Accepted into the nursing program, questions about career path

  1. 0
    Hello! I am excited to say that back in March, I received my acceptance letter for the Traditional BSN Nursing Program at my University. I will start in the fall and I am counting down the days! I have an idea of what area of nursing I would like to pursue, which is critical care. My overall goal is to become an Acute Care Nurse Practitioner. Significant traits about me are that I am detail-orientated and like to plan ahead and have alternative plans established so I can make the best decision possible on a situation. I have read many threads on this forum about new graduates having difficulties finding jobs after graduation. This worries me, so I want to do all that I can to enhance my chances of getting a job. In doing such, I have come up with different possible course of actions to take now until graduation to accomplish my goals. I would like your input as which route is plausible for me to make my dream into a reality. Ultimately I will be talking with a nursing advisor as well, but it is nice to hear from the allnurses community .


    Here is a little background info about myself before I start. I am currently a cna on the Med/Surg floor for more than three months. I have previous experience working at a nursing home as a cna before transitioning to a hospital. I am fast learner and have already orientated new aides on my floor even though I was still new. I have been a member in my university’s student organization taking on leadership roles and enhancing my planning/organizational and critical thinking skills.


    Plan A:
    1.) Continue working as a cna on the med/surg floor during nursing school
    2.) Do two summer nurse intern programs in a critical care setting after my 1st year and 2nd yr
    3.) Work as a Med/Surg nurse on my floor for 1 yr after graduation
    4.) Transfer to the ICU or step-down unit
    5.) Transfer to the ICU
    6.) Work as a ICU nurse for 2-3 yrs
    7.) Continue my education and get my masters to become an ACNP

    Plan B:
    1.) Continue to work as a cna on my floor until I complete my first year of school
    2.) Do a summer nurse intern program in a critical care setting after my 1st yr
    3.) *Apply and transfer to a nurse tech position in the ICU at my hospital if available; if not, continue on my floor
    4.) Work as an ICU nurse after graduation
    5.) Work as an ICU nurse 2-3 yrs
    6.) Continue my education and get my masters to become an ACNP

    I having a hard time deciding on whether to stay on my current floor and work in med/surg to gain that first year experience after graduation. I’ve read threads on here with mixed emotions on whether to start out on the floor or go directly into a unit. I really feel for my med/surg nurses because of the patient load and demands. Even though I did not like working in LTC, the months I’ve spent working there as a cna was an invaluable experience that further helped me with my skills when I transition to a hospital. In a way, working in med/surg would have that same effect for one before moving into a specialize unit. However, I have read great stories about new grads going directly into the unit and really enjoying it. That’s why I want to intern in a critical care setting and hopefully find a tech job to in the same setting. Also, I will work on my resume and cover letter and take additional classes, if needed, as well.

    ***I know it is not a 100% guarantee that I will get a RN position after graduation immediately. I have heard from several nurses on my floor that you have a better chance of getting hired into a hospital as a RN if you already work in a hospital environment—i.e. nurse tech. This scenario is assuming I get an immediate position.

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  2. 21 Comments...

  3. 3
    Your post is extremely long. Not an attack--just an observation. Too tired to read all of it right now.
  4. 1
    Like your name says.... life is a journey Slow down and enjoy it! Lol, your thought process is exhausting

    If you really want to be an ACNP, I heard its best to get ICU experience, and it sounds like you'd be the type of person who is happiest with getting to your goals ASAP. Make those networking connections during school. Stay with your current CNA job while in school and look for CNA positions on a critical care unit. You CAN get an ICU position right after school, just get good references and make good connections.
    Good luck to you. You'll be fine. Just don't overstress yourself!
    LifesAJourney likes this.
  5. 2
    Quote from hopefulwhoop
    Your post is extremely long. Not an attack--just an observation. Too tired to read all of it right now.
    This is not a personal attack, but an observation... this did not help the OP at all, so why you even bothered posting a response like this is beyond me.

    Anyways, to better answer your questions OP...

    Plan A:
    1.) Continue working as a cna on the med/surg floor during nursing school
    2.) Do two summer nurse intern programs in a critical care setting after my 1st year and 2nd yr
    3.) Work as a Med/Surg nurse on my floor for 1 yr after graduation
    4.) Transfer to the ICU or step-down unit
    5.) Transfer to the ICU
    6.) Work as a ICU nurse for 2-3 yrs
    7.) Continue my education and get my masters to become an ACNP
    This is really the best route to go, you will have all the experience you need to be a better qualitifed nurse as the real learning happens after you graduate and actually enter the field. Nursing school equips you with the education, but actually working in the field equips you with the experience. Critical Care is just as it is.. its critical care and you have to learn how to take care of acutely ill patients before you can get the assessment skills needed to work in a critical care area, and that just something experience teaches you and that is my opinion.

