Considering career as NP

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Specializes in Cardiac step-down, PICC/Midline insertion.

Hey all! I'm an RN currently working in specialized cardiac hospital on tele/step down unit. I've been an RN for almost 2 years now. I'm considering making a career move as an NP in the next couple of years before it changes over to a doctoral degree. I'm just having difficulty deciding what specialty to go with. I know for a fact I don't want family practice unless I deal with adults only, I have no interest in dealing with children at all and don't have any experience with it anyway. I have no experience working in ER or ICU, but these areas definitely appeal to me. I'm thinking of maybe going with the acute care program just because it seems like there would be several options. I don't know that I'd want to be a full blown ER NP, that just seems stressful, but an Urgent Care Center seems like it would be a good place to work. Basically I'm just wondering what your job options are for the different specialties, particularly the Adult NP vs Acute Care NP. I have no interest in women's care or peds.

I love working in an acute setting as an RN, but am not sure if I want to be the one calling the shots necessarily, so that's the only thing about working in the hospital setting as an NP that doesn't appeal to me. Maybe I just need to not be afraid and limit my abilities so much. So NP's just explain your different roles that you do and the specialty that you went with.

Specializes in ICU, ER, OR, FNP.

FNP gives you the most flexibility. Adult is going to disappear. Acute is for ICU nurses, not a UCC. You don't have to be a peds person to see peds as an FNP. You do know that UCCs are inundated with fevers and boo boos. Once you've seen a few of each peds problem, you've seen them all. Kids give you all of the clues as to what's wrong as opposed to adults with an agenda.

Specializes in Family NP, OB Nursing.

Well, if I were you I'd really consider IF you really want to be an NP if you are unsure about calling the shots. No matter where you work, working independently is part of the role.

My brother-in-law is an ACNP and he works in a CICU, mostly with post-ops. He likes his job, has tons of autonomy and gets to do procedures he enjoys. He was an ER RN prior to going back to school. I was an L&D RN, and decided to do family practice because it gave me more opportunities for a job. I enjoy seeing a variety of patients, so it works for me.

If you don't want to see kids and don't want to do primary care, I'd go with acute care.

Specializes in allergy and asthma, urgent care.

I'm an FNP and I work in primary care. I love getting to know my patients and providing continuity of care. I also love the health education I provide. I don't see kids, but wish I did. I'd love to work in a true family practice.

Working in an outpatient setting has its advantages. I have a regular day shift schedule and I don't work on major holidays. I never work Sundays and I only work one Saturday in 6, when I do Urgent Care (which is a nice change). I do a lot of Women's Health as part of primary care, which is great. I have a lot of autonomy, but also have a great group of colleagues (NPs and MDs) I can confer with when necessary.

Well, if I were you I'd really consider IF you really want to be an NP if you are unsure about calling the shots. No matter where you work, working independently is part of the role.

(That was my thought, as well ...)

I was a cardiac CCU RN and then a cardiac rehab RN. Before starting and even during the FNP program I thought I wanted to work only with adult cardiac patients in an outpatient setting. Oh my word..I did my rotation and while I learned a lot from an amazing cardiologist, it was YAWWNNNNNNN = boring! Everyone already had heart problems, there was NONE of the prevention I loved so much.

I work part-time in a family practice office and love it. We rarely see infants and I've never seen a child younger than 1. I might see 2 kids all week and honestly they are a wonderful break from the adults who sometimes have a problem list a mile long.

Specializes in Cardiac step-down, PICC/Midline insertion.

Well when I say I don't really like to "call the shots" I mean it more in a way because I'm still fairly inexperienced. Plus right now I'm only 24 and most of the nurses I work with have a good 8+ years on me. Because of that, I don't really have a lot of credibilty. I've learned a lot in 2 years and I know there's still a lot to learn.

Thank you for all the input so far, it's been helpful. I obviously know very little about the NP role, so I'm just trying to figure out if it would be a good fit for me. I'm happy with my current job but I definitely have no interest in being at the bedside my entire career.

Specializes in Med-Surg, Telemetry, Oncology.

