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Found 6 results

  1. FLOATnureCO

    Nurse Practitioner- Job Outlook

    Hi, Assuming I get accepted, I will start FNP School in a few months. We all know how expensive it can be and I have a family...and well, a lot of questions that I'm having a hard time finding the answer to. For one, I don't see myself as a primary care provider and I feel like this is the most common job for FNP graduates. I chose FNP to be more versatile than specializing... but I would rather work someone like a cardiology office/heart failure clinic/ in-patient cardiology/ derm NP/ trauma surgery NP... Like do these things even exist for an NP? I've tried searching for jobs but the market around here is a bit saturated at the moment and I see mostly primary care jobs. Another thing I've been thinking about is how I would want to be part- time until my kids are a bit older. I kinda suspect this will be difficult but I'm not sure? Insight, anyone? I live in Colorado if that makes a difference. Thanks!
  2. Nicole was by all accounts a competent, caring Nurse Practitioner. Her patients loved her and her coworkers spoke highly of her. She was also the proud mother of Remy, short for Remington. Nicole and her husband had tried for 15 years to conceive and they were overjoyed when they had Remy, now 21 months old. Coworkers said she loved to show them photos of little Remy. By all accounts, Nicole was a loving, responsible parent. In the morning of June of 2018, Nicole was working at Evergreen Family Medicine in Roseburg, Oregon. That morning, she drove into the clinic’s parking lot as usual. She got out, locked her car, and went to work her shift at the very busy clinic- as usual. In doing so, she left her 21 month old baby, Remy, in the car where Remy remained for hours until Nicole returned at 4:30, when her shift was over. Nicole discovered Remy unconscious and blue. Nicole screamed for help and attempts were made to revive the toddler, but she was pronounced dead. Supporters and Haters The community quickly divided into supporters and haters. What happened to little Remy is almost too horrific to contemplate. Sides were taken. Both sides felt empathy- empathy for the mother and the suffering she would never escape from. Empathy for Remy, a vulnerable child who suffered a horrible death. The supporters felt ‘This could happen to me”. An understanding that “There, but for the grace of God, go I.” They found room for forgiveness and compassion. The haters responded with “She isn’t competent to be a mother”. Some called for Nicole to be punished. Initially charges of second degree manslaughter were filed but they were dropped. How could this happen? As we understand more how the brain works, we understand better how mistakes can happen. To anyone. She Was Out of Routine Usually Nicole’s husband dropped Remy off at daycare, but he had worked night shift as an EMT and Nicole wanted him to sleep. Thankfully, being out of routine usually results in errors such as remembering to bring in a journal to work but forgetting to take your lunch. I forgot to lock my car! I always lock my car. Oh, right, I was waving at my neighbor when I got out and walked across the street to talk to her. She Was Distracted Nicole no doubt was thinking of her shift ahead of her at the clinic. There was a lapse in temporal memory. Her brain was filled and looking forward. Maybe she was wondering who the medical assistant would be on duty that day, or if the antibiotics she prescribed the day before had helped her patient. She had to remember to ask her boss if she could order large size disposable BP cuffs and she had to renew her license soon. Did she have enough CEs? There was no trigger to cause her to look in the back-facing car seat, where Remy was soundly asleep. No visual reminder. No audible alarm. I was interrupted by my phone during med pass and thought I unclamped the secondary tubing for the antibiotic. She Was on Autopilot In the police affidavit, Nicole said “I thought I dropped her off at daycare this morning”. I thought I took my birth control pill this morning. Or was that yesterday? Called inattentional blindness, we all have operated on autopilot. Memory experts tell us that the basal ganglia takes over and suppresses the prefrontal cortex for many reasons, including when we are tired, as in the case of new parents. Kids in Heated Cars Kids do not do well in heated cars. Approximately 30-40 children each year succumb to death in overheated vehicles. Some were forgotten in cars, others accidentally locked themselves in. Babies and young children are particularly sensitive to the heat as they have larger surface areas and less efficient