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NP Students   (1,100 Views 20 Comments)
by ccuRN24 ccuRN24 (Member)

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Hi everyone!  I'm thinking about going back to school, but have so many questions and no one in my personal or work life to ask.  I'd also like some brutally honest answers on what you think.

I currently have almost 2 years experience working in an ICU that sees mostly cardiac but a little bit of everything (the unit is basically the overflow for other units).  Long story short I'm slowly over it.  The older nurses are leaving they've said the unit has never been like this (it's been really, really heavy acuity wise for 6 months, trying to call nurses in pretty much everyday) and honestly can't see myself doing this for the next 5 years anymore.  I find myself resenting work, resenting patients (we're "fixing" people who will never live a normal life due to pt families not letting them go).  This basically isn't the ICU I signed up for in the beginning (I loved it so much - and I feel that 6 months plus to give it a chance to turn around has been very fair).  It's turned into a high acuity rehab essentially.  Anyway - one of the nurses said if she could do it all over again she would've finished NP school so she could have a nice job that doesn't force you to work nights and weekends and make you feel bad for spending time with your loved ones (or bother you at home constantly).  This got me thinking, I always knew I didn't want to stay bedside forever, but now is the time I should start thinking about school as I'd like to be done when I'm in my early 30s (late 20s now).  My reasoning is for better hours (haven't spent a full weekend with my family in months due to scheduling - want to be with my kids that I don't currently have haha), not inpatient where I'm working nights and weekends (wouldn't mind clinic or inpatient where I can oversee a few patients), and I've wanted a higher degree in my field with more autonomy so this has somewhat been in the back of my mind, I had just thought I'd stay bedside for longer.  Are these good reasons?  Need brutal honesty.

Then, I'd need to decide critical care or family NP.  Again, I don't want to be working in the actual ICU as an NP (one of my friends has a job on the floor where it's only weekday day shifts and they oversee 5 patients) so maybe critical care isn't even a good option and I should go with FNP instead, but I'm wondering if with either of these I would be limiting myself.  I also work in critical care now so I'm not sure if FNP doesn't really make sense.  I love critical care, but can't actually see myself being a provider on the unit at that level if that makes sense.

Furthermore, I will need to be able to work during the time I'm in school (nursing is already my second degree) and I have some loans from that.  Has anyone done an online program?  Or do they not suggest it?  Money will definitely be a deciding factor for me school-wise as I have loans from undergrad, post bac BSN, and now this.  I'll also need to keep my job for insurance, etc. and probably won't be able to go down too much in hours (could maybe swing 24).

I have so many more questions, but I've made this long enough.  I really appreciate any and all feedback as I feel like I'm in a rut right now!

 

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Hoosier_RN is a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

3 Followers; 1,454 Posts; 2,973 Profile Views

Look at the real market for new grad NPs where you are, or wherever you pan to practice-along with pay and benefits; don't let a school's marketing person answer that .  Many areas are now flooded, FNP, ACNP, and PMHNP ; CRNAs are now going in that direction as well.  NPs in some areas take call for Dr groups, etc.  Some of these things (flooded market) drive the pay down and drive the expectations up.  Read the many posts on here.

Make sure that any school that you choose will have preceptors for you, and have it in writing.  This seems to be a major issue that I hear about with the APRN education.  Again, read some of the posts on here.

I will add, if it's something that you truly want to do, then do it.  In a few years you will either have that education or not.  Good luck!

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I was in a similar position working bedside ~5 years and am starting a DNP program in August. Bottom line, if you are miserable doing what you are doing and you don't get to see your family--find something else. Whether that be another bedside job or going back to school, you are too young to become complacent in a career you don't enjoy. You will see that the NP market is saturated, and that may be true in many places, but you WILL be able to get a job out of school. Just like coming out of RN school, you might have to start somewhere and work your way up to your goal position. IMO, paying back loans is a price I'm willing to pay to be happy in my career. I left bedside 2 years ago to work in case management and it pays more than I've ever made as a nurse, but I'm still not content. So while salary is important, its not everything. I am so ready to get back to patient care with the added autonomy of being an NP.

As far was what NP concentration to go with, my bedside experience is solely in NICU, and I am going for FNP. So don't focus completely on what you've done in the past, but rather what you want to do with your future. Working critical care can be exciting and full of new experiences, but there is also something to be said for those working in the primary care setting treating flu and boo-boo's. Both are respectable positions! Just think about how each position's responsibilities will differ and your day to day will look like.

Good luck in whatever you chose!

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AnnieNP is a MSN, NP and specializes in Adult Primary Care.

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I'm an adult NP working in primary care / pulmonary.  I do not miss critical care or emergency room at all!!!!!! 

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23 hours ago, Hoosier_RN said:

Look at the real market for new grad NPs where you are, or wherever you pan to practice-along with pay and benefits; don't let a school's marketing person answer that .  Many areas are now flooded, FNP, ACNP, and PMHNP ; CRNAs are now going in that direction as well.  NPs in some areas take call for Dr groups, etc.  Some of these things (flooded market) drive the pay down and drive the expectations up.  Read the many posts on here.

Make sure that any school that you choose will have preceptors for you, and have it in writing.  This seems to be a major issue that I hear about with the APRN education.  Again, read some of the posts on here.

