Evidenced-based practice was a new concept when I was in nursing school (2004-5). It seemed revolutionary, but I never really understood why. I always thought that nursing protocol was created from the best available research. I was naive and thought...isn't that how it should have always been. That may be so; but the truth is in nursing, we do things because that is what we were taught in nursing school. And for generations before, we handed down how to do nursing tasks without evidence of why we did them. Now because there are an increasing number of doctorally prepared nursing that are investigating nursing care from every angle, it is possible to have evidenced based practice.
What is an average nurse to do? First, learn how to use OVID!! OVID is a wonderful tool that most hospitals offer (through their library) for searching the medical/nursing research. This is the best way to find research articles. But I wonder if the average nurse could read what they found? There are lots of complicated statistics in research articles. Plus you have to understand if the population research is comparable to your patient population...and soooooo much more!
I didn't understand how to read and utilize research articles in my nursing practice until I took Research in my Master's program (THANK YOU DR. HABER!). So what is the average nurse to do? There are advanced practice nurses working throughout hospitals today that do study the literature and help make evidenced-based changes within their practice settings. If you are a nurse looking for a real evidenced-based answer about how to help your patients...search out an advanced practice nurse for guidance or visit your hospital/medical library for guidance.
Florence Nightingale was the first nurse researcher and nurse statistician! If you read her work, you will find that she was always asking why we did this and not that. She was always challenging the status quo. She would be so proud of what nurses are doing today...which will change the future of healthcare and the future of the profession!
Sunday, July 26, 2009
Monday, March 23, 2009
Learn to be a nursing leader, meet exceptional peers and nursing professionals, and PARTY!!
When I was in my undergraduate nursing program, I was fortunate enough to have a local chapter of the National Student Nurses Association (NSNA) that was active and FUN! At the University of Florida (UF), we had monthly meetings, created community service and nursing image projects, educated our fellow students on current issues within the nursing profession and (my favorite) attended both our state and national conferences. I also was an elected leader within my local (University of Florida Student Nurses Association, UFNSA) and state chapter (Florida Student Nurses Association, FNSA).
Imagine traveling to Nashville with your closest nursing friends...we heard amazing speakers, meet student nurses from all over the country, learned about countless areas of nursing through focus sessions, reviewed for our NCLEX (RN nursing licensure exam) and partied all night!! We all had too much fun...but as a young nursing leader I was presented with a challenge as well.
As I arrived in Nashville and met up with my fellow students from UFNSA and FNSA, I was asked by my professor to consider running for national office for NSNA. I had no idea what that meant or how to do it but...why not consider and see where it takes me. So over the next few hours, I learned about what positions and opportunities there were as a nationally elected official for NSNA. It all sounded like a lot of fun and a great way to further my leadership experience in nursing.
Long story short...I ran a successful campaign with the help of my closest friends and colleagues from UFNSA and FNSA. I made my first speach in front of thousands of nursing students, professors, nursing professionals and nursing leaders. It was so scary but it was also exciting. I was elected the national chair for the Nominations and Elections Committee.
Over the next year, I learned so much about myself as a nurse, a leader and a committee member. I got to work along side other student nursing leaders and made close friends that I still keep up with today. I traveled a lot, participated in conference calls, created articles for publishing, supported and worked hard with my fellow committee members and help create the slate of candidates for the next batch of nursing leaders to take our place at NSNA. It was one of the best experiences I have ever had as a nurse and I truly miss my days at FNSA and NSNA conferences!!
If you are a nursing student or a prospective nursing student, please check out the NSNA website!!
www.nsna.org
They also have a great section for nursing jobs within the website!!!
http://www.nsna.org/career/ultimate_adventure.asp
Imagine traveling to Nashville with your closest nursing friends...we heard amazing speakers, meet student nurses from all over the country, learned about countless areas of nursing through focus sessions, reviewed for our NCLEX (RN nursing licensure exam) and partied all night!! We all had too much fun...but as a young nursing leader I was presented with a challenge as well.
As I arrived in Nashville and met up with my fellow students from UFNSA and FNSA, I was asked by my professor to consider running for national office for NSNA. I had no idea what that meant or how to do it but...why not consider and see where it takes me. So over the next few hours, I learned about what positions and opportunities there were as a nationally elected official for NSNA. It all sounded like a lot of fun and a great way to further my leadership experience in nursing.
Long story short...I ran a successful campaign with the help of my closest friends and colleagues from UFNSA and FNSA. I made my first speach in front of thousands of nursing students, professors, nursing professionals and nursing leaders. It was so scary but it was also exciting. I was elected the national chair for the Nominations and Elections Committee.
