LouBean

Yup! BSN to DNP applicant here. Got my acceptance email for the MSN portion. Hope the DNP folks send theirs out soon! Congrats y'all!

Aaaah! That's the lingo I was missing. Awesome. Thanks!

Out of curiosity, is anyone familiar with any clinics/programs for chronic physical conditions that really do a great job of incorporating mental health services? If so, any insight as to the nuts and bolts of how they go about it? I'm doing some clumsy googling and finding a few vague references to an "interdisciplinary approach" but nothing specific. Currently I'm a med/surg RN starting in a psych DNP program in the fall. I love psych, and with my med/surg background, I am really interested in how management of chronic conditions like COPD can be improved with better access to mental health services. My fantasy is a clinic model with an in-house psych provider, and I'm sure it's out there, I just haven't found one. Really I'm just daydreaming, trying to figure out how it might work. Should a mental health eval be required? How would appointments work? Same day as with the other provider? Separate? How would one coordinate care if a pt already has a psych provider outside the clinic? Yadda yadda yadda. Thanks for tolerating a rambling post, folks!

I second this! Put the damn body on the floor. I'm 5'1 on a good day, and even with a stool I have some difficulty.

SSI is its own order set. Low, medium and high. (For example, the low SSI would be 1 unit novolog for a blood glucose of 150-200, 2 units for 201-250, etc. With blood glucose of 351 or higher, give 5 units and notify provider.) The order set includes two PRN orders for novolog (one specifies AC/HS, another specifies q6h if pt is NPO) and a whole host of hypoglycemia protocols. We check sugars at 0500, 1100, 1600 and 2100 to correspond with meal times of 0600, 1200, 1700 and night tour's med pass at 2200. Some patients will have scheduled novolog with meals, and some will have both scheduled and sliding scale. It is not perfect...

Aquacel Ag surgical dressing. MD is the only one to touch, but part of the ortho post-op order set is to reinforce with abd/tape if needed. If necessary, doc will change it on rounds during hospital stay. Otherwise, patient is sent home with an additional dressing. Follow up with postop appt. We don't use wound vacs for knees/hips, although it is my understanding that it can be done. I question if the cost of speed-healing an incision with the wound vac is really worth it, but, Lord knows surgeons love their toys.

I don't know much about how PRN shifts work other places, but we have a couple intermittent RNs. They don't have a set tour, although actually one of them does do nights only. Now that our unit is fully staffed, they usually only get scheduled one or maaaaybe two shifts every month. No idea if that information helps you!

There is a saying in the VA -- if you've been to one VA, you've been to one VA. In other words, it depends entirely on the hospital in question. I work on a med/surg/tele unit and love it. We have a great team. The ICU is the plum job at our hospital, with the bulk of the nurses there having 20+ years seniority. The cath lab and PACU seem to be well-loved by the employees, while our MPU has a pretty high turnover. The most common complaint from former coworkers who have gone from floor nursing to other departments is the drop in pay. Not only is the base pay lower, but you miss out on the night/weekend differential. On the other hand, many of those positions are M-F, 730-1600, and I can certainly see the appeal of that.

Is it that you want to specifically attend *your* church service on Sundays? Or is the priority simply to be able to worship on Sundays? If you are working in a hospital setting, there may be services offered in the chapel. Even at my tiny hospital we have multiple service times for protestant and Catholic worship. They are short and sweet (30 minutes? which seems like 5 minutes on our busy tele floor!) and my coworkers and I have no problem watching each other's patients when we attend. Otherwise, get to know your coworkers and offer to switch shifts like crazy. If you are unencumbered by other obligations (school/family), your coworkers will be thrilled to know there is someone who can swap shifts at the drop of a hat, and will most likely return the favor. Also, on my floor there are many nurses who covet the weekend shifts and the accompanying pay differential, so you may find similar folks in your workplace. Last but not least, pray about it. Maybe you will find peace with working on Sundays, or the resolve to resign and find another position with Sundays off.

This is such a worthy conversation. I'm enjoying reading the lively responses almost as much as I'm enjoying this glass of wine. As I research PMHNP programs and their curricula, I find myself emitting loud sighs at an alarming rate. As previously mentioned in this thread (and many other NP threads on this site), what I'm looking for is an education that emphasizes complex patho and pharm on the level that I will need as a provider who will need to collaborate with MD/DOs. Rarely do the "other" courses seem like they merit a full 3 credit hours. However, my disappointment with nursing "academia" began in my BSN education -- and I do believe some of the downfalls of conventional undergraduate nursing inform these NP programs in a significant way. Despite my BSN program's reputation in the area, I found some of the teaching and coursework to be subpar in comparison with what I had initially expected. I can forgive a few sloppy power points. I have a harder time forgiving the droning on about nursing being a superior holistic and noble profession yadda yadda care plans yadda theory yadda yadda. (I have my own vague suspicions about some of this being rooted in the gendered history of nursing, but that is for another thread and another glass of wine.) Excuse the rambling of a tipsy RN in the corner and carry on with the discussion. *waves hands*

I'm with most of the other folks here. I take report, go see my patients and say: "Howdy, I'm LouBean, I'm going to be your nurse today, let me write my name up on the board so we can both remember it. How are you feeling? Are you hurting anywhere? CP/SOA/N/V/D? Can you locate the call light on your bed for me? Okay, let's see if that works. Great. Do you have any questions or concerns you want to address today?" It takes literally 2 minutes for even the chattiest of patients, and lets me eyeball everyone toute suite, before the day goes to ****.