cooling mechanisms. A child’s temperature rises faster than an adult’s, up to 3-5 times faster. The temperature in a car can rise to 125 degrees in just a few minutes. The prevalence of back facing car seats accounts for the young age, as infants and small children can easily be asleep or not able to communicate. Rear-facing car seats look no different whether or not there is a baby or toddler inside. Conclusion What happened to Nicole can happen to anyone. It will happen again this summer, when the death toll from kids in cars typically rises. What would prevent this? Jailing Nicole would not prevent this. Maybe educating parents similar to education around infant co-sleeping and the use of seat belts. Public service announcements. Supporting initiatives to increase awareness such as Look Before you Lock and occupant detection systems. Perhaps placing a necessary item in the back seat next to the child, such as a purse or cell phone. Kids and cars.org even suggests placing your left shoe in the back seat. Most of these suggestions are to trick the brain out of autopilot and the brain state that allows these accidents in the first place. Mistakes are not intentional but prevention and compassion are. Related Articles When Nurses Make Fatal Mistakes Nurse Gives Lethal Dose of Vecuronium Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  3. On May 29th, a Montgomery, Alabama judge sentenced former Nurse Practitioner, Lillian Akwuba to 10 years in federal prison. Akwuba was found guilty on 23 counts of healthcare fraud and drug distribution. However, she wasn’t alone in her acts that caused Judge Sharon Blackburn to tell Akwuba that she was a “ highly educated drug dealer” who wrecked the lives of patients and families to make money. The Story Dr. Gilberto Sanchez, who owned Family Practice in Montgomery, was arrested in 2017 for allegedly running a pill mill. He was indicted along with other staff members from his office, including Akwuba. They were charged with prescribing unnecessary controlled substances, such as hydrocodone, oxycodone, fentanyl, and methadone. Not only did they give these dangerous drugs for no reason, but they also had patients return to their office every month to get their prescriptions. These visits were considered unnecessary and a form of healthcare fraud. According to AL.com Akwuba left Sanchez’ practice in 2016 and opened her own practice, Mercy Family Health Care in Montgomery. She continued to overprescribe the same controlled substances. However, since she was legally required to collaborate with a physician, she broke the law in new ways. Prosecutors reported that she began forging signatures of physicians and faking the collaboration required under Alabama state law. A WSFA News 12 article , reported that Akwuba pleaded for mercy at her trial and stated that her family depends on her for support. She said that she was remorseful. However, the judge pointed out that at no point during her hearing did Akwuba ever comment about the people that she prescribed dangerous drugs to and probably turned into addicts. Blackburn even replied that she didn’t feel that the former nurse practitioner understood the extent of her conduct and just how criminal her actions were. An Assistant United States Attorney, Jonathan Ross was also present for the trial. He told WSFA that Akwuba showed “complete and utter disrespect to her patients and the court by lying under oath during the trial, and disrespect to the doctors who tried to work with her and curb her prescribing habits.” Ross also called Akwuba a “drug dealer.” Ross feels that Akwuba is at higher levels of blame compared to Sanchez, who pleaded guilty to five counts and was sentenced to serve more than 12 years in prison. Akwuba remains detained until her family produces her passport, at which time she could be released on bond before heading to serve her sentence. The Dilemma There are so many issues in this story. Did Akwuba understand her prescribing actions? How was she able to go for such a long time forging the names of physicians? The state of Alabama only gives nurse practitioners limited authority to prescribe, which means they must have physician collaboration. Did pharmacists in the area not recognize the forgery? Stories such as these can be used as ammunition to support the notion that nurse practitioners should not be given autonomy to prescribe without physician oversight and work independently. However, these stories are few and probably shouldn’t be used to set precedence for future laws. But, we all know what one bad apple can do to an entire bag, right? What do you think should happen to Akwuba, and where did this situation go wrong? Share your thoughts below.