Over the next year, I learned so much about myself as a nurse, a leader and a committee member. I got to work along side other student nursing leaders and made close friends that I still keep up with today. I traveled a lot, participated in conference calls, created articles for publishing, supported and worked hard with my fellow committee members and help create the slate of candidates for the next batch of nursing leaders to take our place at NSNA. It was one of the best experiences I have ever had as a nurse and I truly miss my days at FNSA and NSNA conferences!!
If you are a nursing student or a prospective nursing student, please check out the NSNA website!!
www.nsna.org
They also have a great section for nursing jobs within the website!!!
http://www.nsna.org/career/ultimate_adventure.asp
Wednesday, March 18, 2009
DOCTOR of Nursing?!
I would assume that most people did not know that there was a doctorate in nursing...I know as a young nursing student, the thought was absurd. However, now that I have finished my master's I feel as if I am left wanting more from my education and want to be able to provide more for my profession. There are two different options for getting a doctorate as a nurse: Doctor of Nursing Practice (DNP) or Doctorate of Philosophy (PhD).
The NEW Doctor of Nursing Practice (or DNP) is the most exciting thing to happen to nursing education in probably 30 years!!! As most health care professions have changed their educational standards to keep up with new technology and the changing (more complicated) health care industry, so has nursing. The DNP education is scheduled to replace the master's education for Nurse Pracitioners and Clinical Nurse Specialists. It does not get rid of other specialities that still reside within a master's preparation such as nursing administration, etc. As many Advanced Practice Nurses (APNs) know, the education programs are very heavy in course work (class hours as compared to other graduate level education programs) and clinical hours that could very well equal a full-time position. But how still do APNs get out of their education feeling something lacking when starting their new job...
The DNP education will extend the course work and clinical work by about 2 years. Each program is different but most include a internship/"residency" and a capstone project (instead of a dissertation). This program is supposed to more fully prepare you to be a Nurse Practitioner...not create a NEW ROLE IN NURSING!!! This is aimed towards expert clinical practice NOT research and education roles. In addition, as of now most DNP programs are only post-master's but some are accepting new RN grads.
So what exactly should be in a DNP program...please check out this link to the American Association of Colleges of Nursing to more fulling understand.
http://www.aacn.nche.edu/DNP/pdf/Essentials.pdf
Plus a list of DNP programs: http://www.aacn.nche.edu/DNP/DNPProgramList.htm
But what if you want to go into research and/or academia??? If you are, you will be much happier as a PhD student. This program will most likely take about 4 years (but can be much more depending on your research project). The research project you perform will result in your dissertation which you will present to a committee for approval (graduation requirement).
If you want to become a DOCTOR of nursing, there is money available!!! Especially if you are interested in becoming a nurse educator, a federally funded program will pay up to 85% of your student loans back if you work as a nurse educator for a few years after graduating!!
Personally I want my DNP and PhD, and everyone I tell just rolls their eyes and thinks I am crazy...
The NEW Doctor of Nursing Practice (or DNP) is the most exciting thing to happen to nursing education in probably 30 years!!! As most health care professions have changed their educational standards to keep up with new technology and the changing (more complicated) health care industry, so has nursing. The DNP education is scheduled to replace the master's education for Nurse Pracitioners and Clinical Nurse Specialists. It does not get rid of other specialities that still reside within a master's preparation such as nursing administration, etc. As many Advanced Practice Nurses (APNs) know, the education programs are very heavy in course work (class hours as compared to other graduate level education programs) and clinical hours that could very well equal a full-time position. But how still do APNs get out of their education feeling something lacking when starting their new job...
The DNP education will extend the course work and clinical work by about 2 years. Each program is different but most include a internship/"residency" and a capstone project (instead of a dissertation). This program is supposed to more fully prepare you to be a Nurse Practitioner...not create a NEW ROLE IN NURSING!!! This is aimed towards expert clinical practice NOT research and education roles. In addition, as of now most DNP programs are only post-master's but some are accepting new RN grads.
So what exactly should be in a DNP program...please check out this link to the American Association of Colleges of Nursing to more fulling understand.
http://www.aacn.nche.edu/DNP/pdf/Essentials.pdf
Plus a list of DNP programs: http://www.aacn.nche.edu/DNP/DNPProgramList.htm
But what if you want to go into research and/or academia??? If you are, you will be much happier as a PhD student. This program will most likely take about 4 years (but can be much more depending on your research project). The research project you perform will result in your dissertation which you will present to a committee for approval (graduation requirement).
