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NurseNelly24

NurseNelly24 BSN

ER, Tele/Medsurg, Ambulatory PACU
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NurseNelly24 has 7 years experience as a BSN and specializes in ER, Tele/Medsurg, Ambulatory PACU.

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NurseNelly24's Latest Activity

  1. NurseNelly24

    FNP-CRNA

    To answer your question and allude to the sentiment of the other commenters, you absolutely do need BEDSIDE RN experience in order to qualify for any CRNA programs. By reading your 1st post, I’m assuming that you’re wondering if your EVENTUAL(since you don’t have it yet) FNP experience will suffice as qualifiable experience? It won’t. 1. You’ll only qualify for NP positions in primary care/outpatient areas (the most acute would probably be the ER) 2. It still doesn’t expose you to the hemodynamics, med management of vasosctive/sedatives, and the overall skill set required to care for critically ill patients. So if you’re considering CRNA, you’ll have to start from scratch with ICU RN experience, and sacrifice becoming an expert in the area you we’re educated in (NP in primary/outpatient practice). If you decide just stick with FNP, you’re losing the opportunity to be a competent ICU nurse. Either way to be a novice—> expert in BOTH areas is very rare and a waste of time to some capacity. Not your fault, but I think this is the flaw of many Direct Entry program-NP pathways. Students are only exposed to one “type” of track that they’ve decided is their “desired area”, until you graduate and you’re either questioning your choice or dismayed by the track altogether. You should definitely do more research about CRNA before you dive in, because most people who apply to these programs have had their mind set to enter this area years before, and have put in the work necessary to pursue it.
  2. NurseNelly24

    Which NP Program would you choose?

    Thank you for your insight! I have quite a few NPs who I know I can precept with. However I’ve also—especially because of COVID—became wary of the stories of students whose clinicals were delayed or cancelled because they couldn’t find a preceptor; which I’m trying to avoid as much as possible. Also, having vetted preceptors I think makes a huge difference in the overall quality of a program.
  3. NurseNelly24

    Which NP Program would you choose?

    Thank you for the compliment! And yes I’ve been doing a ton of research to narrow down my choices. I appreciate it!
  4. NurseNelly24

    Which NP Program would you choose?

    Thank you for your insight! And I agree a solid education is worth sacrificing work/life balance.
  5. NurseNelly24

    Which NP Program would you choose?

    Thank you for your insight!
  6. NurseNelly24

    Which NP program would you choose?

    Hi,  So I’m actively applying to schools to pursue a career as an ACNP. A little background, I have years of ER/trauma experience and I’m currently in the ICU as well; married, 5 month old baby, and supportive parents..    The 3 programs I’ve chosen to apply have pros/cons, but I’m at a crossroads at which one should be my “#1” choice or sounds like the best program. My plan is to attend Fall 2021. Some insight will be greatly appreciated!   Not in any particular order, School #1 B&M, meeting once or twice weekly 3 years PT runs concurrently (Fa, Sp, Sum) Clinical Hours: 840 (4 clinical rotation courses) Pros: 1. Schools sets up clinicals 2. Patho class and clinical immersion skills involves use of cadever  3. Faculty consist of NPs and MDs 4. Possible full tuition payment if you’re full-time or part time with the health system for 1 year (which I’m not but can be)  Cons  1. Commute 1+ hr and I live in the northeast 2. Clinicals are only assigned in school’s affiliated health system, wouldn’t be able to do clinicals in my home residence. 3. School is expensive (probably will spend about 60k by the end even with my jobs tuition reimbursement) -More difficult to have a work/life balance SCHOOL #2 Former B&M transitioned to fully online (asynchronous) 3-3.5 years, PT OR FT (not concurrent) Clinical Hours: 720 (240hrs per semester) Pros: -Reputable school, has one of the oldest of the 3 acnp programs that exist in the state. -School is much cheaper than school #1 (925/pc with no additional fees) -Ability to do travel nursing while in school to pay my tuition and home bills (can probably leave school debt free) -Online would provide a better work/life balance Cons: -This is the first time the program will be fully online, concerned for bumps on the road. -They no longer guarantee clinical placements, basically states on the website that you must find your own. -Only 3 clinical immersions throughout the program (is that enough to feel confident in your skills?) -Are fully online programs sufficient for the ACNP track? I’m NOT against it, I just want to know if it is enough to suffice the learning curves that exist with going from RN —> NP  SCHOOL #3  -Hybrid, online (synchronous/asynchronous), and in later semesters class meets 1-2/week -3-6(???) years PT or FT -Clinical Hours: 540 (180/per semester) Pros: -My alma mater; well acclimated with faculty and professors. -I like that there is a synchronous online portion (doesn’t feel like I’m just teaching myself) -Tuition is cheapest of all 3 (600+/pc, can easily pay my way through school, debt free) -School will help you in finding clinical placement, but not all placements are guaranteed. -Short commute to in-person classes (30-45 min)   Cons --This will be the FIRST cohort for the ACNP program (they have 2 existing NP programs ); concerned if there will be bumps on the road for it being a “new” track. -Requires the least amount of clinical hours for all 3.  -if the school accredited but the program track is new, is considered accredited? -Also only includes 3 lab intensives for clinical immersions. Sorry in advance that this is kind of long. Any advice would be appreciated because choosing a school has become more difficult that I anticipated. Please feel free to PM me as well. Thanks a lot!   
  7. NurseNelly24

