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verene MSN

mental health / psychiatic nursing
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verene is a MSN and specializes in mental health / psychiatic nursing.

verene's Latest Activity

  1. verene

    Quality of Online NP Programs and Providers

    What you've highlighted are 3 separate issues: 1) poor quality programs vs high quality programs 2) online vs hybrid vs brick-and-mortor 3) experience necessary for role Online vs in-person in many ways comes down to individual learning style and what checks and balances exist to determine student comprehension and still ensure high-quality clinicals. Online didactic content can be a highly efficient use of transmitting information - my brick-and-mortar program often made use of "flipped classroom" with our lectures online and in-person lab, exercises and in-person discussion of topics we were expected to have already reviewed via independent reading and online lecture -- it's the matter of making sure student understanding is intact which is important via in-person or online means. Experience is another question to explore -- how much experience? Nursing experience in general vs nursing experience in related specialty? How does non-nursing experience which is directly relevant to NP specialty factor in? I think the critical piece is the quality of NP programs - poor quality vs high quality that makes a large difference in student quality and student learning. Would you rather an mediocre RN with 15 years experience who works-full time and does a slap-dash diploma mill online program or a highly motivated direct-entry student who lives and breaths nursing/np education and role socialization for 3 years straight? The former has more experience but the latter may have more support and substantially more focused independent study skills. Is it better for students to have the experience and networking to find their own clinical placements or for school to place students in vetted clinical setting? What kinds of clinical exposure is most relevant in school -- is it better to have a wide range of clinical experiences which may be brief or a singular in depth experience? How much check-in exists between school faculty and the clinical site and preceptors? Does competitiveness of admission to program have an impact on graduate quality regardless of direct-entry vs experienced RN students? I think the field as a whole needs to do a lot more research into the different pathways and the long-term outcomes for providers going through different training methods. So much in this field is really anecdotal and not based on strong evidence one way or another - and that is a huge weakness to evaluating the strengths and weaknesses of different educational and professional pathways.
  2. verene

    YouTube videos for OB and Pediatrics?

    Not sure but I've learned a lot of OB type material from MamaDoctorJones on youtube - it isn't nursing specific by any means (she's an OB/GYN) but generally informative on women's health and reproductive topics. I'd also see if your text books come in audiobook format - I learn better by reading but many of my classmates didn't and found that the e-book versions of our texts had an audio book component so they could listen in the car or while out for a run and found this really helpful to their studying and information retention.
  3. verene

    Thoughts on Accelerated BSN + MSN

    I agree with the above posters and will add to my previous post - that researching job postings for your areas of interest and the geographic area(s) you want to work in can be a great guide to determining the amount and kinds of experience prospective employers are looking for. If all job postings in your area/specialty want 5+ years relevant nursing experience this is going to make RN experience that ties to your specialty more important than if there are lots of job postings that are "new grads welcome, relevant experience preferred but not necessary".
  4. verene

    Thoughts on Accelerated BSN + MSN

    In my own experience (not at Emory) with an ABSN + MSN program I was able to work part-time/per diem as RN during the MSN portion and this was VERY useful to me (even if it did mean insane hours some of the time)- I feel like it helped my education and didactic learning to be working in a relevant environment in addition to clinical experience. This experience has also really helped to develop confidence in my assessment and nursing judgement and allowed for networking - which is how I got ALL of my post-NP-graduation interviews. My current employer does not hire new graduate NPs who do not have relevant prior experience and I am the only new grad NP (of 3) hired in the last year who did not previously work for this organization in RN capacity -- the fact that I worked with 2 of 3 populations this organization serves via community partner agency as an RN was a huge selling point to gaining an interview and in getting hired (and the fact that we charted using the same really weird EHR system didn't hurt my application). Having some familiarity with the interfacing systems and the unique needs of these populations has definitely made the transition to NP easier, and there is still a steep learning curve!
  5. verene