  4. First and foremost, I understand that everyone's situation is different and that we all don't learn/study the same way. I just wanted to share my experiences with the entire process of actually finally being able to pass my boards. I completed my FNP program in December 2015 when I was about 33 weeks pregnant. I was too stressed from school and having poorly controlled blood sugars and being diagnosed with gestational diabetes, I did not take the boards right away. I'm still not sure if this was the right decision to make. Anyhow I had my first born in January 2016, and having postpartum depression and anxiety, I had a hard time focusing. My husband then got a job in California, so we relocated there that summer and it took about 5 months to get my license endorsed. With the cost of living in Los Angeles being so high, i again postponed taking my boards and opted to work instead, night shift so I could save a couple of grand from having to put my infant in daycare. Feeling lonely, still having postpartum depression and living in a city that I was still new to, I continued to feel isolated but wanted to desperately move on with my career and "be someone" that I could be proud of. I decided to take Hollier's APEA online review course and listened to her and printed out her notes. I tried to listen to her while at work and while at home but for some reason I just could not absorb the information. The review course itself was a wealth of information and it was sometimes overwhelming to listen to her. I listened to her maybe once and read the notes 2-3 times reviewing it. Maybe it was because I had been out of school for so long, maybe that's why I wasn't learning so well? I'm not sure. I should also mention I have major test anxiety and always got time and a half as an undergrad bc that is how debillitating my anxiety was and still is. I also didn't pass my NCLEX until second time around. i did not do as many practice questions as I should have. In fact first go round I don't remember doing any practice questions. I did purchase a PSI practice exam which I scored terrible on (50's). That cost $50. I finally scheduled my exam for 11/2017 and failed it with a disappointing but not surprising score of 358. Oh I forgot to mention that I found out I was also 12 weeks pregnant second time a few weeks before the exam and I was so exhausted from work, taking care of a toddler that there was no way I could study for the exam. After failing the first time, I decided to do my research and look up exactly what I needed to do to retake this exam. It took me about 3-4 weeks to listen to all the CEU's and take the test that was required. All of the CEU's were free and offered by the AANP. I could not use the APEA review course as CEU's because I took the course before the exam date. I started trolling these forums again looking up study tips on how to study and what resources to use. I decided to buy Liek's review book bc apparently that was the book to use. I did not go back to listen to Amelie's APEA but revised her notes. I also purchased the FNP mastery questions and reviewed those questions on my phone. I scored terribly on them. I made a study sheet with some nmemonics for CN's, and made some charts on stuff I didn't understand (CN, asthma, copd, htn, ect.). I didn't read Leik's Book and just used it for her practice question. I read the first chapter on exam tips. I put all of Amelie's notes onto index cards. I reviewed those index cards (prob well over 100), made a cheat sheet that was prob one page written front and back and did all of Leik's questions (725). Although I memorized all of them, I still had crazy anxiety. I went to my doctor and she wrote me a note for extended time which I faxed over to PSI. I then reviewed the first exam I had purchased from PSI for the first time I took the exam. I probably maybe spent an hour or so reviewing materials and doing practice questions on the FNP mastery app and the Leik's book. All of the questions I got wrong from the FNP mastery app, I wrote them all and made them part of my study/cheat sheet. I bought 10 exam edge practice exams and scored 450-480 on them first try. I finally scheduled myself to take the exam again, this time 3 weeks before my second baby was to be born. I was about 36 weeks pregnant and determined to pass this gosh darn exam before this baby was born. I went in and got my time and a half but failed again. This time by 7 points. I scored a 453. I wrote down some of the nmemonics I memorized and used the "marked" option. I don't even remember marking a lot of questions. And all the ones I stumble on when I came home to look up the answers, I had them right. I don't know where I went wrong. Second time around I found that Leik's questions were very similar to the ones written on the exam. But I did not do well with 1. Process of elimination 2. There was some information that I just did not know. I felt so terribly disappointed in myself I just did not know what to do. I decided to start doing the CEU's again right away, but when I called AANP they said that I had to wait at least 24 hours before I started to do the CEU's. I waited the 24 hours and decided to start doing the CEU's again. I printed them all out and organized them. I decided to give myself a little bit of a break but continue to read casually. I decided that I would study during my maternity leave. I had my baby and June, started going through post partum depression again and on top of that I had a toddler at home who wasn't