NP school: the interview

If you are thinking about a career as a nurse practitioner, you probably wonder if you'll be accepted after going through the process of applying. 

I thought I'd share a few inside tips about my own interview at Penn. 

I was admittedly nervous for the interview but felt confident about my interviewing capabilities.  I dressed for the occasion in a black skirt and light blue button down shirt.  It was the middle of the summer and I definitely worked up a sweat before I arrived.  I brought along a copy of my resume and essay, just in case.  

I sat down with the Associate Program Director for a one-on-one interview.  The interview lasted approximately 45 minutes and in my opinion, was incredibly thorough.  She started off asking general questions about my work experience and then followed up with scenario related questions.  You know-- the ones where you're asked to give an example of a time you showed leadership capabilities as a bedside nurse?  Or, tell me about a time that you advocated for your patient in a difficult situation?  Also, if I were to ask your co-workers and managers, what would they say about your strengths and your weaknesses?  Gotta love that question.

Then, we talked about the NP role in general and I used this opportunity to tell her why I wanted to become a nurse practitioner.  I also asked specific questions about the program at Penn.  Do not forget that even though you are the person being interviewed that this is also your chance to ask your own questions about the program.  It's important to know if a specific program is the right fit for you.  I wanted to know their board pass rate and which clinical settings/locations do they use, among a few others. 

I do remember the last question she asked which I was not expecting-- it went something like this:
"Do you read nursing or medical research?"  Me:  Oh, yes, definitely. It's important to stay updated on the latest practices because as you know, medicine changes so quickly.
"Ok- can you tell me about the research that you've read recently?" Oh, wow-- did she really just asked me that. (Think, think, think,- sweating again) Luckily, I did recently read a research article about robotic prostatecomy- don't ask me why- but it saved me, thank you, prostate.

 A few take home points from the NP interview:

1. Think through the scenario questions before the interview.  Be prepared to sell yourself.
2. Don't forget to 'interview the program' 
3. Understand the role of the NP and current legislative issues. 
3. Read up on some latest nursing/medical research.


So, there you have it- my interview experience.  I hope this helps you if you're thinking about applying or are preparing for an upcoming interview. 

Neuro ICU Clinical: a typical day

Hi there!  Wow-- it's been quite some time since my last post.  Well, that's because I've barely been able to keep up with all of the demands- school, work and clinical but I'm trying my best.

Here is a typical clinical day in the Neuro ICU:

0600-0730:  I arrive on the unit and am given 3 patient assignments.  I assess my patients, look up their recent labs, talk with the night nurse about any events and record the info on the ICU flowsheet that is then used for rounds that morning.
0800-0900:  Attend morning report.  Morning report consists of the trauma/surgical/neuro attendings, residents and students.  Each patient is discussed- the new patients in detail and a quick update is given about the existing patients.  I did present a new patient the other morning and it went well-- although you could hear the nervousness in my voice-- ugh!
0900-1230:  Morning rounds with the neuro attending, the NP, PA, bedside nurse and respiratory therapist.  Rounds are incredibly thorough and a complete neuro exam is performed on each patient.  We discuss each patient head to to toe, new orders are written and any issues are discussed.
1300-1400:  I usually follow up with my patients if there were new labs that were ordered, etc.
1400-1430:  Lunch
1430-1600:  I assess my patients again in preparation for sign-out.  My NP preceptor will usually select a topic that we discuss ie: ventriculostomies, head CT's, etc.  On several occasions I've gone to the ED with the NP or attending to assess a new stroke patient.
1630:  Sign out

I've enjoyed the Neuro ICU but over time I can see how difficult it would be to manage this patient population day in and day out.  I've only been there for a total of 8 days but almost that many patients have died or have become severely disabled as a result of their brain infarct/injury/hemorrhage.

Chest Tubes or Bacon?

The trauma surgeon was doing an excellent job lecturing to us about chest tube insertion but as soon as the pig rolled in-- all eyes were on the bacon.

He demonstrated to the class how to insert a chest tube and then we went to the lab and tried it ourselves.  Let's just say that inserting a chest tube is not as easy as it looks.  If I ever have to do this on a real human being-- help me.

