Becoming an NP: The Growing Issue of Finding Clinical Placements

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While weighing the decision to become an NP, I thought about the time and money it would take to get into and through the program. I was very interested in the subject of psychiatry and thought it was a good fit for my personality and skill set. I found a program that worked for my schedule and budget and was able to complete the program. I’ve now been in practice for two years. What I didn’t have to worry about when I weighed the pros and cons of becoming an NP was where I would do my practicum or clinical rotations. That’s because the school I attended arranged those for me. However, many NP students are not as fortunate.

The growing difficulty of finding a placement.

Like many colleagues, I have been contacted by students on multiple occasions who are trying to arrange their own clinical placement. There are also numerous posts on message boards and social media from students pleading for someone to take them on at their clinical site. Students have reported having to sit out multiple semesters or not being able to graduate because their schools have left them with the responsibility of securing these arrangements on their own. Others report driving several hours to attend sites far from home or even moving temporarily to get to a practicum site.

One would expect that, when paying thousands of dollars in tuition, the school collecting this money would include the responsibility […]

2022-06-23T10:36:29-04:00June 23rd, 2022|Nursing|1 Comment
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What Happened to Wonder? A Nurse Looks Back

This month’s Reflections essay is by Britni Busfiield, who is an RN on the progressive care neuro/trauma unit at Portsmouth Regional Hospital, Portsmouth, New Hampshire. In this one-page essay, she writes about an experience during her last year of nursing school in which she observed a cerebral angiogram conducted on a patient with a suspected aneurysm.

While very little happens in the essay in any dramatic sense, we felt that we should publish it because it touched on a range of experience that is easily forgotten by those who work in health care, and by everyone else as well.

Wonder: easy to forget, difficult to convey.

The best word for this type of experience might be wonder—when technology illuminates the hidden structures of a complex and often mysterious organ like the brain; when a medical team works with seamless coordination as the patient whose fate may rest in the balance lies shrouded at their center and the physician speaks to her as he threads a catheter into her brain. She writes:

The screen lit up. Bright white fluid leaked slowly into the intricate map of vessels across the display. The dye flooded in like a drop of paint in water, dancing its way through each vein in lazy […]

2022-06-20T11:40:41-04:00June 20th, 2022|nursing students|0 Comments
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Progress in Dementia Care as Treatments and Prevention Lag Behind

Chair exercise class at the Louis and Anne Green Memory and Wellness Center at Florida Atlantic University, Boca Raton. Photo courtesy of the Louis and Anne Green Memory and Wellness Center.

Dementia has long been a diagnosis dreaded by patients and families, as there is no cure. Despite decades of effort, scientists have had little success in developing effective treatments or methods to prevent or slow down the characteristic brain deterioration.

Nearly 6 million people in the United States, including about 14% of the population ages 71 years and older, are afflicted. Dementias, including Alzheimer disease, are among the most common causes of disability and dependency in older adults and projections of the actual number of Americans with dementia—as much as 13.8 million by 2060—suggest rapid growth as the population ages.

Some progress, however, has been made in understanding symptoms and progression of dementias. Recent studies have also shed light on potentially modifiable risk factors, identified new methods of diagnosis, and explored ways to slow disease progression and improve patients’ quality of life. Among these emerging […]

2022-06-15T10:13:05-04:00June 15th, 2022|family caregiving, Nursing|0 Comments
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Understanding Trauma-Informed Care in Nursing Practice

When I first started my nursing career, I worked on the pediatric inpatient unit. I remember feeling sad and upset when getting report on my patients who had experienced terrible trauma in their young lives. I wondered how they would make it to and through adulthood after having survived abuse, neglect, witnessing violence, or serious illness or injury.

That was over 20 years ago, and now many of these patients are showing up in the health care system carrying their pain and bad memories with them. They may be the adult we meet with a substance or alcohol use issue, chronic pain, or help-rejecting behaviors. They might be the patient whom colleagues have labeled “difficult.” Or they might be chronically late for appointments or fail to show up at all. Frequently, people with a history of trauma can be further traumatized by an interaction with an uncaring health care system and choose to avoid getting the care they need. They may be experiencing symptoms of PTSD along with their other reasons for seeking health care.

Practicing trauma-informed-care (TIC) can help address this problem. June is PTSD awareness month, and we’d like to highlight our April CE feature, “Trauma-Informed Care in Nursing Practice.” Authors Elizabeth Dowdell and Patricia Speck point out:

Trauma-informed […]

2022-06-15T14:09:56-04:00June 9th, 2022|Nursing, patient engagement, Patients|0 Comments
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When a Person with Type 1 Diabetes Goes to the Hospital

Photo by Susan Q Yin on Unsplash

I have always done everything I can to avoid hospitalization. Aside from concern about potential surprise bills, it’s a control thing: I’ve simply been afraid of turning over care of my blood glucose levels to anyone else. I’ve had numerous outpatient surgeries and procedures, but for the nearly three decades since I was diagnosed with type 1 diabetes in my mid-20s, I never spent a night in a hospital.

In retrospect, the one time I should have accepted hospital admission was immediately following the shock of the diagnosis, which followed close on several months of unexplained weight loss, increasingly unbearable thirst, blurring vision, and general disorientation. My blood glucose level had been off the charts, plus I needed time to reckon with the loss of freedom for my always more or less healthy and fit body and to begin to learn to balance insulin shots, glucose levels, food intake, physical activity, and much else. But I was in denial (with predictable consequences) for quite some time afterward, and had also turned down the cost of health insurance when entering graduate school.

In the hospital.

In any case, one frigid, iced-over night this early January, I broke […]

2022-06-07T09:32:16-04:00June 7th, 2022|Nursing, patient experience, Patients|2 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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