MC1906

I definitely would not do it because its not an area I am trained in as a FNP. Just like I should not manage ICU patients either, because I'm not an Acute Care NP. My ICU experience as a RN would not hold up in court. Nothing wrong with treating medical problems, but once it goes beyond your training as a NP, you should stop. The clue here is, what was your training in NP school. Get the post masters in Psych if at all possible. But you would be at a disadvantage to yourself and your patients. Your BON and your protocols should never conflict.

What will your DNP projects be on?

I think it would be good to look at some data and show it to the Drs. and your director. They may be unaware that they are taking so long to progress through in Phase II. Nausea: there are a few things that you can give preop that will help. To add to what's been stated, you can apply a Scopalamine patch for those with known PONV prior to surgery. I usually give Zofran 4mg/IV. They could also be behind on their fluids. Sniffing an alcohol pad sometimes works. Pain: Fentanyl is awesome, my PACU does it use it much. I like Dilaudid, Demerol, and Toradol. Also they need to really breathe to get the gas out used for the Lap procedure. If your having lots of problems with PONV and pain management, maybe it could be something going on. I would review the OR sheets to see what are they getting in surgery. Not all patients should be the same. So if they all are coming out with extreme pain, that may be something else that needs looking into. Good luck!

Just started Chamberlain's DNP program....anyone has any feedback on the program? So far so good....they are very nice and professional!

Join local NP group Ask your preceptors Primary Care....Community health centers Retail (target, cvs, walgreens...) Home Health Assessments.... Talk to the physicians you work with on a daily basis...that is how I found my job. Network...network..network.

I graduated from Ball State in July 2013. I'm glad the program was designed the way that it was because I was able to continuing working full time. The last semester is the most challenging, especially because of the amount of clinical hours you have to put in. Being organized is key and having good group members to do assignments. The program exposes you to a lot of material. Take a review course to help you prepare for boards and you will be fine! I passed boards on my first try and so did others that I heard of. Good luck.

Thanks Deliahgirl.....inbox me. Quick answer to one of your questions......Yes,buy the yellow book STAT! Definitely worth it! The first 3 chapters were the biggest help!

I decided on nursing as a second career. I went back after having a masters in another field. Never too late to go back. I started with as associates and now in a DNP program! ASN- 2007 @ 29 BSN- 2008 @ 30 MSN-2013 @ 35 DNP- 2015 @ 37 (Keeping my fingers crossed)

I used several resources because not everyone covers everything. Sometimes I understood something better from one person and not the other. Just depends on how much time you have and how you learn best. I studied for about 3 months. I passed both AANP and ANCC on the first try. I definitely think it was worth it all! Here is what I used: Fitzgerald CDs & study book Barkley CDs Hollier Lecture CDs (very easy to listen to +she is funny) Maria Leik's book FamilyNPPrep.com Stuff from ANCC inbox me if you have any questions.

I studied like crazy for a few months. Here is what I did: Created study plan and tried to stick to it as much as possible Broke it down by systems Don't keep studying stuff I know to feel good, move on to what I don't know well Review national guidelines Use the test content outline to help guide my studies Quiz partner Fitzgerald CDs X3, Barkley X1 ----certain sections I listened to repeatedly. You must master info, not be "familiar". Should be able to spit it out like the Alphabet Questions----any free questions do those. I purchased questions from ANCC and did their free questions; familynpprep.com (5 test ANCC and 5 test AANP) Maria Leik (used this last)---bunch of fast facts, which were great reminders Questions from review books---Fitzgerald, Hollier, and Leik Looked up any word I don't know; used youtube to help with some topics Know non-clinical stuff really well. Must know how to apply it. email me: [email protected] if you want a little more help with studying.

The M.Fitzgerald CDs were God sent. They are definintely a great way to review for the boards and for test during school. I would listen to them in the car over and over. I used M.Fitzgerald book, CDs, and Leik's book. Passed both ANCC and AANP, first try.

