Friday, March 8, 2019

My Nurse Practitioner Journey

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I'M A NURSE PRACTITIONER!!!!!!!!
I can’t believe it and so thankful to finally be done!! It was hands down the hardest two years of my life, especially this last year where I
juggled clinicals, two work days a week, and just life in general. I have a Q&A post all about Nursing, NP School, why I decided to go back to school, how I juggled everything, etc HERE. This post will be more on timeline of NP school, studying for boards and what’s next! I’ve said it a million times, and I’ll say it again….thank you, thank you, THANK YOU!!! For all your encouragement, prayers, and support throughout the program! You all have hearts of gold and were such a huge part of this journey!

RECAP OF THE LAST TWO YEARS 

Ok, back track to my Orientation/White Coat Ceremony on December 14, 2016. I started Nurse Practitioner School at a local University with a good friend of mine. We actually both started in the ER as new grads, met during orientation, and continued to get closer as we worked together. We both decided to go back to school for various reasons, mostly because we couldn’t see ourselves being nurses for the rest of our lives. I honestly loved ER nursing and still do, but it does burn you out (physically & mentally) and although there are so many different paths you can take as a nurse, I just didn’t think I would enjoy any of them as much as I enjoyed the ER. I prayed about it, talked to my husband, applied and got accepted into the program. The night before my White Coat Ceremony, my husband got Buffalo Wild Wings and I had already eaten, but ate one of his wings. A few hours later, I woke up and spent the rest of the night spilling my guts out in the bathroom. I went back and forth as to whether or not I should go to orientation/the White Coat Ceremony, but I didn’t know who to call that early in the morning and was afraid if I didn’t go, I wouldn’t be allowed to continue the program, so I sucked it up, took my BFF PeptoBismol with me and went. I felt weak, tired, shaky, miserable, but I got to orientation. I had to step out a few times because I felt so nauseous and ended up sleeping in the car during our lunch break because I couldn’t stand the smell of food and was so exhausted from being up all night. After orientation, we had a little bit of time to get ready for the White Coat Ceremony which is a ceremony where you walk on stage in front of friends and family and hand faculty your white coat, they put in on you, you walk off stage and basically officially kiss the next two years of your life goodbye. I don’t remember much haha! I just remember seeing my husband walk in with flowers and literally almost started crying when I hugged him because I felt so miserable and then praying I wouldn’t pass out as I stood up for almost an hour while I waited my turn to be called lol! Great times, but I guess I should’ve known because that program was all downhill from there……..

So, I had already submitted my transcripts, etc and was accepted to start the first semester. Little did I know, they don’t really look at all that stuff until you’re ready to apply to the next semester. Fast forward to May, I passed my first semester, went to apply for my second semester classes and they said I needed my Bachelor’s transcript. I was like ok, I sent it to you months ago, but I’ll contact the school and have them send it again. I still wasn’t able to sign up for classes, so I reached back out and they’re like we have your transcript, it just doesn’t have you graduation date on there, just have them fax it over. So I reached back out to my Bachelor’s Program advisor and she’s like sure, I’ll send it right over. About half an hour later, she’s like uhhhh you don’t have your Bachelor’s. Um… WHAT?!?!?!?!? Literally couldn’t believe this was happening. I finished my Bachelor’s almost 2 years ago at the time and took every class I was supposed to for the program. She’s like, I’m so sorry, I must have miscounted your credits, but you’re one credit short of the degree and it never processed. I can’t blame her, because I remember after I finished the online Bachelor’s Program I was like ok, all done, went on vacation, kept thinking it was weird that I didn’t get my diploma, but was like maybe I just missed that email or didn’t get one because I didn’t walk at graduation, etc and just didn’t think much of it. Well, now I know why and never heard a word from the school about any of it. Anyways talk about a nightmare and not knowing what was going got happen, I discussed options with both schools and concluded the best way was for my advisor to write a letter talking about the situation, how the miscount of credits happened, and waive it. My Master’s Program accepted that too, however, the letter took time to process and the letter was received 6 days after the start of the next semester, so they said I couldn’t start with everyone else. Shocking and I fought hard to stay in because it’s seriously so easy to catch up less than a week’s worth of work, but they wouldn’t allow it, so the plan was to skip the Summer semester and start again in August. It was less than a week and am still blown away at

