cross road like the decision you are facing I typically weigh pros and cons and then decide. I hope this has helped. Good luck in whatever path you choose!!!

Please help!!! Personal and professional opinions extremely needed. I am a FNP in the field of Interventional Radiology. I have been working in this area over 3 years and recently had my second child. I am due to return the second week in November. My dilemma is that I have a husband who travels weekly for work. He is typically gone 3-4 days a week and mostly out of state. What I feel now is that I am torn as all mothers are in this situation. I would love to stay home longer with her. My mind says I have a professional obligation to return and my heart says to stay home longer to provide care and nurture my relationship with my spouse and other child. I have been given the blessing to stay home from my husband. Also complicating the situation is that a new NP was hired to cover for me and partner once I return, however, she informed us shortly after hire that she is pregnant. She will be on leave in Jan. Advice I need.....do I professionally withdraw in the next week? Return full time and see how it goes and then negotiate part time or place notice depending on how it goes? Or try negotiating part time now? I am in desperate need of any opinions and advise from fellow peers. Thank you in advance!!!

Hi Jeremy, First of all Thank you for the reply. I am hospital based and also seeing clinic patients. We are currently in the process of having an IR clinic being set up (unfortunately not completed yet). I spent 100 clinical hours with the IR Doctor prior to being hired. We do procedures as well as follow ups and patient management. The MD I work with does anything from as minor as PICC lines to SIR-Sphere treatment, chemoembolization, vertebroplasty, etc. Have been doing this since June and just was looking for advice and tips from others in the related field. Thanks, Jen

Hello, Things that helped me as resources were: Maxwells clinical guide that you can get at Barnes and Noble, alsotry this link for various pocket guides... wwwccspublishing.com/ccs. I also used Lange Case Files books to help study and learn current recommendations for various common conditions. Hope that helps, Jen

Hello everyone, Would like to connect with NP's working in Interventional Radiology; looking for advice, clinical pearls, resources, etc. that have helped you in this specialty. New FNP and first year of practice in this specialty. Appreciate all suggestions and assistance in advance. Thank You, Jen

That is unfortunate. You should try contacting a recruiter, especially if you are willing to relocate. There are still plenty of jobs out there....you just really have to look. I know...I am a new grad and can relate. I most recently took a position in Interventional Radiology. Foreign to me because I have been a ICU and Progressive care RN plus APN edu does not offer edu in this specialty area. I was fortunate to have completed a clinical rotation with him and we got along very well. If you are willing to relocate, I know there are ONC NP positions in Phoenix and there are positions available in WY. I personally know because of this week and last I had looked into a couple positions. Might be worth a shot. Hope that you found this helpful and good luck with the job hunting!

I would recommend Margaret Fitzgerald. I bought her CD's and she is an excellent speaker. She offers a review course as well. I think I paid about $450 for the seminar. Hope that helps! Happy studying!

Dear ArkansasFan, I believe FNP's are a blessing to a healthcare system that is crying for Family Practice Physicians. Just as any career, there are components that one learns in a fashion that is both learned scholastically and through clinical on the job integration (i.e. suturing, chest tubes, etc...). I would tend to agree that the lack of additional A&P studies is somewhat a shame. Physicians have the beauty of gross anatomy which I believe would be a great addition to the NP curriculum. One has to remember though that the role of the NP is relatively a new one with the physician dating back centuries; the role and edu is ever evolving. The NP originated in CO in the 1960's out of need for pediatric care and the realization that Nurses could be trained in advance practice and fill a need. I have completed so many procedures that I cannot begin to count. It is fun and an art that is taught both in school and further appreciated in clinical rotations. I am an advocate for NP's doing procedures. We are just as capable as MD's within our scope of course. As far as the PA and NP role....the clinical components tend to blur, however, the backgrounds vary. There is one thing that remains the same. The NP always is a BSN prepared RN prior to the NP degree achieved. I am an advocate for the NP! Great discussion posed:)

Hello all, I am anticipating graduating with my MSN, FNP on May 3rd 2009 and am looking for any help in finding a website or good location to possibly work. Currently I am located in the cold North and am in a huge need of climate change. Wondering if anyone has any good suggestions for job hunting. Thanks, Tired of "Cold and Snow"-aka Jen

Hello all!!! This is a little bit off the topic of Jay Leno, However, I saw a few comments made about the program House. I am usually quite laid back when it comes to jokes/comments, feel pretty secure in who I am as a person and a nurse. Anyways I saw an advertisement for House about a week ago, went like this...Something happened to a pt, like he had an emesis or something like that, Dr House goes, "That is exactly why I created nurses.", then he turned and left the pts room:angryfire I just found myself angered after that commercial. I couldn't help but feel resentment for being portrayed in that light. Anyways, I got over it, but this thread opened up that can of worms again. Thanks for letting me vent that to you all.