    Which NP Program would you choose?

    So I’m actively applying to schools to pursue a career as an ACNP. A little background, I have years of ER/trauma experience and I’m currently in the ICU as well; married, 5 month old baby, and supportive parents.. The 3 programs I’ve chosen to apply have pros/cons, but I’m at a crossroads at which one should be my “#1” choice or sounds like the best program. My plan is to attend Fall 2021. Some insight will be greatly appreciated! Not in any particular order, School #1 B&M, meeting once or twice weekly 3 years PT runs concurrently (Fa, Sp, Sum) Clinical Hours: 840 (4 clinical rotation courses) Pros: 1. Schools sets up clinicals 2. Patho class and clinical immersion skills involves use of cadever 3. Faculty consist of NPs and MDs 4. Possible full tuition payment if you’re full-time or part time with the health system for 1 year (which I’m not but can be) Cons 1. Commute 1+ hr and I live in the northeast 2. Clinicals are only assigned in school’s affiliated health system, wouldn’t be able to do clinicals in my home residence. 3. School is expensive (probably will spend about 60k by the end even with my jobs tuition reimbursement) 4. More difficult to have a work/life balance SCHOOL #2 Former B&M transitioned to fully online (asynchronous) 3-3.5 years, PT OR FT (not concurrent) Clinical Hours: 720 (240hrs per semester) Pros: 1. Reputable school, has one of the oldest of the 3 acnp programs that exist in the state. 2. School is much cheaper than school #1 (925/pc with no additional fees) 3. Ability to do travel nursing while in school to pay my tuition and home bills (can probably leave school debt free) 4. Online would provide a better work/life balance Cons: 1. This is the first time the program will be fully online, concerned for bumps on the road. 2. They no longer guarantee clinical placements, basically states on the website that you must find your own. 3. Only 3 clinical immersions throughout the program (is that enough to feel confident in your skills?) 4. Are fully online programs sufficient for the ACNP track? I’m NOT against it, I just want to know if it is enough to suffice the learning curves that exist with going from RN —> NP SCHOOL #3 1. Hybrid, online (synchronous/asynchronous), and in later semesters class meets 1-2/week 2. 3-6(???) years PT or FT 3. Clinical Hours: 540 (180/per semester) Pros: 1. My alma mater; well acclimated with faculty and professors. 2. I like that there is a synchronous online portion (doesn’t feel like I’m just teaching myself) 3. Tuition is cheapest of all 3 (600+/pc, can easily pay my way through school, debt free) 4. School will help you in finding clinical placement, but not all placements are guaranteed. 5. Short commute to in-person classes (30-45 min) Cons 1. This will be the FIRST cohort for the ACNP program (they have 2 existing NP programs ); concerned if there will be bumps on the road for it being a “new” track. 2. Requires the least amount of clinical hours for all 3. 3. if the school accredited but the program track is new, is considered accredited? 4. Also only includes 3 lab intensives for clinical immersions. Sorry in advance that this is kind of long. Any advice would be appreciated because choosing a school has become more difficult that I anticipated. Please feel free to PM me as well. Thanks a lot!
  8. NurseNelly24

    What is up with the level of entitlement?

