Acute Care NP without ICU experience?

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I am in an acute care NP program (pediatric) and I have never worked in an ICU. I applied in the past but timing didn't work out and I stayed on my med-surg unit. Now I am busy with school and about to start clinical. My job has moved me to PT days which is what I need right now to get through school. I am worried I will not be able to find employment as an acute care NP without having ICU experience. If I moved to an ICU now I would be FT nights and unable to manage classes and clinical. I know some are able but I have a lot of other things on my plate as well and I know I won't be able to do it. Is this going to hold me back?

6 hours ago, Numenor said:

I am sorry, pray tell how someone with <1000 hours NP experience (school combined and being generous) prepare someone to be a competent critical care provider. I did acute care at a large state school with NP colleagues who came from top 5 programs and none of them felt prepared until they were a couple years into practice.

I am not questioning your intelligence but after being an ICU nurse for years and doing a 1 year internal medicine residency/fellowship, I still feel unprepared on many days as a hospitalist in a metro hospital. Sorry, It just doesn't add up to me.

You don't know what you don't know.....Or the MD residents and fellows are just chumps for doing thousands and thousands of hours for no reason...

PAs don't have RN/ ICU experience prior to going to PA school and they're still considered competent at their job.

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16 hours ago, Seasea122 said:

PAs don't have RN/ ICU experience prior to going to PA school and they're still considered competent at their job.

PAs also have 2000-4000 hours of clinical experience not 600. Also I have met quite a few PAs who were RNs, paramedics etc.

Thats a huge difference. Also PAs are fine under the supervised model, I have NEVER heard of a PA clamoring for independence. They know their role.

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18 hours ago, AMD88 said:

There isn’t a new NP that comes out of school fully competent. As a new NP in any specialty, there is tons of on the job training in the first few years. That doesn’t mean I was not competent for the job and my program did not fully prepare me for the start of my NP career. I was not placing lines and running codes on my first day. But I knew the basics of treating common medical conditions in critical care, managing vents, ACLS and knowing when a patient was about to crash so I could move them to the ICU and get help from my Attending. This would be a normal expectation for a new NP in critical care that did not go through a residency program. I’m basically encouraging people that despite not having ICU experience as a nurse, you can still become a Critical care NP. Would it be better to have experience in ICU? Of course, but like I said in previous post, it didn’t work out for me and it did not hurt my NP career at all.

NP programs do not prepare you to be a fully independent practitioner in critical care or any specialty. That takes many many years-hence residents and fellows are doing thousands of hours so that when they get their first job out of school, they have to be ready to run codes and place lines on day 1. 2 years later, I’m running codes, doing procedures independently and managing critically ill patients.

I’m sorry if my prior post was misleading but what I meant, was I felt prepared by my education and did not struggle when I started in ICU any more than any other new NP, regardless of their experience, struggled. Of course I still had plenty to learn but this is clearly something that can be done if you are willing to put in the work.

I mean yeah, a lot of critical care is algorithm based with vents, sepsis ACLS etc. I am talking about those days when you are dealing with a roaring blast crisis, an erysipelas that just doesn't seem right, an AMS with a strange rash that appeared overnight, a patient with a subtle new kinetic tremor and myalgias or what about a gaze deviation with a quartile temporal visual field cut and wide based gait. Who do you call? What do you order? How quickly do you need to act?

NP school just doesn't prepare anyone to be independent off the bat and many people are...regardless if its ICU or not, its scary. I think an ICU role with a STRONG orientation for NPs would work but I dont see those positions very often. Often they make these positions with new NPs just sinking and it leaves a bad taste towards NPs in general.

Rather than talk about RN experience (IMO matters much less), I think residencies should be standard. I was shocked at how much new interns learned vs NP education. NP schools standards need a huge overhaul STAT.

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49 minutes ago, Numenor said:

PAs also have 2000-4000 hours of clinical experience not 600. Also I have met quite a few PAs who were RNs, paramedics etc.

