Madriver

[COLOR=#000000] [/COLOR][COLOR=#000000]My advice for studying: Mometrix CNS flashcards: My colleagues used these exclusively and passed Read entire Foundations of CNS Practice (Fulton book) – look up models mentioned, read case examples, know business stuff. Possibly read Crucial Conversations and something on educational theories, styles [/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000]Youtube Paul Bolin USMLE prep~ 200 videos, puts it all together for direct care: patho, assessment, dx, ddx, tx, pharm (some are 2 years old – look at latest guidelines for CHF, DM, HTN) covers everything you may need for the clinical section of test and what you need for practice. This is overkill, but it made me a better nurse and its free.[/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000][/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000]Counseling, preceptor, education theories, adult learning, staff teaching, coaching, leadership, translational, transformational, educational theories, change theories[/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000]Research terms, research subject protection [/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000]End of life laws, counseling, care include drugs and tx used during dying process, family psy issues.[/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000]Know the geriatric stuff including labs.[/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000][/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000]Read question stem carefully: one term can make the difference in choosing between 3 or 4 correct answers.[/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000]Do not study FNP books, flashcards or take their tests.[/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000]What wasn't on test : specific ATB therapy, DM therapy, any pictures of diseases, xrays, assessment for ortho, visual tests, all those assessment tests named after somebody that have little specificity or sensitivity, inducers and inhibitors, drugs that shouldn't be given to pregnant women, drug interactions, specific models such as Iowa, PARIHS but their application was on test. PS the sunshine question was probably "sundowners" a geriatric syndrome. Know your geriatric stuff. [/COLOR] [COLOR=#000000] [/COLOR][COLOR=#000000] [/COLOR] [COLOR=#000000] [/COLOR]

I work as a set medic on commercials and films. I have a BFA in motion picture production and a MSN. Much of the work is first aid and workers comp paperwork. The work is sporadic. There is also a huge responsibility that most don't consider. People have been killed on movie sets, because producers and directors are trying to make their day. It is your responsibility to shut down production if you see something dangerous (grips rigging in an approaching lightning storm). This does not endear you to production management. If you stop production 60 crew members may go into overtime and penalty payments. If you don't and someone gets killed or injured you will lose your license and could go to jail for negligence. I started as an intern through my college program. On that first set you have to make an impression- hard worker, quiet, fast, not on your cell phone. Being quiet as a crew member is really important. Your cell phone ringing or dropping something, or scooting your chair can ruin a perfect performance. I did 4 films for free as an intern before I got my first paying job. That is about 1200 hours. If you want your foot in the door, I would go to the closest film school and offer to be set medic for free on student projects. Build your resume. Often times even student projects have some professionals for certain positions and your name gets on people lists. After you have some film experience you can join the union. Larger films have to hire union first. Although it seems exciting it isn't. You have to be there until the last truck door shuts, which means a 12 hour day for most crew is 16 hour day for you. People resent that you are getting paid for sitting there doing nothing but knitting or reading books, while they are sweating their asses off. Pay rates are dependent on the film budget and you probably will never get onto the big films. On the little ones expect $ 22/hour or less. Union rates are time and a half after eight hours. Another tip. You will have to keep things confidential. If you start taking photos or posting things about the production you will never work again and may get sued.

Darn I just found these statistics that refute the connection between microbiome and obesity PLOS ONE: A Taxonomic Signature of Obesity in the Microbiome? Getting to the Guts of the Matter

Kalycat-I love it that someone else is talking about the microbiome. The bugs in our gut serve a purpose. I think it is the most exciting new research out there. They have taken feces from lean people transplanted it into obese people and they lost weight. Farmers give animals antibiotics to cause them to gain weight. Fecal transplants have been shown so superior to vancomycin for c-diff treatment, yet people can't access treatment. I am disappointed with the FDAs flip flopping about fecal transplants being a drug or a tissue three times in the last year. People are turning to DIY on you tube. The implications that this treatment show it may be helpful in DM, metabolic syndrome, heart disease, Parkinson's, Multiple sclerosis, autism, obesity, sepsis etc means in the future we may be giving a lot more enemas. I used to think obesity was a matter of self discipline. Not any more. If you have more firmicutes than bactiodetes in your gut you will absorb 150 more calories per day. That antibiotic you took ten years ago may still haunt you. It plowed under your bacterial diversity. Autopsies of people who died of sepsis have shown that the only bacteria left in their gut was one antibiotic resistant type.