Hello everyone, I've never initiated a thread here b/f, so hello and nice chatting w/ you all who have been here for some time.:) I would like a little help regarding preparation for graduate school in nursing. I currently have my BSN and would like some tips on how you all eased yourselves into a program. Like, what steps and tips helped make the process easier? I would like to apply for some sort of specialty NP program, however, the only programs available through the University I've been researching are MSN for nurse educator and FNP option. I've also researched Phoenix online programs. Any suggestions on these topics would help. Also, I have a 16m/o @ home, so any input from nurses who have little ones @ home would also help. Thanks so much!:)

Hello there, Just thought I would offer my input. First of all congrats on your new pregnancy. Thought I would offer my personal experience regarding this topic. I worked @ a regional hospital for about a year and 1/2 prior to becoming pregnant and did not notify my supervisor until I was into the 2nd trimester. No problems, however, I don't think you will qualify for paid time off until you have been w/ your current employer for a year. During that time, I was approx. 5months along, I had applied for a VA hospital. After much preliminary work, they called me back {after my phone interview and letting them know I was preg.}, and informed me that I could not be hired as I couldn't meet the physical requirements. Part of the physical required a back Xray and well for obvious reasons, could not have that done. I was a little upset over the issue as I felt it was discrimination, however, did not pursue the issue. I would definatelly check w/ your employer to see if you would qualify for FMLA and in most circumstances like this, employers are pretty good about it. Just check it out and work out a plan on when you plan to return to work after the baby is born. That is what I found helpful. Heck, most large facilities are just so understaffed that they're happy to have you return, even if it's PRN. The way I look @ it is....Your pregnant not sick. That was my motto everytime somebody said, "Oh your pregnant, I'll ask someone else." If you do your job and work out a "after baby-return to work" plan everything should be fine. Hope this helped, Jen, RN/BSN

Hey there, I tend to agree w/ you, regarding this topic holding up in court. I feel that, yes we were trained and had to pass a competency, however, in the event that a negative rx would occur would the fact that it was not w/in a nurses scope of practice cause a malpractice case. The answer is YES. That is what worries me. I will investigate into this issue further. Thanks so much for your input. -Jen, RN, BSN

That is waaaay too funny of a story!!! Sounds like something I would say to a student if I were in that situation. Isn't the pospartum experience lovely!?!? :roll :)

Hello everyone, Just wanting a little feedback on how you guys feel about the removal of chest tubes on a post-CABG/Valve pt via an RN. I previously worked @ a hospital were on the Tele/Stepdown Unit I and the other RN's removed chest tubes all the time. The requirements were that you had to have successfully completed ACLS, be an RN, completed a basic critical care course, and be witnessed by a trained person in chest tube removal 3X's prior to being able to remove them yourself. I recently reviewed on the states BON website that it is contraindicated for RN's to remove chest tubes. The hospital that I worked for was the only REGIONAL medical facility in the state and us nurses regularly removed chest tubes as we were given both verbal and written orders by the cardiac surgeons to do so. I guess what I would like is a little feedback on this topic b/c looking back if anything would have went wrong I could have been in some serious trouble in a court of law. I would have been found guilty of practicing a skill outside of a nurses scope of practice. How can a large REGIONAL medical facility allow this to happen when it is clearly stated in the BON? Thanks-Jen, RN, BSN

Hi there, I started out on a TELE/Stepdown Unit as a new grad and as it was well umm... a bit overwhelming @ first, I ended up loving it. It is overwhelming for the fact that 1) you're a new grad, 2) You have to learn many new procedures, interventions, and skills you only brushed upon in nrsg school, 3) every doctor has his/her own "little" ways of wanting things done, and 4) the fact that every hospital has it's own system to be learned. That being said, after I got all those things down (it took me a good year to feel autonamous), I truly loved my job. A few tips that helped me and you too may find useful was that I took notes, lots of them on little tips about each doctor, what they wanted, and what they expected of me. Take advantage of your resources. Ask questions and when an interesting pt comes in and is not yours ask the nurse if you can help out/observe a procedure. Also take advantage of your hospitals edu. opportunities. I was ACLS and ENPC certified w/ in 6 months of hire and took a basic critical care course w/in the first year. All of those classes helped out tremendously. Ask your charge if you can run to a code and observe &/do the charting to get a more passive exposure to codes. I did that and it helped me when faced w/ actually being on as code nurse for my shift. Just remember that you are never alone, when in doubt, just ask. Another helpful tip, when faced w/ calling a Dr on an issue always have your ducks in a row. Have the chart out, what your question is, current lab values, primary diagnosis, and ask the other nurses prior to calling if anyone else needs to talk to him/her. Nothing makes a Dr more upset than to call him and not have up to date data regarding the pt available. Carrying a quick reference nrsg handbook can also help. Another thing to have is a sheet that is your own personal "charting" on your pt such as a notecard that has med times, procedure times, vitals, lab values, etc. Fill this out @ start of shift and update w/ periodic pertinent info. and you will be prepared when a Dr walks by and asks you a random question about one of your pts. Hope this helps. I could ramble on and on....hhmmm...maybe I should go into teaching b/c I so love helping new grads. That's probably why I was also a preceptor. :)

