Latest Comments by Miiki

Miiki, BSN, RN 24,132 Views

Joined: Jan 10, '12; Posts: 1,737 (37% Liked) ; Likes: 1,672

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    Does the school offer health insurance?

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    kitty29 likes this.

    Im in a similar unit as NICU guy. I've never been mandated and no one has been mandated at all in the 3 years I've been here. Our hospital would rather use incentives as that causes less burn out and totally voluntary.

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    Quote from jdsmom
    Thank you for the feedback! I definitely like busy, and I think starting out in level 2 might give me time to learn without the stress of level 3 preemies and newborns. I appreciate you taking the time to respond
    I work in a birthing hospital with a Level 3 NICU. We have a full surgery service and only usually send out for ECMO and hearts.

    We start orientation with Level 2. You don't move on to level 3 until you sign out of level 2. It really doesn't take that long to get the hang of Level 2 enough to work independently. Don't feel that you have to start in a Level 2. Most of my unit were new grads.

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    live2bme22 likes this.

    Quote from live2bme22
    Do you think it would limit me from getting a job because I am within a specialty? I just want to make sure I could get a job
    No. Not in my area. The NICU nurses basically have 0 experience with people over 15 pounds and still get jobs.

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    I'm in NNP school now. I've worked in a NICU for 3 years. Several nurses in the NICU and in the ER were I worked as an ER Tech have become FNPs and get jobs quickly.

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    Another of my answers copied from another post:

    I will use the term APRN because that is what my state uses and what the consensus model recommends. ARNP is still used by a few states.

    APRN - Advanced practice registered nurse. An RN who has completed graduate education (MSN or DNP) to practice in one of the four APRN roles: nurse practitioner (NP), certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA), or clinical nurse specialist (CNS).

    A nurse practioner is a type of APRN. There are quite a few specialties. Think of them like medical residencies. Yes, you have to choose before you start. There is a good bit of overlap but none can do everything that any of the other can. It's becoming more and more common for NPs to be dual ceritified to expand their scope of practice (FNP/PMHNP, FNP/AGNP-AC -> emergency, PNP-PC/PNP-AC)

    The most common is FNP - trained in PRIMARY CARE of people across the lifespan. This includes uncomplicated maternity care, but not delivery. FNPs are not generalists and aren't trained for acute care. States following the consensus model do not allow them to work in acute care settings.

    WHNP (Women's Health) - primary care of women across the lifespan. More emphasis on OBGYN than FNP (Only CNMs deliver babies)

    AGNP-PC (Adult/Gerontology-Primary Care) Emphasis on primary care from about 13 yo to old age.

    PNP-PC (Pediatric Primary Care) Primary care from birth to about 21 yo. (Why would you choose this instead of FNP? Pediatricians around me are hiring PNPs more often because they do all of their clinicals in peds instead of just 1 semester.)

    AGNP-AC (Adult/Geri Acute Care) - Acute care of adults. May work in hospital or specialty clinics

    PNP-AC (Pediatric Acute Care) Acute care of children

    NNP (Neonatal) Acute and primary care of infants up to 2 years old. Most NNPs work in NICUs with premature and critically sick infants. (Obviously the best specialty )

    PMHNP (Psychiatric Mental Health) - psych and mental health care across the lifespan

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    My own answer copied from another post:

    I'm a DNP student at a big state university. I prefer to knock it out all at once. 1 extra year now vs. 2 or more later. I really don't want to do school again after this.

    Educational degrees: DNP & MSN. Either can prepare you to be a nurse practitioner or other roles.

    DNP is a practice doctorate that includes translational research (not new knowledge like a PhD). The nurse practitioner courses are the same as MSN. It's the core courses and the research project that is different. It should take 3 years full-time including summers or 4 years without summers (per the Essentials of DNP). This degree is being pushed as the entry to practice similar to the Doctor of Physical Therapy or the Doctor of Audiology who get practice doctorates with less clinical hours than most MSN programs. The idea is that for NPs to truly gain independence, they have to be prepared to add to our knowledge vs. following what others are telling us is best practice.

