CrazyPremed

I would say yes! In my state, they allow new grads to start the application process and will hold it until thier exam is passed. It may take 2 months to for the fingerprint/background check to be processed. This may be completed while you finish you last semester. I would check with the Illinois state board of nursing for specifics. Good luck! Crazy

It looks like the letters have started going out at the end of May. I received my acceptance! Good luck to all that applied! CrazyPremed (now CrazyPrePMHNP!)

Anyone heard anything yet? Any acceptance letter received? CrazyPremed

I've applied for the Fall RN-MSN PMHNP class. Has anyone heard anything, yet? I hope I get in!!!!

You've gotten some great responses to your questions. I've worked Tele and ICU for a little over two years, and can understand what you are trying to ask. I think great advice would be to work in an ER (or an ICU if possible) as a tech while you finish the Bachelor portion of your program, then move to an ICU while you finish the Master's. This will give you insight and may help you develop the skills that you are looking for. In all honesty, my transition (which I'm still going through) to becoming a solid ICU RN is only beginning. I wanted to fly through an Nursing school and an Acute Care NP program, and didn't want to take years off in between. I have actually held off on finishing my BSN for a year, just to focus on the ICU that I am currently working in. It is amazing how much time, classes, and energy it takes just to be a functioning ICU RN. To become a leader will take even more. Secondly, as many have stated before, even if a person can go straight through these programs without having a certain amount of experience, it may be difficult to find certain NP jobs without the RN experience. Although I am frustrated by this fact, I am slowly understanding why. It would be horrible to go through all the schooling and licensing, then have to return to the bedside in an RN role for 2 years just to find work. You might as well work at the bedside now. Finally, working as an RN in the ICU might even show you that you may not like that particular role as an NP. There have been so many ICU pts that I have taken care of that wouldn't have gotten as sick if they had good primary care. At times, I feel that I may be more fulfilled working in a community clinic managing and educating diabetics than in the ICU managing pts in the throws of DKA. Gaining some RN work experience may actually change your direction. All in all, that is just my two cents. I think the best way to learn of the ICU is to volunteer, or find a tech job in one. Good luck on your journey. CrazyPremed

This is one of the few things that frustrates me with the NP path. Although this is a generalization, it seems that - If I went to PA school - I could find a job in an ER, with a Cardiologist, FP group, or pediatric hospitalist group right out the gate (if someone would be willing to train me). As an NP, it feels like I've got to get years in the ICU if I want to work for hospitalists or surgeons in a hospital setting, years in the ER if I want to be an ER/Fast Track NP, or years in Peds/PICU if I decide to work with inpatient or ER/Urgent Care kids. I know the PA vs NP thing has been beaten to death and I don't want to restart it with this thread. Truth is, I'm leaning more towards the ICU/Hospitalist/ER/Acute Care route, but the idea of working in an inner city Family Practice/Infectious Disease(HIV/STD, etc.)/Low income area has always been a desire with my volunteer work. I think I'm trying to feel out what experiences I need, and what lack of experiences would make me unable to find work in the field. I could always find a combined FP/Adult Acute Care/Peds Acute Care/PNP program, and work 200 hours a week to keep all certifications. Thanks for the replies, and please keep 'em coming. CrazyPremed

Thanks for the reply. Anyone else? CrazyPremed

There are many threads about the experience that one should have before starting an NP program and applying for jobs. Is there anyone who didn't have enough before starting a program, and had difficulty getting the job he/she wanted? Everyone knows what we SHOULD have before NP school, but I would love to hear true life stories. Thanks in advance! CrazyPremed

I started on Tele then moved to an MICU/CCU. I have worked with nurses that have moved to the MICU from tele and from med/surg and the tele nurses usually fare better. Although you may see more MICU diagnoses on a med/surg floor, your day to day activities will involve more of what you see on tele. While my med/surg counterparts were learning how to read strips and 12 leads, I was taking ACLS. While they were being introduced to basic drips, I was titrating multiple pressors. Working on a tele floor, we tended to be more involved in the codes on my floor, instead of defering many things to a rapid response team. With that said, there are things that I am not familiar with, like traches and oncology patients. Non-cardiac surgery and long term nursing home patients are somewhat new to me. These are things that the med/surg nurses seem to be much more familiar with. Honestly, I think that it is much more difficult to have to learn strips and hemodynamics from a non/tele background. I think you will be more than OK, and you should not switch to Med/surg just to get the experience. CrazyPremed