    If you work in a critical care area first, you will be nervous and feel like you may not do a very good job when you get a very, very critical patient that is in and out of being stable, which is quite normal to feel that way if you do not have the experience. So your plan A is the best route to go for you to obtain the nessecary experience that is required to working a speciality such as critical care, but again that is my opinion. I worked in the ER for three years after I worked on a med-surg unit for 1 year. I hated working on the Med-Surg unit, but I will never give make that experience I got on that floor because I feel like it gave me the nessecary assessment and time management skills to actually excel as an ER Nurse.

    Also another think to take a notice of... you want to be a ACNP, and thats great, but just remember as of 2015 and even starting this year, most Colleges and University's are doing away with the master level NP and actually requiring their students to have a DNP (Doctor in Nursing Practice). So after you graduate with your BSN, get a little experience, but check in to the NP programs around your area, or one that suites you the best and actually see entrance requirements and degree requirements.

    Education is the key to success and great experiences, I'm very impressed to see a student who hasn't even started classes yet to have a game plan already outlined, you are going to make a great nurse one day and I'm so glad you decided to join our community to share your experiences with us.

    Good Luck!
    hiddencatRN and LifesAJourney like this.
  6. 1
    Quote from JTworoger

    Also another think to take a notice of... you want to be a ACNP, and thats great, but just remember as of 2015 and even starting this year, most Colleges and University's are doing away with the master level NP and actually requiring their students to have a DNP (Doctor in Nursing Practice).
    2015 is still just a proposed timeline where the DNP is being brought forth as the standard for being an NP. Nothing is set in stone. It could come sooner (not likely), or it could come later (most likely). A lot of instructors believe that it will be later because of a lack of health care providers. Requiring a DNP for being an NP would only increase the problem with shortages, in my opinion (and in other's opinions, as well). I went to Vanderbilt's open house in March of this year, and this was brought up several times. Several different instructors made it a point to say that nothing is certain about this "2015" date, although some schools are going to a DNP in anticipation of this date. The majority, however, are not..... just yet.

    I still say if you want to do ICU right out of school, then go for it. Saying that Med/Surg is best first is old school at best. The best experience is OTJ experience, so if you want that ICU, make good connections, and go for it!
    LifesAJourney likes this.
  7. 1
    2015 is still just a proposed timeline where the DNP is being brought forth as the standard for being an NP. Nothing is set in stone. It could come sooner (not likely), or it could come later (most likely). A lot of instructors believe that it will be later because of a lack of health care providers. Requiring a DNP for being an NP would only increase the problem with shortages, in my opinion (and in other's opinions, as well). I went to Vanderbilt's open house in March of this year, and this was brought up several times. Several different instructors made it a point to say that nothing is certain about this "2015" date, although some schools are going to a DNP in anticipation of this date. The majority, however, are not..... just yet.
    I knew that there was some speculation regarding the 2015 date of the NP - DNP situation, that is why I suggested that she completed her BSN program first and check around for degree requirements. And I agree with the above post, if you want to be a ICU Nurse, then go for it. I can only give my opinions based off my experiences and my experience is the better rounded you are as a nurse, the better nurse you will become. I completely agree with the statement that nursing is OJT, its all about the situations and experience you have to deal with as you are working. Every day is a new experience, diease process you haven't taken care of before, and situational structures that place you in awkward situations as times, but that is what defines nursing and makes good nurses.
    jollydogg_RN likes this.
  8. 2
    Quote from JTworoger
    I knew that there was some speculation regarding the 2015 date of the NP - DNP situation, that is why I suggested that she completed her BSN program first and check around for degree requirements. And I agree with the above post, if you want to be a ICU Nurse, then go for it. I can only give my opinions based off my experiences and my experience is the better rounded you are as a nurse, the better nurse you will become. I completely agree with the statement that nursing is OJT, its all about the situations and experience you have to deal with as you are working. Every day is a new experience, diease process you haven't taken care of before, and situational structures that place you in awkward situations as times, but that is what defines nursing and makes good nurses.
    For sure, I was not in any way discrediting your opinions. Looking at your experience posted, you have more than me by any means, and are more knowledgeable as an RN. I only disputed the fact that most schools are switching to DNP. In fact, the two programs that I remember switching to DNP of 2013 were online programs only, if you can believe that! I think that was out of 10 or so programs I looked into. You would think it would be the other way around, but I guess not!

