Emergency Department NP

Nursing Students NP Students

Published

Specializes in ICU.

Hello,

I'm a California CCRN-CMC certified ICU nurse who has experience with medical, cardiac, surgical, trauma, and neurosurgical patients. I was recently accepted to a CRNA program out of state. After much soul searching and research, I've decided not to attend. As an ICU nurse, I am occasionally floated to the ED. Yesterday, I was able to witness an NP in the ED environment. The role definitely appeals to me. I like the fact that in the ED NPs can do shift work which allows for more days off or more overtime. Unfortunately, we were slammed, and I didn't get to ask the NP about his role, education, or job satisfaction.

How does one become an ED NP? I live by a brick and mortar program that offers both FNP and AGNP. The program wouldn't require me to move out of state, would allow me to continue working full-time (they allow you to complete it in 2-5 years-most do it in 3 years), and I could pay half cash, which means I WOULDN'T be crippling myself with debt the same way I would for CRNA school. Would the FNP or AGNP degree be more beneficial?

Also, does prior RN experience help with employment as a new grad NP? I would like to stay in ICU as a bedside RN because I love the critical thinking aspect of it, and I love my coworkers.

Our trauma bay is connected, but has different staff than the ED. Trauma staff work in trauma only. I currently have an opportunity to transfer down to the trauma bays in our busy hospital with the 2nd busiest ED in the state(The trauma bay staff are all prior ICU nurses because our hospital is busy and our trauma bays have a lot of ICU holds). I think this may be AWESOME experience. Would this, or transferring to the ED be more beneficial? I think that ED proper may expose me to more of what I would be doing as a NP, but then again shouldn't school teach me what I need to know?

Any former ICU nurses work in the ED as NPs? How was the transition? Should I stay in ICU where the residents love to teach and I can pick their brains, or transfer to trauma (and get cool experience) or ED (be exposed to the ED environment and patients more)?

Thanks!

0 Votes
Specializes in Outpatient Psychiatry.

Think carefully. Don't be over taken by a novel stimulus. The ED steals souls.

0 Votes
Specializes in Cardiac, ER.

I am currently an FNP working in the ED. I worked 12 years in a Level I ED, prior to becoming an FNP. I graduated in May, so my experience as an FNP is limited, but I'll share what I can. First off, the role as ICU RN and ED RN are very very different. I have worked with many who loved the transition, but many who hated it. ICU is very detailed work, ED is quick and focused. As an FNP I can see pretty much what I want, with the exception of classed out traumas or strokes, the MD must be primary on those. My role as FNP is really to help through put. In theory I try to see the stuff that I can get in and out quickly, of course this depends on who is there at the time, and often I end up seeing sicker patients that are admitted because that is what is there.

My experience as an ED RN was invaluable to this job! ED experience gives you exposure to everything, and eventually you get a good, quick sense of who is "sick" and who isn't almost by looking across the room at a patient. This is a big deal in the ED, remember, your ICU patients have been seen, worked up and at least initially diagnosed. In the ED you often get a patient with little to no info about the patient. You may get an unresponsive 40's male, that's it,.no history, is he drunk, is he high, is it a trauma, an MI, an OD, a stroke? To me this is the "fun" of the ED, to many ICU nurses this is frustrating and not enough structure for them!

PshchGuy does make a point too. The environment in the ED is like no other. It is real easy to start hating the human race in the ED.

As for shift work and overtime, I can only speak for my area of the country, but as a provider you are salaried. You are exempt from OT or holiday pay. Many of my coworkers who left the ED to start as an NP took pay cuts from RN to NP. I have been with the same hospital system for almost 20 years and am working ED so I did not take a pay cut, but it was not a huge raise. I do have the ability to work extra shifts, but it is at straight time. I would do some research in your area, where I am the CRNA makes more money if that is what is most important to you. Good luck to you!

0 Votes
Specializes in Hospitalist Medicine.

As stated above, it depends on where you live and what your hospital prefers. I'm going for dual FNP/ACNP because that is preferred by our hospital

0 Votes

emergency department is usually just a giant walk in clinic with a trauma section. depending on location you may be stuck in a fast track or something that isn't so exciting. id work there as an RN first to see if you like it. like psych guy said, the ER is soul sucking madhouse that completely will make you question the advancement of the human race.

