ACNP2017

The problem is that fact that there is no standard acute care NP program and certifying body that encompasses the entire lifespan. lol I wish there was. Yes it would make the program longer but it would be worth it. FNPs are meant to be outpatient.

I went in this order ...hospitalist, medical ICU, pulm ICU, CV ICU, then a combo of heart/lung transplant ICU. I had 7 years experience in the ER as an RN, so I didn't feel the need for ER.

This is a little pet peeve of mine. Having FNPs evaluating ESI 2s and 3s in the ER (not fast track/thru care/urgent care) is not ideal. Im getting my post-masters FNP so my marketability is larger for ERs. I can't speak to all programs but mine had an in-person skills labs.

Good afternoon, There seems to be so many "types" of NP schools and certifications. I don't necessarily think that does a service to NPs. Im disappointed that my program did not have the opportunity or requirement for ortho or surgical rotations. By splitting up the NP programs into specialities - we are self limiting ourselves by requiring more education and board certifications if we ever desire to do other specialties. There probably does need SOME speciality education but not like we have now. WHNP, psych/mental health NPs and CRNAs are probably good as is. FNPs, Adult gero primary care NPs, pediatric primary care NP -> why not just primary care NP instead? I understand people not wanting to work with peds or whatever but still Adult gero acute care Np, pediatric acute care NP, emergency NP --> straight up Acute care NP works fine All DOs or MDs go to "medical school", not "acute care med school" or "primary care med school". Same with PAs! Then there all the different certifying bodies, ANCC, AANP, plus lots more I don't feel like looking up. I can understand where those are coming from who like the individual programs but I don't think that is the best for the future. This isn't meant to ruffle feathers, just to generate conversation. Im interested in hearing personal views.

UC without a doubt. Better experience and knowledge growth. Easier to transition into other NP roles. Those minute clinic Nps have a hard time finding work elsewhere generally.

One of the great things about NP's have been the RN experience they generally possess. I personally feel the bedside nursing experience is invaluable and sets us aside from PA's. Most NPs had to work during his or her schooling to support themselves. I don't care for the salty undertone of the OP. Just because one can, doesn't always mean they should.

What type NP are you? AGACNP Where (state)(rural/urban) do you practice? Fort Worth, Texas - suburban Are you independent or in a group? GROUP How many years experience? New Grad What is your before tax paycheck amount? 4000k/ pay Monthly or bi-weekly?Bi weekly Salary/hourly/other(explain)? Salary - was offered 98K/yr but neg to 105k/yr Avg hours on check? 80 What are the perks of your contract? (ie. PTO/vacation/bonuses) Multiple bonuses, full benefits, 401K with matching, tuition reimbursement ,1500 CME, DEA and malpractice paid - 7 on. 7 off scheduling

Any ER NPS??

Sweet. Thanks Is it EM docs or EM care?

Sorry for the delay. I have actually. I had an interview last week for a hospitalist position at one branch and another interview Tuesday for another hospitalist position at a second location. Im hoping for these position as they are 12 hour shifts.

Hello! I passed the ANCC AG/ACNP boards yesterday! Wohoo. Anyways, Im moving to DFW Texas at the end of the month. My husband is already employed down there. Being a new NP grad, I feel like none of the local hospital systems are willing to give me a chance. Being new to the area, I have no "contacts". Anyone have any recommendations? Much appreciated. Edit to add: Ideally, I would like to be hospital based. My RN experience is level 1 trauma/ER based. I would enjoy sticking to the ER however I would enjoy ICU work as well.

We draw ABG's all the time. We send them down to lab who processes it and posts the results just like any other blood work. I work at a stand alone ER - we also manage the vents until we get bed placement at main campus. We are RT. We do not have that much ancillary staff.

Hello. I currently work full time however I would like to change hospitals. My question is whether or not I should leave my grad school on my resume. I don't want the managers to assume I will leave them soon (I have at least two years left as an RN by the time I pass boards). However, school leaves my schedule restricted to work every Friday, Saturday, and Sunday for those two years (which I'm completely happy with). I'm sure they will inquire about my scheduling restrictions during the interview. I'm not sure how I could pull off the interview positively without telling them about school. i absolutely love the hospital I want to get into. Many of the current staff are former coworkers who more than likely know about my schooling. I'm not sure what to do. Please advise.

We don't have anyone to cover for our lunches. We have a payroll variance book we have to fill out - otherwise they automatically withdrawal those 30 min from our checks.

In our ER, we can use any PICC line that has confirmed placement and we have no difficulty getting blood return and easy flush. Then after we finish whatever we are doing - we flush with the appropriate heparin flush and place a new curos port protector.

I watched the video. Sorry, you're probably not going to get many accolades here. You lost me shortly after you stated the nurse "spewed BS" ...

I received my BSN thru Kent and now I'm in their MSN program. The professors are definitely hard - they like to weed out those who they dont feel fit. However, they make sure YOU KNOW YOUR STUFF. I have experienced quite a bit of sexism. If you are a man, some of the professors will "less hard" on you.

