Experience to Become Adult NP

hawkMSN · Mar 27, 2015

Med-Surg in acute care. Patients are being discharged earlier and earlier to home and often return home with more acute problems as well as chronic problems.

You will see so much more and more quickly in acute care and will be able to build a huge knowledge base. Not saying it can't be done in long term care.

socialworknurse · Mar 27, 2015

Thanks for the reply! I'm currently an extern on a GI Med/Surg floor and have the opportunity to start as a new grad RN when I graduate. While I think the experience I had in AL was a more applicable population for home health and cemented the fact that I want to work with the geriatric population, I can see that the actual nursing experience on the med/surg floor will be more applicable to ANP. I guess my hesitation was that a lot of the patients on the hospital floor are ETOH withdrawal and C. diff, but maybe I'm just not on the right floor for what I want to do. I recently had the opportunity to shadow a home health nurse and was reminded of the high incidence of CHF and COPD in the geriatric population, but I don't see that at the hospital currently.

Dranger · Mar 27, 2015

Thanks for the reply! I'm currently an extern on a GI Med/Surg floor and have the opportunity to start as a new grad RN when I graduate. While I think the experience I had in AL was a more applicable population for home health and cemented the fact that I want to work with the geriatric population, I can see that the actual nursing experience on the med/surg floor will be more applicable to ANP. I guess my hesitation was that a lot of the patients on the hospital floor are ETOH withdrawal and C. diff, but maybe I'm just not on the right floor for what I want to do. I recently had the opportunity to shadow a home health nurse and was reminded of the high incidence of CHF and COPD in the geriatric population, but I don't see that at the hospital currently.

CHF and COPD exacerbation are extremely common in most hospitals as are ETOH withdrawal and C-diff. You have to get used to it.

socialworknurse · Mar 27, 2015

I guess I wasn't clear in what I wrote. I don't have a problem with working Med Surg, just not sure if GI Med Surg is valuable experience for future work in home health. ETOH withdrawal patients on the floor are mostly younger. I am NOT seeing patients with CHF or COPD on this floor which is part of my concern.

When I worked in AL I interacted with home health and hospice nurses and dealt with chronic conditions. But as hawkMSN said I should work acute care for experience. Just trying to find relevant experience. Thanks for the input.

sadiemae1123 · Mar 27, 2015

The most valuable experience is probably going to depend on where you want to practice as an Adult/Geriatric NP.

Med/surg will give you insight into how to manage acutely ill patients, how to troubleshoot problems, and arrange for post discharge care. It would be good experience if you want to work as a hospitalist in an acute care setting as an AGNP.

LTC will give you insight into long term, chronic disease management and end of life care issues. Good experience if you want to work as an outpatient provider or in a nursing home type setting.

Honestly though, any work experience is going to be highly dependent on what effort you put into it and the quality of support you receive from coworkers and management.

And, people go into a variety of NP programs with a variety of previous life/work experiences. Most end up doing just fine.

anh06005, MSN, APRN, NP · Mar 28, 2015

As PP said NP students come from all walks of life and many may not have experience with COPD or CHF and do just fine. There were several in my class who worked L&D or in a pediatric hospital yet as FNP a major part of your population are adults/elderly with chronic conditions. They are all now working and doing fine in the FNP role.

Will it help you to have experience with things like COPD, diabetes, CHF, CAD, etc.? Yes. I think so. You'll be more likely to pick up on small changes that are pertinent that those unfamiliar with the conditions may overlook. Is it absolutely necessary to have experience with these conditions? No. Will it affect your ability to get into a program? Likely not.

I worked on a cardiac step-down unit for about 18 months when I first got my RN. I moved to home health and worked there a little over 3 years until I graduated and started my FNP job. I do think home health helped me overall with my FNP role as it's second nature for me to say things on the patient's understanding level. I have analogies to explain different diseases so they can understand them. I know what patients are up against in the home. Again it's not absolutely necessary but if your ultimate goal is home health I'd try there also. I would work in a facility FIRST before home health, though. When you're in the home YOU are it. What happens if a patients starts to crash in the home? Can you think on your feet and handle it? As a new grad I couldn't and I'm not ashamed to say it. I wasn't confident in myself in the RN role.

If you enjoy your floor then work there for a bit (or all the way through school even). An almost guaranteed job is better than many new grads can ask for right now.

Just my thoughts on your post! Good luck in whatever you choose!

socialworknurse · Mar 28, 2015

Thank you so much sadiemae1123 and anh06005. You have helped me figure out a path. The med surg job is in a well respected hospital on a floor with a great manager and low drama. You are right that it is up to me to put the effort in to learn, just as I did in the AL setting. I think it will be a solid learning environment for me as a new RN. And I know that home health is not appropriate for the new grad, so I can plan on gaining experience there later. Appreciate your help!