Retired APRN

Thank you; that clears up several issues for me. I gather that these "less reputable" schools are the ones with the least demanding entrance criteria, as well? I am concerned about this because one of the major criticisms I hear from MDs about nurse practitioners is that the education and clinical experience is not standardized and that on-line, for-profit schools (which are perceived as the majority of NP schools) are turning out NPs who are prepped for the exam but are not well-trained clinicians.

I studied many years ago, so I am ignorant about some modern practices in AP education, particularly with regard to the burgeoning online option. Most (all?) online nurse practitioner programs seem to require that students find their own preceptors. Is there any control on who can be your preceptor? Do you need to have your choice approved by the school? What sort of verification of their qualifications and your clinical experience is in place? Thanks!

Yes, by all means, use paragraphs. The essay is representing you; it needs to be the best you can make it. You wouldn't go to an interview with your hair uncombed, right? Also, appropriate amounts of white space frame your words, emphasize them, and make them easier to read. I did read a few sentences. The first few sentences come off as a poor-me bid for sympathy. I'm sure that is not what you intended.

This makes me sick. Sounds like the patient was forgotten in what as a nurse I have always considered the flagship of patient-centered care. (As a patient with breast CA with mets, it terrifies me.)

I definitely would not chart "per MD Smith, no new orders at this time" if she didn't respond. There is a huge difference between no response and "no new orders". "No response", at least to my ears, means that Smith did not answer the page or call back or whatever the arrangement is. As I mentioned above, there are ways to chart "no response" more tactfully. One such way would be "Dr. Smith paged" or "phone message left for Dr. Smith" with no further comment.

There may be cases in which documenting "no response from doc" is important to the preservation of your license. There are ways to document that are tactful but honest and keep you covered. Depends on the situation.

If you have the physical stamina, go for it! You may have to work a little harder than your younger classmates at memorizing things, but you will have a huge advantage in terms of life experiences that have taught you perseverance, kindness, prioritizing and time management - especially if you've raised a family. Again, getting hired might be an issue, but it is for pretty much all nursing graduates these days. I say: if you love it, go for it!

1. I discovered that I was a better clinician than administrator. 2. I found that I was particularly good at interventions that were more in the NP realm than the floor nurse realm. 3. I discovered a huge interest in psychopharmacology. 4. I wanted greater independence in practice.

I passed out in the hallway after my first code. As Esme said, happens to all of us. This is not a game changer. Hugs!

Why do you want to become a nurse practitioner? How do you know you want to? I am admittedly old school. After a year in med-surg, I spent a few years as a staff nurse, then charge, then head nurse in psychiatry. I came to realize that * I was a better nurse than I was an administrator; * I had a good sense for connecting with different kinds of patients and working with them therapeutically; * I was fascinated by psychopharmacology; and * I was straining at the reins in pursuit of more independence in my practice. Those are the factors that decided me to become a psychiatric and mental health nurse practitioner. I would not have been able to make that decision at the very beginning of my career. However, I had already started on my MSN before making this decision. I knew that I was academically oriented. I figured an MSN would be useful if I went into education, administration or advanced practice. I can't tell you if you're too young; maybe you're more mature than I was as a new grad. All I can do is share my experience and hope it gives you some kind of perspective.

In addition to placement/level of care issues (are these patients newly admitted?), I strongly suggest pharm reviews and ruling out physical origin in the first place. It sounds like some of the patients are disinhibited, which can be related to drug interactions as well as to primary organic causes. Have there been changes in policy, personnel or schedule that affect the patients' daily life? Has there been a change in diet or food supplier? Is there a new provider prescribing for the patients? Like a previous poster, I wonder why the homicide attempt is considered psychiatric. Sometimes "bad" behavior is just bad, not "mad". Clusters of events like this are very interesting. Please let us know if you find out anything more.

Hmm. It sounds like you have some experience in the world of health care provision, which is a good place to start. You say that sometimes you feel right about it, and sometimes you are not sure. May I ask how old you are and how much schooling you have already completed? Those are tough decisions to make. Maybe you could speak with a career counselor at a community college or university near you. They might be able to help. This is a very personal decision. It depends a lot on what you are like, what you are looking for in a career, how you see your future. It is not really the kind of thing someone who doesn't know you can give much help with. Maybe you could start by making lists of positives and negatives or reasons why you do and do not want to be a nurse, and then do the same for health care administration. That might help you get closer to clarity. I'm sorry my response is so random. Good luck to you, whatever you decide!

Remember: this too shall pass! You're more than halfway there. Practical measures to reduce stress: eat a balanced diet in sufficient quantity and at regular intervals, even if you're busy. Get enough sleep. Get some exercise (hiking, biking, running, aerobics, volleyball - something to work up a sweat): endorphins are our friends. Focus more on your patients and on the material and skills you are learning than on your feelings during clinicals. Consider that dealing with a difficult instructor is giving you experience in dealing with difficult charges, managers, supervisors and colleagues. It's an entire skill set on its own. As soppy as it may sound, try to find a few positive things that happened during each clinical. It's an exercise in changing the focus. Good luck!

I'm sorry you're finding school so stressful! From the symptoms you are describing, I strongly suggest that you see someone at student health or your own family physician. Depression, weight loss, frequent migraines, lack of sleep need to be investigated and treated. (All of them are highly treatable.) Having all these symptoms all or most of the time is not normal. Is nursing school worth it? It sure was for me. I had a very fulfilling 35-year career. Is it worth it for you? Only you can decide, but deciding while you are stressed out and depressed may not be the best idea. Get yourself checked and also consider talking to a counselor at school. You may want to continue now, you may want to take a leave of absence to get treatment and then return, you may want to quit. All three options are legitimate; it's just a question of choosing what is best for you.

In addition, you can describe a situation or an observation and tell us how you think it should be charted. Your question is far too vague for us to help you.