going to let me accomplish anything. Luckily my CEU's were done. I had already finished Leik's questions once I decided to finish them again. Someone mentioned that Amelie's APEA certification questions (3rd edition) was excellent. So I bought this also. I still had my exam edge questions (the 10 I had previously purchased, bc u can take them 3 times). I had my daughter in June and decided to start studying again. This time around I read Leik's book. I decided that I could not study with my toddler at home, so I put her in full days at preschool (she's 2). She went to school from 8-5. My newborn was with me at home and I nursed her every 2-3 hours. I trolled these forums again. I Also decided to Start from scratch with studying. I didn't fully start to immerse myself into studying and focusing until a couple of weeks after my daughter was Born. I made myself a kind of study schedule. I would fully commit to reading every chapter in that book. Which is exactly what I did. It took me about 2 days to finish each chapter in Leik's book. I bought colored gel pens to make studying fun. And also some computer paper with no lines (like the scratch paper they give u during the exams). I did Leik's practice questions again. This time I tried my best not to memorize the answers. It's so easy to memorize the answers. Instead I would write down why I got it wrong or why it was the right answer. I would flip to back to the chapter and read about it. It took me a month to finish Leik's book. I finished her book in the beginning of August. With Amelie's book, I did every single question in there except for the adult Geri practice exams. Again with Amelie's practice questions, I wrote down why the answer was right (for questions I got Wrong). After writing all of the answer and rationales down to all of the questions I got wrong, I started creating charts and ways to memorize certain body parts or guidelines, STD's, vaccine requirements, TB, cancers, treatments and antibiotics and vocabulary. I took pix of the notes so I can read them in bed or while nursing my daughter. I read Leik's book again and did her practice questions again. I read her book a total of 3 times and did her study questions a total of 4-5 times. I obviously read it faster each time. I did Amelie's questions a total of 3 times. I spent probably 5-6 hours studying and reading a day. I sent in my re-take paperwork in August. Two months before scheduling my exam I bought another PSI and scored 75. I repurchased the one I bought first time around and got an 88. I also decided to spend a little more time on pharmacology, drug side effects and interactions. I made a new study sheet on that. I also didn't use any of the index cards I made previously because regurgitating the information was not helpful to me. I also bought an hour session tutorial with Prepping For FNP Certification. She kind of told me what I needed to know for the exam and shot some questions at me. It was $75/session. She didn't give me real pointers but helped me realize what I should focus on. Also explained to me some things I needed differentiating on (different anemias). I finally decided to schedule my exam the week before Halloween. You can only take it twice a year so I definitely had to take it before December just in case I failed and had to take it again in January. I scheduled it for this past Friday (second week of November, November 9). Asked my husband to take the day off. He was great and decided to take 3 days off so he could help with our baby who is exclusively breastfed, while I study.). Him being at home helped ease my anxiety and also he helped with house chores and prep dinner, picked up our older daughter from daycare and stuff. I decided to make myself a 2 week calendar of what I was going to review. Those past 2 weeks I only did practice questions from Leik's and Amelie's book. Third time around I did not use the FNP mastery app at all although some of my notes already contained info from the app. I also did about 5 exam edge exams scoring 530-611. I finally decided to buy Amelie's predictor exam feeling confident that I would score >70%, which I did not. I scored 67, putting me at risk. Never the less, I took those questions I got wrong and looked up information on it. Four days before the exam I copied my notes for each system. The night before the exam I read over any topics I was not sure of. I did not get a good night's rest the night of the exam bc my daughter still nurses every 3-4 hours and my toddler now has night terrors. I also reviewed the 2 PSI's I purchased the night before. I scheduled my exam for 0830, wrote out directions for my husband on what to do for our girls. Grabbed a latte and a sandwich from McDonald's before driving to the testing site. I listened to some relaxing music and got there at 0745. I walked in and started as soon as I sat down. I did not write down and nmemonics except for the cranial nerves (which I got no questions on) I also did not get any questions on hepatitis. I got one heart murmur question and maybe a handful of pediatric questions. I surprisingly got NO question on contraceptives which I was happy about because it is one of my weak areas. I finished at about 11:30. I used the "marked" button but only marked 2. I prob had about 10 questions I felt iffy about. The others were either straight forward, or I used process of elimination. In fact I got a lot of questions that were either similar to Liek's or questions I remember from the second time I took the exam. One