If you want to become a DOCTOR of nursing, there is money available!!! Especially if you are interested in becoming a nurse educator, a federally funded program will pay up to 85% of your student loans back if you work as a nurse educator for a few years after graduating!!
Personally I want my DNP and PhD, and everyone I tell just rolls their eyes and thinks I am crazy...
Monday, March 16, 2009
2 Years Experience...
I was hit with some very disappointing news. The hospital that I have been waiting on credentialing me for outpatient mental health services discovered that psychiatric nurse practitioners are unable to be paneled without 2 years experience for the vast majority of private insurance companies. I completely understand why this standard exists. BUT should they have known that when they offered me the job almost a year ago. It took them 8 months to figure out that I would be unable to do the job that I was hired for.
Now the hard work comes, finding a new job...
The only reason for stay in Connecticut after graduate school was to start this job. The most "perfect job" for what I wanted to do: medication management, psychiatric evaluations with LOTS of research options. I am not so sure that I am going to find everything I always wanted from my first job...and maybe I was not supposed to.
So now the search begins and where it will take me, no idea but I feel that makes it so much more exciting. In addition, this gives me the option of leaving the cold weather of the Northeast and head down south towards family, friends and less inches of snow per year.
Since I love politics and I am truly enthralled by what is currently going on in Washington, D.C. I am almost positive that this is where I will be living in about two months. I was so surprised by the amount of job options available within the metro area. There are several excellent schools of nursing, wonderful hospitals and (my personal favorite) the possibility of working for the government.
Now the hard work comes, finding a new job...
The only reason for stay in Connecticut after graduate school was to start this job. The most "perfect job" for what I wanted to do: medication management, psychiatric evaluations with LOTS of research options. I am not so sure that I am going to find everything I always wanted from my first job...and maybe I was not supposed to.
So now the search begins and where it will take me, no idea but I feel that makes it so much more exciting. In addition, this gives me the option of leaving the cold weather of the Northeast and head down south towards family, friends and less inches of snow per year.
Since I love politics and I am truly enthralled by what is currently going on in Washington, D.C. I am almost positive that this is where I will be living in about two months. I was so surprised by the amount of job options available within the metro area. There are several excellent schools of nursing, wonderful hospitals and (my personal favorite) the possibility of working for the government.
Tuesday, March 10, 2009
Does your state suck as much as Georgia?
Each state legislature decides the scope of their nurses' practice under the Nurse Practice Act. When you are a RN, it is important to know what your scope entails; however, its going to be about the same from state to state. If you are an advanced practice nurse (APN), this is NOT the case.
So first, let me explain how much nurses love their abbreviation, love adding and/or changing them whenever we feel like we want to further confuse the public. An Advanced Practice Nurse includes a nurse with a master's and/or doctorate degree. They normally practice either as a Clinical Nurse Specialist (CNS), Nurse Practitioner (NP), Nurse Mid-Wife or Certified Registered Nurse Anethestist (CRNA) but could also be a nurse executive, nurse researcher, etc.
Each state determines within their Nurse Practice Act if a APN can diagnose, prescribe and hospitalize their patients. Before deciding on going through a master's or doctoral program to become an APN, you NEED to know your Nurse Practice Act. Before you move or take a job in another state, you NEED to know their Nurse Practice Act.
For example, in New Jersey an APN you can diagnose, treat, prescribe controlled substances, pronounce death, receive/dispense drug samples from pharmaceutical companies fairly independently but you do need a collaborating physician on premises.
In that state of Georgia, functions of an APN must be delegated by a physician under their Nurse Protocol Agreement. Their needs to be an ability for "immediate consultation with the delegating physician." They are not able to prescribe schedule II controlled substances (which for my practice, would be crippling since I could not prescribe Ritalin to children with ADHD). Georgia was the last state holding out the ability for APNs to prescribe. As of July 1, 2006 prescriptive authority was passed but with great limitations to practice independently from physicians.
You can look up this information on your state's governmental website but if you are like me and constantly move or haven't decided where you are even going for nursing school...then please, DON'T WASTE YOUR TIME!!!
Go to www.webnp.net. This site includes the full Pearson Report that will break down every single Nurse Practice Act in the country and even compares them side by side. It is constantly being updated and is the best place to find information regarding each state's prescriptive authority.
Trust me if you go through all the hard work it takes to become an APN, you are going to want to practice to your fullest potential. Plus, patients will be difficult to keep if you cannot give them the drugs or treatments they need.