    Direct entry NP programs

    I applied to a variety of programs from ASN to direct-entry programs and graduated from an ABSN/MSN program. There are pros/cons to taking this pathway (just search the forums and you will find many opinions). As I posted on your thread in the Student NP forum knowing which specialty you are interested in and if you have any geographic limitations will make a difference to program recommendations. It would not be helpful to recommend a school which you are unable to move to attend or a school which doesn't offer the specialty you desire. Direct-entry programs are intense and you should expect the first 12 months (at least) to feel like an accelerated BSN program (because even if they don't award separate BSN this is essentially what the initial phase of the program is) meaning, full-time study where a student should expect to make school their primary obligation (i.e. anticipate 50+ hours/week commitment). Following this -- after obtaining RN license is where programs vary - some have a "gap year" where students work full time as RNs for a year, some drop to part-time study (or allow the option) and others continue on as full-time MSN or DNP programs. If your thought is to work along side school the whole way through I would recommend against direct-entry -- particularly in the first year as there is not time to hold more than a very part-time work position and meet school obligations.
  6. verene

    Typical clinical days as a NP student

    From a PMHNP student perspective clinicals started with meet&greet with preceptor and discussing expectations/goals (assuming this wasn't done before clinicals started). Usually the first day or two was primarily shadowing, then being allowed to document interviews done by preceptor, then interjecting commentary during preceptor assessment and being responsible for documentation, then interviewing with preceptor in room and finally interviewing independent of preceptor and providing a brief assessment summary and treatment recommendations to preceptor and having them sign off on treatment decisions & orders. Each preceptor I worked with had a slightly different time frame for this based on their & my comfort level with the patient population and setting. My adult outpatient clinical had a SLOW ramp up ( I think 3 or 4 weeks before I could complete full interview and treatment plan with preceptor in room), my adult inpatient clinical had me seeing people independently by day 4 and carrying a full daily-panel with in just a few weeks. In one of my rotations I used a cheat-sheet to make notes to then document later for school. For the others I would log data into our school's online tracker at the same time as I logged into organization EHR that way everything was done quickly and I wouldn't forget information (e.g. was that 99214 or a 99215 CPT code? What non-psychotropic medications was that patient taking? etc). In terms of references/resources I found asking what the organization offered to providers to be really useful - it got me using a variety of different resources (both those I'd been exposed to in school and those I hadn't) and was also "real world" to what might be offered by a future employer in terms of resources. I did bring a couple of references with me to clinicals (DSM5, Stahl's Drug Guide, and MGH's psychiatric resident pocket book were the most useful) but generally limited extra stuff I brought with me.
  7. verene

    NP schools without an RN license

    It will REALLY help you to narrow down your interest areas before heading this direction. NPs are specialists and you MUST decide which direction you want to go during the application phase of direct-entry programs. Gaining admission can also be much easier if you are able to articulate WHY you want to focus on Gerontology, or pediatrics, or psych, or are passionate about primary care in a rural area, or whatever it is that motivates you. Direct-entry programs are looking for motivated students who have a solid sense of what they are getting into and WHY they are going down this career path. I'd also encourage you to take another look at NP programs if you think they are the "easy" way out of not having to take the GRE or have professional experience - - while direct-entry programs may not require nursing specific experience they usually do want to see transferable skill set and an applicant's ability to articulate how their current/prior skills and profession set them up to succeed in the profession they are transitioning into (again knowing which specialty one wants is key here -- much easier to talk about how your previous experience as a small business owner will transfer to opening a private practice mental health clinic or how your years volunteering with a summer camp for children with disabilities has fostered a desire to become a pediatric NP). The good direct-entry NP programs are highly competitive, and good doesn't mean "Ivy league" but those who have a reputation for turning out solid new graduates who are ready to enter practice and who actively work to ensure their students have clinical placements which support student learning along the way. I applied to several direct-entry programs all of which required GRE as part of the admissions process, along with good GPA, essay, letters of recommendation, and interview among other requirements - this wasn't the "easy" path. If you really don't know which specialty is for you, it may be worth while to either look at PA programs - which are generalist in nature and which allow for easier transitioning of specialty down the road -- or of attaining ASN/BSN and working as a RN for a while and figuring out what you want to do with an advanced practice degree. Finally - remember that being an NP involves being an RN -- in many states the NP is a credential which is tied to RN license not a separate license. It's okay to know that you want the training and responsibility of an NP going into the field -- it is not okay to disparage the role of the RN or the knowledge and skills acquired at this level. Even through a direct-entry program you must still learn the foundational RN knowledge and skill-set before continuing into higher level training.
  8. verene