I have a coworker Im surprised got hired. She's loud, obnoxious, wears wrinkled scrubs that are too small for her, and has a constant odor of stale cigarettes. The amount and color of her make up makes her look like a clown. She just doesn't look like she takes care of herself. Her hair is long and greasy - Ive yet to see her hair kept back. There are just so many GOOD nurses out there who present themselves well ...why did they pick her?

Well, kinda related. When I was in orientation for the ER - a wise nurse told me ..."its their emergency, not yours - slow down and think"

Well, you're new. You only shadowed for 6 days - you are not going to know everything and you are not going to have great time management skills right away. Take incidences like the foley cath brusing and ask for additional education and guidance. Show the DON that you are interested in improving. They knew when they hired you this was your first CNA job. Please don't let other staff members bully you. Nicely but sternly make the cafeteria lady aware you are new and improving - thank her for the suggestions and just leave it at that. Same goes with the relieving CNA - don't let him/her bully you into making you feel inferior and guilting you into staying to help after the shift. I don't know you personally, but try to be confident in yourself. You don't have to be cocky about things - acknowledge things you don't know. You just need to know where and how to find the answer. Ive met new grads who come in sheepishly shy, quiet, and reserved. They became prime targets for the bullies. Honestly, those are the one who seem to quit. Last week I gave report to a newer (approx 1 yr) male RN ..I stayed a lil after to tidy up things. The floor RN came down to retrieve her patient - they were both inside room X giving bedside report and I hear "why didn't the er Dr doing anything about this ....why hasn't that been done, have you even attempted to call the admitting doctor?" - I wasn't even a part of it but It got my blood boiling - I went into the room and asked the floor nurse to come with me to the conference room. I let her know it was unacceptable behavior to interrogate a fellow nurse in front of the patient and family. She ended up apologizing to our male RN and the pt and family. All the while the male RN stays in the room in attempt to comfort and answer questions from the pt and family. The newer RN in question is the nicest, helpful, quietest, and non confrontation guy in our department. It made me livid to see another RN tear him to pieces. He later thanked me. He was "I was just shocked, I wasn't sure how to even respond to her especially in front of the patient". Kinda off topic but please don't let others walk on you. Be polite but consistent - stand up for yourself.

Well, I kinda feel lucky. I can't say I have too many complaints from our ancillary departments. In the ER, the two main departments we work with the most is radiology and housekeeping. Radiology most of the time will call our voceras and ask if the patient is ready for xray/ct/us. My biggest complaint with them is taking patient off wall o2 and using the portable o2 on the bed and then leaving the patient on the portable when they return the patient to the their room. I feel that is indicative of additional teaching on their part rather than pawning off their work onto us. Housekeeping is probably where I have the biggest complaints. We have 1 designated housekeeper per shift and they also seem impossible to find. Not all of them are like that though, there has been an increase in new staff. So perhaps its just not properly training rather than them intentionally not doing their work. Our housekeepers will NOT touch anything human waste - no matter the circumstance. Anything like used suction tubing or canisters, ambu bags, even urinals and emesis containers. I understand then not touching IV bags and tubing - thats fine - It'll take me 15 sec to get ride of those. Other than replacing the trash and floors - I don't think our housekeepers in the ER do much to the patient rooms. We have to clean the rooms ourselves and dress the bed for the next patient. We really don't work with the other ancillary departments very often. In the ED, we do everything ourselves. Being so independent from others, there really isn't too much to pawn off on us that isn't already something we do.

Sometimes the world around us just 'sucks'. Just know you did everything within your power to help those who need you. You are not going to fix the world. Comfort those who are in pain, hold the hands of those who are scared, advocate for those who can't speak up for themselves, and enable those who need guidance and direction to seek help. Just be the best you can be. Be the best parent - the best friend - the best child - and the best nurse as you can and no one will think less of you. Theres things that are said and done by patients and family members in the ER that you shouldn't take to heart. In the ER, patients and families are scared, impatient, nervous, and can be emotionally driven. There may also be underlying factors like drugs and alcohol when once gone - the patient may be a completely different person.

Depends - If I see the midlevel or Dr carrying around the patients chart - I just go ahead and say that. "Dr XYZ is walking around with you chart. She will see you when she can". If we are particularly busy or happen to have Dr SLOW as our main Dr - we have protocols we are encouraged to initiate. If the patient is fairly alert or have family at bedside when I make good of the protocols - I will literally explain each step to them. I have found if the patient and family understands everything we are doing and how it benefits the patients - they will feel like there is progress happening and worry less about "when will the doctor be in?". When the Dr does come in - its nice for her to do her assessment and then see the results -EKG/PCXR, and blood work. Then the Dr can address the results with the patient at that time and give the patient and family the expected outcome (call PCP, admission, additional testing, or dispo home). I personally don't like to use the "its based on acuity level" when the Dr will see you. I have been a visitor with a family member at another hospital and the nurse told my family member that. It provided me with a different perspective. It almost insinuates that the patient is lower acuity and not a priority. Honestly, that could be the case but no patient wants to hear it. For those patients who's complaints do not fall with within protocols - I always ask them "what physical symptoms is most bothersome?" -- usually pain or nausea but I have surprised with a request for water/blankets/crackers. I attempt to stress the fact and use the word 'advocate' with the patient. "The Dr is in with a very critical patient right now but I am going to advocate for you to get you some pain meds" is the normal line I go with.