Technology in medicine

Tomorrow is our panel presentation in 'Advanced Technology & Clinical Decisions in Acute Care.'  Why must the course names be so long, really?  Anyway, this presentation is kind of a big deal-- as in 40% of our grade.

The assignment is to select a controversial therapy that is currently offered to patients- select a pro side and a con side, find the latest research on the topic and creatively present on this topic for 30 minutes.  Our topic is standard radiation therapy vs. proton therapy in cancer patients.  I won't bore you with the details but instead, have posted this TED talk for your viewing pleasure.

Sometimes, we rely too heavily on technology to provide us with assessment information that we can obtain from a good old fashioned physical exam-- let's not forget that.  

The Chest X-ray

Today was our chest x-ray lecture.  It was truly a captivating 3 hour lecture given by Dr. Wallace T. Miller, Jr.  He is an expert in his field and an amazing teacher.  It's pretty awesome when the lecturer is also the same guy who wrote the book about chest x-rays that I have on my shelf. 

We looked at many slides of-- well, you guessed it-- chest x-rays.  His tip for the novice reader is to ask yourself these 4 questions.

1.  Is it normal or abnormal?
2.  Is there a problem with the heart or the lungs?
3.  Is the problem diffuse, focal or multi-focal?
4.  Is the pattern alveolar or interstitial?


I know that I was mesmerized and so was the class.  There is so much to learn and I came away wanting to learn a lot more.  It also didn't hurt that he enjoyed cold-calling students for their 'expert' opinion about the films.  Yikes!

Here's an article about the Miller duo- Father and Son

SimMan

Today was our SimMan practicum.  Admittedly, I was nervous and did not know what to expect.  The professors were vague at best.  Also, this was my first experience with a SimMan.  We did work with mannequins in nursing school but never an 'intelligent' SimMan.

They divided us into groups of 4 but one of our group members couldn't make it because of car trouble.  The room was large and along the wall was Mr. Hottie himself- Sim.  He was connected to a speaker in the room next to ours.  Another professor was speaking for him, in other words, playing the role of the patient and observing us through a one way piece of glass.  Two adjunct clinical faculty members were grading us in the room and our professor was assisting us with obtaining the lab results, EKG results, etc when we asked for them.

The setting was in an ED and we were his NP's.  We were given info about him ie: age, presenting complaint, past medical/past surgical history.  Then, it was our turn to elicit the history of present illness, conduct a review of systems, a physical exam, order labs, drugs, oxygen, etc.  We interpreted the labs and proceeded accordingly.  In the end, our case scenario was a pt with a NSTEMI (non-ST segment elevation myocardial infarction).

It was pretty straight forward and we received high marks as a group.  Although, I was trying to complicate things by also ruling out a pneumonia.  I thought that our professors would give us 2 issues that we had to address-- but it ended up being simpler than that.  In the end, I was glad that I explored the possible pneumonia/resp infection because SimMan did have a temp, coarse breath sounds and a high WBC count so it did fit the clinical picture but the chest x-ray was normal.

Overall, I did like the SimMan practicum.  I thought that it was helpful in understanding my own strengths/weaknesses.


Have you ever used a SimMan?  Did you find the experience helpful or a waste of time?


Image by John McLellan

Christiana Hospital

It's official-- my first clinical rotation beginning in January will be at Christiana Hospital! I received an email from the Delaware Board of Nursing that my nursing license by endorsement was approved. Yay!  I was worried that it would not be approved in time.  

I'm very excited because I wanted this rotation for several reasons.  I will be working alongside a NP in their Neuro/Trauma ICU.  According to the clinical faculty, this is an excellent rotation.  The clinical coordinator had only glowing things to say about the NP who will be my preceptor.  Also, I'm especially excited about this patient population.

My first job as a registered nurse in an ICU was at University Medical Center- Brackenridge in Austin, Texas.  I worked in their neuro/trauma unit and really enjoyed it.  I learned so much in that unit because as you can imagine, the acuity was incredibly high.  The patient population consisted of traumatic brain injuries, brain aneurysms, strokes, multiple fractures, and the list goes on.  I'm ready to dive back into this setting to see what the job is like from the nurse practitioner perspective.