What kinds of patients do you see?

Specialties NP

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I'm finishing my BSN in 9 weeks, YES! My goal originally was to go straight into NP school initially but I've since been schooled that I should work for a while to gain nursing experience. One of my clinical instructors told me I should have 3 years in the ICU and 2 in the ER because as an Adult NP she deals with really complicated heart medications and she felt unprepared dealing with them when she started. That scared me quite a bit because I thought NPs mostly dealt with straightforward patients. Now I'm second guessing if I should pursue NP at all. I want to go into pediatrics so I don't know if that makes any difference. Can someone fill me in on what kind of experience is beneficial, how much of it I should have, and what kinds of patients/issues I should be prepared for when I get into the field?

Thank you!

Specializes in ER.

What are the benefits to being a nurse practitioner in the hospital vs outpatient? Or vice versa? I imagine the pay is higher in the hospital. Are there other things I should consider?

Specializes in NICU, adult med-tele.
Good point, thanks so much! I like the idea of working in a peds office, the hours would be so much more compatible with my kids schedules.

I would never discourage you from pursuing this but keep in mind some peds clinics are going to a more school friendly schedule. Ours operates normal business hours, then every night one provider and one nurse rotate late clinic which runs til like 8pm or something. Plus they're open on Sat for a while too. Just wanted to throw that out there. :)

I think our hospital NPs work 2 8s and a 24 hr on call shift where they stay in hospital.

There's opportunities for civilian NPs with the army. I see alot of psych jobs posted, but other areas as well. I know they have several NPs at the peds clinic we use. If you live near a base or VA that might be worth checking out.

OMG, I think you're right. I did my first day yesterday in clinical -- and almost every patient had these two common threads running through -- they were depressed, bipolor, or had some sort of psychological ailment, AND/OR they were overweight, either mildly or grossly so, and it was complicating every aspect of their health.

Americans are a MESS. But I can't even say it's all Americans -- plenty of folks from other nations there in the office as well, with the typical complaints.

What is WRONG with people in this country? Why is everyone turning to pills and food to solve their problems?

I plan, as an NP, hopefully, to try to offer people hope and other solutions. If I even break through to 1% of them, I feel I will have accomplished something.

... sigh. I really feel like weight is a lot more complicated than most healthcare workers give it credit for. Research clearly shows that not only is weight loss extremely difficult to achieve (and we're talking in highly controlled hospital settings where everything is measured, all exercise is counted, etc.) but it's damn near impossible to keep it off because of hormonal changes in the body. I really wish we could stop berating people about their weight and getting down to a certain BMI, when research shows this is nearly impossible for most people. Instead, why don't we encourage people to eat well and be active at any size? Seriously, an obese person who exercises has their risk go way, way down, even if they don't lose much (or any) weight. It's being sedentary + overweight that is the true killer.

Anyway, I blame processed carbs and excess sugars in the diet for the obesity epidemic. Research shows that 3/4 of the excess calories we consume since 1970 come from those sources, while the last 1/4 come from soy-based fats. I think the lowfat diet craze has caused people to turn to sugar/carbs, and when those reach excessive levels in the diet, they wreak havoc on metabolic processes.

Specializes in ER.

Good points myelin.

I'm finishing my BSN in 9 weeks, YES! My goal originally was to go straight into NP school initially but I've since been schooled that I should work for a while to gain nursing experience. One of my clinical instructors told me I should have 3 years in the ICU and 2 in the ER

1. It's fine to get advice from people you respect but it is your life, your career, your practice. Never let anyone else make your decisions for you.

2. Many highly reputable schools and programs are accepting students straight from their BSN programs. The idea that you should have to pay your dues somewhere before moving forward with your educational and career goals is the old, outdated way of thinking. We don't ask PA's to go sit around out in the field for a while before being deemed deserving of a ticket in to the profession they desire.

You should do whatever your heart tells you to do, and what you feel you are ready for - whatever that may be.

Best of luck to you, and congrats on your pending graduation. It's a heck of an accomplishment, enjoy it :-)

Specializes in ER.

Wow those are really great points. Thank your for your input. A lot to think about for sure!

I'm finishing my BSN in 9 weeks, YES! My goal originally was to go straight into NP school initially but I've since been schooled that I should work for a while to gain nursing experience. One of my clinical instructors told me I should have 3 years in the ICU and 2 in the ER

That amount of experience would be MORE than adequate. Most of the NP students in my courses have been in nursing for 3 years or less. I wished I'd had a little time in the ER, but I'll still be ok. Your'e going to re-learn everything in your clinical experience anyway.

I did 3 years on a cardiac/tele/stroke unit and I felt it REALLY prepared me well. I dealt with all the heart, lungs, kidney and vascular issues, neuro, etc. Hit just about every system. Dealt with a lot of diabetics, etc.

A lot of NP's will tell you, though, that it's your ability to communicate that will serve you the best. That trait is not always something everyone has, even with loads of clinical experience.

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2. The idea that you should have to pay your dues somewhere before moving forward with your educational and career goals is the old, outdated way of thinking. We don't ask PA's to go sit around out in the field for a while before being deemed deserving of a ticket in to the profession they desire.

Uh, you do know PAs have 2,000 or so hours of clinical vs NPs 500 or so. So basically a PA with no experience and an NP with none...well, you see the difference.

Uh, you do know PAs have 2,000 or so hours of clinical vs NPs 500 or so. So basically a PA with no experience and an NP with none...well, you see the difference.

Right, but at least an NP has trained as an RN. A lot of PA programs now accept people with no paid healthcare experience, I believe it's about 1/3 of programs. Furthermore, don't PAs need all those hours since they can work in any medical specialty, whereas a NP focuses their hours on one specialty (and goes back to school and accrues more hours if they want to work outside that specialty). It just seems like it would even out in the end, to me. PAs dilute their hours across all specialties. I do think that NP schools should beef up their hours to some degree, but I don't think that the PA model is necessarily superior.

Specializes in ER.

Absolutely. To get an NP one must get an RN. I don't know for sure how many clinical hours I've had but I know I had near 100 for my last clinical site (96) and I've been at 5 sites so far which would be near 500 hours so far. My final clinical is my preceptorship which I am about to start and it is around 250 hours so that would be a total of 750 clinical hours just for my undergrad. Additionally, my school and many others require RNs to practice a certain length of time before applying. My particular school requires an RN to have 3 years of full time hospital experience or they will not be accepted to the NP program.

I could care less about getting into any contests between PA's and NP's, but my hospital nursing experience was very valuable. I cared for at least 4 patients a day for 12 hours, for 3+ years. Everyday I got a rundown of a disease process, SAW how it affected the person, understood their needs in relation to that. I saw the doc's notes, the labs, understood which tests were being ordered and why, and I saw the progression to wellness, usually. Granted, these were acute illnesses, but I also got to understand how their daily health habits and perhaps how their primary care, or lack of it, affected them. Sometimes I was just dressing wounds and changing sheets, but at the same time, I was taking those orders, and after a while, I KNEW what the order needed to be, or should have been.

Now, in NP school, I'm learning the rationales behind the orders ... as well as far deeper pharmacological and psysiologically info ...but a lot of it I already know -- and have seen in a clinical setting.

Have also dealt with family members -- and that is a skill all in its own.

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