nurse7502

I'm considering a career in public health nursing and I've been searching the internet for a job description. I've seen that public health nurses do various things such as educating the public and working on disease control and prevention. But I wanted to get a better sense from everyone on here as to what a public health nurse does. Is anyone on here a public health nurse and can comment on what their job is like?

I graduated from an Adult/Gerontology primary care nurse practitioner program 1.5 years ago with a 3.73 GPA. I've been in an adult primary care residency for the past several months and while people say I've done well, I've feel like I've really been struggling. I was selected by my residency to train for a permanent position in urgent care, which I've been training in for the past 5 months. The urgent care is located within the ER of a hospital. However, I find myself really struggling to keep up with the pace of the urgent care/ER work and get all my work done. I feel as though urgent care is too fast-paced for me. So, I'm looking for another work setting that might be more manageable. I know that no nurse practitioner job is going to be very slow-paced or easy, but are there specialties that might be somewhat slower or more manageable? I've researched dermatology and cosmetics, and people have thought that I would be great in that setting. Does anyone have any suggestions?

Thank you for the reply db2xs. My question is... what were the last 3 classes like in the program? They would be AGPCNP 1, 2, and 3. Those are the classes I'll be taking (except mine will be FNP 1, 2, and 3). Those seem like the big in-depth classes and I worry about managing courses in that class. Were you working an RN job (and were you doing night shift) or are you already a nurse practitioner in another specialty?

Hi everyone, I'm applying to the GW FNP post-masters certificate program. I'm finishing my MSN AGPCNP program next month. However, I realized that Primary Care isn't for me, I prefer episodic complaints and more focused assessments. I had a rotation through Urgent Care and LOVED IT, but they said you'll need to be a FNP to do that. So, the only post-masters FNP program that I could find that is specifically designed for NP's in other specialties was GW. However, there may be similar programs for other NP's wanting to bridge to FNP, but I just haven't found any other programs. I have a 3.7 GPA in my MSN program and I'm Sigma Theta Tau. My MSN program is a top-tier school (Johns Hopkins). Is that competitive for the GW program? Does anyone know what the courses are like at GW? They said I'll only need to take FNP I, FNP II, and FNP III which I know are big courses. What's the workload looking like? Should I expect clinical write-ups and discussion boards like my MSN program, or something else? My patho, pharm, and health assessment they said will transfer. I've worked at my RN job on a PRN schedule throughout my MSN program, but would like to work 1-2 days a week as an AGPCNP throughout the FNP program. I know I'll need to dedicate 2-3 days a week to clinicals with a preceptor. If anyone can help, I'd greatly appreciate it.

Thanks for your reply. If I get a PNP certificate, can I then sit for the FNP boards? Do you know of any online PNP certificate programs?

Hi everyone, I wanted to get everyone's opinion. I'm graduating in December 2017 from an AGPCNP (Adult/gerontology primary care nurse practitioner) program. While I have been grateful for my education, I realize that this isn't what I want to do anymore. This past summer, I had an amazing rotation through an Adult urgent care center. There, I worked with adult patients and learned to treat acute problems such as Viral URI, gastroenteritis, abscesses, etc. I loved it! It seemed manageable to me to be performing highly-focused assessments on acute problem(s), despite the fact that the patient volume was higher and the setting is very fast paced. I also loved the procedures like suturing and draining abscesses. In the primary care setting I worked in, I learned that providers are supposed to address all chronic and acute issues the patient presents with in that office visit, and I don't like chronic management. I definitely like the style of urgent care better than primary care. Sadly, I'm now looking at jobs for Urgent care, and none of the jobs hire AGPCNP's. They all require providers to be FNP's so that they can treat patients of all ages. While I've never worked with Pediatrics as a nurse, I've had pediatric patients in my volunteer EMS work, and I've done well as a provider working with them in that setting. So, I have looked into an FNP post-master's certificate program from another university that I would start after I finish my current program in December. It's specifically designed for NP's in other specialties (women's, adult, peds, etc.) who want to become an FNP. My question to you all... how hard is it to bridge from AGPCNP to FNP? The program I'm looking at is three classes total - 1 class per semester, which I'm hoping to manage with a part-time job while in school. Has anyone ever been an AGPCNP and gone back to school to become an FNP? How do you manage clinical and your job? Can you give examples of other post-master's certificate programs that allow you to do this?

