FNP Student, need opinion on experience

allnurses Guide · Oct 5, 2016

I think you are as good if not better off in telemetry than you would be in the ICU.

Salter444 · Oct 5, 2016

If you are going the FNP route you really do not need the ICU experience and at times it can confuse you when attempting to think outpatient while working critical care. I remember studying for exams or the boards and had to remind myself to think clinic/outpatient and not try to think beyond that point.

ICU experience overall is beneficial as it lets you see disease processes at the far end of the spectrum and in dealing with many chronic conditions it provides perspective on the importance of maintaining control of these conditions and the complications/risks that can result from poor control.

But id your immediate goals are FNP in a clinic. I would stay put and focus on that..

Cnrsego · Oct 5, 2016

Hmm...that's true. I can see how it would be good to see those end stages of chronic disease. Actually, you see that in telemetry as well. It seems like those who have done ICU have more cardiac knowledge too though. I noticed a couple of them are focused on specializing in that direction.

Anyway, thanks for your input. Definitely puts some ease in deciding what direction to go.

YoutubeTheNP · Oct 7, 2016

I would stay out of the ICU if you're finishing the FNP program. Why would you even consider that with a 2 year commitment? Won't you graduate soon?

Cnrsego · Oct 7, 2016

My FNP program is 2.5 yrs and I was just told by my co-worker that it is a two yr commitment. I was talking to some students today and a ACNP and they advised to stay in telemetry for FNP which I understand...I just can't let my classmates intimidate me with their critical care stuff.

lhflanurseNP, APRN · Oct 11, 2016

If you plan on working in an acute care setting, ICU experience is not necessary. The majority of the time, you are going to be working with chronically ill patients...diabetics, high cholesterol, heart disease, colds, etc. Every once-in-awhile you may get an "emergent" case. Your experience will more than cover the nurse practitioner primary care environment quite well.

applesxoranges, BSN, RN · Oct 11, 2016

One thing that was funny was when our instructor said something like "what do we need to think about if our patient presents with abdominal pain." First things out of the ICU nurses mouths were AAA, sepsis, and other off the wall stuff. What the instructor wanted was more general such as first whether it is an emergency and then whether the patient is eating and drinking. This made me laugh because 90% of abdominal pain is not the dreaded AAA. It is not sepsis. Most abdominal pains are sent home after a negative work up in the ER but the ICU nurses don't necessarily see that.

In a way, general med-surg is better for you. Most hospitals will not let a non-acute care NP take care of an ICU. So you will see the med-surg side if you decide to round. You will get a better experience dealing with the non-intubated patients. You get a bigger picture since you will see more stuff.

Buyer beware, BSN · Oct 18, 2016

A lot of these posts sound like rationalizations for not having or requiring experience in this or that area and then making a case to justify why this lack of exposure or experience is acceptable to them in particular and by extension to others also.

The proliferation of NPs and the undermining of heretofore long standing experiencial and clinical standards has been supported by, I believe, self-serving perogatives of greed and expediency that play on vanity and in some cases delusions of grandeur.

The greed factor today of NP programs is out of control as evidenced by their dime a dozen presence in the marketplace.

And the canard that prior substantive experience in caring for people prior to attending NP school may be an unnecessary side show to providing credible care does not serve to inspire commensurate confidence in an increasingly informed lay public.

With this said, I can't help but feel we are heading in the wrong direction by democratizing the care of patients to those who may not be emotionally, socially or clinically prepared to take on such a awesome task.

ndnursepract · Oct 21, 2016

I am a current FNP Student who has been working part time as a telemetry and med-surg float while focusing full time on my FNP program. It has been working out well so far. Prior to NP school, I had a couple years experience in telemetry and a year in pre-op.
A couple months before my FNP program, I was offered a PCU position full time, but I turned it down because I wasn't sure about it since I was just beginning the program. Now I am kinda regretting it because in my program, almost all my classmates and my professors love to talk about their ICU/Critical care experience. Hearing it sometimes makes me feel like I am "beneath" them because I just don't have that experience. I never had a desire for critical care as I had negative experience when I was a student; however, this opportunity to work ICU and be trained at my hospital has been offered. It is full time with a two year contract. Plus, seeing old co-workers who transferred, they say they love ICU because it is less stressful than the floors. However, I am afraid full time will be more difficult to manage with my clinicals. (I plan to keep working at bedside until I graduate and work as a FNP).
My question is, will not having "critical care" experience hurt me as a FNP? Should I work ICU and leave my part time floor nursing job just for the experience? Will critical care be more beneficial for a primary care FNP than working telemetry?
Any advice from a NP is greatly appreciated.

ICU experience definitely not necessary to practice as an FNP. I worked in both ICU and med-surg prior to becoming an FNP. While I loved working in ICU (and didn't so much love med-surg), the med-surg experience was definitely more valuable. The sickest of the sick you take care of in ICU are nothing like the patients you see in the clinic. Med-surg will give you a wide variety of different illnesses and conditions and also a very good idea of what a "sick" patient looks like. So that one day when you are seeing patients in the clinic, you'll be able to recognize which ones need hospitalization and which can't be managed outpatient with close follow-up. It will also give you better experience in coordination of care, i.e. home health, case management, nursing home placement, etc. etc.