FNP needing a change

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Hi there,

I am currently a FNP with 11 years experience(17 as RN). Most of my experience has been in pediatrics with my first 5 years as a RN spent at Childrens' National in DC in Heme/onc/bmt, PICU, NICU and basically anywhere they needed some help. Loved the experience except the crazy hours with rotating for a while. Then I moved back to Cleveland and worked my first NP job in the ED at Metro moving into the Peds clinic after 1 1/2 years or so. Did about 8 years there and enjoyed it somewhat--not sure how I feel about "primary care". Now I have done retail clinics for the last couple of years or so and I think I hate it. The first one I worked at was okay-good money, boring stuff for the most part but scheduling got dicey for me. This particular clinic I am in now is a disaster in my humble opinion but really close to home. I am feeling so bad about this job though that I am re-considering all my career choices.

At this point I am wondering if I should have went the pediatric acute care route or CRNA. I definitely feel that the PICU was the most interesting/challenging position I have ever had. I am considering looking into PICU again and seeing where it takes me. I can only work prn since I have 5 small children so I worry about getting overwhelmed since I can't be there as much as may be needed to gain all the knowledge.

I need advice from nurses on the following:

-is it crazy to want to go back into PICU? Has it been too long?

-what certifications would be best to pursue to get me ready for PICU?

-has anyone worked with an acute care peds NP? If so, any thoughts?

Thanks so much, especially for reading my rant!! I appreciate any advice you may give!

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Specializes in PICU/NICU.

I need advice from nurses on the following:

-is it crazy to want to go back into PICU? Has it been too long?

-what certifications would be best to pursue to get me ready for PICU?

-has anyone worked with an acute care peds NP? If so, any thoughts?

1. No it is not crazy! Nor has it been too long. If it is what you really think you will enjoy, then you should do it.

2. Certifications meaning in general? Like PALS ACLS? I recommend both- we are actually required. As for you... with your advaced practice degree... are you considering a CCPNP?

3. I have worked with some WONDERFUL CCPNPs(critical care pediatric nurse practitioners) They pretty much act as residents(only much smarter-lol) rounds, orders, put in lines, intubate,ect. I have also worked with 1 or 2 acute care peds NPs and I honestly have to say that I wasn't really impressed with them in the PICU setting- I think their education was geared more toward clinic/ floor status kids if you will. I don't mean to offend anyone by that statement- just my experience. If you want to work in PICU as an NP- I would recommend you find a CCPNP program.

Good luck!

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Thank you so much for your reply and encouragement! I would love to take advantage of a PCCNP program but unfortunately there isn't a program here. I am going to get moving on renewing my PALS and ACLS though! Again, thank you very much--it is so good to hear other perspectives!

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I didn't realize there was a specific critical care peds track. Our local PICU uses a general PNP (that's all our local school offers) but I've been told that a lot of places are now requiring you to have acute care PNP to work in the PICU. That is what I want to do. Where are these critical care programs? I haven't found many acute care programs out there, I would have to move to go to one (which we're willing to do).

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Specializes in PICU/NICU.

Yes.... There is a PCCNP- Pediatric Critical Care Nurse Practitioner track that is not found everywhere, you'd have to do a search(Our PCCNPs were trained in Chicago, but I cannot remember which University- DePaul maybe??? I couldn't be sure). They are trained for Pediatric Intensive Care- focus on the ICU/cardiac component.

Then there is an Acute Care PNP- which hase focus more on the "hospitalized child" as opposed to the PNP. But still not critical care based.

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Specializes in PICU/Peds CVICU.

The PICU I work in has 6 PCCNP's (4 are practicing while 2 are currently in the year long orientation process at our hospital). They all went through the RUSH UNIVERSITY program in Chicago, IL. They are all wonderful and extremely intelligent. I trust them much more than the residents - partly because they all worked in the PICU at our hospital before they went back to school, therefore, they understand our unit culture. I'm thinking of applying to the program once I get a few more years of experience. Hope this info helps!

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Specializes in PICU.

I'm in an acute care PNP program while working in a PICU. There have been some recent grads from my unit with AC-CPNP degree who have very successfully gone to work in a pediatric cardiac ICU. I'm still trying to figure out what I want to do when I graduate. I LOVE working in a PICU, however I'm not sure if I want those hours.

The other night, I had a discussion with one of our intensivists about a theoretical PNP position there. He said when they hire one, s/he will be treated as a fellow with a one-year orientation. I assume that will be full time. I also have 5 children and I'm not sure I'm up to the demands of the job. I can't imagine doing it part-time and being/becoming proficient, much less working fewer hours.

Good luck to you whatever you decide!

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