I am graduating from an AGPCNP program in December 2017. However, I've realized in my clinical rotations that I don't think primary care is for me. It requires a lot of administrative work in addition to the practice of healthcare. One of my clinicals right now is with an inpatient patient management service at an acute-care community hospital and I love it! I love going around to the different units... general medicine, psych, telemetry, etc and helping people with their pain. Sadly, as a future AGPCNP I don't think they would hire me in that setting since I'm primary care. My other clinical is in a primary care HIV clinic and I find it rather monotonous. Most patients are taking their medication as prescribed and are stable with their viral load, but have several other co-morbidities which can get complicated, yet I find it boring because there's not a lot of hands-on stuff. I imagine though not all primary care is like that. I realized this week that I'm someone that likes to do more focused care on individual problems such as pain, neuro, etc. rather than focus on general care. I'm better at seeing "the trees" but not "the forest" if that makes sense. I have current experience working as a volunteer EMT-IV (EMT-B who also does IV skills). I like dealing with acute illnesses and focusing on what's going on right now with the patient. Working in an ED might be overwhelming especially for someone who's new, but I really like the idea of working in urgent care. You get everything from fractures to mild/moderate asthma attacks. You have the opportunity to work days and evenings and you're treating acute illness. It may be tough adjusting to the urgent care pace at first, but I can definitely do my best. But, urgent care typically hires FNPs because they work with patients of all ages. Here's what I want to do. I'm doing well in school (GPA is 3.52), so I figure why stop if you're doing so well? However, I'm now considering applying to an FNP post-master's certificate after I graduate from the AGPCNP program. It's specifically designed for NP's in other specialties who want to go for FNP. There's only 1 program in the USA that is accredited in my state. It's online and you get placed with a preceptor. It's 17 credits, I'm guessing that's a max of 2 semesters part-time, so I can work part-time as an AGPCNP while in school. Do urgent care centers typically hire new NPs? I imagine they'd be a great place to learn. I would need help learning things like suturing because I haven't learned that skill yet. Is It normal for people to be in NP school and want to change their direction? I feel like sometimes you don't realize where you fit in until after you start school.

Hi everyone. I work on a sub-acute rehab floor in a LTC facility on evening shift. I am a new grad and have been working there for 4 months. It is my first RN job. When there are days in which I have an admission, I get quite frustrated. Here is a checklist I made of all of the steps in the admission process I have to do: [TABLE=width: 655] [TR] [TD]General Assessment - [/TD] [/TR] [TR] [TD]Pain or PAINAD Assessment [/TD] [/TR] [TR] [TD]Urinary Incontinence Assessment (If Urinary Incontinence Present or Urinary Catheter in Place) [/TD] [/TR] [TR] [TD]Psychotropic Medication Assessment (If Patient is Taking Psychotropic medication) [/TD] [/TR] [TR] [TD]PUSH Tool (If Pressure Ulcer Present) [/TD] [/TR] [TR] [TD]Skin Sheets (If Skin Alteration) Also Include Dry Skin, Bruises, Surgical Scars [/TD] [/TR] [TR] [TD]Tasks for GNAs [/TD] [/TR] [TR] [TD]Immunizations Records – Includes Immunization Packet and Data Entry into Immunizations section of Electronic Health Record [/TD] [/TR] [TR] [TD]Admission Note [/TD] [/TR] [TR] [TD]Inventory Sheet [/TD] [/TR] [TR] [TD]Weight [/TD] [/TR] [TR] [TD]Vital Signs [/TD] [/TR] [TR] [TD]Physicians Orders – Medications, Skin treatments, Oxygen, Immunizations, Diet, and Advance Directive [/TD] [/TR] [TR] [TD]Care Plan- Include ADLs, Pain, Skin, Falls, Monitoring [/TD] [/TR] [TR] [TD]Labs if Ordered [/TD] [/TR] [/TABLE] What's sad is that all of these steps have to be completed on my own. My supervisor (who usually sits around and does nothing) refuses to help put orders into the computer or help complete the care plan. In addition, it's really hard when admissions come late like at 8pm when I'm starting my 9pm med pass. I often stay several hours past 11pm (when my shift "officially" ends) to finish admissions and charting on all my other patients. My questions to you all is this: Do admissions at your facility/hospital have the same number of steps as mine? Do you get any help with your admissions? How long do admissions usually take you? For those that work in hospitals, what are hospital admissions like? My supervisor said you're supposed to spend no more than 2 hours on admission, but I definitely have to spend more time than that because perhaps I'm slower as a new grad. Do you have any suggestions for a new grad like me for making the admission process go smoother? Thanks for your help!