their denial for less than a week, but I don’t make the rules. At the time, it was a nightmare and on top of that there were all these issues on in-state and out of state tuitions that they didn’t address until after the first semester and although I lived in the state for years, they wouldn’t count that without other proof I didn’t have so tuition was doubled and long story short, I couldn’t believe it was happening…..
According to that program, I was supposed to graduate in May 2019, but how it was scheduled out, and with the delay, I wouldn’t be done until the end of this year, December 2019. At the time, I felt like it was all a movie and nothing was going right. I mean, how do you finish a degree and find out years later you actually don’t have that degree and then not be accepted for in state tuition even though you’ve lived in the same state for years. Anyways, looking back, I couldn’t be more thankful how things played out. After all of that settled down (we’re still in May) I started talking to colleagues and somehow decided to transfer to a different program. I called and applied to different schools. I honestly didn’t care if they were “good” schools or cared what their ratings were. I was enrolled in a University which cost more than many others and I still had to find my own preceptors and during orientation, there were a lot of questions about the program left unanswered including the graduation date because originally we all had thought it was December 2018 until we got to orientation and they said May 2019. Anyways, I ended up talking to a school that accepted monthly enrollments and their next one started the middle of May-hello answered prayers! By the time everything processed, I was allowed to start the program a week into class AND I would graduate faster than I would have in the other program. They transferred all my credits except statistics because they didn’t require statistics, so I kind of jumped right in. I was so grateful and couldn’t believe after such a nightmare, this was really happening!!

So, I jumped right into the program and that first year until the end of December was online classes/discussion boards, tests, etc. I honestly don’t remember much, but I don’t recall it being extremely difficult. You had your curriculum/due dates so it was easy to spread them out to fit your schedule. It was very, very time consuming, but I think nursing school was much harder since you started from zero. Here, its more of a step up of what you already know. Of course, stressful at times, but more to get assignments in on time/make time to study because in my opinion there is SO MUCH busy work with online programs/discussion boards, etc. I do remember taking a few trips but I was always up early or stood up late to study, do assignments, or take tests. For example, after dinner one night during New York Fashion Week a few friends went back to the hotel to hang out and I couldn’t go because I had to finish a paper lol! Second year was a whole different story…..

Second year (well, more like the beginning of December 2017 to December 2018) was very challenging. I started clinicals and on top of that we still had online classes. Each class was 10 weeks and each 10 weeks had a different set of clinical course and classes. It was very fast paced and I thank God that He gave me strength and health to get through because I keep thinking back, if I had to take a few days off for health reasons, or a funeral, or anything, I have no idea where I would have been able to. Yes, we went on a few shorts trips either around my preceptors schedule that year, but always last minute and never without taking school with me either early in the morning or late at night. The first ten weeks I had 60 hours of Family Practice, 180 hours of Family Practice, 180 hours of Women’s Health, 180 hours of Pediatrics, and then 180 hours of Family Practice again. Every week of mine was basically clinicals during the week and then come home to submit clinical assignments or class assignments, two 12 hour shifts, and one day off which half of it was sleeping in from working the night before. It was such a blur especially Women’s health which I commuted almost 2.5 hours there and then 1.5 hours back where I slept away from home most of the week, came home, did my two shifts, had most of the second half of Sunday off then did it all over again for almost 10 weeks. Ahh! PTSD haha! It was so tough! BUT it passes, just stay focused and keep your support system near and dear!

STATE BOARDS

I say this lightly, but I honestly thought it was easier than the RN exam. The Nurse Practitioner role and guidelines are evidence based, so it’s very straightforward. I feel like the RN exam was like, all the options are right, which one is the most right? I honestly think the review course and practicing a million questions was what prepared me the most. 

I scheduled my exam at 2pm because I was like I can wake up, take my time, not worry about traffic…. horrible mistake! I remember waking up super anxious. That whole week and a half was just filled with stress, worry, anxiety, etc. It was honestly the most stressful two weeks of my life and was a nervous wreck. I had a hard time sleeping, eating, etc. By the morning of my test, I was super anxious and of course had a pit in my stomach so I forced myself to eat a little something. I did what you’re not supposed to do and studied/did more practice questions, but I was up since like 7am because I couldn’t sleep and I couldn’t have all this time and not study. So, by the time I got to the facility, filled out the paper and just sat there waiting for twenty minutes I realized how starving and tired I was!