    Even at the end of our ADN program, all of our instructors were saying "hurry up and get your NP by 2015 if you don't want to receive a doctorates". I just think its a misconception, and if a school such as Vanderbilt (which is usually up to date on the latest) is saying this, well, I'm sure I could believe them

    You're right as well; it could be awkward for a new nurse in ICU, and as much as I can't stand med/surg, I am thankful for my rough 8-9 month stint in it. It helped me with time management and how to deal with stress and reality shock. I think it seems like the OP has clearly defined goals, and could successfully manage being a nurse nurse in a critical care environment.
    LifesAJourney and JTworoger like this.
  9. 1
    Quote from jollydogg_RN
    For sure, I was not in any way discrediting your opinions. Looking at your experience posted, you have more than me by any means, and are more knowledgeable as an RN. I only disputed the fact that most schools are switching to DNP. In fact, the two programs that I remember switching to DNP of 2013 were online programs only, if you can believe that! I think that was out of 10 or so programs I looked into. You would think it would be the other way around, but I guess not!

    Even at the end of our ADN program, all of our instructors were saying "hurry up and get your NP by 2015 if you don't want to receive a doctorates". I just think its a misconception, and if a school such as Vanderbilt (which is usually up to date on the latest) is saying this, well, I'm sure I could believe them

    You're right as well; it could be awkward for a new nurse in ICU, and as much as I can't stand med/surg, I am thankful for my rough 8-9 month stint in it. It helped me with time management and how to deal with stress and reality shock. I think it seems like the OP has clearly defined goals, and could successfully manage being a nurse nurse in a critical care environment.
    I apologize if I implied I felt like you where discrediting my opinions, I don't feel as if you where doing that at all, so no hard feelings on that part. I know I'm an LPN, but experience as a nurse serves as experience as a nurse. Well rounded nurses who have experience in "entry-level" nursing just seem to have better nursing skills that actually make them better nurses, you even said it yourself with this statement...
    You're right as well; it could be awkward for a new nurse in ICU, and as much as I can't stand med/surg, I am thankful for my rough 8-9 month stint in it. It helped me with time management and how to deal with stress and reality shock.
    Because I do believe you are right on the money when you say it helped with time-management skills and helps you deal with the intial shock of just graduating and getting your feet wet.

    Good post Jolly_Dog, RN. Kudos to you!
    jollydogg_RN likes this.
  10. 0
    Quote from JTworoger
    I apologize if I implied I felt like you where discrediting my opinions, I don't feel as if you where doing that at all, so no hard feelings on that part. I know I'm an LPN, but experience as a nurse serves as experience as a nurse. Well rounded nurses who have experience in "entry-level" nursing just seem to have better nursing skills that actually make them better nurses, you even said it yourself with this statement...

    Because I do believe you are right on the money when you say it helped with time-management skills and helps you deal with the intial shock of just graduating and getting your feet wet.

    Good post Jolly_Dog, RN. Kudos to you!
    No apologies necessary. I was actually wondering if you were an LPN or an RN due to the fact it says you're 24 with 5 years of experience, lol . But thats ok, I'd trust some LPNs over RNs anyday. (Everyone knows I don't play into the LPN vs. RN bs-argument. They both are an integral part in healthcare, although I can see the progression into LPNs being mostly phased out eventually).

    I believe as long as NPs are called NPs (you know, nurse practitioners), then some form of nursing experience should be had before becoming one. I know the majority of places require one year of verifiable experience (or 2000 clock hours) before allowing you to undertake the clinical portions of their school. I'm not discrediting any NP that did a direct entry program. Our FNP at our psych facility is a great guy, and did a direct entry program from Vandy. He really takes the time to talk to the patients, which is great. Like I said, its OTJ that really matters, but having that experience as an RN beforehand is just icing on the cake.
  11. 3
    I think both Plan A and Plan B are good ones -- and you should remain open to either plan in case the one you choose doesn't pan out the way you hope.

    However ... if I were in your shoes, I would choose Plan B. If an opportunity to work in an ICU as a tech or CNA or whatever comes along, I would take it. Those types of opportunities don't come along every day and I wouldn't want to squander one if it appeared. Such an opportunity would give you a chance to see that environment from the inside to help you decide whether or not it is as good as a fit as you now think it will be. It will also give you a chance to get comfortable in the envirionment so that you will be more ready to work there as an RN when the time comes.

    Base on your experience in the ICU while you are a student, you could then decide whether or not you should seek an interenship there as a new grad or not. The choice will be yours. If you don't get the ICU experience as a student, the choice may not be yours. I'd want the choices to be in MY hands as much as possible -- and getting the ICU experience early is the way to put more choices in your hands.


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