I recently tested and passed the exam. IMHO there really isn't a great benefit to doing a review course that is non-NP focused. Ere are tons of NP reviews available that will prepare you for the exam. I used several np review resources to prepare. Look at the test content outline. Passing the test is by mastering the content. You are not expected to know everything. It depends n what test you are taking (AANP OR ANCC).....but I would d the following Fitzgerald CDs and workbook National guidelines ....asthma, COPD, JNC7, Cholesterol,etc.. Hollier ...she has tons of stuff Barkley...another great resource. Family prep.com,,,,,,I used this and it was good because it gave rationales and similar questions to the test. I also read Maria Leik's book, which was great for fast facts after studying all the content. Know your content first...then practice questions will reveal you knowledge gaps. Read over anything that is published on test taking strategies for passing boards. That is extremely helpful. Part of doing a review course is being exposed to concepts and questions/wording that will be similar to your exam. If you want to take a PA course after boards for educational purposes...that would be different, but going into boards focus on NP related information and reviews. I hope this helps.

Nervous...but I PASSED! MUCH harder than I would have ever thought this exam would be. I would definitely get the yellow book from ANCC, familynpprep.com questions were really helpful and use Fitzgerald (attend a seminar or buy the CDs). If anyone has any questions about the new format....please let me know.

SOM- I will definitely do the practice questions on the ANCC website. In addition to those, are you referring to the questions that you can buy from the ANCC. It comes with 2 sample test banks and you can review them over and over w/rationales? I have the yellow book! It's great...I need to reread the first few chapters again, as was suggested previously. Nervous....I'm trying not to be! But I'm doing my best so hopefully I will pass the first time around! Thank you once again! MC1906

SOM-Congrats on passing boards! Did you take them before the recent change or after the change? I'm sure you feel a load lifted off your chest. I am planning to take the ANCC/FNP exam. Of the review materials that you studied from...which one helped you the most on the test. I have the yellow book from ANCC and I also have 5 test from familynpprep.com .....this thread has been really helpful. I'm getting really nervous as the time approaches! Any additional advice, hints, tips, I will definitely appreciate! Thank You, MC

TSH...... Have you had a chance to look back in the record to see whats been happening? What does your consulting provider say?

First thing that comes to mind is how one could stand out with a video interview?----Creativity! I would get someone that can make your "interview" into something that is attractive but yet professional. Follow all the guidelines they have given you. Practice your presentation on camera wearing professional attire and in the location with appropriate lighting. You can always have cue cards, but you also don't want to look like you are reading. Hit buzz words from the school's mission inside your answers. Use any language that is appropriate from any nursing theorist. Mention your desire to acquire additional skills that master prepared nurses have. I would vote for an ethical scenario and show that you involved the patient and their family in the solution. For the last question, I would say something that expresses your thirst to be involved in shaping healthcare with the skills you will acquire during your FNP program. This is your goal.......Healthcare is changing and you need additional skills...... Sound professional, humble, and caring. Avoid sounding tired of bedside nursing and wanting a better job to spend more time with hobbies on the weekend. Stick to the topic and focus it on nursing. Pitfalls to avoid: Reading directly from a piece of paper Video is unclear (sound or lighting) Not dressing professional Noisy background (turn off all ringers, phones, dogs, cats, etc) Not following their guidelines good luck!

Hopefulwhoop---thanks again for the information you provided. I am taking the ANCC--FNP exam in August after they change the test. I hope it doesn't throw me for a loop. I have 5 exams from familynpprep, so I will go over those and any theories associated with them. After I'm done taking the test, I will hopefully be posting that I passed! Once again, congratulations!

Congratulations on passing! I am sure that is a load lifted off your chest! Congrats congrats congrats! What theories did you look over which helped you on the exam? Thanks in advance!

Congrats, congrats, congrats! I would go for the NP job. I would look at the NP job as $79,500 (add in the CME). The NP job does have less vacation time and a little less money. But I think with the Director job, you will have to be "Available" 24/7. I don't know any administrator/director that works "set" hours. Speak to current directors and see if they can provide you with additional insight on working as a director, working at that level in your company, and how is it working for your Senior Admin team...especially the CNO. The NP experience can lead to more NP jobs and even Admin jobs in the future. The Admin job will not necessarily lead to more NP jobs. You will not be gaining the NP experience, which is becoming competitive to find a job nowadays. I'm sure you'll make the best decision once you have all the information you need. Where in Florida are you located? What school did you grad from?

Mary...what is ur email addy?