Anyways, my name was called and I honestly was just like wake up girlfriend!! You’ve got a test to take! The test was 3 hours long, 150 questions and I took every single last second of that test. I remember getting to like question 30 and I read it a few times before I realized I was reading it. I was completely zoned out! So, I snapped myself out of it, got to around question 50, and took a 5 minute bathroom break. I stretched, ran in place for a few seconds and finished the test!

After I submitted the last question, I went to the front desk. They gave us this bag to put our stuff in and locked it, so we had to take that back to the desk along with our scratch paper. She didn’t say a word and so by then, I was like ok I failed. After she checked me out, finished with my bag, she printed the paper, handed it to me and said congratulations. I literally burst into tears and was like “Oh my God!!” I couldn’t believe it! This guy was sitting there waiting to test and started laughing haha! I got up laughing/crying/just a mess and was like, “good luck” and just sat in my car for 40 minutes starting at the paper on and off crying! It was such a surreal moment and felt such a huge weight lift off my chest. The last two years were brutal, but it was finally over!! I’m so very thankful and will never forget that moment!

HOW I STUDIED FOR STATE BOARDS?

After finishing the program, I dragged it out for the month of December. With the holidays and finally having a breather, I had absolutely zero motivation to study. Zero! I got approved to take my test about a month after applying to take it and that was right after the New Year a day or two before my husband’s grandfather passed. We went to Romania for a week and then when we got back, I decided I would start studying for my test, but then went back and forth on this project on decisions that couldn’t wait and after about 5 rounds of back and forth issues I gave up, settled on a decision just to put an end to it and then scheduled my exam, took two weeks off of work and focused on studying.

Backtrack to the last year, around the Spring time until graduation, I listened to Amelie Hollier’s Board Review Course any time I was in the car, showering, cooking, etc…basically anytime I had free time. I didn’t know it at the time, but the last 10 weeks of our program, we actually got access to the review course and were required to listen to it/submit proof of completion each week. By then, I had already listened to the whole review course once through and a several parts multiple times, so then were required to listen to it all again in a shorter amount of time. It was super helpful and helped wrap my head around a lot of things I was learning in clinicals. Throughout clinicals, I also really loved the Leik Book and took it with me.

When I started studying, I was kind of all over the place until I figured out what worked best for me and wish I had thought of it sooner…. 

  • I listened to Hollier’s review course at home in front of my computer and took notes in the Leik Book while also reading the text/their bullet points to remember. This was my third time listening to the Hollier review course, but it amazed me how much more I learned actually sitting there taking notes and reading. She also had powerpoint presentations during her course that I was actually able to read and remember which you obviously couldn’t do driving/having it play in the background. I’m definitely more of a visual learner and reading while I listened to her helped me remember it most of the time just going over it one more time.
  • Take practice questions with rationales over and over and over again. This was a requirement for the second year course. One of our weekly assignments was to submit proof of at least an 80% on the APEA tests for whatever subject we had that week. I took all the APEA questions twice that year and then I did a few more subjects and practice tests while I was studying for boards. The first time I went through the questions, I didn’t realize we were allowed to take the tutor mode, so I struggled through them and had to take them multiple times to get an 80% but the second time around I found out we could do tutor mode and it helped SOOO much and many times was able to take the tests one time through to get the 80% because I actually understood the material!!! I recommend doing tutor mode for any practice questions you take!
  • My brother is in Medical School and introduced me to SketchyPharm and it is a life changer for pharmacology! I only found out about it after my pharm class so I barely referenced it until studying for my boards, but I so wish I did sooner! For boards, I didn’t have time to go through all the videos so I only focused on a few subjects like HTN, antibiotics and asthma/copd, but he said he watched the videos over and over again and barely looked at any other resources for his pharmacology class and aced his test if that tells you anything! It is SO good especially if you’re a visual learner like me. I will be watching them over and over again even now with my boards out of the way because they are just so helpful in understanding and remembering drug class, action, use, side effects, etc. Pricey but so worth it! Oh! You can sign up for free and then try out a few videos before you purchase. They also have videos for micro and patho.
  • Get practice questions apps! There are so many out there, but an access to over 700 questions and rationales came with my Leik Book, so I would study 8-10 hours for the day for boards, shower then do some practice questions before I fell asleep. I heard Board Vitals and Fitzgerald were other good options, but I didn’t use them. 
  • Take predictor tests. I feel like this is a ripoff, but I paid $50 for 75 questions from “retired” questions from old exams off of the PSI website where I signed up for my test. If anything, the test score gave me peace of mind and the rationales were helpful, but if you’re getting most practice questions right on say APEA or the Leik Book, I don’t think it’s necessary. I was happy I took it though because until then, I was really freaking out and it definitely relieved some anxiety. It also mimics the test so that’s another plus.

