Best RN experience for FNP

[Futurefnp88]

I have applied to FNP schools starting in the fall. Currently I am working in the ICU in all areas (neuro, medical, and cardiac). The opportunity to cross train to the ED has presented itself. I am interested in cross training due to the invaluable experience of seeing the presentation of patients across the life span/working closely with physicians/NP's. I would like to know from those of you that are FNP's, do you think ER nursing experience would help me be a better FNP? I hope to work in primary care in a clinic when I am an NP. Thank you for all of the advice.

[futureeastcoastNP]

I've always thought ED is the best prep for NP, at least on the surface. You see a ton of different diseases and treatments, and since the person comes in with no diagnosis, you get to help in that process and see the decision making process from the start. You learn what tests are usually ordered for what symptoms, lots of differential diagnoses, etc.

[zmansc, ASN, RN]

Well, I have ER experience so I'm biased. I think futureeastcoastNP is correct in that the ER experience I have has helped me with the tests for conditions and given me an idea of diff dx for various Sxs. Having said that, I think ICU experience probably would help some in the same ways and in some others. You will see pts for longer, and get more of an idea how their chronic conditions and comorbidities affect their long term care, which may also be helpful.

I personally think both have their pluses and minuses, and the important thing is you use the time you do have wisely, and have an inquisitive mind when you are working wherever you are working. I try to stay ahead of the providers on my patients and think about what I would do if I was the provider, and ask why they did what they did so I can learn something new every shift. If you do that, you could work anywhere and gain the necessary experience for FNP school.

[BostonFNP, APRN]

All in all any experience is as good as any other experience; they will all contribute to how you approach patients. I would say, for most PC NPs, that the more varied your experience the better with the caveat of planning to stay in a single speciality or subspecialty.

Nursing experience may help you a lot in school, especially ICU and ED experience, however you will find in practice that those experiences may not directly translate, as APN practice is so much different from RN practice. ICU experience has some great benefits but also some drawbacks. ED experience has some great benefits and several drawbacks. Same for med-surg and even case management work. The only experience that won't benefit most PC/AC NPs is operative experience, unless you are in a speciality that requires it.

In the end it's a big jump from RN to NP and from student NP to practicing NP.

[newFNP2015]

I think all areas have something to offer when looking into NP preparation. I have a professor who likes to say the ICU and ED are the best preparation because of the degree of critical thinking required. I have ICU experience and often wish I had gone the ED route for the variety of diagnostics, disease processes, and treatments. However, I don't necessarily feel under-prepared in school. In addition, clinic work is helpful to grasp billing and day-to-day scheduling in primary care. Med-surg sees a variety as well and it takes a special type of time management to get around that many patients. So, I say everything has its applicable experience related to school. A variety of these experiences is probably the best, but no single experience is likely the best.

Related to practice (and I'm still student), I think there is no substitute for playing the role of a provider in clinic. Everyone is on a relatively similar playing field the first day of clinical because the roles of RN and NP are so different even if some of the same skills apply. Just my humble NP student opinion.