I will add, if it's something that you truly want to do, then do it.  In a few years you will either have that education or not.  Good luck!

The market is definitely starting to become saturated where I am, but I also have a really great rapport with my hospital (started as a nurses aide and have worked my way up) and know that they're coming up with new programs where NPs will be highly utilized (clinics and floors where they don't do any off shifts), which is where I'm hoping to end up.  I'm thinking by the time I graduate these programs will have worked out the kinks.  If I can't find a job right away I will still have my current RN position to work at in the meantime, although it would be nice to start working shortly after graduation.  I've also read a bunch of posts on here stating their schools make them find preceptors - much less work on the schools and more stress for us!  Thank you so much for your feedback!

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6 hours ago, nicu_RN88 said:

I was in a similar position working bedside ~5 years and am starting a DNP program in August. Bottom line, if you are miserable doing what you are doing and you don't get to see your family--find something else. Whether that be another bedside job or going back to school, you are too young to become complacent in a career you don't enjoy. You will see that the NP market is saturated, and that may be true in many places, but you WILL be able to get a job out of school. Just like coming out of RN school, you might have to start somewhere and work your way up to your goal position. IMO, paying back loans is a price I'm willing to pay to be happy in my career. I left bedside 2 years ago to work in case management and it pays more than I've ever made as a nurse, but I'm still not content. So while salary is important, its not everything. I am so ready to get back to patient care with the added autonomy of being an NP.

As far was what NP concentration to go with, my bedside experience is solely in NICU, and I am going for FNP. So don't focus completely on what you've done in the past, but rather what you want to do with your future. Working critical care can be exciting and full of new experiences, but there is also something to be said for those working in the primary care setting treating flu and boo-boo's. Both are respectable positions! Just think about how each position's responsibilities will differ and your day to day will look like.

Good luck in whatever you chose!

Totally agree with both being respectable positions!  I love critical care, but I know I wont love it at the NP level.  Plus, my hospital doesn't even have NPs in our units (only PAs in cardiac surgery).  In a way my experience in critical care has made me want to work in the prevention/primary care side as soo many people just need education and someone to check in on them in order to be successful.
I'm thinking worst case in a saturated market I don't get a job right away and I continue to work as an RN on my unit, still gaining a ton of new knowledge and fine tuning my skills.  Since I posted I have been thinking about the FNP route as you're right - it's the future I need to be thinking about.  Thank you so much for your help - it's so nice to be able to reach out to unbiased people whose responses aren't based off of unit competition and staffing issues! (not kidding if some people on my unit found out I was thinking about this they would try to change my mind or be like why is she going to school again?? so frustrating!)

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5 hours ago, AnnieNP said:

I'm an adult NP working in primary care / pulmonary.  I do not miss critical care or emergency room at all!!!!!! 

I love it, but most days I'm so over it!  I'm thinking worst case I can always stay per diem in the ICU and still work as an NP.

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AnnieNP is a MSN, NP and specializes in Adult Primary Care.

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On 7/10/2019 at 4:03 PM, ccuRN24 said:

I love it, but most days I'm so over it!  I'm thinking worst case I can always stay per diem in the ICU and still work as an NP.

Trust me, you will get enough critical care while in primary care!!!!  This week I had a patient call for an "asthma follow up appointment".  I had a cancellation and the patient was given the same day appointment.  When he got to the office he was not looking great.  Inspiratory and ex, piratory wheezing / severely dyspneic / new onset A-Fibrate 140-160.  Sent straight to the hospital.  

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juan de la cruz is a MSN, RN, NP and specializes in APRN, Adult Critical Care.

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If your RN experience is heavily focused on Cardiac, you could consider a Cardiology NP role. That's been a long been established role for NP's (dates back to my bedside RN days in the 90's). In fact, the American College of Cardiology recognizes the role and many hold key positions within that organization. They typically work weekdays sometimes take call and can have long hours. I've seen a mix of AGACNP's, FNP's and AGNP's working in that role.

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Like stated above, check the market in your area.  In my area the FNP market is over saturated.  There are very few jobs and these have job posting from 99K- 120k. I have posted these ads on this site as I watch the wages continue to plummet. RN's in this area are making 120k.  It doesn't make sense to be a FNP here.  Psych NP is a different story.  Much better pay as the market is not flooded.

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I would shadow some NPs in both settings before making any decisions.  I am an old ICU nurse, was there for 13 years.  If you don't want crappy hours and weekends, don't do ACNP.  Most jobs I saw for ACNP in ICU/hospitalist were 7 on 7 off, and you usually have to rotate through nights.  You could do ACNP and not work in the hospital, but most of your clinicals are inpatient.  So I would say FNP or AGNP. 

And this is why I say shadow- please go back to school because you want to be a provider, and not just to get away from crappy staffing & acuity in the ICU/advance your career.  You have to go back because you want to think, act, etc. as a provider.  That means thinking a lot about the billing side of things and thinking about your work as a business.  I was surprised about how much of my day revolves around this.  I think this is why a lot of nurses are unhappy when they become an NP just to get away from bedside.  Just a thought - good luck!

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Hoosier_RN is a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

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3 hours ago, bryanleo9 said:

Psych NP is a different story.  Much better pay as the market is not flooded.

As many are rushing to that to cash in, some areas are seeing oversaturation, and I suspect it will be driving their pay down soon as well...

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