Your floor is crazy. My first tele job was similiar. Extremely sick pts with patho and gtts (and 5:1 ratios) that would easily be in the ICU in many other hospitals. Later, I moved to an ICU at a different facility. At this hospital, the only drip on their tele floor was Heparin. The nurses in this ICU commented that the tele floor was not "progressive" and they remember all the things that they titrated when "they" were on tele. When I first started out, I though it was a 'badge of honor' to tell all of my new grad nursing school friends about all the stuff I have seen (drips, meds, crashing pts, etc.). I felt that I was having such a better learning experience than they were (which, to some degree, I was). As time passed, I began to realize how much the stress was waring on me. I was leaving work frustrated, barely getting through the orders of the day. Because many of the patients were sick enough to need ICU care, they took a great deal of time and energy to care for. Lunch was a joke and bathroom breaks were rare. Codes and transfers back to the ICU were a little more common than they should have been. All of this translates into a decrease in the quality of patient care. Was I teaching my new onset CHF pts about lifestyle changes? Nope, I was too busy titrating the 75 mcg/min of nitro that my HTN pt needed. Was I preparing my preop CABG pt for his postop recovery? Nope, I was too busy grabbing lidocaine (who still uses that? ) for my post code whose bag is running out and is throwing PVC's. This stress that you experience at work carries over to all areas of your life, whether you realize it or not. I was gaining weight and becoming less healthy. I even think I started getting a little depressed. I know that I saw this with many of my co-workers. Most importantly, in all this chaos mistakes will be made. If they are, no one will take into consideration that you had a crazy pt load - not administration, the pt or family, or the nursing board. Do not underestimate this last comment. Also, my friends who were working in better environments were making the same amount of money, because this area pays based on years of experience. Although they weren't stress free, I could tell that things were better. Too often we rate our nursing abilities by how sick our patients are. Everyone wants to be the hero that saves the lives on the high-ratio, drip-giving, IV-pushing, code-having floor. It's great to be able to manage high acuity patients, but we also have to realize that if we only focus on that aspect of nursing care, we are doing much more harm than good for our patients. When Mrs. Johnson is admitted for STEMI, it's a big deal. Do you think she would really trust you as her nurse if she knew that - because you've accepted a crazy work load - you may not have time to teach her about her labs, give her pain meds, or be there right away if she codes while another pt decompensates? What about John Smith, the new diabetic on the insulin gtt? Would he drive to another hospital if he knew that you probably didn't have time for his q1hr BS's? How could you with the ratios? We are nurses, not super heroes. The economy is tough, I know. Unfortunately, you really need to move to another area. You aren't doing anyone any favors by working in (and, in a way, helping to maintain) an environment like this. These environments exist because we - as nurses - allow them to exist. CrazyPremed

Just a quick update from when I started this post. I deferred the first time, so I will actually be going this fall. I think that the majority of the program is now online instead of the one day a week option that it was last fall. I've also taken Gateway's Critical Care course; PM if you have questions. CrazyPremed

That's great advice. Which program are you in? Are you paying out of state tuition or did you get in-state residency? I'm beginning to see that many of these programs are $30-45,000 total. There has got to be a cheaper option! CrazyPremed

Hey folks, I'm considering my options as far as NP (ACNP mostly, but also FNP) schools and I am concerned about the cost. I have entertained the idea of moving to Texas, working for a year to gain residency, and then applying to some Master's Programs. I've been pretty interested in the websites of some schools (especially UT Houston), and was wondering if I could get some input on their NP programs. Any advice would be appreciated. Thanks in advance! CrazyPremed

My advice is to stick with the NP program. You have three years before you finish and this will give you plenty of familiarity with the nursing field. Also, it may not be as difficult to find an NP job, applying with three years of RN experience as opposed to the 0 years you have now. You are like me, and have many different interests. When you are talking about a three year program, it's better to start it now than to put if off until you have the feeling you will be sure about it. By then, it will be another three year hurdle. I've also noticed that the more in-depth I go into an area, the more focused I become. Buckling down and focusing on the NP degree may help keep you on the straight and narrow. Once the degree is finished, then you can find the job that fits many of your interests. Good luck on your journey. CrazyPremed

Hey folks. I have a background in ICU (MICU/CCU/SICU) and Tele (AMI, Cath, Vasc Sx, etc.) nursing, but have been contacted about working agency shifts. Most of the need is in tele (where I feel extremely comfortable) and Med/Surg (which is brand new). I want to branch out and am excited about learning new things. Although the company thinks that my experience with higher acuity patients will be enough, I wanted to hear from you guys. Any tips for a Tele/ICU nurse working extra shifts in Med/Surg? Thank in advance! CrazyPremed

I took Gateway's EKG class 2 years ago and HIGHLY recommend it. The books are great, but being in the class room environment taught me so much. I forgot the name of the teacher, but I've taken other classes from her and she is great! CrazyPremed

