So it goes that I am so very near the end of my graduate school journey (at least for this leg of it—more on that in a bit) and the step after graduation includes certification. That means testing. A big 3.5 or 4-hour test. Depending on which certification board I choose I will be sitting at a computer (oh the horror!) for that length of time to assess if I have the very basic competency to be safe as a Family Nurse Practitioner. My emotions regarding this are all over the place. I am thrilled that I am reaching a goal. I am terrified that I have too little of an idea of what I’m doing. (I’m told this is normal and good.) That fear is what motivates me to take any opportunity available to do more, do better, be my best.
One tool in my arsenal of study included a live review provided by Fitzgerald Health Education Associates, Inc. There are other companies providing this service such as Hollier, or Leik. I have no incentive to plug one over the other and I know little of the latter two. I selected Fitzgerald because it was the first one I heard of and a Family Nurse Practitioner I work with recommended it. Additionally, I was gifted the materials my friend used for her boards and found it works for my learning and study styles. Margaret Fitzgerald is an excellent facilitator as I learned through listening to the 2013 CDs. Those primed me for my clinical practice and helped to gear my clinical decision making. Solidifying this practice-specific knowledge allowed me to hone my understanding of assessment, diagnosis, planning, intervention, and evaluation.
Hang on. ADPIE. I thought that was for just RNs. Pshaw! While the order is the same, as advanced practice nurses, this scientific-method based approach is still valuable. The nuances of change are related to the higher level of knowledge and responsibility my new role will entail. These are not nursing diagnoses and interventions. NANDA need not apply. What this process also aligns with is the SOAP format. That “medical” model is necessary to get to the end point and determine the direction of plan of care. Furthermore, as NPs, the vast majority of us will have a collaborating physician. As that is the model they know, presenting your patient to them if you need to will be straight-forward and not a nurse-report format. Trust me. Out of 8 different preceptors, only three didn’t care how I presented it. It was crucial to be able to say succinctly (with the SOAP format) the presenting complaint and history of it, the physical assessment, my differentials, and then plan.
Back to the review: I attended a live seminar that was an intensive two-and-a-half day affair. Brett Snodgrass, NP is a dynamic and entertaining speaker who reinforced knowledge learned, assisted in guiding us to our areas of weakness, and I could tell not only was she experienced in her own right, she follows the Fitzgerald model to a T. (As compared to the 2013 CDs…the content was almost the same with the differences being updates on guidelines and evidence-based practice.) I gotta say, I came away from that exhausting and exhilarating weekend all the better for it. My first day home was the first day of my last rotation and darn if those concepts didn’t pop right out into my practice. I was amazed at how concrete some of those guidelines were. I could tell a difference in my approach from a year ago. This preceptor had me for my first rotation and I suspect he sees the growth, too. (So much so that he hinted at needing an NP soon, would I think about it?)
The supplemental certification exam text that I purchased is eagerly awaiting my use. I know it will only further improve my knowledge base and get me that much closer to my goal. Once I meet that I can work on leaving the ranks of Novice toward beginner. Then more graduate school! A DNP is in my future, but I have other fish to fry in the mean time.
Nurse Who 