Hi everyone, I wanted to ask about how everyone has found their niche in nursing. I'm still a new grad a I haven't really found where I want to be yet. I used to work as a CNA in inpatient psychiatry, which I liked, but I couldn't see myself as a psychiatric nurse. I graduated nursing school in June this year. I currently don't like the job I have, which is my first RN job. I work in a sub-acute rehab. It's hard balancing 12-16 patients at once with their IVs, meds, TPNs, wounds, and tube feeds, plus often doing an admission on top of that. I love doing the actual care, but it's difficult with so many patients. I also don't like working 5 days a week on evening shift. My shift technically is 3-11, but me and my co-workers stay often several hours later to finish up charting and admissions. We're not allowed to pass on any work to night shift unfortunately. I also don't feel a lot of support from the other staff I work with. And there's definitely no support from management. There's been a lot of turnover at my work since I started working there in July. I would definitely prefer a 12 hour shift schedule, day shift preferably. I'm also a licensed EMT. But, I'm still relatively new to that as well. I just got my license a couple months ago and recently started riding-along with the more experienced EMTs at my volunteer fire department. They love having an RN ride with them because I bring a diverse array of skills to the team! They let me participate in the assessments and take the vital signs. I LOVE working at the fire department and wish I could be with my EMS crew more often. I have no problem moving quickly with decisions/clinical judgment with this type of patient care only because it is a limited scope of practice and there are super specific protocols and flowcharts that dictate care. Nursing isn't as clear cut unfortunately. I know only I can truly know where I belong as a nurse, but I ask for your help. Given the fact that I like EMT work, you probably would think I would like ER nursing. I'd like to think I would like it as well, but I'm worried it would not be a good fit at this time given the fact this I have limited nursing experience. In addition, I am not by any means a nurse that moves at lightning speed like an ER nurse does. As I'm still new, I move at a much slower speed. I plan on going back for my NP in less than a year or maybe a couple years. The NP program I'm applying to doesn't require any acute care experience, but I'm guessing everyone will say it's better to have acute care experience before you go for your NP. I'm waiting to hear back from an interview I had for a neuroscience floor in a hospital. The same hospital wants me to interview for other positions there including their Ambulatory Surgery Center. I'm also going to be interviewing for an Emergency Department at another hospital... but not sure if that's for me. Lastly, I'm waiting to hear back from an urgent care center. My conclusion is that I should try to find a job on the Med/Surg floor. I should probably brace myself for an even higher stress level on that type of floor. But what do you guys think?

Hi everyone, I am a new grad RN who since July has worked in a post-acute rehab setting. Next week, I am interviewing for a job in urgent care. Not sure if all urgent cares are the same, but this urgent care center has a wide scope of practice. It's almost like a fast track ER. Here is what they treat: Allergic Reaction Possible fracture Cough Cut or scrape Ear or sinus pain Eye swelling, irritation, redness or pain Fever, cold, flu Frequent and painful urination Mild to moderate asthma attack Nausea, vomiting, diarrhea Rash Sore throat Sprain, strain, fractures Stitches Tetorifice and flu vaccinations They do X-Rays, Lab tests, and prescriptions on site They also give IV meds In addition to having a BSN and working in post-acute rehab, I am an EMT-B that rides with a volunteer fire department. So, I've seen patients with a high level of acuity. My question to you all is this... What is working in an urgent care setting like? Do nurses have a high rate of satisfaction from working in urgent care? Is urgent care a good setting for a nurse like me with limited experience? I'm used to working under stress and having a high volume of patients... I currently manage 15 patients a shift with all of their IVs, tube feeds, TPN, etc. Is working in an urgent care center a good way to get experience to work in a hospital in an ER or Med-Surg floor (that's my ultimate career goal)? I would greatly appreciate everyone's input.

I do stay later. Usually it's only a 1/2 hour or 1 hour later so that I can get all of my charting done. But when it's time for shift change all of my medications and wound dressings are done so I'm ready to hand over the keys to the med/treatment cart to the oncoming nurse

Thanks xobritney24! I glad to know the fact that another new grad is going through the same thing I am. Do you hope to stay in rehab or do you want to eventually transfer to a hospital? Do hospitals have the same issues with lots of patients and overworked nurses? Also, are you ever able to get out of work on time at your current job, or do you have to stay for overtime often at work?

