First years as NP...

[NickG, MSN, APRN]

I am finishing up my BSN (already have my ADN) and plan on jumping right into the ACNP program my school offers. Out of curiosity, is there any info a relatively new NP could give to an aspiring NP? Any of the "I wish I had known this at the time" advice? Any "this was the best/worst decision ever"?

[Spacklehead, MSN, NP]

Advice from a newer NP (and probably a suggestion you don't want to hear) - try to gain some experience first as an ICU RN before jumping into the ACNP program. It would only benefit your practice and NP student experience.

[NickG, MSN, APRN]

I've been working in the ER for a few years and never really thought about going to the ICU. We only have PA's in our ICU and PA's/NP's in our ER. I like the pace of the ER and my ONLY interest in the ICU was when I was contemplating doing the CRNA route. Besides, we admit to the ICU all the time and after having dealt with those nurses I would never take a job on the same floor as them, not saying it may be different in other hospitals but ours always seem like someone ran over their dog in front of them before they came to work that day...what a miserable bunch!

[AbeFrohman, BSN, RN]

I would say that attitude is true of staff nurses in general.

[pedspnp]

I would say that attitude is true of staff nurses in general.

i miss staff nursing only for the camaderie , I dont miss the politics that went on, the head nurses who had not seen the inside of a pt room in years, I love the respect and support that I get from the MD's I work with and the staff is the happiest group of nurses i have ever worked with, admin came by one day saw us all happy and laughing and left wondering what the heck is in the water supply:)

[Corey Narry, MSN, RN, NP]

I've been working in the ER for a few years and never really thought about going to the ICU. We only have PA's in our ICU and PA's/NP's in our ER. I like the pace of the ER and my ONLY interest in the ICU was when I was contemplating doing the CRNA route. Besides, we admit to the ICU all the time and after having dealt with those nurses I would never take a job on the same floor as them, not saying it may be different in other hospitals but ours always seem like someone ran over their dog in front of them before they came to work that day...what a miserable bunch!

You sound like me when I was in my ACNP program. I had ICU experience in a different hospital but I was an ER nurse when I was working towards ACNP. I hated bringing patients to the ICU, specifically the SICU. The nurses always seemed to be in a bad mood when an ER patient is wheeled in and I always felt unprepared for their "transfer of care" questions because on many occasions "I just happen to be the RN transporting the patient". Believe it or not, I actually ended up working in the same SICU as an NP. Having seen perspectives from both sides, ER being one - ICU being the other, I gained a better understanding of why the nurses behaved that way. The nurses in the ICU weren't really that miserable, they just hated patients coming from the ED all bloody and gory looking with a nurse who only knew half of the information about the patient. I found the SICU nurses were just the like the ER nurses in their job outlook, they just operate differently and have to deal with different issues in their patient care. You never know what your future is going to hold, I'd keep my options wide open if I were you.

[traumaRUs, MSN, APRN]

Where are you wanting to work after you get your NP?

With an ACNP you are limited to seeing pts over the age of 13 so unless you plan to add a post-MSN PNP or PACNP you might still find that you can't work in the ER

[Spacklehead, MSN, NP]

I apologize, I missed the part where you mentioned that you are already an RN. That's the only reason I mentioned getting ICU experience. Since you have already been an ED RN for a few years, you should be fine. Although, I do wonder where you would ultimately like to wind up as an NP? What type of program did the other NPs in your ED go through? Was it ACNP? Here in my area, the ED NPs are mostly FNPs; however, they cover mostly the fast-track areas. I would think to work the main ED an ACNP would be the way to go - with the additional cert. as a PACNP as Trauma already mentioned.

ETA: I do think that for the most part and for most of the patients that present to a community-type ED, an FNP is qualified. However, if you work for a trauma center or a bigger ED, having the ACNP definitely would be the better move.

[NickG, MSN, APRN]

One of the reasons I am doing the ACNP track is because that it all that is offered in my area. I would need to drive at least an hour to get my FNP. Plus, being a small state, we only have 1 trauma hospital and it's a teaching hospital so the closest an NP would ever get to a trauma room is walking by it on their way into work. When a trauma comes in, there is an attending, surgical attending, resident (er and surg), anesthesia, various years of med students and a couple of nurses. In fact, the nurses don't even start the IV's during a trauma, sad. Plus, there is a dedicated woman and infants hospital right next door so seeing pedi's is their thing. At my hospital we see ages 16-100+ and rarely if ever see traumas or pedi's with anything more than a sore throat. Plus, now the state is making it a law that you must have your ACNP to work in the ER, an FNP won't cut it anymore. Having said all that, I would love to work 9-5 in a private practice doing whatever the heck specialty will scoop me up :-)

[AbeFrohman, BSN, RN]

What state is this and could you provide a source for this law against FNPs in ERs please?

[NickG, MSN, APRN]

Rhode Island, they haven't made it a "law" yet but are highly encouraging NP's who wish to continue working in ER's to have their ACNP. It's probably partly a money thing and partly a liability thing.

[TRR8021]

What about URI? They have an FNP program: College of Nursing - University of Rhode Island