    I fully agree!
  9. NurseNelly24

    Covering 1:1’s in the ER

    Agreed. I’ve noticed over the years that management, out of the entire “web” are the ones that are least likely to take risks and make changes for improvement the unit. You could hit them with hard-core evidence, and they’ll still find a way to limit resources. The staff nurses will have tons of ideas to improve the unit (many of which are evidenced-based) and they are either never executed or watered down to meet budget requirements or because they’d straight up don’t care.
  10. NurseNelly24

    Covering 1:1’s in the ER

    This sounds like something you def want to approach management about. Is there a committee within your unit to discuss some of the problems with staffing and behavioral health pts? Just something to consider. But as far as advice, here’s a few things to consider: -The layout of your ED: Is there an area/room section where psych pts can be cohorted instead of being placed in random spots in the hallway or rooms? At one of the EDs I worked at, whenever there was an overflow of psych, patients, we opened up our “D” section in the back of unit so that they were all placed/or transferred to that area. This was especially beneficial when we closed off certain parts of the unit at 3am, we would keep that area open exclusively for psych patients. -Piggybacking from the first point, if you have that pop. placed in one spot, it will be better for you to utilize your techs. At my hospital, we have 1:1 for our actively SI/HI who any form of destructive behaviors in the ED. Other patients who are depressed, psychotic, etc. but calm, cooperative for the most part would be placed on a “Line of sight” observation. This means that you’re constantly observing the patient, doing q15 min checks, but we do not have to be side by side with them (e.g. observing them at the nurses station as opposed to the bedside) This allows techs/nurses to observe more than one patient; and this would probably prove benefecial if you have a patient who was chemically sedated. -Another point: Do your restrained patients still need to be in restraints? I know hospital dictates how long a patient can be in 4 locks, but I’ve had situations where I took over for a nurse who was taking care of an initially combative patient, was given ATI/Haldol combo, restrained, and then kept in restraints for hours despite them being pretty much asleep the entire time. When asked, the nurse had no rationale. If your patient is in 4- points restraints but obviously sedated, you’re wasting a resource by having that patient as a 1:1. I’d say unless, they were failed attempts at calming the patient despite meds/restraints, a patient shouldn’t be in restraints for more than one hour. -Utilization of Psych nurses to cover in ED: this can be a future convo for your mgmt team, but utilizing psych nurses can be a big win on your department’s end. For one, they’re better at managing psych patients than us ER nurses do, and they are able to address some of their needs, while we take care of our medical pts. Remember why some of these patients get agitated: they spend hours on a stretcher, sometimes no TV, phone, or their belongings, waiting hours to be evaluated by a psych doc, unfamiliar environment, eating cold sandwiches, not on their home meds, etc. Having psych nurses in the ED as a resource to address some of those issues can help with can take a load off for the nurses and techs. -Collaborating with nurses, techs, management and physicians to create a possible algorithm for evaluating which patients require a 1:1 can also be a future project. This way the process is cohesive and consistent on all days during all shifts. Hope this helps!
  11. NurseNelly24