So first, let me explain how much nurses love their abbreviation, love adding and/or changing them whenever we feel like we want to further confuse the public. An Advanced Practice Nurse includes a nurse with a master's and/or doctorate degree. They normally practice either as a Clinical Nurse Specialist (CNS), Nurse Practitioner (NP), Nurse Mid-Wife or Certified Registered Nurse Anethestist (CRNA) but could also be a nurse executive, nurse researcher, etc.
Each state determines within their Nurse Practice Act if a APN can diagnose, prescribe and hospitalize their patients. Before deciding on going through a master's or doctoral program to become an APN, you NEED to know your Nurse Practice Act. Before you move or take a job in another state, you NEED to know their Nurse Practice Act.
For example, in New Jersey an APN you can diagnose, treat, prescribe controlled substances, pronounce death, receive/dispense drug samples from pharmaceutical companies fairly independently but you do need a collaborating physician on premises.
In that state of Georgia, functions of an APN must be delegated by a physician under their Nurse Protocol Agreement. Their needs to be an ability for "immediate consultation with the delegating physician." They are not able to prescribe schedule II controlled substances (which for my practice, would be crippling since I could not prescribe Ritalin to children with ADHD). Georgia was the last state holding out the ability for APNs to prescribe. As of July 1, 2006 prescriptive authority was passed but with great limitations to practice independently from physicians.
You can look up this information on your state's governmental website but if you are like me and constantly move or haven't decided where you are even going for nursing school...then please, DON'T WASTE YOUR TIME!!!
Go to www.webnp.net. This site includes the full Pearson Report that will break down every single Nurse Practice Act in the country and even compares them side by side. It is constantly being updated and is the best place to find information regarding each state's prescriptive authority.
Trust me if you go through all the hard work it takes to become an APN, you are going to want to practice to your fullest potential. Plus, patients will be difficult to keep if you cannot give them the drugs or treatments they need.
Monday, March 9, 2009
Need a recession proof job?
I hear stories from my friends about their job searches..."the only thing out there right now are nursing positions." The United States, and really the world, is in the middle of a very bad nursing shortage that will not end for many, many years to come. If you want real job security and can handle the "blood and guts" of the job, nursing will be the most rewarding career you can imagine.
Over the next two decades, the projected shortage will reach over one million vacant Registered Nurse (RN) positions (Health Resources and Services Administration, 2004). However, there is a problem with becoming a nurse right now. It is going to take some determination. To further complicate the nursing shortage, there is a nurse educator shortage (professors with master's or doctoral degrees). This means that there are fewer spots available in nursing schools for applicants.
A substantial proportion of nursing education is clinical work, read: hours training under a nursing clinical professor at a hospital or community center with patients. Each clinical professor is allowed to oversee only a limited number of nursing students according to state laws. Certain clinical sites need lots of supervision by clinical professors, such as labor and delivery. These sites limit the number of students that can be admitted to a nursing school program for each year.
This interaction has resulted in ever increasing numbers of applicants being denied admittance each year to nursing schools. According to the American Association of Colleges of Nursing, 32,000 potential nurses were turned away from nursing programs in 2006.
Please, don't be discouraged...they are just the facts of my profession. As I recommend to coworkers from my hospital that are interested in nursing, apply to many programs, build your resume and you will get into a program. You do not need to know what kind of nursing you want to do, trust me it will come with time and experience in nursing school.
If you are interested in a nursing career, please check out these important websites to get more information.
Discover Nursing
http://www.discovernursing.com/home
American Nurses Association
http://www.nursingworld.org/
American Association of Colleges of Nursing
http://www.aacn.nche.edu/
References:
American Association of Colleges of Nursing. (December 5, 2006). Student enrollment rises in U.S. nursing colleges and universities for the sixth consecutive year. Retrieved January 5, 2008 from http://www.aacn.nche.edu/Media/NewRelease/06Survey.htm.
Health Resources and Services Administration. (September 2004). What is behind HRSA's projected supply, demand and shortage of Registered Nurses? Retrieved January 5, 2008 from http://ftp.hrsa.gov/bhpr/workforce/behindshortage.pdf.
Over the next two decades, the projected shortage will reach over one million vacant Registered Nurse (RN) positions (Health Resources and Services Administration, 2004). However, there is a problem with becoming a nurse right now. It is going to take some determination. To further complicate the nursing shortage, there is a nurse educator shortage (professors with master's or doctoral degrees). This means that there are fewer spots available in nursing schools for applicants.