Hi everyone, I wanted to brief you on my situation and see if you had any suggestions as to how to handle it. I graduated with my BSN in June 2015 and started working in a skilled nursing/rehab facility 7 weeks ago. For the past 7 weeks, up until today, I had been on orientation. I spent almost the entire orientation on the rehab floor where I learned how to do wound dressings, give meds, and start IVs and TPN. I was able to learn all of the skills I needed, but it was hard to keep up the pace of the floor. I only oriented to each skilled nursing floors 1 day each (there are 2 in our building). Today was my first day off orientation, and surprisingly they put me on a long term care floor! I had 26 patients for my shift and each had to get multiple medications at multiple times during the day not to mention the treatments I had to do for each patient. That's quite a lot of patients if you ask me. But I imagine it's the norm for the skilled nursing/rehab industry. So, I was unsuccessful in giving the 9am medications even though I tried really hard. This was the 2nd time ever working with these patients so I'm not familiar with them or their meds. I couldn't finish in the 2 hour window (8am-10am) and many of the medications I was looking for weren't in the patients' drawer in my med cart. Talk about frustrating. I had to go search for their meds in other patient's drawers to see if they had the matching drug and dosage (which I imagine you're not supposed to do, but everyone does it where I work). Searching for medications I can't find takes forever! Many meds had to be crushed and given in applesauce, which takes time. Some had to be given through a G Tube which also takes time. I was so fortunate that I had a wonderful charge nurse who was able to help me finish the med assignment. The other floor nurse on the skilled nursing floor I work on told me that I shouldn't be ashamed of myself for needing help with my assignment. After all, it was only my 2nd day on the floor. She said that the first couple of times she was by herself she wanted to cry. But, she said, as time went on she got faster! And she said I will too. My question to you all is that are all new grads going to work at a slower pace than everyone else? Time is a huge factor in getting my assignment done in a facility like mine where the staffing ratios are very poor in my opinion. I don't know how I'm going to be able to relax and do my job knowing that I feel like I'm in a race against time during my shift. I felt during the day that I was going to have to resign because I'm not doing my job fast enough. But, my director of nursing didn't even approach me about my meds being late, so I guess I'm ok. As for now, I'm going to pick myself back up and try again tomorrow! I will probably be frustrated at times, but you just have to work through it I guess. Did anyone else on here have trouble managing their time as a new grad? I feel like my time management skills are going to hurt me, despite the fact that I'm always on task and never ever just sitting around being lazy.. To all the nurses that work in a hospital setting (which is different from long term care), are the staffing ratios also difficult where you work? Do you have trouble getting your work done on time in a hospital setting as well? I hope to work in a hospital in 6 months when the new grad residencies start again in my hometown (Baltimore, MD area), but I'm extremely nervous that if I can't get my work done in a long term care setting, I would definitely fail in a hospital. If anyone has any suggestions and words of wisdom, I would greatly appreciate it.

Hi everyone, I am graduating from nursing school with my BSN in June and will soon after that be taking the NCLEX. I then will be applying to new graduate nurse positions. However, I need your help with guidance on my specific situation. 1.5 years ago, while I was in my junior year of nursing school, I was diagnosed with bipolar disorder and suddenly had to be hospitalized. My classmates and nursing professors are completely unaware of my hospitalization or me being bipolar because my symptoms that warranted hospitalization occurred while I was at home. I also had take time off from school due to my illness. I have been completely stable for well over 1 year now without even the smallest mood disruption. I have also been completely stable since I returned to nursing school last fall for senior year, which has been quite stressful. My grades are good (I was even inducted into Sigma Theta Tau [The National Nursing Honors Society]). I graduate nursing school in June. Honestly, if you were to meet me (before or even after my diagnosis of bipolar disorder), you would not at all suspect I have the disorder. My personality is always calm and collected. I have never exhibited any risk taking or dangerous/criminal behaviors. My psychiatrist has told me that when I graduate nursing school, it will be absolutely contraindicated that I work night shift. He said that people with bipolar disorder have to keep a consistent sleep schedule. I will be more than able to work day shift, evening shift, and day/evening rotating. However, I will never be able to work night shift. The problem is that most of the new graduate RN jobs in my area (Baltimore, MD Metropolitan area) are Rotating shift jobs. I'm assuming that rotating shift includes night shift. How should I go about finding a job that fits my sleep schedule requirements? Is it okay to apply to a rotating shift jobs and then show the HR person (or nurse manager) that I have a documented disability that prevents me from working night shift? What are the laws behind that? Can they not refuse to hire me because of my disability even though my disability prevents me from performing one of the core functions of the job (working night shift). Please feel free to comment and give any advice that you may have. Also, if you know any recruiters or nurse managers in the Baltimore, MD area who may be able to give advice on this, please let me know.