I love it that someone else is talking about the microbiome.

Unfortunately the ANA no longer is offering anything but test taking skills for the CNS exam. They offer preps for NPs, but we our the step children. Mometrix has Adult-gerontology CNS exam flash cards that are pretty good.

Trauma - I wonder sometimes, just as back up, if I too should do the FNP rotations. If I do them now, I won't have to repeat any of the advanced pharm, assessment or patho. I am an older nurse. I would spend about the same money getting the FNP as the certification in wound ostomy, and I think that the FNP would give me more employability. I also would like to do charity/mission work when I retire and I think the peds/Ob rotations would be valuable assets. Did you have to repeat any classes?

I want to do direct patient care in a specialty. I wanted to do wound and ostomy, but the certification education is pricey. Some hospitals are paying CNSs without prescript authority less money. I know of at least one hospital that is probably regretting that the decision. Another hospital system that recognized and rewarded talent snatched her up and paid her what she is worth. There are so many regulations, quality initiatives, evidence to be researched and implemented, informatics issues, and coordination between different disciplines and departments that I hope the CNSs that do those jobs will be seen as important assets to the executive team. I do not want that CNS job. I like the research part of it, but I lack other necessary skills such as diplomacy, tact, technical proficiency and speed in informatics. My professors have tried to convince me those are skills that can be learned...

I am almost finished with my Adult-geriatric CNS program. I have had clinical rotation in wound-ostomy and Emergency.I have bariatric and diabetes clinical rotations left to complete. (These were my choices). For the first time I had a FNP say to me she wishes she had gone the CNS route. She feels she will be stuck working in a minute clinic. I see FNPs working at the hospital, but she may be correct that some hospital options may not be open to her. I have been blessed with wonderful preceptors. My wound-ostomy preceptors spent about 50% to 90% of their time in direct patient care and the rest in staff education, creating order sets and procedures, working on committees etc. My emergency preceptor does no direct patient care. She oversees the ER remodel, works with informatics committee, writes policy and procedure, creates order sets, data mines information for core measure reporting and quality initiatives, is on a variety of committees, and seems to be the go to fixer for everybody for everything ER. I never understood the whole spheres of influence blather until now. Physicians, CNOs, nurse educators, managers, staff, construction engineers, everybody turns to her for advice.

Congratulations on passing your exam. In my school I have taken the "consensus" classes; which means took the exact same classes as the NPs. I haven't taken anything in education or health care systems management so I hope the newer exams reflect this change in focus. It has always been my intention to "practice" in a specialty. I may do a dual major after I finish my CNS and go back and take the two semesters of rotations I would need for an adult NP so that I could work in geriatrics. Many of the major employers here only hire NPs for nursing homes. Even if I concentrated my clinical rotations toward geriatrics I wouldn't be hired. But there are lots of specialties that do hire CNSs so I am going to focus on those. What was your focus and what kind of rotations did you take?

I live in Ohio and we can use any advanced practice nurse or MD as preceptor. Does your program require a CNS? My program is setting up preceptors for us, but the FNP program has to find their own. They have a hard time finding preceptors for pediatrics and OB because they are competing with Midwifes and pediatric NPs for the same spaces. We have to do a variety of clinical experiences. We can't focus on just one thing. I am doing diabetes education, wound/ostomy, palliative, bariatric, and emergency. That way when I graduate I'll be employable. Most of the CNS's in my group are critical care nurses and they are doing the flight/disaster training. They will take rotations in areas like critical care, cardiac, orthopedics, emergency, trauma and then take two extra courses in flight and disaster management.

Laws vary from state to state. The diabetes association has a helpful web site. It deals mostly with unlicensed/school issues. You should also review your state's laws. Nurses are usually prohibited from even administrating over the counter drugs without an order. If this nurse calls the patient's doctor and has "orders" they can give the insulin. You are held to different rules than parent care givers. Daycare, Camps, and Recreational Programs: State Laws and Regulations: American Diabetes Association® Sifting through your state's rule can be difficult, and then there is board rules, but at the end of the research you will know what is allowed. You are actually required to know this stuff. Ignorance of your scope of practice is not an excuse.

Has anyone taken the CNS exam recently? What study materials did you use? I am about to start clinical rotations, and I want start studying for boards. Thanks