On the tele floor where I work we routinely have 5 pts (true tele patients), and we pull sheaths. It drives me crazy, but it really is doable. The only thing that worries me is the situation in which the patient died. I would check with risk management and get the true story. Otherwise, it isn't too bad. CrazyPremed

Don't feel bad about not being confident as a new nurse- most of us went - and are still going - through it. Although many schools require at least a year of ICU experience before an ACNP program, you are already in the program. I recommend that you look for a job in an Medical ICU somewhere to get your feet wet. I'm in a CCU that takes MANY MICU and other ICU overflow patients. The Medical patients can be very sick, but the pace is slow enough to learn a great deal. In the SICU's it is very fast paced, and not always the best place for a new grad. Keep us posted! CrazyPremed

Don't be too disappointed with the LPN portion being changed. I worked as an LPN after Block II in nursing school. There weren't many job options besides nursing homes (I was able to get a job in a hospital), and - once you take the LPN - you can't work as a tech, CNA, monitor tech, PCT, etc. You might be better off taking out some school loans. PM if you have questions. CrazyPremed

i don't ever give ice to a vented patient. are a couple of chips of ice really worth the risk of aspirating? no! the patient can wait until the tube is out. let's get the priorities straight, here. secondly, i just attended a critical care course on vents taught by a rrt who has a phd in education. she is faculty at the local rt school, and is really into evidence based medicine. she said the routine use of saline during suctioning is prohibited in the most current literature. she was very aggressive about getting this point across to a room of icu nurses. if i can find her articles, i will post them. crazypremed what the heck, here are some studies: crit care med. 2008 nov 28. saline instillation before tracheal suctioning decreases the incidence of ventilator-associated pneumonia. am j crit care. 2008 sep;17(5):469-72. instilling normal saline with suctioning: beneficial technique or potentially harmful sacred cow? pediatr crit care med. 2008 sep;9(5):465-77. a comprehensive review of pediatric endotracheal suctioning: effects, indications, and clinical practice. intensive crit care nurs. 2008 jul 14. endotracheal suctioning of the adult intubated patient-what is the evidence? although it seems like there is some disagreement, i tend to see more articles that recommend not using saline than those that do.

It seems we have a lot of questions about Hopsitalist NP's. Here are some threads that I have found. If anyone has any to add, feel free... CrazyPremed Hospitalist NP's - How do you do it? Looking for info on NP's as hospitalist Is anyone here a Hospitalist NP? Hospitalist NP Question? : Is there such thing as Hospitalist Pediatric Nurse Practitioner? Question? : Hospital NPs: What's your specialty? Question? : How many NPs work in hospitals? What are the roles of FNPs in hospitals? ( 1 2 3) NPs working in hospitals?? NP as Hospitalist ( 1 2 3) Hospitalist?? ACNP and hospitalist Roles NPs as hospitalists Here are some general Acute Care NP threads, too... Question? : For the ACNP's, why acute care?

I'm considering becoming a Hospitalist NP, but am concerned with the training (my 1 year of tele, then 1-2 yrs ICU, then a 1-2 year acute care NP program). For the NP hospitalists (or those working in specialty clinics who round on inpatients), do you feel that your training has been enough to see patients in the ICU/acute care setting? How long did it take for you to feel comfortable? How much autonomy do you have? Is there something that I can do now to help down the road? Thanks in advance! CrazyPremed

I did my internship in a CICU, also. Read about the coronary artery system. Review the basics about strips. Take a look at some ACLS algorithms - just the basics - and read basic stuff about the cath lab and what to do about chest pain. You don't need to know it all, but if you can shout out some basic facts then you might look like a superstar. I LOVED it! Good luck! CrazyPremed

Are they registry? Do they get benefits? If that were a full time position that would put them at over $100000 a year! CrazyPremed

Actually, for me it was admitting that I was more like a brand new grad when I went to the ICU. There is a larger difference between ICU and tele/Med surg than many people think. On Tele/Med-Surg, etc. it seems that balancing and executing skills are many goals that a nurse strives for. You have so many things to do for 4-6+ patients and admits and discharges, etc., that you have to learn how to multitask, prioritize, and fit everything in. In the ICU I feel more like a partner in the patient's recovery and the medical team expects me to know more about the pathophysiology and wants my input on the treatment. This has challenged me to learn more about the medical management of the disease process. Also, in the ICU, you can't 'send 'em to the unit' because YOU ARE THE UNIT! The buck stops here, and it is imperative to know what to do in the middle of an emergency (ACLS, AMLS (for my chest and abd pain new admits, etc.). I'm not saying that one is better than the other, but - in my experience - one is much more technical than the other. Seeing the difference helps me transition depending on where I am working for the day. Good luck - I love Tele but I'm CRAZY about the ICU!! CrazyPremed