RNtoNNP

I personally chose to get my DNP for a couple reasons, but that isn't to say that the DNP is the right path for everybody. I went back for my DNP after only 3 years of NICU experience, so adding another year of school was actually beneficial for me so I could get more experience before graduation. The other main reason I went for the DNP was because some NNP job openings at bigger children's hospitals said "DNP preferred". I wasn't sure where I wanted to work when I was done, so I wanted to give myself that edge up if possible. I also just really wanted to be done with school now before I have kids and life gets more chaotic. That all being said, there were plenty of times during my DNP program where I wished I had gone for the MSN instead. The DNP is a lot of fluff classes that, just like the BSN, feel pointless at times. I actually did enjoy the focus on QI projects/research more than I thought I would, but a DNP is not necessary to work on QI projects in your unit. My preceptor who oversaw my project does tons of projects on our unit and does not have her DNP. Basically, I don't think either choice is wrong, and you have to pick what feels right for you. If you think you're going to have to take out large student loans to get the DNP, then it may be best to get your MSN and then finish the DNP once you graduate. If you do decide to do it that way, though, I would recommend continuing on with your DNP right away while you're still in the school mode and before you lose motivation to do it. You'll be earning more money as an NNP, so that last year to finish your DNP shouldn't be as hard financially. Best of luck whichever path you choose!

I think Coronavirus has changed how NCC is doing things. They used to give out results right away, but aren't anymore (at least for right now). I took my NNP certification exam through NCC on a Saturday in June and found out a few days later on Wednesday. I didn't get an email from them for a few days after that, though. I just went on the NCC website Wednesday morning and saw that I passed. Several of my classmates also found out they passed the same day even though we took the test on different days, so I think NCC updates their website on Wednesdays. So, just keep checking the website and hopefully you'll find out soon!

I am graduating in May and got an NNP job in January. Both of the offers I got are from hospitals that have a pretty significant NNP shortage right now, so they are hiring on a continuous basis until they reach capacity. If a hospital only has 1 or 2 open positions and are looking to fill those sooner, they may not consider you until you are closer to graduation. One thing I would caution you on though, is that if you don't know for sure where you want to work, it may be beneficial to wait a little longer before applying so you can try to get as many offers as possible before deciding. If you know you want to work at a certain hospital, it may not hurt to apply now, but since other hospitals may not consider you this early, you might end up really only having that one choice for now. If you wait a little longer and apply to several places you think you might want to work, you can figure out which place is the best fit for you. As hard as it was for me to decide between two very good offers, I'm glad I got that chance to figure out which place would be the best fit for me. I did clinicals last fall at one of the hospitals and probably could have applied then and gotten a job, but it may have been too early for the other hospital to consider me (even though they have a big shortage) and then I wouldn't have been able to compare the two places and weigh my options. It definitely doesn't hurt to look into doing clinicals at a hospital you think you might be interested in working in, though, even if you don't apply for a job there right now. If they are short on NNPs, they will probably gladly have you do clinicals with them if you express an interest in working for them in the future! Also, adding onto what babyNP said about different shift options, one of the big deciding factors for me when choosing between my two offers was shift length. Both of my options were level IV facilities but one does 8, 16, or 24-hour shifts while the other one does 12 hour shifts days and nights with the option to lay down and rest at night when possible. I have a friend who works at the one that does 24s and she rarely gets any sleep. To me that sounded awful, so I ended up going for the offer with 12 hour shifts (for that and other reasons).

I save my articles to specific folders on my computer rather than printing them off because I find that easier to navigate. I have a large folder for my DNP project and then put articles in individual folders within that DNP folder based on the specific topic. I also put the last name of the first author after the title when I save it so that helps me keep track of articles better as I am writing my DNP paper and referencing each article by author name. The nice thing about not printing the articles off is that I can search by title or author on the computer and I can search for certain words within the article as well, which makes research much easier. If you do prefer to print off articles, I would recommend putting them in binders and using tabs to separate by topic. Hope that helps a little! Ultimately, you just have to figure out a system that works best for you and stick with it.

I agree that having a positive attitude makes a huge difference in how we handle working the holidays. Yes, it stinks to work the holidays, but it stinks for our patients and their families to have to spend holidays in the hospital too. Reminding myself of this helps me have a better attitude about it. Also, while I hate being away from my family on the holidays (especially Christmas), holidays at work can actually be fun. There is typically a more relaxed atmosphere with no management there and there's always food! If nothing else, at least nurses know how to throw a good potluck!

35 bed level III unit. Everyone except for the charge nurses has to sign up for one night call shift in every six-week schedule. If the on-call person is not called in for their shift, they are on-call at home from 1900-0300 unless told otherwise. If that person gets called in, they are paid time and a half. If that one call person is not enough, they will send out a text for more help. We also frequently use float nurses from pediatrics and postpartum (we have to float to them as well when needed). Lately, we have been busy and short-staffed, so management has also made everyone (even the charge nurses) sign up for an extra call shift (days or nights). I can't say I love working call shifts, but I also know that it sucks to work short-staffed when we don't have a call person.

So far it's mostly been listening to recorded lectures and taking weekly quizzes along with posting on discussion boards. Typically there have been powerpoint notes to go along with the recorded lectures so you can follow along and take notes. I find it all to be pretty user friendly so far. The online learning system they use has an app for your phone or tablet too so that is handy. I have not started clinicals yet but I will have to find my own preceptors. However, I know that at least for the neonatal program, our main instructor helps people find clinical placements a lot, so you're not completely on your own.