thing I did do was write down key words from the questions on my scratch paper to help me identify the stem of the questions. Words like "except", "ALL but which", to make sure I would not choose the wrong questions. I wrote down key characteristics each patient had in the question to help me pinpoint what the test was actually asking me. After 3 grueling hours I received s preliminary "passed". I am so ecstatic about finally moving on with my career and focusing on my health and happiness with my family. I should be getting my scores in the next week or two and can update this post then. Sorry for all the typos and the extremely long post! Thanks to all of u who shared ur study experiences and to those of u who picked ourselves right back up after falling. You really helped me to focus more and work harder! Also, pls don't hesitate to contact me if you need any study tips. I'm more than happy to help! I understand this struggle too well now.
  5. Lane Therrell FNP, MSN, RN

    The Future of Nursing: Reflections of a Nurse Educator

    Download allnurses Magazine Golden thread and soft skills The future of nursing parallels the future of medicine, which is bright with technological innovations. From robotics, telemedicine, smart sensors, artificial intelligence, gene editing and more, the game-changing technological advances available now and on the horizon promise incredible improvements in healthcare across the board. It’s an exciting time to work in the biosciences. And it’s also a time when clinicians and caregivers must remain vigilant in recalling the reason healthcare exists: To improve the lives of human beings. Communication is the golden thread that ties future to present and past, and connects individuals to one another. Communication involving digital screens and online connections creates convenience and leverages time and money but it also changes the nature and dynamics of human connections. I believe technology has created a real and relevant need for genuine human contact, a revival of the art part of nursing. In recent years other professions including medicine have formally acknowledged the value of “soft skills,” which include interpersonal communication. That’s because interpersonal communication skills really aren’t that “soft” after all. Communication skills are powerful, and mastering them can be just as rigorous, difficult, and demanding as learning other clinical nursing skills can be. There is an academic and technical rigor associated with communication skills that too often remains unrecognized in nursing. Nursing must treat soft skills as clinical skills that are worthy of development. My perspective Before I get too carried away, let me clarify my perspective. I entered nursing at midlife after a successful 20-year career in public relations for agriculture. I hold two master’s degrees in two very different areas of inquiry—rhetoric and nursing—which gives me a truly multidisciplinary academic background. I bring a mature, holistic, mindset to my practice that embraces a full spectrum of thought and ideas. My perspective matches the ideals of advanced practice nursing and offers the kind of outside perspective that exposes insular thinking and promotes innovation. And because I’ve been academically trained to deliver instruction in communication and leadership, I can teach people how to communicate more effectively. My diverse experience in classrooms and clinics has shown me that better communication translates into better nursing care. It has also brought to light a great opportunity, as I see it, for nurses at all levels of practice to improve their interpersonal communication skills. The Patient-Centered Illusion Patient. Centered. Care. Those three words when used together capture the essence of why I became a nurse. Yet, without effective interpersonal communication, patient-centered care is merely an illusion. In nursing, we perpetuate the illusion by failing to communicate effectively. Three ways this can happen are: 1) treating numbers instead of patients; 2) using words that separate patients from their health; 3) establishing plans of care for our patients instead of with our patients. Treating numbers At its core, patient-centered care is built on individual conversations between patients and providers of care. These conversations allow us to treat the patient, not the numbers. Too often, though we become so heavily invested in counting quality measures or improving patient satisfaction scores, that we forget to check in with the actual patient. We even get tempted to use lab results alone to develop care plans, short-circuiting full patient assessment. Delivering care that is truly patient-centered means addressing the needs of the individual in front of you, not blindly following an algorithm. Ultimately, no matter how advanced the technology becomes, the best way to discover what is going on with our patients is through careful assessments, focused conversations, and critical thinking. Disempowering words Consider how we use our medical vocabulary. Indeed, medical terms have a place, and we must communicate accurately and collaborate effectively with our highly educated colleagues. But we also must use words with our patients that are appropriate and easy to understand. Words that are unfamiliar or unsupportive to our patients can create and perpetuate gaps in understanding, and contribute to feelings of helplessness and lack of control. Any type of disempowering language in a clinical setting leaves