Go after what you want the most. It is possible to find scholarships that may defray some of the cost to either nursing or dental school. You could always get your Bachelors in Nursing and then apply to dental school. You need a bachelors anyway, so why not go after something that will allow you to earn some money when your done. That leaves you the option of going in either direction CRNA or Dental school. Of course the prereqs may be different but its an option. Don't worry too much about the debt....there are programs, scholarships and loans available to help with that! Focus on getting good grades and graduating! Good Luck!

Based on the information provided.....there could be various possibilities. Looking back, we can all say what we would have done or take a different course. In regards to the BP....if the O2 Sats were 60%, the patient could have been confused. Could they have been slightly combative or moving around and the cuff went off at the same time? What was the trend in BPs? Was the SaO2 verified on a different hand? Or what did the ABG state the numbers were? Metabolic acidosis? :::scratching head..thinking.....ARDS? SIRS?:::::: In the initial stages of sepsis, cardiac output can be well maintained or can be even higher than what we would expect to see. That could also be another reason why the BP was high. Tachycardia could be present to help increase cardiac output the patient. It's important to know WHY the tachycardia is present--- early shock? fluid volume deficit? anxiety? confusion? ---remember.....treat the cause! Tachycardia can still be present in shock, even though adequate fluid repletion. Fluids---based on my knowledge, septic patients need lots of fluids. It's important because not having enough fluids can result in tissue hypoperfusion and worsen organ dysfunction. CVP should be monitored to help determine how much fluids you want to give the patient. A CVP of 8-12mm Hg should be suffice. If having other issues, then this range may be suggested to be higher. Interesting patient overall...hopefully he is doing well. Please follow up with any additional information!

I have a lot of concerns about the practice described of IVPB instead of IVP for pain medications. I think this may have stemmed from an incident in the past and the fear of having this occur again (Need more info). I would first want to explore the "thought process" for why this practice has become the standard for this nurse. I think we need to consider the following: - Fluid status of the patient---could you be overloading the patient? Is this recorded on I/O? ---think about this from a 24 hour perspective. What if the patient is on a fluid restriction? CHF? - How do you monitor and reassess the patient? Dilaudid for example is metabolized by the liver.....this can be a slow process for certain patients. Will she be monitoring these patients differently? Pain assessment should be done 1 hour after the medication is given? -This practice sounds like a nurse-created PCA machine w/o an order. YIKES!--doing it her way...these patients should be on at least a continuous pulse ox monitor. -The medication should be given based on the rights of medication administration with consideration to the concentration of the medication, how the medication is designed to be administered and within the scope of nursing practice. -How is the medication kept secured when giving it IVPB -If the IV infiltrates, how much of the pain medication would have been administered? Wasted? Is there affect of the medication on the tissue? -How much of the pain medication is left in the IV tubing? Is that the full dose? -I wonder how much pain control are these "PATIENTS" reporting? -Why was 50ml and 30 minutes chosen? Why couldn't this be less? more? shorter? longer? -Is the IV bag labeled? --From Pharmacy? Nurses should not be reconstituting medications at the bedside. This is out of the loop of what Joint Commission requires. -Is this practice approved by the hospital? Quality? Risk Management? What does the hospital policy state? -The drug concentration is being altered. The medication is most likely less potent and will not have the same desired affect. These patients may report uncontrolled pain, and then may be perceived as "med seeking" when they aren't being appropriately managed. -I think the decision to do this maybe out of the scope of practice for nurses. She is now deciding how to administer a medication with concentration, strength, rate, fluid selection, etc. -When the physician prescribes IV it is meant to given IVP....IVPB is written IVPB (which is usually for medication that are required to be given over a longer period of time or if the concentration is higher). -If the physician did write for IVP, would she still give it that way? -Could she be diverting? (Not trying to be funny). I agree that we should do the best for our patients. I just think that in this situation it may not be the best. I would recommend that you do what you think is best for your patients.

I'm both a health educator and nurse. I started out being a health educator and working in public health. I found that most jobs that looked interesting required a RN. I've focused on clinical health education but those jobs are not very "consistent" but yet so important. There is a shift that is occurring now requiring hospitals to focus on certain populations (CHF, Diabetes, etc). Most places will just take someone and put them into that position. You can look into getting your BSN and get your MSN as a public health nurse. There are two fields that have very different training but can be blended with experience. Good Luck!