@ heartRN_09 ~ I'm like you. I'm 24 with 2 years of nursing experience and desire to go back to school to become a nurse practitioner. I've done some research and totally agree with carachel2 & BCgradnurse, FAMILY NURSE PRACTITIONER is the WAY TO GO! I've already applied at TWU in Denton and UTA. I'm waiting to hear back.

But FNP will definitely give you flexibility & a bigger job market once you graduate. I've even heard that with an FNP you can work in various settings, ER, CLINICS, HOSPITALS, etc you name it.!

Good luck with your endeavors and keep me posted. It's rare to hear someone as young as us wanting to go back for a NP degree with only 2 years exp. Most ppl I've been in contact with that are going to get back for their NP have YEARS of experience!

Specializes in FNP-C.

You know what, I went into the FNP program directly after my BSN program. I did lots of extra hours in BSN program, but then worked in ER for a while as an RN while in the FNP program as a full time grad student. As I neared the end, I had to quit since the USAF was going to pay for my stuff. :up: So I had less than your two years. I struggled, but made it with help. Great to know you had at 2 years! I had none when I was in the program and was learning to be an RN at the same time and it was difficult, but doable. Just have confidence and do it. Go FNP, more options. I'm a 25 year old male btw :D and I finish with my FNP in August this year. :yeah:

@ heartRN_09 ~ I'm like you. I'm 24 with 2 years of nursing experience and desire to go back to school to become a nurse practitioner. I've done some research and totally agree with carachel2 & BCgradnurse, FAMILY NURSE PRACTITIONER is the WAY TO GO! I've already applied at TWU in Denton and UTA. I'm waiting to hear back.

But FNP will definitely give you flexibility & a bigger job market once you graduate. I've even heard that with an FNP you can work in various settings, ER, CLINICS, HOSPITALS, etc you name it.!

Good luck with your endeavors and keep me posted. It's rare to hear someone as young as us wanting to go back for a NP degree with only 2 years exp. Most ppl I've been in contact with that are going to get back for their NP have YEARS of experience!

Just a word of warning to you. If you go through UTA's FNP program you will NOT be prepared to work in an ER or in a hospital. You CAN do that, but you will not be clinically prepared to do it and I would HIGHLY caution against it.

Specializes in ICU, ER, OR, FNP.
Well when I say I don't really like to "call the shots" I mean it more in a way because I'm still fairly inexperienced.

If it helps, I can relate when I decided, "I need to call the shots". In the ER, the charge nurse covers every single PT in one form or another. So I found myself managing chaos 13 pts at a time x 65 pts a day x 7 days a week. All the while, making sure triage was going well. After presenting my 10,000th pt presentation to the MD - I had an epiphany. I realized I had presented thousands of pts and 99% of the time, I had the correct Dx and r/o (DDX) with correct labs, rads, and meds already done or in mind awaiting the ok or clarification. At that point is when I finally realized I was doing the wrong job. Anyone can start an IV (no matter how much we pride or skills on sticking a DKA when everyone has failed), anyone can push drug xyz (given proper license and certs) so why was I running around like a stressed out headless chicken when I could be the one calling the shots. I was already calling the shots, I just couldn't sign the chart as such.

So, if that sounds familiar - then maybe you are ready to "call the shots". Keep in mind that those times that the shorts hairs stand up on your neck will never go away and they just mean - go ask the MD what he thinks. They know we don't know everything and don't forget that they get the same uneasy feeling and that's why we consult all of the specialties when trying to figure out something really complex.

Specializes in ICU, ER, OR, FNP.
Just a word of warning to you. If you go through UTA's FNP program you will NOT be prepared to work in an ER or in a hospital. You CAN do that, but you will not be clinically prepared to do it and I would HIGHLY caution against it.

It's not school specific. FNP focus is on primary care. It's suppsed to be and I'm glad it is. Hopefully, one day we will adopt the real model that's proven to work (MDs) and have everyone start off as a generic NP that then takes up a residency for a specialty. The consensus model is a step in the right direction. Can FNPs work the ER, absolutely and I think we are the best fit for the setting (sorry ACNP peeps), but not right out of school.

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