    MSN is a master's degree. It has been the standard for a long time. It obviously should take less time. Like I said, the nurse practitioner content is the same. It's more common right now, but the number of DNP programs are steadily rising. Some schools are phasing it out. If you get an MSN degree, you'll most likely always be grandfathered in if the DNP actually becomes the standard, but you may have a harder time competing with DNPs (like BSN vs. ASN).


    APRN - Advanced practice registered nurse. An RN who has completed graduate education (MSN or DNP) to practice in the four APRN roles: nurse practitioner (NP), certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA), or clinical nurse specialist (CNS).

    An NP is a APRN who can either have an MSN or DNP.

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    Pattoncy likes this.

    Most NNP programs want 2 years experience in a Level III or higher. This is important. You aren't exposed to the same problems in a Level II, and in the rare instance that more acute shows up, you transfer them out. The practice requirement is very important to your success and NNP is the only specialty that still has a requirement consistently among NNP programs.

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    LPNs are nurses. CNAs are not. CNAs tends to have much more physically demanding jobs.

    Neither CNAs or LPNs work in L&D in my area. This will depend on the location/hospital. Our L&D only has RNs and surg techs.

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    eg1014 likes this.

    Quote from pro-student
    Thank you for clarifying. You're right, in your OP you mentioned first assist which would be limited to what occurs in the OR (and is not an advanced practice role). For the other duties an NP might do in a surgical practice, clearly an ACNP is the appropriate credential. I think you have also identified the real issue which is that different states and even facilities have adapted to the Consensus Model at different rates. Eventually, things will even out but this will probably be at least a decade as people who have been working in APRN roles outside the Consensus Model retire and are replaced by those trained appropriately under the model.
    My state is experiencing a hard-stop on out-of-scope practices. They've been notifying NPs working in inappropriate areas that they must pursue the appropriate education or find a new job. An FNP working in an NICU was told this years ago (there was only one case like this that I'm aware of), last year they demanded that NPs have RNFA certs to assist in surgery, and more recently, the BON has been cracking down on FNPs working in acute care or psych roles.

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    Finishing the BSN would be a better route in my opinion. BSN programs can be usually completed in a about 1-1.5 years as you gain experience (and decide what you want to specialized in) and are cheaper. If timed right at a more affordable school (like only taking 1-2 courses a semester), you can probably get your employer to cover a large portion of the tuition. RN to MSN programs don't usually award a BSN in the middle. If life happens or whatever, and you don't fully complete the MSN program (about 2.5-3 years), you are left with no degree and a bunch of credits.

    I don't have a preference on whether you complete a MSN or DNP after the BSN. DNP just brings the research component up to doctoral level. But you really shouldn't jump into an NP program if you aren't sure about what you want to do yet. FNP isn't a generalist degree that lets you work anywhere. Even if your state isn't enforcing the consensus model yet, FNP programs DO NOT train you to be a safe provider outside of primary care.

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    jennylee321 likes this.

    Don't feel obligated to do medsurg. If you can get a job in a NICU right away, take it. Don't turn down the job you really want. PICU nurses are the most prepared, but even they have a bit of a learning curve. No other nurses really have a shorter orientation than the new grads where I'm at.

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    eg1014 likes this.

    My state strictly follows the consensus model. That seems to be the general direction a lot of states are going. To function as a FA, RNs (including APRNs) must be RNFA certified. A lot of RNFA programs will waive the OR experience requirement for NPs. FA is not covered in your NP education, and therefore, outside your scope unless you get formal training and education. On-the-job training is not acceptable in my state. Last year, they mandated that the NPs working as FAs produce RNFA certs.

    This is a question for your BON. Only they can tell you. If they allow you to do it without the RNFA now, I would work on getting the RNFA cert in the meantime. It takes about a year, and should be fairly uncomplicated since you're already working with a surgeon. That way, you won't be up a creek without a paddle if/when they decide to change it. And if you move to a consensus state that requires it, you'll already be qualified.

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    decotes likes this.

    Ask questions (ask experienced people, not people as new as you), don't assume. Accept feedback. Read policies.

    Most people on my big unit started as new grads.

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    Edit: I obviously misread the whole thing.

    Unless the hospital agrees to the lengthened time, you'll have to do a program within the required amount of time.