Tuesday, May 11, 2010

And now, the moment of truth!!!

I will admit, I am nervous! The new job starts next week. For the past three years I have been in school, studying hard and becoming the best nurse ever and the moment of truth is upon us: Can I successfully articulate my education into clinical expertise?

I will be embarking on this leg of my journey as a nurse practitioner in a STD clinic that is a branch of a local health department. Since I am still in the process of completing my doctorate, I will be working roughly about 32 hours a week. But I think I should back peddle a little bit so that you have a clearer picture of how I ended up in this position. I would also like to illustrate how my higher power aligned this opportunity, I still can't believe it myself!

I was applying for positions and as you know I am an FNP. I wanted more than anything to be an internal medicine nurse practitioner (with an HIV specialty) at the local free clinic or at a homeless health care clinic doing outreach work. (I chose family as a specialty because I have a plan to do Doctors Without Borders or Peace Corps when my kids are all grown up). A good foundation would be a position in Internal Medicine or Family Practice. To work in primary care most of the units want 2 years of nursing experience.

You see, I have only been a nurse since 2006. And I only practiced for a year and change. I basically had no nursing experience so to speak. But, I worked in sales for many years...I can sell ice to an Eskimo ;) I was offered a position in 2 units: A neurological specialty and internal medicine. There was just one catch: They wanted me to work five days a week, 8+ hours a day with an occasional Saturday and they couldn't promise me a schedule that was not more than 40 hours weekly. I quickly calculated that I would have to not only meet the learning curve, but I would have to manage the demands of a strenuous schedule, mother my children, manage my household and also work on finishing my doctorate. I could have managed it but, I would be so overwhelmed!

As I was calling to plan my interview for the internal medicine position, I happened to ask the recruiter if there might not be a position in Infectious Disease. She said that she just had a position come across her desk for a nurse practitioner in, you guessed it: Infectious Disease. 32 hours a week, working with STD's, the staff willing to teach a new nurse practitioner the ropes. As a matter of fact, she gave me the phone number of the collaborating physician and encouraged me to call immediately. The MD and I talked on the phone for like an hour! While I was on the phone, she scheduled my interview and a tour of the unit for one week later. When I arrived at the unit, I learned that half of the staff were people I worked with when I was a clinical instructor (I'll have to tell you that story one day as a throwback). Luckily, I had a really good relationship with the staff in clinic and they were excited to find that I was interviewing for the clinician job. A week or so later, I was offered the job!

I know that this position is a narrow application of my skills and my goals as a clinician are so much more loftier than where I am starting out. For now, I believe that this is where I am meant to be! This position is in my area of interest and my new superiors encourage my academic pursuits...They love it that I am working on my doctorate! It is only the beginning :)


Thursday, April 29, 2010

I really need to chill out and also get motivated!!

I have completely lost my motivation to write my proposal. Seriously! In the beginning I was so excited and energetic. I wanted to get a committee together and change the world. Then I met the red tape of making appointments, inexplicable delays and people deciding at the last minute that they don't have the time or expertise to help me with my study. The first draft of my proposal was the final project of the last course of my doctoral degree. I got a 'D' on my proposal...Yes folks, a 'D'!!! I received the first 'D' of my collegiate academic career on the 'crown jewel' of my studies, which resulted in the first and only 'C' as a final grade on my college transcript...At which point I just put on my big girl panties and said "Screw it!"

I can't write a decent literature review to save my life. I had to change the study...Well not change, just make a few minor adjustments. Thank GOD it doesn't require a whole new literature review! I have to change my theory, (not really a big deal) but after the horrific feedback that I received from the last person that reviewed the draft of my proposal I have just felt my confidence sink to an all time low. I guess I just need to whine. I have tried Vodka, chocolate, sleep and a chat with a therapist...I still feel poopy :(

I think what makes this 64 page masterpiece so overwhelming is that it is a 64 page fiasco. Today, the goal that I am setting between me and my chair today is to break this monstrosity into small digestible portions so that I can reduce my anxiety. The next step is to talk to people in my community who can realistically help me plan my intervention. I have been doing a bit of research in this area and was disappointed to find that there has already been a project of my kind done...However, no one has published their findings which I find to be somewhat comforting.