I think Creighton has a really good program and I've been impressed so far. I know someone from undergrad who is in the FNP program and we took the exact same classes the first two semesters. I think she is liking the program so far as well. I chose Creighton because it is fairly close to me and has a good reputation. Also, I liked that it was a completely online BSN to DNP program. I will have to go to campus for a skills lab for a couple days, but that's it. I looked into a program that would have had fairly regular on-campus classes and that would have been hard to manage with a full-time nursing schedule.

I am working full-time while doing Creighton's DNP-NNP program part time. I'm currently in my 3rd semester and while it's been a bit tricky to balance school and work, it's still manageable. My program will take a total of 4 years to complete and I have about 6 credits each semester. The full-time program would have taken 3 years, so I figured that one more year was worth it to save my sanity a little bit! The only advice I have is to try to keep on top of your assignments and don't save things for the last minute. Also, use all of your time wisely; if you have some downtime on a night shift at work, try to get some homework done. It's definitely hard some times, but just remember that all of the hard work will be worth it in the end! Best of luck!

I find it interesting that this is so different in other areas! We had another set of twins once who were brought to our hospital because mom delivered while on vacation nearby and our hospital was the closest level III. Once the babies were stable, the parents wanted them transferred to a level III NICU closer to their home, but the insurance company wouldn't cover it even though our hospital was out-of-network. We all thought that the cost of keeping the babies at an out-of-network hospital for several months (they were pretty little at birth) would cost more than covering the transport, but the insurance company didn't go for it. Thanks for your post babyNP! I wasn't aware that these policies were so different in other parts of the country.

I LOVE that you posted this because, you're right, it's easy to get caught up in the chaos and forget why we do this. I had a moment just yesterday that reminded me why I love my job. I was taking care of a 35-weeker who had just been born the previous evening. Parents had an older boy who had been a 28-weeker in another NICU. When parents visited for the first time in the morning I told them that the baby had been able to come off of CPAP to NC, that mom could hold him, and that he would be able to start trying to breastfeed. They were both so happy (mom started crying) and just couldn't believe how different this was from their previous stay when they had to wait days to even hold their son. Then the dad saw the little card we made for Father's Day that had the baby's footprints on it and he started crying too. This just reaffirmed why I love what I do and was such a needed reminder on a busy day with poor staffing!

In my area transports are done only if there is a medical need. If babies are transported to our level III NICU, they stay there until discharge, and if we transfer a baby to a level IV NICU, that baby will stay at that hospital until ready for discharge as well. We recently had to send a baby to another hospital for a PDA ligation while his twin brother remained in our NICU. Once the baby had the surgery and was stabilized, we started trying to figure out a way to get him reunited with his brother. We couldn't send his brother to the other hospital because there was no medical reason for him to need their higher level of care, and the baby couldn't be transferred back to our hospital because, again, there was no medical reason for him to come back so insurance wouldn't cover it. Our hospital has a charity fund to help pay for things like this, but we couldn't use that because our hospital would be making money off his transfer back to us. Basically, the hospital couldn't use it's charity money for something that would bring in more money in return. We did finally get him back to us by finding a charity air ambulance service, but it took quite a while to get all of that sorted out. I believe that this is why we don't transfer babies back to their community hospitals once they no longer need "NICU" services. I would be very surprised if insurance companies would pay for that transport because there would be no medical reason. It's interesting that your hospital does well-baby transports!

I work in a level III NICU that sounds pretty similar to yours, and I'm also in my first year of a 4-year NNP program. I've had about 3.5 years of NICU experience and I know I was worried about not feeling prepared for school too (sometimes I still don't feel completely prepared!). But, I also still have 3 more years to soak up every learning opportunity that I can. I would love to work in a level IV NICU after I graduate, so I am planning on seeking out clinical opportunities in larger NICUs that can give me more experiences that my own NICU can't. At work I try to seek out new experiences as well and and learn about the sicker kids on the unit from the nurses around me. If you have a light assignment, offer to help another nurse do cares on an intubated baby or offer to help with a procedure. Most NNP programs are going to be several years long, so you will have time to continue to learn new things and to have more opportunities to care for the sicker babies. And, as others have said, talk to your charge nurse if it's been a while since you've had a sick kid and ask if there is anything you can do to get those sicker kids in the future. I think level III experience is enough for NNP school if you make the most of all of your learning opportunities, whether that's in the classroom, at work, or at clinicals. There are a couple people in my NNP program that work at level II NICUs and they are doing just fine. Don't count NNP out just because you don't work in a level IV.

My unit uses a different bedside lab analysis system called epoc (epoc® Blood Analysis System - Alere). It works similarly to the iStat and also requires just 0.1mL of blood. Bedside RNs are taught how to use the epoc and we can test blood gases, electrolytes, glucose, hematocrit, lactate, and creatinine. There is only one card to insert and then you can choose from all of these different test options. Once the card is inserted into the reader, it takes a couple minutes for it to be ready for blood insertion, but once the blood sample is inserted, the results are available in 30 seconds. We use this to run all of our blood gases and we don't send any blood gas samples down to the lab. As adventure_RN said, this is typically used to get additional lab tests if we are already getting a blood gas, but we also will use the epoc just to get electrolytes or a hematocrit on some of our smaller babies just so we don't have to send so much blood down to the lab. I love using this for our micropreemies who are on the vent since there are times that we are getting blood gases every couple hours. Not only does the epoc not require a lot of blood, but also, we get the results very quickly. I also worked in a pediatric ER for a while and we used the iStat there. The bedside RNs were trained to use these as well as the RTs. We used the iStat for our critically ill or trauma patients and we also used it to get blood gases on our new diabetic patients to determine if they were in DKA. Using the iStat for these types of patients made a huge difference since we could determine how sick these patients were much quicker than if we had to wait for lab to send us the results and we could start treatment quicker.

I do like it. It is a good program. It's almost entirely online, so I am able to do it while working full-time in a different state.