patients disconnected from their health and disengaged from their health behaviors. Planning in a vacuum Too often we are guilty of establishing plans of care for our patients instead of with our patients. If the plan of care is not relevant to the patient, and they’re not invested in it, they won’t honor it. This goes beyond “teach back” all the way to buy-in. If the patient can’t tell you step by step what he’s going to do to honor the plan between now and when you see him next, he likely won’t. As an educator, I work hard to make abstract concepts relevant to my students. I tell them why it matters, and relate it to something they already know so they can remember and “own” the information. We must all do the same with our patients if we want them to engage and comply with their plans of care. The teaching aspect of patient education is not about reciting massive amounts of information to patients, it’s about making any new concepts and information relevant to their daily lives so they can own the plan and take appropriate informed action for themselves between visits. But we’ll never know what’s relevant to the patient if we don’t have a meaningful conversation first. Barrier, value, and taking action The biggest barrier to improving interpersonal communication in nursing is thinking we’ve already mastered it. We talk about effective communication a great deal, and we’re communicating all day every day, so we think we already know how to do it. But are we doing it well? Most of us are blind to the fact that we’re not being effective. And we’re missing an opportunity to teach interpersonal communication as a skill in nursing. Effective communication is so much more than delivering information to a patient in their native language, following APA style to the letter when writing a term paper, or composing a persuasive letter to a legislator. All of this is important, but interpersonal communication skills are worthy of close academic scrutiny. To break the barrier, nursing must value interpersonal communication as a skill and teach it as one. It’s not that we don’t value interpersonal communication at all in nursing, it’s that we don’t formally recognize it as a skill to be taught. If we did, we’d have communication labs the same way we have health assessment labs. What if nursing did treat interpersonal communication skills with the intellectual and clinical practical heft I think they deserve? I believe nursing would thrive, improve, and facilitate the delivery of true patient-centered care in an age of booming technology. The bottom line is: Communication skills are as important as clinical nursing skills. Without them, empathy cannot be expressed, ethics cannot be honored, and a true patient-centered environment cannot be created. What are we doing to support nursing students’ mastery of the skills underlying our target competencies and course objectives? Effective communication is the unnamed skill that supports virtually all the advanced practice competencies. And yet, who is teaching these fundamental skills to nursing students actively and experientially? Future benefits Advances in biomedical science are happening faster than the slow-moving wheels of academia and clinical practice can turn. Fortunately, effective interpersonal communication happens in real time and moves at the patient’s pace. Effective interpersonal communication is the single best mechanism I know for meeting patients where they are on their individual continuum of change. From that perspective, what could be more patient-centered than engaging in interpersonal communication? The best strategy for keeping healthcare patient-centric in response to technological integration is improving interpersonal communication skills. Communication skills improvement has great potential to improve outcomes in primary, pediatric, and geriatric care, among cancer survivors, and in any situation that involves patients with multiple chronic comorbidities. It is a topic that nursing scholars and doctoral candidates may wish to tackle. Nursing is both art and science. While our education and industry may be biased toward science, it’s the art part that keeps us focused on our purpose and our patients. I infuse this ideal into all my interactions with students, patients, and clients. And I leverage my background in communication to do so. I celebrate nursing for the connections it allows me to create with others. And as professionals, we can strengthen those connections by improving our communication. I challenge my fellow nurses to begin valuing communication more highly for the good of the future of nursing, and for the good of the patients we serve. No matter what technology emerges in the future, there will always be a need for nurses to connect with patients as they deliver quality care. The future of nursing holds great possibilities and opportunities which we can embrace by integrating effective interpersonal communication into everything we do. Article Sources: 5 Key Trends for the Future of Healthcare Communication in Nursing Practice Effective Communication Skills in Nursing Practice Effective Interpersonal Communication: A Practical Guide to Improve Your Life Integrating the Art and Science of Medical Practice: Innovations in Teaching Medical Communication Skills Nursing Students’ Perceptions of Soft Skills Training in Ghana The Most Important Soft Skills Employers Seek The Art and Science of Nursing: Similarities, Differences, and Relations What are the NP Core Competencies?
