Emergency Dept. NP... A few Questions

FNP grrl · Jan 31, 2004

hi-

i didn't answer this at first, b/c i haven't been in practice in the ER as an FNP for 1 year (yet)- let me tell you my background & you decide if i can help:

-12 years ER nursing

-1 semester FNP clinical in fast track of ER

-1.5 years FNP/urgent care

-1 year FNP/orthopedic call in ER w/ some inpatient rounding also

-just got offered job in fast track of ER, starting in 2 months (yea!!!!!!)

like you, my love is emergency medicine, and i am thrilled about my new ER job--it's in the same ER i worked last as an RN for 8 years- i am very excited.

i'd be happy to chit-chat about NP practice in the ER.

Nelly, FNP · Feb 5, 2004

I am currently applying to BSN/MSN bridge programs as I already have a prior bachelors degree in a non-nursing field. After the first year of pre-licensure courses I plan to work as an RN while taking the MSN courses part time. I am interested in becoming an FNP because it seems like they are more marketable than ANP's but I an specifically drawn to the ED. FNP grll, You seem very knowledgable of the field and I would like to ask you some questions, if you don't mind:

-Some schools have Emergency NP programs, but is that necessary to work in the ED?

-How many years do you think an RN should work in the ED before becoming an NP in that field?

-What is the salary increase for NP's in the ED as opposed to RN's?

-What are the added benefits/resposibilities of the NP's?

-What are the relationships like between NP's and the MD's? and are PA's more marketable than NP's?

-What are the drawbacks?

I would really appreciate your input on this? Other NP's/RN's feel free to join in. Thanks a lot!!!

FNP grrl · Feb 7, 2004

Originally posted by ncprev
-Some schools have Emergency NP programs, but is that necessary to work in the ED?
-How many years do you think an RN should work in the ED before becoming an NP in that field?
-What is the salary increase for NP's in the ED as opposed to RN's?
-What are the added benefits/resposibilities of the NP's?
-What are the relationships like between NP's and the MD's? and are PA's more marketable than NP's?
-What are the drawbacks?

1.) no, an emergency NP program isn't necessary to work ED. however, it is my opinion that any NP working in an ED setting should have some kind of emergency work experience as an RN or in EMS or the like- or be an experienced NP, comfortable w/ fast-paced, high-risk settings. i have never met anyone who graduated from an emergency NP program- i would have done that instead of FNP but it wasn't really an option for me. as it turns out, my ED nursing background combined w/ my urgent care/orthopedic NP jobs have been excellent preparation for working ED. Also, the FNP degree includes all ages which is helpful in most EDs.

2.) how many years of ER experience as an RN before working as an FNP in the ED? depends. i guess i'd say the more the better- but probably 2 minimum. urgent care settings & EMS background are also relevent, IMO. i'm sure there are some NPs out there who have done fine w/ less experience than that...i am biased toward more nursing experience being better.

3.) salaries really vary from locale to locale & job to job. RNs at the very top of their scale make more than NPs at the bottom of their scale. i'll make significantly more now as an NP in the ER than i did as an RN. i suggest you do some online research to check salaries in the areas you are considering working.

4.) i posted about this in another thread in this forum. briefly: NPs do the whole work-up/exam/H&P, order tests/meds, make medical dx, write Rx, and do more invasive and/or higher-risk procedures. all of this varies from state to state and job setting to job setting.

5.) the relationships between NPs & MDs depends- again, it varies state to state & setting to setting. i'm not sure if you mean the legal relationship (ie, licensure/supervising/etc) or if you are asking how collegial & respectful the relationships are. i'd be happy to answer if you clarify your question a bit.

6.)imo, PAs are not more marketable than NPs, though some disagree. it depends in part on what kind of work you are ultimately interested in. if you want to do a lot of surgical assisting, for example, you might be better off going the PA route (not that NPs can't do that too, but it seems that far more PAs end up in the OR). if you truly have emergency medicine as a goal, you can do it w/ either a PA or NP degree. my ER job is only NPs & MDs- no PAs. some ERs are the opposite. look at job listings in your area. and be prepared to advocate for & market yourself assertively after you graduate.

7.) drawbacks? do you mean NP vs RN? higher liability, expensive malpractice insurance (often paid by employer though), increased responsibility that isn't always fairly compensated, potential for negative work environment if MDs or staff aren't supportive of NPs, call (not in ER though!!!!).

hope that helps- good luck!

zacarias, ASN, RN · Feb 7, 2004

FNPgrrl,

Thanks for the ED/FNP info. I'm not the poster who asked the question originally, but I've enjoyed your responses and comments on this board.

I'm a newish RN in WA state area considering either an NP program or actually going back to med school. I've got a lot of decisions to make. I wish someone would make them for me! :)

FNP grrl · Feb 7, 2004

Originally posted by zacarias
Thanks for the ED/FNP info....
....I've got a lot of decisions to make. I wish someone would make them for me! :)

you're welcome.

and i know what you mean about those decisions!!!!!!!!!