First job as a new AGACNP

[TraumaLlamaBSN]

Would starting a career in an inpatient rehabilitation unit as an AGACNP be a detriment to future career opportunities? The job sounds fantastic after working as an RN in critical care during a pandemic. However, I'm worried that a few years from now if I want to work in critical care/surgery as an NP I won't be considered for the job since my only NP experience will be rehab. Anyone else make a similar transition with their career?

[djmatte, ADN, MSN, RN, NP]

58 minutes ago, TraumaLlamaBSN said:

Would starting a career in an inpatient rehabilitation unit as an AGACNP be a detriment to future career opportunities? The job sounds fantastic after working as an RN in critical care during a pandemic. However, I'm worried that a few years from now if I want to work in critical care/surgery as an NP I won't be considered for the job since my only NP experience will be rehab. Anyone else make a similar transition with their career?

Many acnp areas require some form of acute care experience. If you want that option, I’d recommend a combo course after a year of active hospital experience. 

[Neuro Guy NP, DNP, PhD, APRN]

If ICU or surgery is what you want ultimately, I'd highly advise against rehab. If you do physiatry, you'll physically, doing almost no medical management since there is usually a hospitalist on consultation. If you do a hospitalist type role in rehab, it likely will also not be as rewarding of a medicine experience because the patients are in a subacute phase of care. Therefore, something even as simple as vital signs is not being done very often and this would be a detriment to a more acute role such as the hospital because you will have limited experience managing those acute issues. In the rehabilitation setting your answer to any sort of acute issue is to refer the patient to the hospital so it will hamper your ability to manage acute issues in the hospital should be able to land such a role.

[Corey Narry, MSN, RN, NP]

I can speak to your questions since I actually worked in PM&R the first year after graduating from an ACNP program.  I enjoyed the interview process with the group and the role involved in-patient management (in a free standing acute rehab hospital) and consults in an acute care hospital.  I thought what a great group of people and how nice it would be to have a chill specialty that is still hospital-based.

Anyway, one year in and I was super bored. The patients were stable medically but when they start to show an indication of instability, they oftentimes no longer qualify for continuation of their rehab plan and are transferred back to the acute care hospital for evaluation. There were plans to transition us to spend time in the out-patient clinic doing pain injections but it wasn't something I was interested in.

In the end of that year, I talked to the PM&R chief and was honest to him about how I was wanting a more acute care related specialty and luckily one of my classmates who worked as an ICU NP told me about a position that has opened and I left PM&R to join that team. If I had stayed in PM&R longer, I may not have had that chance.