ER nurse to FNP

Specialties Emergency

Published

Hello! I am beginning coursework and pre-requisites to become an FNP. I have been an ER nurse for 2 years, and I feel it is time to dive more deeply into learning! I would like to switch units to ICU or IMC (Intermediate Care). Do you think it is a step backwards from ER to move into IMC?

I am a fairly new nurse (2 years) and looking for guidance and mentorship!

Sincerely,

Anne

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

A step backwards? I am not sure what you mean....it is a completely different specialty. I think you could only benefit from seeing long term planning and management of patients and not just the treat em street focus.

friendlylark

151 Posts

Specializes in Nursing.

To clarify, when I apply for an IMC job, it is listed as RN II, when I apply for ER or ICU, it is listed as RN III. When I build my resume, I want it to show an upward trajectory, moving in the direction of my goals, with greater skill and responsibility with each move I make. My concern is that an IMC position (RN II) is regarded as less skilled perhaps than an ER or ICU (RN III) position. This is in no way meant to denegrate the position of IMC nurse, but rather a thoughtful consideration of my career path and direction, and how it will be perceived by managers, directors, and physicians as I move into the role of FNP.

My true goal is to dig-deeper in to my patient's medical case and gain more knowledge of disease process and pathophysiology. I suspect that I may be able to accomplish this goal by moving to a unit other than ER, such as IMC or particularly ICU.

Thoughts?

eCCU

215 Posts

Specializes in CCU, CVICU, Cath Lab, MICU, Endoscopy..

FNP is more preventative care ACNP is more acute care. Case and point FNPs do not do rotations in critical care but more in primary care. If you wish to see what you learn in school ICU may not be the best thing unless you want to change to ACNP. Most FNPs if not in primary care are in the Emergency rooms. Most ACNPs are in acute care and specialty clinics.

friendlylark

151 Posts

Specializes in Nursing.

Hello eCCU! Yes, I have been looking into the differences between FNP and ACNP. My concern with ACNP is that I will still end up with nights/weekends/holidays. I definitely do NOT want to be in the emergency department when I graduate with my nurse practitioner!!!

eCCU

215 Posts

Specializes in CCU, CVICU, Cath Lab, MICU, Endoscopy..
Hello eCCU! Yes, I have been looking into the differences between FNP and ACNP. My concern with ACNP is that I will still end up with nights/weekends/holidays. I definitely do NOT want to be in the emergency department when I graduate with my nurse practitioner!!!

If you want to work with critical care patients thats is unavoidable since you have to take call for your colleagues at some point. Other option is to go with specialty clinic and no hospital privileges that will keep you on the mon-fri no weekends or holidays you can be more marketable if you go fnp if thats the case. Most specialties like some relief call over the weekends or holidays like cardiologists, renal, neuro etc

zmansc, ASN, RN

867 Posts

Specializes in Emergency.
To clarify, when I apply for an IMC job, it is listed as RN II, when I apply for ER or ICU, it is listed as RN III. When I build my resume, I want it to show an upward trajectory, moving in the direction of my goals, with greater skill and responsibility with each move I make. My concern is that an IMC position (RN II) is regarded as less skilled perhaps than an ER or ICU (RN III) position. This is in no way meant to denegrate the position of IMC nurse, but rather a thoughtful consideration of my career path and direction, and how it will be perceived by managers, directors, and physicians as I move into the role of FNP.

My true goal is to dig-deeper in to my patient's medical case and gain more knowledge of disease process and pathophysiology. I suspect that I may be able to accomplish this goal by moving to a unit other than ER, such as IMC or particularly ICU.

Thoughts?

The most important thing your RN position can give you is background information for which to apply the information you are learning in your NP program. Career path, RN II vs RN III (which is a local facilities designation), etc. are of little to no importance to the program or future employment. You will learn far more about your future career in your didactic and then your practical portions of your NP program than what you had learned by being an RN in any of these positions.

I'm not suggesting that the exposure in one or all of these fields wouldn't help, because it certainly does help. All my experience was in the ER prior to entering my program. I would have loved to have had a few months in the ICU and a few months in hospice, and.... It would have been nice just to have a slightly wider variety of knowledge about the needs of those various patients prior to starting to learn about them. Nice, yes. Necessary, no. Those who did the best in pathophys in my class were all ER nurses. I don't know if that is always the case, or was just a fluke of that class, but I think an ER nurse who pays attention, asks questions, researches their patients, will do very well in FNP school. I'm sure an ICU or other nurse who has the same attributes I mentioned above will also do fine. Those attributes are the key, not the specialty the nurse practices in.

PG2018

1,413 Posts

Specializes in Outpatient Psychiatry.

I would think the ER, particularly if you can focus on urgent care types of complaints, would benefit your experience and training as a FNP far the more. The best job, however, is one that will accommodate your school schedule. Is there a position that will let you get off for academic commitments? Is there a position that is less stressful than others (because you'll have enough stress otherwise)? Is there a position with down time during the shift where you can sit and work on your studies? Those were all fundamental to me in pursuing my psychiatric mental health nurse practitioner program. I worked at a sleep, rural med-surg unit starting out because it offered enough downtime during the shift to do a lot of my research, adv. research, theory classes, and all of the other time consuming courses. I switched to an office environment after a year of that to stop working nights, see some primary care stuff, learn some more about psychotropics, and start doing some clinical work for my PMHNP program. Now that I'm pretty much through with the didactics I've started a new position that is only three days a week that will give me two to three days off during the business week to complete my psych clinicals and learn/see more of the urgent, primary care stuff. It's an ER position so there's a lot to it, plus I started out as a paramedic 13 years ago and took a long hiatus from healthcare until I got my RN license two years ago.

Best wishes!

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