  6. DysrhythmiaRN11

    Failed AANP Then...Passed!

    Hi I just wanted to give back and provide support to anyone out there looking for answers on passing their NP boards. I want to start by saying I took my boards in July and failed. I recently just took them today, 9/8 and passed. So to start, I graduated in May and decided to relax and have fun versus jumping right in. I just needed a break. I vacationed and did fun things for about a month. I purchased an online review course by Amelia Hollier. I loved it versus in person reviews because it was at my own pace and I studied as I had time. With my schedule it took me a few weeks to get through the review. It was great and I really learned a lot such as diagnosing murmurs and interpreting hematological disorders, and a lot of different intricates as such. It was a great review and Hollier said at the end of the review to take a few weeks to go through each system on your own which I didn't do. Next, I purchased Fitzgerald mp3 player that came with her book. I was happy because I felt like I could listen to it during my free time at work and really get a good study in. I also had the Maria Leik book which by this point I was too worn out to take my time to go thru it and study it. I glanced through it and then I did something unimaginable.... I moved my board exam up by 3 weeks and guess what.. I failed it. I was so upset and sad and it took me just a little bit to get myself together and figure out what to do next. I scrolled the internet for similar situations that could help me and realized I wasn't alone. I immediately started doing my CEUs that same day thanks to reading a bunch of similar situations because AANP doesn't give you a true breakdown of what to focus on, so I did random CEU topics. I finished that in a day then resubmitted my application and was approved within few days. My letter came like 2 weeks after that of areas to focus on which was useless. Preparing the 2nd time.... I had this imaginary thought that I would retest in 2 weeks.....but I didn't, I retested 2 months later.. I already had the Leik book and decided to update it to the new edition since it came with an app. Once it came, I hit the books hard... planned out in my calendar each lesson... took my time, had a notebook, wrote down everything important by system and would refer to my notes to study that particular system and answering questions from Leiks online app to correlate... I read the entire book and at the near end of my readings, I found out that Hollier had an excellent question and answer book that was great for practice for the boards. I did not retake that exam until I totally understood everything because the exam is so random that you just don't know what's on it.. I had the information down packed this time... I learned with this exam that you have to KNOW the information and understand it... cramming will not help you at all. I went over my notes until I was blue in the face and I answered questions like crazy the second time around... when I took the exam again I thought it was so easy because I could rationalize and think out the obvious thanks to Hollier's question and answer book, and Maria Leik's review book.... I was able to ace the exam with my knowledge I had acquired. I have a youtube link that can further give you what I did to pass and some advice on the boards... there are many people who look to the internet for help and I would like to say don't give up... you can do it.. just take your time and do it... one little bit of advice... don't purchase too many books... or reviews..it can overwhelm you.... choose a review of your choice... ... Amelia Hollier is a great review and online is convenient and just as good as in person.. Fitzgerald offers too much information for me and its overload for the exam and her style of questioning gave me anxieties... I personally did not like this as a review for boards but will use it to review for my actual NP practice.... she has alot of knowledge.. Stick with Maria Leik review book definitely and I would buy Hollier questions and answer book...

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