0 Votes
Specializes in Outpatient Psychiatry.
emergency department is usually just a giant walk in clinic with a trauma section. depending on location you may be stuck in a fast track or something that isn't so exciting. id work there as an RN first to see if you like it. like psych guy said, the ER is soul sucking madhouse that completely will make you question the advancement of the human race.

You know I preferred fast track to traumas and codes. It seemed real and practical like you could actually cure those people in most any setting. Without the technology of the trauma rooms, code patients wouldn't live five minutes. Now, my time in the ED yielded some negative behaviors. When people ***** about being nauseous or they vomit I just about flip out. When I get coughed on I only become upset. When folks complain of diffuse abdominal pain I envision myself jumping off a tall room.

0 Votes
You know I preferred fast track to traumas and codes. It seemed real and practical like you could actually cure those people in most any setting. Without the technology of the trauma rooms, code patients wouldn't live five minutes. Now, my time in the ED yielded some negative behaviors. When people ***** about being nauseous or they vomit I just about flip out. When I get coughed on I only become upset. When folks complain of diffuse abdominal pain I envision myself jumping off a tall room.

Yeahhhhhh I'm not a huge fan of any of it. I'd rather tinker with the brain. Hence why I only work a day or two per couple months while in school. Neuro or psych is where the cool kids chill out

0 Votes
Specializes in ICU.

Thanks for replying everyone! I would like to do dual FNP/ACNP, but FNP, AGNP, and PMHNP are the only three concentrations offered in my area. I considered PMHNP because it seems there's a demand, but because I volunteer to float to psych at my per diem gig, I had to go to the psych unit's CE day. Studying the psych meds just didn't spark an interest for me, and it's just not for me.

I think ACNP would be the way to go for me, but there isn't a program in my area, so I think FNP will be what I do. It also seems like all of the ED/Urgent care jobs in my area only require FNP. There are a ton of FNP jobs in Southern California. It just seems that the pay is only slightly above what I make at the bedside. The pay also seems to vary quite widely from position to position, and there's not much uniformity in pay. One job will pay $50/hr, while another offers $130k/year. For me, it's about better working conditions and advancing my career into a new role. I guess I just have to wait until clinicals to see which area sparks an interest for me. ICU is my comfort zone, but I'm not sure that the FNP concentration would prepare me for ICU.

There are no CRNA jobs in my area. My buddy who got a job here started @ 130k/year. Sure, he can move around after a year and make more. The problem is that CRNA jobs here seem to be so few and far between. All of the good paying CRNA jobs are in Central California, which is an area I wouldn't really want to live if I didn't have to. That, along with moving across the country for school, not being able to work while in school, and graduating with $150k debt only to end up possibly having to work out of state away from friends and family just doesn't appeal to me. There are too many variables in my particular situation, which is why CRNA school doesn't appeal to me as much as it once did. I want to stay in Southern California. I was born and raised here. It's my home.

At least with NP school I could still work (our program only requires 1 days/week of in class time), and will have a lot of options locally when I graduate. Will it pay all that great? Possibly not, but I'm fairly good with numbers, and I'm a business-minded person. I've been able to maximize my income working the bedside, and I have no doubt that I'll be able to do the same as a NP. In the meantime, I just may pick up OT in our ED, or volunteer to float there when needed. Or maybe as a FNP I could pick up one of those coveted "derm" jobs. Who knows?

I would love to keep hearing from you guys!

0 Votes
Specializes in Anesthesia.

I'm in the same boat. I was accepted to a CRNA school across the country as well, but I ultimately decided not to attend for multiple reasons. If I can get into CRNA school here in California, I'm sticking with my path, however, I will simultaneously be applying to an NP program as a backup plan since time is of the essence for me, and I'm getting tired of bedside.

I'm HIGHLY interested in ACNP because acute care is what I'm comfortable with. I would love to work in ER or ICU as an NP though, but I fear that the lack of pediatric training in ACNP programs would render me undesirable as an ER candidate. FNP seems more marketable, and I wouldn't mind outpatient or urgent care as an end game. Derm would be cool too. The only thing that puts me off about NP are more fluff nursing courses.

I really don't understand why NP curriculum can't just have a general curriculum like PA.

0 Votes
+ Add a Comment