    Price Point for Service

    This will vary by insurance reimbursement rates for the insurance(s) on is paneled with. Billing rate / reimbursement will also depend on on billing code - which is based on combination of time and complexity, and also on add-on codes which may or may not be used depending on services rendered. Individual state can also influence this as some states have parity (e.g. PMHNPs may bill at equivalent to MD for equivalent services) whereas others cap NP reimbursement at a percentage of MD rate (e.g. up to 80%). Alternatively if not accepting insurance private-pay cash rates are going to be based on combination of what going market rate for services are in your region, operating expenses, desired income, and what your patient population can afford to pay (among other factors I'm sure).
  9. verene

    Question for PMHNPs about clinical scenario

    I high recommend the Columbia Suicide Severity Risk Scale - it's evidence-based, easy-to-use, has a triage-aspect built in, is available in EHR and paper formats, and best of all is FREE! http://cssrs.columbia.edu/ You might recommend it to management where you work.
  10. If he hasn't already, have your son reach out to Disability Accommodations at his school - he doesn't have to share his disability(ies) with his instructors but this will allow him access to resources and supports and Disability Services can speak with teachers about the accommodations that would benefit him. Schools are obligated to allow students to miss class for Religious Holidays - I recommend that your son reach out to his instructors in advance of missing class and see what they recommend - he may have to make up class another time, study independently, or complete alternative assignment(s) to make up for missed time, or they may just want him to get notes from a classmate. He may want to speak to both instructors and disability services about resources to support student learning - many schools offer free tutoring, writing assistance, open lab time, etc -- and knowing (and utilizing) the resources available could really help him improve his study habits and scores in school.
  11. verene

    Question for PMHNPs about clinical scenario

    Again - good judgement - the patient has risk factors but also has some solid protective factors -- they are a patient I'd want to keep an eye on and reassess periodically but doesn't seem imminent risk. Not violating trust and having the patient continue to engage in services is huge! How do you assess for suicide risk in your setting? Is it solely clinician judgement or do you use a validated screening tool?
  12. verene

    PMHNP compensation and benefits Southeast

    That is terrible! I work on the west coast - as a part-timer (pro-rated benefits) I still get 3 weeks vacation + 3 days CME time (and $1500 to pay for it) + 2 weeks sick leave + 24 hours "personal business time" + 10 holidays a year -- additionally any local CME offered by our hospital or community affiliates counts as "worked" time at usual pay rate and doesn't count against CME time or money. I'd definitely push for more time off - having space to care for yourself is important!
  13. verene


    Khan Academy - it is free, online, and an AMAZING resource. I've never been great at math and was worried about going back to school. After using Khan Academy to review I went from testing into Math 98 to testing into Calculus - and my College Algebra requirement was waived! Plus I have a lot more confidence in my math skills now - for the first time in my life math makes sense!
  14. verene

    Question about nursing career schedule

    While it is true that many new grads in acute care will start out on nights - this is not always the case. If days is your priority then it *is* possible to get a day shift position - it just may be in a less competitive specialty or outside the hospital (e.g. clinic / ambulatory center etc). If working in the hospital it *will* be normal to pick up weekends (every other, or every 3rd is not unusual) but again - if working in a clinic or non-hospital setting there may not be any weekends to work. While not working the same schedule as your wife can seem difficult - there are also opportunities to this as well - a coworker works exclusively e/o weekend because he wife works during the week - this lets him be a stay-at-home dad to their young son during the week and bring in a little extra money for the family by picking up a couple of weekends a month.
  15. verene

    NP schools without an RN license

    Direct-entry programs do require sitting the NCLEX after the first year (usually) either via awarding BSN along the way or providing letter which allows one to sit NCLEX with out degree - in which case RN license is obtained with out award of degree. EDIT: I have no idea why there are pictures attached to my post. I didn't intend for them to be there. I tried to delete them but they won't go away! I also tried deleting my post and rewriting but that didn't work either... If an ADMIN or MOD can delete them it would be much appreciated. - Thanks!
  16. verene

    NP schools without an RN license

    Online format and direct-entry do not go together. There may some lectures or didactic content online but there is a LOT of in-person time for skills lab, simulation, and clinicals at both RN and NP level. Some level of learning will always be independent at the graduate level how much is "too much" learning on your own? It would help to know what NP specialty you are interested in as not all schools with direct-entry programs offer all NP specialties, or offer direct-entry into all of the specialties they offer. Additionally are you looking for direct-entry programs in a specific geographic region or anywhere in the country?

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