ACNP clinicals, expectations

[NPmimzy75]

Hi all,

I will be starting my ACNP clinical rotations in 2 semesters, and I am freaking out to say the least! I'm not sure what to expect and what will be expected of me. There is only one ACNP in my area, so I will be precepting mostly with, MDs (if I can even find some to take me, which is a whole other ball of wax!). I feel like I need to start "studying" and "memorizing" now to be prepared. I'm wondering what others have to say about their clinical experiences and how they were treated (try not to scare me too much). Are they going to expect me to have an equal knowledge level to them, which obviously I cannot? Were you actually taught, or just expected to "start working" and were supervised and/or critiqued?

I have 3 years experience in cardiac nursing and am feeling way behind because I don't have 20 yrs ICU experience. Any tips, tricks or ways to prepare for clinicals? Each of our rotations is only about 100 hours, so I want to make the most of it.

Thanks! Jen

[Corey Narry, MSN, RN, NP]

Oh I'm sure they (physicians) will not expect you to have an equal level of knowledge. Just based on my experience in clinicals, I actually enjoyed having the physician presence during clinicals as I was paired with a nurse practitioner all throughout my rotations. And just to share my experience with you (because I'm sure it's not exactly going to be the same in your case):

1. Internal Medicine rotation - did it at a VA hospital and loved it. We were assigned our own patients but an IM resident was responsible for guiding us through. Attending was super nice and taught a lot. I was never put on a spot or embarassed. My NP preceptor was mainly in the background as he did mostly primary care in the clinic while I was in the hospital.

2. ER rotation - paired with another NP but saw my own patients and had to present my assessment and plan to attending ER doc. Different ER docs to deal with depending on the day. Some asked a lot of questions and made me feel like an idiot but some were super nice. Some taught me stuff, some gave me compliments, and some were just flippant when dealing with me. All in all, it wasn't too bad.

3. Cardiology rotation - paired with an NP who worked with a large practice of Interventionalists and EP guys. Didn't round with the EP guys as the NP didn't deal with them but did a lot of rounding with the Interventionalists doing mostly hospital consults and cardiology step-down unit admissions. Saw patients in the clinic as well. The NP was super smart and saved me during rounds most of the time. Was never put on the spot during rounds. I was told one of the attendings liked me as a student which was nice to hear.

4. Critical Care rotation - worked in a MICU in a VA system. Very low volumes with not as crazy acuity as you'd find in academic medical centers. Rounded with different Intensivists and was assigned patients on my own to do notes, write orders, etc. There was a resident who was with me but the assignment was split between him and I and a PA-C. Same preceptor as the IM rotation who was not really there but designated as the "official" preceptor. Tried to do procedures but miserably failed (nerves maybe). Some of the attendings made me nervous on rounds but I was never picked on to answer clinical questions during rounds or put on the spot so to speak (they picked on the resident more than anyone else).