Thats a huge difference. Also PAs are fine under the supervised model, I have NEVER heard of a PA clamoring for independence. They know their role.

Most PAS are not RNs or paramedics, and am not sure where you get the 2000 hours from that's insane, no one was talking bad about PAs I was just saying at the end of the day we still end up doing the same job regardless of education path, and I don't know what you mean by PAs know their role, you most an MD cause only MDs seem to have an issue with NPs because IDK maybe they lack confidence in their job, they think NPs are going to steal their job, if they were confident they wouldn't think NPs would take their job.

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13 minutes ago, Seasea122 said:

Most PAS are not RNs or paramedics, and am not sure where you get the 2000 hours from that's insane, no one was talking bad about PAs I was just saying at the end of the day we still end up doing the same job regardless of education path, and I don't know what you mean by PAs know their role, you most an MD cause only MDs seem to have an issue with NPs because IDK maybe they lack confidence in their job, they think NPs are going to steal their job, if they were confident they wouldn't think NPs would take their job.

What's insane? The accrediting bodies literally require 2000 clinical hours minimum in PA programs. In additional most require patient care experience prior to PA programs (750-2000 hours). I know because I looked at applying.

To reiterate, it is NPs who are constantly lobbying for independence. PAs literally function as a physician extender and are always under a MD. You don't see PAs clamoring state congresses pushing for independent. NPs do that.

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Specializes in CTICU.
On 4/10/2020 at 7:44 AM, Seasea122 said:

PAs don't have RN/ ICU experience prior to going to PA school and they're still considered competent at their job.

Yeah but they do a hell of a lot more clinical hours during their program, including critical care.

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Really how do you know that, are you a PA

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5 hours ago, Seasea122 said:

Really how do you know that, are you a PA

Umm this is public info if you Google the accreditation standards. I also work with them daily and know their rotations. Surgery is required and many do critical care. This isn't a fable, their programs are superior in every way.

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Specializes in Cardiac Tele.
On 4/8/2020 at 4:21 PM, ghillbert said:

If you're graduating as an NP, do not go get ICU RN experience. Find a critical care residency/fellowship for NPs.

I am a new RN thinking about get masters, but the critical care fellowship requires acute NP Program, FNP they don't accept. I am very confuse which one I go now. I am thinking about PA that no restrictions?

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5 minutes ago, struggleforfuture said:

I am a new RN thinking about get masters, but the critical care fellowship requires acute NP Program, FNP they don't accept. I am very confuse which one I go now. I am thinking about PA that no restrictions?

Hey there, I think you need to decide what you want to do with your degree. If you want to work in an ICU then you need an acute care program for your masters, if you want to work in a clinic or do primary care then the FNP is fine. The programs are very different on purpose, it helps to train a specifically to practice at the tarp of our license in the field that we are looking to provide care in.

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Specializes in Cardiac Tele.
1 minute ago, Stybring said:

Hey there, I think you need to decide what you want to do with your degree. If you want to work in an ICU then you need an acute care program for your masters, if you want to work in a clinic or do primary care then the FNP is fine. The programs are very different on purpose, it helps to train a specifically to practice at the tarp of our license in the field that we are looking to provide care in.

Ya, because I want have critical experiences but not all my life stay in ICU, that is why I am confused and look PA program. I want to change after I get older (maybe 10 years later) physically hard to work on my feet. Now I want critical experience. I saw cardiac electrophysiology and don't know this one is FNP or acute, those really confused me LOL. 

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8 hours ago, struggleforfuture said:

I am a new RN thinking about get masters, but the critical care fellowship requires acute NP Program, FNP they don't accept. I am very confuse which one I go now. I am thinking about PA that no restrictions?

Isn't this sort of obvious? Why would a CC fellowship want a new nurse with a FNP degree? Why would you want to be a CC fellow without an ACNP degree? I think you need to research more and probably need more working/life experience first. In addition, most PA schools are very competitive and usually require additional classes to apply.

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