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Step 1-05/15/10 Graduation from MSN/FNP program 

Step 2- 05/17/10 Request for final transcript submitted to university, paid via echeck per suggestion of registrar (BIG mistake-takes 10-14 days to clear) 

Step 3- 06/04/10 Transcript received, 2 sealed copies, 1 copy opened to check for accuracy.

Step 4 - 06/07/10 AANP application complete now that final transcript received, mailed to AANP

Step 4- 06/17/10 Received letter from AANP "pleased to notify you …application to sit for exam approved" Now need to wait for letter from testing site with "window"

Step 5- 06/25/10 Letter from Prometric with number required and info on date selection, date for exam tentatively scheduled 6 weeks ahead for August 7, 2010 (really losing it now…looked at moon schedule, horoscope and biorhythm prediction before choosing date:)

Step 6- 07/27/10- panic mode, realize that every 1 out of 3 questions will be Pedi, decided to postpone date, to Sunday 8/22/10 (Feast of the Immaculate Heart of Mary, moon entering capricorn, at some kind of astrological crossroad…really losing my mind)

Step 7- 08/22/10- Take exam and pass! On-screen notification "you have successfully PASSED…." after 3 minutes of staring at screen, pure joy sets in!

Step 8- 09/10/10- Receive certificate from AANP in mail

Step 9- 09/30/10- Application for State of Connecticut APRN license mailed (needed to raise $200 for state license fee). Required passport photo; notarized application; proof of graduate level 40 hour pharmacology course, signed by school administrator

Step 10- 11/01/10- Received State of CT APRN license, effective dat 10/25/10 (expires month of my B-day Jan 2011, will need to pay another $200)

Step 11- 11/4/10 Application for State of CT "Controlled Substance…" submitted. One page form, $40 fee. 

Step 12- 12/6/10 Received state DEA license, mailed Federal DEA application with $591 fee

Step 13- 12/15/10 Received Federal DEA license- Now officially ready to work- a full SEVEN MONTHS after graduation

Step 14- 01/05/10 Negotiate employment, construct "Collaborative Agreement" with new MD employer. Apply on-line for free NPI number (federal requirement to bill as practitioner). Receive official NPI number via email same day.

Step 15- 01/13/10 Apply for Malpractice Insurance- $1000 for one year policy (includes new-grad discount, "tail", $1,000,000/$3,000,000 coverage)

Now, work for six weeks learning the ropes. Had to teach myself about CPT codes, documentation requirements for reimbursement, new EHR system, order prescription pads. Still not officially recognized by medicare, medicaid or insurance companies. 03/11/11- Submit application to "CAQH." Very long and painful application process. Required names, dates, description of all clinical rotations, date of initial RN licensure (9/8/91), references, background check, etc. CAQH will submit application on my behalf to multiple insurance companies for approval as provider. Saves time and effort of applying to each individual company. 10 months after graduation, still not done with the red tape. To be continued…

This is the time of year when soon-to-be-graduating nursing students start to panic. Their college years are almost over. In two short months, they will be graduating and preparing for the NCLEX exam - It’s time to get a job. As if there isn’t enough going on, they are faced with the critically important task of writing a resume. I am posting some suggestions I offer to them below: 

Some ways to describe student nurse /PCA duties:
Instead of  "I gave baths and assisted with ADLs"
Say I assisted patients in meeting their personal care needs and provided individualized attention/interventions while encouraging patient involvement in self-care, promoting independence,  and maintaining dignity

Instead of:  "I was a float"
Try:  I have experience adapting to any hospital unit / a variety of clinical areas /changing situations/environments.  I have the ability to quickly establish rapport and a positive working relationship with nurses and ancillary staff. I can quickly orient myself to unit, independently take initiatives/ require minimal assistance/ encouragement/ instruction…

I can function as an integrated member of the staff/team in any situation and deliver the safe, effective/efficient care to complex pts. I can readily/easily adapt methods/ interventions to a wide range of situations.

Instead of  "I was a sitter"
Try: I have experience providing focused, one-to-one care and ensuring a safe, nurturing/caring/positive environment for patient’s who are at a significant risk for injury or complications.

Other descriptions of duties
-Acted as pt advocate, expressing pt concerns/needs/desires to nurses and other staff who were unable to devote/ spend as much time with patient

-Utilized the time spent providing personal care/bathing to: perform thorough skin assessments, assess nutrition and hydration, look for signs of neglect and abuse, spot early signs of skin breakdown and/or identify pts who were at risk, promote measures to prevent skin breakdown, initiate toileting schedule,  etc

- Ensure adequate nutrition and hydration, assess for problems with chewing and/or swallowing /eating difficulties that may increase risk of aspiration/ poor nutrition.  Assisted pt/family with increasing safety awareness/promting a safe environment;  set-up meal, encourage independence/feed self,  ensure proper positioning to promote adequate food absorption and digestion, prevent aspiration, etc.

-Accurately monitored/assessed and reported/recorded intake and output, nutrition/hydration status.

-Educated pts/families on fall prevention, safety risks, use of call bell, importance of calling for assistance, etc.

-Ensured adequate lighting, clear pathways, safe transfers, promoted/reinforced proper positioning, transfer techniques, use of assistive devices.

-Ensured that all items were within reach and pt was comfortable, adjusting temperature, lighting, clothing, bedding/ linen was clean, dry and wrinkle free.

- Assisted with communication with families, making pt/family needs known, answered questions, directed to appropriate sources to answer questions, etc. 

- Promote socialization, conversation, allow patient to express concerns in a non-judgemental, non hurried environment.

- Assessed level of orientation, ability to read and understand written material (menu, paper) and comprehend what was read, ability to make decisions (meal choices), etc.