When I first started work as a graduate nurse, I started out @ 16.75/hr. That was b/f I passed my NCLEX and was still on orientation. I quickly went up in pay to 20.38 base pay. I've only been an RN for a little over 3 years. I also lived in an area that was a relativelly low cost of living. That base pay didn't include night differential which was 1.75 extra an hr and weekends were 2.50/hr extra + night diff. It all depends on were you live. For that particular area, that was a pretty decent wage. Many poverty stricken people and medically indigent. Hope this helped. :)

You put a smile on my face :) Yes it is a great feeling to leave the stress and caos behind after a busy day. To answer your question re: Why things go wrong @ shift change. It's b/c the dear little pts are aware that "we" are about ready to get the heck outa there and their little "stress" buttons go off in there heads thinking no-ones around for approx 30 minutes, all the sudden they become "trigger-happy" w/ their call lights and need something. :rotfl: Anyways, Thanks for the smile!!

Hi there, I would like to add some advise on how to handle this situation which sounds to be very frustrating. First of all, I am a true believer that the ethical standards in any profession tend to directly reflect upon management. Not in all circumstances, but many for that matter. I think that the source of the issue should be directly addressed. What went wrong? When did the downward negative spiral start? And who needs to be addressed directly. Whenever you're encountering a sensitive topic which involves any number of people and their general code of practice regarding teamwork and pt care, it has to be approached in a non-threatening manner. Otherwise you're going to meet resistence. I think that it would be helpful to have a list of issues you'd like to be addressed, a list of how to implement positive change, optimal outcomes, and how it can be made a group effort (b/w nurses and OTs). That way they (OTs) can have the chance to have a voice in it and not feel as if they are being "ganged-up-on" as many people tend to become defensive when approached regarding these standard of care or lack of issues. Hope this helps!! Any questions, I'd be glad to answer. Let me know how everything turns out. Good Luck!!

Hello everyone, I was just wondering if any of you have any experience working in a sleep disorder lab and if so, what are your opinions regarding non-medical professionals working in a sleep disorder lab? Even if you have never worked in a sleep disorder lab, I would like to hear what you have to say about this topic. To give you a little Hx, I am an RN who has experience working on a cardiac/stepdown unit and have now been working in a sleep disorder lab for about 6 months. The lab that I work in only hires RN's and RT's b/c this is the standard of care in this particular state. I recently attended a sleep disorder conference in Denver and was educated to the fact that many sleep disorder centers hire people w/out medical degrees and give them on-the-job-training. In the sleep center the main condition that you see is Obstructive Sleep Apnea and these people require interventions of either CPAP or BIPAP. Many of these pts have underlying diagnoses and require an astute person to recognize Arrythmias, 02 therapy when appropriate, and appropriate titration of CPAP or BIPAP. I just don't think that it is a safe practice having non-medical professionals in a sleep disorder center. I'd like you to share your opinions good/bad/or otherwise. Thank-You :)

Hello everyone!! Just thought I'd share my thoughts w/ all of you. I currently work in a sleep disorder lab and previously worked @ a regional medical center, working on a cardiac/stepdown unit. I always start out introducing myself and who the CNA is. We actually write down our names and titles on a marker board in the pts rm. I then start out by asking how their night/day was and how they are currently feeling. Next I go into my physical assessment. I always (when deamed appropriate) ask them if they know what to expect for the day/night. I educate them on what to expect for the day and try to add a little light humor when appropriate. An eg. includes: Pts often have the misconception that they will get uninterrupted sleep. I tell them @ the beginning of the night that I will try to let them sleep as much as possible, however, there are routine vitals to be checked and other necessary interventions that need to be tended to in order to maintain pt safety (more often they tend to be less angry w/ interruptions when forewarned). I always try to base my edu. on person specific appropriateness. There are definatelly those that want to learn more and those that either don't care/are too sick to comprehend. I'm always amazed @ some 1st impressions that I've had. One pt for instance was a quad who was on the vent. My 1st "initial" thought was that he was incapable of comprehending much (I try not to let that 1st impression stick however). I will never forget the look in his eyes when I took the time to look him in the eyes and tell him everything that I was doing and the rationale behind it. It was a look that went from fear to ease. I could tell that his fear was lessened and having the opportunity to care for him left a lasting impression upon me. Whenever you can, try to get a feel for the pt individually, and educate them to the level appropriate for them. I think we often get so wrapped up in the "politics" of nursing and forget that yes, we are educated professionals who have a voice and one of the greatest impacts is to leave a positive impression w/ our pts and family members so that they can spread a positive experience to the public that they had w/ nurses and other healthcare professionals. Also remember that it was not too long ago that RN's could not give IVP meds, this was an MD's responsibility. As our scope of practice advances there are certain skills that can be delegated to CNA's when deamed safe and appropriatelly. Every state board is different. Hope I helped answer the thread a little. :) :)