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Discussion

CT Surgery NP?

Hi,

I have been a RN for 6 years working with CT surgery patients (post-op, on a step down PCU unit) at a large hospital in Los Angeles area. I'm graduating with my FNP this coming May & was tentatively offered a position for CT surgery NP. We have about 20 NP/PAs between the ICU and step down unit and some go to clinic & OR for harvesting & assist PRN. Coverage is 24 hour (12 hour shift). So I would work night shift 6 pm-630 am (with a fellow available) on the same unit I work now: 3 x/week, one weekend/month, salaried with OT pay. I know the unit, RNs, NP/PAs, and the surgeons well. I prefer day shift but probably would need to stay on night for 1-2 years (training would be during the days for the first few months). They would train me as a permitee until everything is clear. My concern is I have a FNP. What can I do to be prepared for this role? Any book you recommend? Any tips you can share?

I plan to go back for ACNP certification in the near future. Maybe in 1-2 years.

I also have an offer for a management position on the same unit (same hours, slightly more pay) but I lean toward the NP position as that's what I went back to school for. But I'm afraid of the learning curve. I know how to care for these patients as a RN but I'm sure it's very different as a NP.

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    Hi, I saw your PM for the same question but thought about responding here instead.

    First off, are you just going to be managing the patients in the PCU? To me, that would answer your questions about the learning curve you'll have to overcome. It would be easier for you to transition in this setting already knowing how the patients are managed in that particular level of post-op Cardiac Surgery care. I'm sure you've run across the usual post-op issues that arise in that stage...A fib, wound infections, anticoagulation dosing for those that require it, etc. Procedures are easily learned and that shouldn't scare you (i.e., pulling chest tubes for example).

    On the other hand, are you also going to manage patients in the ICU? That might be harder for you not having that experience but again, anything can be learned or taught. You would also have to deal with pressure from bedside nurses who have been working with critically ill post-op Cardiac Surgery patients for a long time and will be seeing you as the newbie NP with no ICU experience. Not that it can't be done (and I personally know people that have done it) but be prepared for some growing pains.

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    Go for the NP position. I was in a very similar position as you a few months ago. I worked in my neuro/trauma ICU for 11 years and when I finished school, I had an option of taking a NP position with neurosurgery or taking a clinical Manager position. I am also a FNP. The manager was the easy choice cause I was already the relief charge for 4 years. But, like you, I wanted to practice what I went to school for. I finally decided to take the NP position in January. I am so happy with my decision. Being a Neurosurgical NP is so much easier than being a bedside RN. We kill ourselves at the bedside. I'm really happy with my decision. I think you will be too!

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    Thank you! Any book or reading material you recommend?

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    Great! Thank you so much. I want to read up to prepare myself before the training starts.

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