Best RN Experience for FNP Program

Tinabeanrn · Sep 17, 2012

Definitely shy away from the ICU. It will not help you with primary care..trust me did it for 6 years. I always wished I would have worked in a doctors office. Try to find a primary care family practice nurse job...which is a tall order since most use MA's. If I was deciding between the two I would go with the peds office. That would be a broader scope than women's health in my opinion. Good luck :)

allnurses Guide · Sep 18, 2012

I will second that you should strive for a family medicine office. Our office tends to us MAs but we just hired an LPN and would happily take a RN provided they were willing to take a little less money then a hospital position. It would be a great RN experience as triage would be an important part of that job. Good luck!

Good Morning, Gil · Sep 18, 2012

Really, TinaBean? That surprises me. I mean, I do realize that primary and acute care are 2 different worlds, but wouldn't being in a high acuity environment help you as an FNP in terms of all of the complex co-morbitities that you help treat on a daily basis, keeping a holistic view of your patient, etc?

I feel like these are the kind of patients you would see in geriatrics, post-hospitalization, etc, and that's where some jobs are obviously. I mean, if you're an FNP at Walgreens, I guess it wouldn't be as pertinent, but my ICU experience will be a waste of time? I feel like I could learn what I need to learn about working in an office setting while in school clinical rotations (lots of clinical hours). Do I need to pick up a PRN job in an office? By the time I'd start school (hopefully), I'd have 3 years of experience, 2 of which would be in ICU, and then I'll have a few more years of experience in ICU before graduating.

prajwala · Sep 18, 2012

Ah let me clarify...

My responsibilities in the pediatric office would be mostly phone triage and giving immunizations. The practice is connected to a teaching hospital so the residents and attendings are the ones who would spend the most time with the children. Knowing this, would this still be a good learning experience?

The job at the women's clinic is more than just OB/GYN issues. This clinic takes care of all women's primary care as well. Therefore, hopefully I'd see more than just cervixes ; )

What is appealing about the pediatric ICU job is that it is an internship program for new grads so I would have an extended orientation, etc.

Annaiya, NP · Sep 18, 2012

I completely disagree with taking an office job. The work you would do there will not prepare you for an FNP job. There are things like immunizations that you would learn better, but that's easy to learn while in school. The things that are hard to learn like picking up on subtle assessment changes you will learn in the ICU and not in an office. I have never seen a nurse in primary care responsible for doing a complete head-to-toe assessment. You would be responsible for this in the ICU. You also aren't going to learn medications or labs in an office. As an ICU nurse you are expected to know all of the medications you are giving and why, in addition to being able to interpret the labs of your patient and know when to call the MD or NP. Although you will learn a lot of stuff that you won't use as an FNP, that background will still help you a lot more than working in a primary care office. If you work in an ICU for a couple of years and then want to transition to an office while you're in FNP school, that would be fine, but you will lose your basic nursing skills if you only work in an office.

SHGR, MSN, RN, CNS · Sep 18, 2012

I completely disagree with taking an office job. The work you would do there will not prepare you for an FNP job. There are things like immunizations that you would learn better, but that's easy to learn while in school. The things that are hard to learn like picking up on subtle assessment changes you will learn in the ICU and not in an office. I have never seen a nurse in primary care responsible for doing a complete head-to-toe assessment. You would be responsible for this in the ICU. You also aren't going to learn medications or labs in an office. As an ICU nurse you are expected to know all of the medications you are giving and why, in addition to being able to interpret the labs of your patient and know when to call the MD or NP. Although you will learn a lot of stuff that you won't use as an FNP, that background will still help you a lot more than working in a primary care office. If you work in an ICU for a couple of years and then want to transition to an office while you're in FNP school, that would be fine, but you will lose your basic nursing skills if you only work in an office.

I could not disagree more with the above. We do refills, reconcile med lists, do med teaching, confer about med changes. You really learn your medications back and forward. Assess walk ins (rashes, respiratory, you name it). Work with all ages of patients and their families, from pregnancy/newborn/well child/adult/chronic/episodic/psych/geriatric, even hospice. All the stuff that you see in our office is the same stuff you would see as an FNP. Most of our RNs are doing FNP programs and feel that working in our big Family Medicine office is great preparation for the new role, and many switched from ICU and acute care to our site just for that purpose- and since you get to know the patients well, you pick up on subtle deviations from baseline. We don't do head to toe assessments, but we learn to focus our assessment on the pertinent areas.

Tinabeanrn · Sep 18, 2012

Yes Goodmorning, Gil. Yes, I totally regret working in the ICU for so long. It was a waste of time in my opinion. I am not using anything I learned in critical care in the primary care office. And the way my mind works is to fix everything right now, instead of slowly over time bc of too many years in ICU. It does not help in primary care. Its something you will have to see for yourself. I felt like a fish out of water when I went to NP school. I felt like I didn't have any prior knowledge that I could apply in the primary care setting. I didn't care what the half life of amio was in ICU. I just knew we used it for afib on a daily basis. And the head to toe assessment you do in the ICU really didnt help me in primary care. Just about everyones exam in primary care is benign outside of edema or muskuloskelatal pain. I agree with the prevous writer. The MAs here know quite a bit about primary care. I say avoid the ICU. It wont help. Trust me. Did every ICU there was for the last 6 years. Wish I wouldn't have..

Tinabeanrn · Sep 18, 2012

Oh and to the OP, I would probably go with the OB GYN job then. Let us know what you do. If you can find a family practice RN job that would be nice!

Good Morning, Gil · Sep 19, 2012

Hopefully this helps the OP, as well! OP has some good options/decisions to make. I see that there are mixed reviews, but it's still helpful. Knowing what TinaBean said, I will make sure I take an office job at some point, PRN or otherwise, to help prepare me to be an FNP. However, I'm going to stay in the ICU for the duration, as well; I have only been there for a year thus far (nurse for 2 years), and I do enjoy my job, and feel loyal to the unit (really good nurse manager, etc).

Since I work in an adult ICU, I will probably take a PRN peds office job in the future, if available, to give me some experience with children. We'll see, though. While I like children, I prefer working with adults, but I'm trying to broaden my experience for possible FNP jobs later. If there's an outpatient PRN oncology job, though, I will jump on that.

Thank you for the advice!! Good luck OP!

Bumashes, MSN, APRN, NP · Sep 21, 2012

I left a med/surg/tele floor after a few years for the ER because of the possible help it would be for NP school. We serve about 70% under/uninsured, so many many primary care cases come through our doors as well as acute. We also have a Minor Care area open part of the day that we all rotate through periodically that sees just those types of pts. This has been extremely helpful, but I must say, I agree with a previous poster about wanting to fix everything now now now because of my experience. And my mind immediately flies to loads and loads of testing that needs to be done for just the simplest of things it seems. My preceptor laughs at me sometimes because I tend to overanalyze situations. A 74 year old male with dizziness..oh man, cardiac workup in the ER! But my preceptor looks at his chart and says that since he was started recently on X medication then that is why he's dizzy. Deflate my huge trauma balloon! The ER has taught me to differentiate between sick and not sick, though. That may sound stupid, but it is horrendously important to be able to pick up on the subtle clues that will tell you, "Hey idiot, you can't handle this in the outpatient setting." LOL! Good luck with whatever you choose!