Being a bit of a trailblazer is HOT! But this is a lot of work (I am making excuses!!!) I don't know where to start, (lie). I need some guidance, (now you're talking). Perhaps today's meeting will be insightful, (let's hope so). I want to graduate in August (we'll see about that). Hey...It could happen!

Thursday, April 15, 2010

My Adventure with FNP boards ;)

The past year has been so very busy. I completed my Masters and (next week) I will have finished my Doctoral coursework obligations. I opted to finish all of my doctoral courses before taking my Family Nurse Practitioner Boards. That was kind of crazy given that I have 'poor test taking skills' but it was what I needed to do because I didn't have the money to pay the exam fees. I had been away from the content for ONE YEAR and I managed to pass after only studying for TWO WEEKS!!! So there...I control my own success and failure ;) Because I was unable to find anyone else's study plan for boards, I have decided to post mine...

To prepare for boards, I spent a total of $52 and I used only three items. I studied using the $40 Fitzgerald book and the sample test questions posted on the ANCC website. I surveyed the Fitzgerald book chapter-by-chapter in order from 1-15 (This is important because one chapter leads to the next in a very methodical way). I also used (borrowed from a friend) the 2005 ANCC guide, but for the information on Theory/NP Practice, as a reference to the Fitzgerald and for the questions in the appendix. If you can't afford to buy the ANCC reference manual, try to find one of your nursing texts that covers NP practice, family theory and health care policy for the purpose of review. This is how I did it:

Step One: Answer the questions that proceeded the content in the Fitzgerald guide

Step Two: Read the content...The Fitzgerald book is a very EASY read

Step Three: Create flashcards based on the Fitzgerald content using plain 3x5 notecards. After I used notecards for the first two chapters, I decided that it would be better to make powerpoint slides so that I could put them on my Blackberry. As I made the flashcards, I read the questions and then the correct answers ALOUD

Step Four: Find some more practice questions. I found mine in the ANCC guide and on the ANCC website. I did these questions and my flashcards over, and over, and over again. I used the adult, peds, gero and family ANCC sample questions on the website. This proved to be helpful in learning the flow of the questions and building confidence.

For two whole weeks, any spare time I had was used to study the Fitzgerald book, doing about one chapter a day. I woke up with that book...Laid down with the book...I even loaded the questions onto my Blackberry so that I could practice questions whenever I was idle. An amazing source of support during my studies was my daughter's father...Yes,I have vilified him in the past, but he kept an eye on the kids, made sure I stopped to eat and made me take sensory breaks (Like going to see 'Why Did I Get Married, Too). When I wanted to fuss, he let me. When I wanted to give up, he encouraged me. The morning of the test, he prayed with me. I guess he is not ALL bad.

When I arrived at the testing center I was terrified. I placed all of my items in my locker and checked in...I was a nervous wreck. I completed the tutorial and proceeded to take the test. The first question popped up...I didn't really know the answer. It was in that moment that I decided that I would 'mark for review' every question that I thought I missed. The first 7 questions I marked. Then finally I started to get questions that I felt pretty confident about. I was moving along at a pretty good clip! Then I got to the last question and I though..."Could it be over that quickly?' After I counted the questions that I 'marked for review'...There were only about 50 questions. Not Bad :/ So I went back through and reviewed the ones a thought I missed. I might have changed a couple since my nerves were a little more settled...I had plenty of time, at least a hour and a half to review my questions. Then I said, either I know it or I don't. I decided to end my test. A survey popped up and then I was directed back to the proctor.

I walked out and asked, 'Did I pass?' She said it depended on the print out. I was feeling sick! She had to re-boot the computer because my paper didn't print out. I was hoping that didn't mean I would have to take the whole thing again. After about another 5 minutes, the paper printed and I found out that I passed. I am a ANCC Board Certified Nurse Practitioner! I don't have my state license yet because it requires me to complete paperwork. The test was not so bad after all :) If you are reading this and preparing for boards just breathe and be confident that you have all that you need to pass...I am sure you will do just fine!

Now to get my proposal written so that I can get my study moving!