*waves* I just graduated from Bellarmine (in Louisville, KY) from their 12-month accelerated BSN for second-degree students. I will copy and paste what I wrote to another poster on here a couple days ago. They had a couple specific questions that I answered, but this might be helpful: Hello! I just graduated a month ago from Bellarmine's accel program. The requirements aren't that unreasonable (Admission Requirements) and the impression I got in the admissions process was that if you met the requirements, you were pretty much in. That being said... yes, a LOT of people dropped out in the beginning. Folks realize pretty quickly if they're not a good fit for the program. It moves fast, requires the commitment of a full-time job (plus some!), and it is pretty rigorous academically -- just because it's accelerated doesn't mean they skimp on material! The best way to prepare for that first couple weeks? Honestly? You just really have to figure out if you can really commit to the program and put your life on hold for a year. You absolutely need a support system -- if you have to live with your parents, do it. Most of the folks who dropped out were just not in a good place to be able to focus on school. As for the cost, they don't do any scholarships. You're stuck with loans. And if you want to work as a nursing aide somewhere PRN, you can, just know that you probably won't be doing more than one shift every couple of weeks. In other words, you are probably not going to be able to work enough to get you anything more than pocket money. All in all, I really am grateful for this program. I found some really amazing friends that I wouldn't trade for anything. I had some great professors (had some real duds too, but you just have to suck it up in those classes). The program prepares you very well for the NCLEX (no one from my cohort has failed yet, at least) and the hospitals here LOVE Bellarmine accel grads -- nearly every single accel student I graduated with had a job offer before graduation. Those that didn't were applying out of state. Hope that helps. Any other questions, let me know.

Hello! I just graduated a month ago from Bellarmine's accel program. The requirements aren't that unreasonable (Admission Requirements) and the impression I got in the admissions process was that if you met the requirements, you were pretty much in. That being said... yes, a LOT of people dropped out in the beginning. Folks realize pretty quickly if they're not a good fit for the program. It moves fast, requires the commitment of a full-time job (plus some!), and it is pretty rigorous academically -- just because it's accelerated doesn't mean they skimp on material! The best way to prepare for that first couple weeks? Honestly? You just really have to figure out if you can really commit to the program and put your life on hold for a year. You absolutely need a support system -- if you have to live with your parents, do it. Most of the folks who dropped out were just not in a good place to be able to focus on school. As for the cost, they don't do any scholarships. You're stuck with loans. And if you want to work as a nursing aide somewhere PRN, you can, just know that you probably won't be doing more than one shift every couple of weeks. In other words, you are probably not going to be able to work enough to get you anything more than pocket money. All in all, I really am grateful for this program. I found some really amazing friends that I wouldn't trade for anything. I had some great professors (had some real duds too, but you just have to suck it up in those classes). The program prepares you very well for the NCLEX (no one from my cohort has failed yet, at least) and the hospitals here LOVE Bellarmine accel grads -- nearly every single accel student I graduated with had a job offer before graduation. Those that didn't were applying out of state. Hope that helps. Any other questions, let me know.

I have not started my position at the VA yet (three weeks away ), however, I would encourage you to contact a nurse recruiter and ask about shadowing opportunities. From what I have gathered (both from peers and from posts on this forum) VA hospitals *really* vary from location to location; it might be wise just to see for yourself what the hospital near you is like. The culture at the hospital near me is what attracted me in the first place -- I couldn't walk down a hallway or ride an elevator without hearing a cheery hello. I was also impressed by the telemetry unit I shadowed on -- the patients were lovely, the nurses were excellent, and everyone seemed to *want* to be there. I also saw nurses and other members of healthcare team (social workers, PT, etc) really working their butts off to connect veterans to the services they needed. Some of the downsides seem to be some of "extras" that aren't quite up to par with the private sector -- like the equipment (the pumps on this unit were... vintage), charting system (I got a headache just watching my nurse patiently click through all the tiny little boxes), and cafeteria (motivation to bring my own lunch, for sure). The most common complaint from the nurses I talked to on the unit was about the snail's pace of the federal government -- it does seem difficult to effect change. By reading the forums on here, it seems that others have complained about the difficulties in the boarding process, the bad apples in management, and the hoops to jump through in order to earn a higher grade. With regards to being a civilian -- I also lack military experience. This did not seem to put me at a disadvantage during the hiring process, but I do anticipate a learning curve while on the job. For example, while waiting for my pre-employment physical I spotted a brochure that was for OIF/OEF/OND veterans. Now, maybe I'm just a dum-dum, but I had to google those acronyms (Operation Iraqi Freedom, Enduring Freedom, and New Dawn). I imagine that's not the last time I will have to google something... Anyways, hope that helps.

I had a wonderful instructor for critical care. In my final clinical eval, she looked me right in the eyes and told me I was going to be a "safe nurse". Maybe that sounds like a weird thing to say, but it was so reassuring and it was said with such confidence that I almost cried!