Advice from acute/critical care NP's

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Well I'm not exactly looking for advice as much as looking to hear about your job. I am still up in the air as far as whether I'd like to become a CRNA or critical care NP. I have looked into both professions quite extensively as well as the training involved. I have also shadowed a CRNA at my hospital. I know that CRNA salary is generally higher than that of an NP but I would really hate for salary to be the deciding factor in which profession I choose since money doesn't mean squat if your miserable at work. What I'm looking for is any acute/critical care NP's who are willing to share info about your job such as what responsibilities you have, what hours you work, where you work, what you would change if you could, and if your willing to share info about pay. Maybe hearing from some more people who do the job for a living will help me out in making my decision. I am also putting a similar posting in the CRNA area. Thank you.

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

12-hour shifts 3 days a week. Anything over that is considered over-time. Shifts are 6A-6P and 6P-6A. Off Saturdays, Sundays, and Holidays. These days are covered by residents on the team. They work 24-hour shifts on those days which is really rough for them considering that they have to be around during the week as well. Sometimes we do work those days if the resident is on conference or vacation and have requested us to cover. In that case, we get weekend differential or holiday pay whichever is the case.

Day and night rotations happen randomly, sometimes 2 weeks of nights and then a long stretch of day shift. That's because one of the NP's prefers straight nights so pretty much nightshift is covered on most days. Residents also take on nightshift rotation per the monthly schedule.

I think I've given out too much info about myself and the practice. PM me if you have further questions.

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I really appreciate the information. I have never understood the secrecy.

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Specializes in Pulmonology/Critical Care, Internal Med.

So out of curiosity, no NP's do any First Assisting at all where your at? You just do pre and post op care in the ICU? Are you able to do things like Chest tubes, and if no, are the PA's. Can the the PA's do anything that you can't?

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
So out of curiosity, no NP's do any First Assisting at all where your at? You just do pre and post op care in the ICU? Are you able to do things like Chest tubes, and if no, are the PA's. Can the the PA's do anything that you can't?

Just to clarify, our NP service is directly under trauma and critical care services although we exclusively work in the cardiothoracic surgery ICU and sometimes follow patients on the floors at night when there is nobody from the cardiothoracic surgery service physically present at the hospital. The PA's who first assist with the cardiothoracic surgeons have been doing their jobs for an average of 15-20 years. Needless to say, they are excellent at it. Us NP's are credentialled to place chest tubes in and out of the unit, place triple lumen catheters or introducers, float Swan-Ganz catheters, place A-line, and perform BAL's.

Other hospitals are different, however. Two of the NP's on our team have experience first assisting in cardiothoracic surgery when they worked in other hospitals. Interestingly, they were doing the role when they were not advanced practice nurses yet. Both received in-hospital training in their respective hospitals to assist while at an RN capacity. All of us prefer the ICU and that is the reason why there is no push for us to assist in the future.

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From another slant: I am a CRNA and am going back to school for ACNP. I was not happy in the CRNA role and no amount of money was going to change that. It is glamorous....but only from the outside looking in!! I practiced anesthesia for 7 years....

Hope this helps.

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From another slant: I am a CRNA and am going back to school for ACNP. I was not happy in the CRNA role and no amount of money was going to change that. It is glamorous....but only from the outside looking in!! I practiced anesthesia for 7 years....

Hope this helps.

You are the second person I have heard of that has done this. What were the main reasons you were unhappy as a CRNA?

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Specializes in Anesthesia.
From another slant: I am a CRNA and am going back to school for ACNP. I was not happy in the CRNA role and no amount of money was going to change that. It is glamorous....but only from the outside looking in!! I practiced anesthesia for 7 years....

Hope this helps.

I would also like to know why you were unhappy in the CRNA role, especially since I start a CRNA program this fall. Thanks

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Main reasons:

1. My main job was not critical care anymore, it was anesthesia. Totally different. It was mostly routine/boring. I missed the patients (as they are asleep) and the families (yes, believe it or not). This job was mostly talking to surgeons and other OR staff all day (without windows I might add......). Not to mention you are STUCK in the OR until someone gets you out to eat/go pee/anything if you are in a long case (which was common).

2. Call. The kind where you do anesthesia all day and sleep in a call room (if you are not working) until 7am the next day. Very stressful over time.

3. MAIN REASON: I did not realize how far anesthesia really was from critical care nursing until it was too late. I tried to make a go of it, but in the end, I quit and went back to the "critical care track", so to speak.

chell

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Specializes in Pulmonology/Critical Care, Internal Med.

Well its official......I've decided to go get my ACNP instead of going to PA school. Surgery is great but can be pretttty boring....Trauma.....now THATS some fun.........ICU.....ohhhh yeah....I'm hooked now.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

John, I don't know where in AL you live but doesn't UAB offer a combined ACNP/RNFA option for NP training?

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John, I don't know where in AL you live but doesn't UAB offer a combined ACNP/RNFA option for NP training?

http://main.uab.edu/sites/nursing/98239/

Not sure about the ACNP/RNFA program but their surgical PA program is very well regarded.

I thought there was a PNP/ACNP program on the east coast but I can't find it now.

David Carpenter, PA-c

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Specializes in Pulmonology/Critical Care, Internal Med.

Yes there is they do have one, only catch is you have to work OR for minimum of 2 years before hand, PA schools you don't. I originally went to Nursing school so I could go to PA school since I wanted to do surgery, to say that its complete gone would well be an over exaggeration, but I like the autonomy that NP's seem to have, and I don't have to take anything extra to be a NP.

Its a real shame that NP programs do not have a surgical component like PA programs do I'm not talking about RNFA you can have that without being a NP. I'm talking real rotations in surgery etc just like PA's have to do. If I were to try to do UAB's PA program which is a surgical program I would actually have to take MORE pre req classes honestly I'm not interested in taking more pre-reqs for anything. I've thought about Emory''s I actually have all their Pre-Reqs. I'm just really curious as to why NP programs don't incorporate surgery. I would love nothing more than to work for a Ortho. Surgeon as his midlevel being a FA and seeing patients in the hospital/ER/OR. Love to do things like long bone reductions.

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