A substantial proportion of nursing education is clinical work, read: hours training under a nursing clinical professor at a hospital or community center with patients. Each clinical professor is allowed to oversee only a limited number of nursing students according to state laws. Certain clinical sites need lots of supervision by clinical professors, such as labor and delivery. These sites limit the number of students that can be admitted to a nursing school program for each year.
This interaction has resulted in ever increasing numbers of applicants being denied admittance each year to nursing schools. According to the American Association of Colleges of Nursing, 32,000 potential nurses were turned away from nursing programs in 2006.
Please, don't be discouraged...they are just the facts of my profession. As I recommend to coworkers from my hospital that are interested in nursing, apply to many programs, build your resume and you will get into a program. You do not need to know what kind of nursing you want to do, trust me it will come with time and experience in nursing school.
If you are interested in a nursing career, please check out these important websites to get more information.
Discover Nursing
http://www.discovernursing.com/home
American Nurses Association
http://www.nursingworld.org/
American Association of Colleges of Nursing
http://www.aacn.nche.edu/
References:
American Association of Colleges of Nursing. (December 5, 2006). Student enrollment rises in U.S. nursing colleges and universities for the sixth consecutive year. Retrieved January 5, 2008 from http://www.aacn.nche.edu/Media/NewRelease/06Survey.htm.
Health Resources and Services Administration. (September 2004). What is behind HRSA's projected supply, demand and shortage of Registered Nurses? Retrieved January 5, 2008 from http://ftp.hrsa.gov/bhpr/workforce/behindshortage.pdf.
Sunday, March 8, 2009
How long does it really takes to see patients as an APRN?
I was hired almost a year ago now for my job as an APRN. I have been waiting and going through the motions of filing out the paperwork. After graduating from my master's program, I had to apply and take my boards to become nationally certified. Then, had to apply for my state license as an APRN. Then, had to apply for my DEA and CSR numbers so I could prescribe controlled substances for my patients. To my surprise (and my future employer's) this process has taken more than 11 months so far. Now I have to wait on private insurance companies to panel me, so I can begin to seeing their patients. Of course, this process may take another six months!
The scary part is...since my hire date, I have had a waiting list. There is a year's worth of patients for me to see. I will be seeing patients that are referred from a pediatric primary care company for mental health concerns. There is such a shortage of providers that I have a year waiting list and I can't even work! Luckily, we have had a few people filling in trying to see these children and families. Meanwhile, I am sitting at my night nurse job bored out of my mind, trying to keep my skills up so I can start whenever I am finally allowed.
My classmates have been working for the past 11 months. So why am I not? Well, they all work for mental health community centers or other clinics that only take governmental insurance. On the other hand, I will be taking primarily private insurance clients. They are allowed to work under the provision of their institution before receiving credentialing, license or DEA/CSR numbers.
This has lead to a real problem in the mental health care community. Most children that have private insurance coverage are unable to see a psychiatrist/psychiatric nurse practitioner because there is that YEAR LONG waiting list to be seen. I end up seeing these children anyways as a hospital-based RN. These children that have been sitting on waiting lists for months trying to get medication to help them manage mental health symptoms end up in the emergancy room and subsequently, inpatient psychiatric hospitals. There is something so wrong with a system that results in emergancy room and acute care treatment for something manageable with medication and psychotherapy...if only they had been treated months earlier. We are relying on a broken system that hurts and stigmatizes children and families.
The scary part is...since my hire date, I have had a waiting list. There is a year's worth of patients for me to see. I will be seeing patients that are referred from a pediatric primary care company for mental health concerns. There is such a shortage of providers that I have a year waiting list and I can't even work! Luckily, we have had a few people filling in trying to see these children and families. Meanwhile, I am sitting at my night nurse job bored out of my mind, trying to keep my skills up so I can start whenever I am finally allowed.
My classmates have been working for the past 11 months. So why am I not? Well, they all work for mental health community centers or other clinics that only take governmental insurance. On the other hand, I will be taking primarily private insurance clients. They are allowed to work under the provision of their institution before receiving credentialing, license or DEA/CSR numbers.
This has lead to a real problem in the mental health care community. Most children that have private insurance coverage are unable to see a psychiatrist/psychiatric nurse practitioner because there is that YEAR LONG waiting list to be seen. I end up seeing these children anyways as a hospital-based RN. These children that have been sitting on waiting lists for months trying to get medication to help them manage mental health symptoms end up in the emergancy room and subsequently, inpatient psychiatric hospitals. There is something so wrong with a system that results in emergancy room and acute care treatment for something manageable with medication and psychotherapy...if only they had been treated months earlier. We are relying on a broken system that hurts and stigmatizes children and families.
Subscribe to:
Posts (Atom)
