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Wednesday, March 7, 2012

Hx of This Student

This blog fulfills a requirement of my current course, Transitions in Practice:  The Advanced Practice Nurse as DNP.  The course calls for a "reflective journal" to be completed at least once a week throughout NURU601.  This is my second course in Brandman University’s BSN to DNP program and I continue wrap my head around the concept of Carrie the Doctor.  It's Happening!

Many roads lead to an RN.  Mine started with an ASN from Keiser University (Shout out to Keiser Melbourne and all my nursing school friends for life - Anna, Stacy, Lisa, Kim M., Deanne, Kim, J.R....!)  For many nurses, that first step is the initial hazing, a comparative shut-up-and-drive-or-get-out-of-the-fast-lane style of nursing instruction.  We entered with various backgrounds and skill levels and left competent, qualified nurses.  My first job as a GN was in the ER so complete was my training.  (I've since mentally blocked my Intro to Nursing instructor's name just so you know.  She was one scary combination of Jean Watson-sy theory and Attila the Hun.) 

From the initial ASN, I plowed my way through the obligatory BSN.  I chose University of Phoenix online for the support provided to the military and for the flexibility afforded to a busy, working mom.  If asked my opinion and I rarely am, the ASN is a practice focused degree while the BSN is a management focused degree.  Everything I know (to this point), I learned in ASN school.  (An aside – this is why you need your BSN, better patient outcomes.  http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-workforce )

So you've completed your BSN, what's next?  Okay, after going to Disney World (literally, took the kids because we had a house near Orlando); I looked at my practice and wondered where I was headed.  I had graduated with an ASN and hit the ER like a tornado later fizzling out with a 300+ pediatric caseload in the Department of Health.  Moving from Florida had many disadvantages.  Primarily, I moved FROM Florida.  I had to wait a year, enlist help from my Congressman, and call the Board of Nursing daily to obtain my MD license. Awesome.  During a recession, that and a can of Coke bought me a $28 dollar an hour job in the heart of the inner city handing out condoms to high schoolers and dodging flying metal detectors.  Sometime ask me the antidote to pepper spray.  I now know.

Eventually I found my way into a job with a government agency (that I love) with people (that I love), but there's another group of people I love just as much and they are hurting.  In 2009, I took my fancy, new nursing degree and traded it in for a pair of ACUs and a lifelong (seemingly) commitment.  AHA Moment!  She knows what she wants to do with her life.  The best way for me to help my fellow soldiers is through mental health care.  There is a shortage of mental health providers.  I am currently pursuing a degree in Family Mental Health.  My capstone project involves PTSD (more to come on that!)

Now you know the who-what-where-why, I’m free to discuss what I’ve learned.  Our introductory class was the first time in my nursing education and nursing career that nursing theory made sense.  Not only did theory make sense, I’m using it in my practice!  There are three theories I’m incorporating into my advanced nursing practice:  Maslow’s Hierarchy of Needs, Kolcaba’s Comfort Theory, and Roy’s Adaptation Theory.  Best Parts???  I can intellectually defend my choices AND I care about them.  That’s a long way from the nurse who made fun of “sacred space” and “singing bowls”.  The three I have selected genuinely benefit the patient base I’ve chosen to target.  Theory Rocks!

The current class explores the history of doctorally prepared advanced practice nurses, regulatory issues, conceptions and misconceptions, etc… all issues that affect DNPs.  Apparently, there are quite a few physicians bothered by our use of the term “Doctor”.  I think they prefer if we enter the examination room and introduce ourselves, “Hi, I’m Carrie.  I’ll be your server today.”  There’s even a list of states in which I am barred from calling myself a doctor even though I’ll have earned a doctorate of practice.  Honestly, if we just pooled our monies and bought the loudest protestors Porsches would that ameliorate the insecurities?  No one is usurping their doctorieness.  Calling doctorally prepared nurses, pharmacists, or psychologists “Doctor” does not detract from their authority or achievements.  I have yet to find a valid argument for their fear of the Nurse-Doctor.  I’m not scary; I'm geeky smart and tell funny stories.  I’m the least threatening person you know.  Until you tell me I can’t have something and then I’m simply determined.  Dr. Nurse.  Yes, that sounds just right.

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