Specialties Critical


Hi y'all.

Wanted to connect and get advice from anyone who has done this.

Quick background: I worked as an AGNP in Philly for almost two years before moving to a more rural area for my husband's job. At the time of the move, I was full-term and gave birth to our child, and was just super burnt out from primary care. I took 3 months off to focus on baby and wasn't quite ready to return FT. I took up a Per Diem RN gig to keep my feet wet-- no per diem options as an NP in this area (I've searched high and low).

At this point, RN's are making out only a few dollars below the APP's -- it doesn't seem worth it to return to the APP role with increased responsibility and liability for $1-2 more. I am considering applying to an ICU position (pay is pretty good, 3 x 12s, I still get to be home with my baby 4 days a week)

My RN experience is CV surgery stepdown for 4 years. My experience is mostly lacking in ECMO and ventilators, CVICU would be my preference. I am weighing the possibility of doing a CRNA in the future (talking 5-7 years from now)


Anyways..... has anyone gone from being an APP to ICU RN? Thoughts, tips?

Specializes in ICU | Critical Care | CCRN.

I would think that nearly any ICU/Critical Care units, would like to have an AGNP.

In, NYC area, for example, hospitals will have NPs and PA work along side DOCs covering specific units. Have you thought about that, is that an option for you? What about urgent care? 

Specializes in Cardiac ICU.

Ventilators are a big part of ICU. ECMO depends on the hospital. Knowledge of vasopressors, any acute condition (septic shock, cardiogenic shock, DKA, trauma) and performing central line/art line insertions is important as well as general critical care knowledge. It is a very stressful environment, too. It is a very difference world from Step Down.

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I work as both a ICU NP and per diem as an ICU RN, (in two different health systems). The only thing that was brought to my attention as a word of caution is that while working in the RN role, if you were to be presented with a situation where your NP skills could have prevented some sort of adverse outcome, you could be sued as a NP, not a RN. I haven't fully investigated that claim myself, and I should just to clarify, but you should just be aware that your additional education, while in the primary care setting, could work against you in a very specific sort of scenario. Good luck with your future plans!

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