    Hofstra 2021 CRNA

    I attended the Virtual Open House last week and here’s a few highlights I was able to grasp from the session (btw it was informative, and Dr. Greco seems extremely kind, welcoming, and passionate about this program). -The Purpose of the combined CRNA/ACNP program is to expand the advanced practice nurse role so that he/she is able to utilize their skills and knowledge set in various areas of the surgical setting (pre, intraop, and postop). NY currently has many restrictive practices on advanced practice, and depending on where you work, CRNAs/ACNPs have limitations on what they can and cannot do; with this program being the first of its kind, the goal is to address those limitations. -Experience: two years of full time critical care experience in at LEAST the last two years. He stressed heavily on what is acceptable Critical care experience: MICU, SICU, CCU, CTICU, Neuro ICU and also PICU. Unfortunately, ER, Stepdown(whether it be Cardiac, trauma, etc.) Medsurg, NICU, OR, are not considered acceptable specialties for the program. There may be exceptions for PACU, or if you’ve had critical care experience in the past and currently work in another role (I.e. Nurse leader) but basically ICU nurses will be the highly preferred candidates. Also part of the admission requirement is to be CCRN certified, so that’s probably another way to ensure nurses with critical care experience are the status quo for the program. GPA: He had a very lighthearted take on the GPA requirement (3.0 or higher) by mentioning how many of us probably didn’t do well in our undergrad years because we were probably partying a lot LOL. He said that if your GPA wasn’t the best, it would be in your best interest to retake some courses (Chemistry, Organic Chem, A&P, Micro) to show that you’re interested in being a proactive learner and are prepared for the rigor of the program. -Program Length/Clinical Hours: The program is full time and runs concurrently in Fall, Spring and Summer. All students complete ~2900 clinical hours. 2500 for the CRNA Portion and I believe about ~400 for the ACNP role. Dr. Greco emphasized the INABILITY to work full time or part time during the program. He states that with practicum and didactic classes it will be very difficult due to the program commitment. Clinical Experience: Dr. Greco highlighted the structure of clinical practicum in the different anesthesia specialties. Since the program is affiliated with Northwell, all clinicals would be assigned at Northwell hospitals around LI, NYC, and Staten Island. He stated that in most instances, he’ll consider a student’s home location when placing them in clinical, but to ensure students receive a well-rounded experience they may have to travel . My take on it was, while he make some accommodations, expect to travel far at some point during the program. LOL Admissions: I forgot he mentioned a specific deadline, but there will be 20 seats for the Fall 2021 cohort. Applications will be on a rolling admissions basis and done through NursingCAS (all that info is on the school website) Selected candidates will go through and interview conducted by either Hofstra faculty or Dr. Greco. Professionalism: He stressed heavily on selecting nurses who were continued learners in their current role and have proven interest in the area of anesthesia. It seems like he wants individuals who are up-to-date on current issues in critical care and anesthesiology, active in hospital committees or organizations, etc. He wants you to be committed to learning the role of the CRNA by shadowing, becoming familiar with the Anesthesia’s role in intubation (supplies, technique, special considerations), being proficient in IV skills, understanding the different dysrhythmias and their interventions, etc.; basically he wants to ensure you are acclimating yourself to the duties and responsibilities of the advanced practice role even before you apply. Most importantly, I think the biggest takeaway is that Dr. Greco is looking for flexibility. Since this will be a new program at Hofstra, and a new type of program in general, there may be bumps on the road that will occur along the way. IMHO, it seems like he is willing to address all those issues as promptly as possible. Being that he was faculty at Columbia U’s CRNA program, served on CRNA organizations, and his passion Nurse Anesthesia, I think he’ll have a great gasp on leading the program in an exponential way. I wouldn’t be able to apply until Fall 2022 but for those of you considering the Fall 2021 cohort I would definitely tell you go for it. It seems like a great deal of commitment but in the end being dual certified as an ACNP and CRNA will give you an edge amongst CRNAs from other programs. Good luck!
  12. NurseNelly24

    New grad from online RN program with ZERO CLINICAL EXPERIENCE

    Exactly, COVID has only been prevalent for approximately one year. It wasn’t until March, that we started seriously wearing masks and taking precautions. So my question is what were they doing before then? Definitely scary.
  13. It’s hard to say what will happen when the current administration is refusing to concede, and therefore delaying the process of transition for the new administration. In previous Presidential elections, the old administration would meet with the new one to discuss and address current issues, but it seems like that won’t happen, despite COVID killing thousands of people every day. Apparently Biden has already developed a task force of medical professionals to address the virus come January, but plans can only be discussed and NOT instated unless there is some sort of peaceful transition. Who knows how heavily COVID will attack after the holidays? It’s pretty shameful and only does a disservice to the citizens of this country.
  14. NurseNelly24

    Is ICU worth the stress?

    It’s worth trying if you really want to explore it and see what it’s really about. If you have a good relationship with your current employer you can either 1) go per diem so you maintain your status as an employee or 2) if you work at the ICU and realize it’s not for you, you can always go back. The ICU, depending on where you work, can have its exciting moments, but it’s still high level of stress and can often be overwhelming if bedside nursing isn’t your thing. Even when I do have mentally challenging/stimulating experiences at work, it’s still a job LOL. There is definitely boring/task-oriented/ every job, no matter how sophisticated the unit/specialty is.
  15. NurseNelly24

    Johns Hopkins vs Yale vs MGH IHP - Which is better for DNP?

    I don’t go to either school, but I’ve heard great things about Yale. While the hospital (Yale-New Haven) is not officially affiliated with the school, I’ve heard great things about clinical placement, faculty, and the structure of the program overall. Just be mindful that if you’re going for NP, only the Masters is offered at this time (per Yale’s website). They do have a DNP program, but it looks like it’s more centered towards organizational leadership. John Hopkins and MGH I believe out of the three places, has a straight BSN-DNP program.
  16. NurseNelly24

    Hofstra 2021 CRNA

    Hey! Hofstra has a pretty strong ACNP program, so I see good things with this combined DNP program. The only thing I’m curious is what is the goal of the combined degree. Is there a demand? Is it to enhance the role in the surgical setting? The ACNP and CRNA are very unique roles so I’m wondering if it’s to make advance practice nurses perform in pre/post and intraop care. I asked in an FB group the other day to see if there are any people who are both an NP and CRNA, but no one seemed to be. Theyre having a webinar on December 12th to answer any questions so I’m interested to hear more info.