My biggest tip is to basically study for Boards throughout the program! Yes, it’s easy to breeze through discussion boards or SIM labs, but if you’re not practicing questions throughout the program, reviewing all the information, or reading test question rationales, that’s a whole lot of learning you need to do for the state exam. I don’t know how your program is, but I highly recommend using a review book like the Leik Book as your “textbook” throughout the program. If I ever didn’t understand something, I would alway look there first and it helped me grasp the information and then if I needed further understanding, I would look in the textbook.

WHAT SCHOOL IS BEST?

Many of you have reached out saying you’re going back to school after reading my posts and that’s amazing!! You go girl!! People also ask me what school I went to so they know which one to go to, but I don’t think it matters. Each Nurse Practitioner Program has its positives and negatives and for me, I chose one that would get me right in even though some people advised me it was better to wait than to go to that school because there were better ones out there. I read a few NP forums later of people that hated that school and others that loved it and it was the same for many other online programs. It was accredited, accepted the classes I already took, I got to jump right into the program and that’s all that mattered to me. 

My program was 100% online, we had to submit certain assignments like our physical assessment check off on video, exams were camera/microphone monitored, and I had to find my own preceptors. I honestly feel like my program was very much self-teaching compared to others I looked into and because of the above situation, I was ok with it because I got in and didn’t have to sit out for a few months. I would’ve liked for many things to be different/better, but at the same time, I got my degree. I’m honestly indifferent to the school and wouldn’t recommend it or deter anyone away from it because I don’t have any other program to compare it to nor did I look into other schools when I found out this one would take me in right away.

From what I’ve heard, most online programs are similar but if you want guidance as to what school to go to: 
  • Ask fellow colleagues who went to NP school.
  • What is their start date vs. graduation date?
  • Do they help find preceptors or do you have to find your own? And if they do help, how wide of a radius are they looking? I’ve heard some are local, some are within 150 miles, others are out of state.
  • How many clincial hours can you do per week? The first program only allowed, I believe, two clinical days a week. I’m not exactly sure, but there was a max amount whereas the second program didn’t care how many you did a week as long as you met the requirements by the end of the ten weeks. I prefer that because its so much easier to schedule around.
  • Are you ok with online classes? Some schools are 100% online while others have on-campus days mixed with online classes. I love online classes because it fits my schedule and know where to ask for help if I need it. I do wish I had in-person skills instead of online video, but I am signing up for those through another program. 
  • How much of it is self teaching? Do you have virtual sims labs where you can practice on “real” patient scenarios? Do they have weekly online lectures scheduled or is it more like heres 400 pages to read by the end of the week.
  • Do you have an NP review course included at the end? 
  • Cost/payment plans. 
  • No brainer, but is it accredited/have a good reputation in this area.

Hopefully that helps in narrowing down the school that is best for you. There are several nurse practitioner forums on Facebook that are extremely helpful in this decision and a lot of them already have input from students from different schools that love/hate their programs: Nurse Practitioner Newbies, NP Guidance Group, Nurse Practitioner Faith Community, Preceptors for Nurse Practitioner Students. Please don’t hate me for not sharing my school name. I don’t want to be associated to it because there are so many other factors involved in choosing a school that is best for you and going to one because I went there shouldn’t be one of them <3. 

WHAT’S NEXT?

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Honestly, whatever door God opens up! I would love to continue in the ER or anything acute/in and out, but these options right now are such a slim chance due to a lot of changes that occurred in the last year or so in the area I live. I haven’t really started looking for that reason and because we have been so busy with other things, but I will just take it easy for now and then start looking more fervently in the next few months. I will continue working as a nurse until then, you’ll definitely see more of me around the blog, and have more time to focus on that big project I keep teasing you all about! I will definitely keep you all updated and can’t wait to see what’s next :) 

As always thank you so much for following along and please feel free to let me know if you have any questions/comments in the box below! XO


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