How much/best experience for FNPs/ACNPs...

Spacklehead, MSN, NP · Mar 2, 2008

I can't really answer on how much experience is enough, because I feel that it is totally an individual determination. Some people feel that 1-2 years of RN experience is sufficient for them, and others don't feel they have enough experience to go back to become an NP after 10+ years of RN experience - it all depends on how competent and confident the individual feels.

I am currently a year away from graduating and becoming an FNP. My RN experience has included telemetry, progressive cardiac, urgent care and ED. I have spent the majority of my time in the ED and feel that it is what best prepared me for my clinical experiences as an FNP student. I returned to school after being an RN for 8 years, with 5 years of ED experience. As an ED nurse, you see all different age ranges, from newborn to geriatric - and you do get the random OB/women's health cases. Also, many times in the ED, you get similar patient complaints as to what you would get in a FP office. For me, it has been the best road to prepare me for becoming an FNP.

Editorial Team / Admin · Mar 2, 2008

I'm curious why ICU/CCU would be recommended for FNP and not just general med-surg?
Do most FNPs also round on inpatients? I had had the impression that some FNPs only saw outpatients, covering the routine stuff and referring the more complex cases to the MDs.
Is ICU/CCU recommended for the increased depth of comprehension of the pathophys that one can't often get on a chaotic med-surg floor where several patients compete for the nurse's attention?
Am I totally off base and confused with my questions?

I found the complexities of ICU/CCU served me well as FNP. I round on pts. throughout the hospital.

I'm certain general med-surg experience will be a good choice.

Just my 2 cents.......

Dixiecup · Mar 4, 2008

I'm beginning to think that TOO much experience is not a good thing before going into an NP program. I was a nurse for twenty years before I took the plunge and NP is a whole different ballgame from RN.

You have to change your whole thought process and the way you look and deal with situations. I found it hard to give up my nursing habits and switch modes to the NP route.

An example would be something as simple as the charting. In my program, they teach SOAP charting. Well, I've done SOAP charting for years and thought it would be a breeze. I found out that SOAP charting as a nurse and SOAP charting as an NP are two different animals.

I had to learn everything all over again. It's all just at a different level and while my nursing experience IS helping me as far as A&P and such, as I said, it's a whole different thought process when it comes to the NP.

TX_ICU_RN · Mar 7, 2008

I think it totally depends on the individual. I went to nursing school with the goal of quickly becoming an NP. After I graduated with my BSN, I returned to school PT for my MS with a PNP specializatioin. While I completed my one year of required RN experience, they allowd me to take the theory, research and other pre-clinical courses. After I got my year of inpatient pedi experience, I quit working as a RN. I do not regret my decision at all. In fact, I am about to start in an adult ICU and am returning to school in the fall to work on a post-master's ACNP. I would not change the path I have taked one bit.

lifelong · Mar 7, 2008

I am a little of an odd ball. I have been a nurse for a long time, but left nursing all together after 12 years because I was tired of 'playing the games'. I had been a NNP with 3 years experience worked before CTP/COA (90s) and was grandfathered in (when the CTP/COA requirements came about). The MDs were very skeptical and life was miserable for me and the other 3 NNPs I worked with. So I left went to work for IBM and came back a few years later after being on a plane and asking myself what was I doing? I have kids that my husband is raising...and I am missing so many things. When I returned to nursing, I initially thought about anesthesia and went to work in adult ICU, shadowed many CRNAs and found I needed the patient interaction, plus the gray walls of the OR suites wasn't for me. I have been in SICU for 5 years and moved to CVICU the last year and always remained on the flight team (it's so hard to get on). I should graduate in November with my second Masters & ACNP. Hope this helps.

Trauma Columnist · Mar 7, 2008

Wow - there are some really inspirational stories here. I think what this all proves is that there is no one right route to the APN role. What works for one person, might not for another. You guys are wonderful.

NYNewGrad · Mar 12, 2008

I agree with CraigB - yes, the more years you work, the more opportunities you are exposed to, however some people make every single patient interaction a learning experience and become great nurses/NPs that way.

I have 2 more semsters left before graduating an FNP program. I've worked adult med/surg and PICU/NICU for a year and change each. That kind of gives me a diverse background. I aced the peds component of the program and did well in the OB/gyn component by studying hard. I think adult primary care should be comfortable enough for me given the med/surg experience. (The FNP program is focused primarily on outpatient primary care so although adult ICU experience would've been nice, I don't think it's crucial...)

If there's one other area I'd choose to work it would definitely be ER.

Either way, it's not like once you become an NP you stop learning. Any field that you're interested in is open to you.