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!
For what it’s worth, I have a few friends who are critical care NPs and all three of them say they wish they had gone FNP. They’ve mentioned the pediatric component of FNP and said they’d have more job options with FNP vs critical care 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.
This is good to know! I will definitely stay per diem at my current job (assuming I would be allowed to - I don’t see why not) so I can still do some bedside critical care. I just no longer want it all the time! Thanks for your input!
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.
Thank you for your input! I do really like cardiology and was thinking maybe a clinic position as there aren’t a lot of inpatient cardiology NP positions at my hospital (they are beginning to make some positions). Although I might have to change my place of work - even though I love where I am now! I’ve been trying to put some feelers out but don’t want to “alert” anyone on my unit. I also don’t want to seem sketchy like i’m hiding something, but ultimately I’ve realized I’m furthering my career for myself and shouldn’t care what people are going to say. I’d rather just not have to hear it before I even apply to school!
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.
The Boston market is definitely flooded I’m sure! I know other Massachusetts cities are so Boston definitely is - this is also a concern, but I haven’t heard anyone say that who actually works here. Two of my friends just graduated and both got jobs right away so I think that may be affecting what I think too.
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!
What kinds of jobs can ACNP have that aren’t in hospital? Maybe urgent care? I have always thought I’d go back to school to be a provider, just not this soon. But you’re right I will definitely need to shadow!
Just remember that if you have to take out student loans those usually start coming due 6 months after you graduate, you could possibly get it deferred for up to a year but I am not certain. But if you're just working as an RN and then those student loan payments kick in it may be trouble.
If I were you I would change things up by finding a new job either at a different hospital and in the same setting or maybe try your hand at a different type of nursing to get out of that environment and then choose your track for graduate school based on where your strengths and interests lie, not in what you think is going to give you the coziest career. There are tens of thousands of people who never work a weekend, a night shift, or a holiday but end up still hating their jobs, if you're that worried about "limiting" yourself just do a dual track degree or a post master's.
or do what a lot of people I know have done, go be a travel nurse, save up a big bankroll and go back to school on your own dime or with minimal loans.
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.
These are good reasons. I would keep in mind that most NP gigs, at least when someone is first up and running, are five days a week with varied hours (they often say 0800 to 1700 but you may never really actually just do those hours). So while I say the "better hours" depends on the position you take, more than likely you won't be working nights or weekends. A higher degree with more autonomy is a great reason--because you will have more opportunities with a higher degree and indeed, more autonomy.
On 7/8/2019 at 2:03 PM, ccuRN24 said:
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.
Sorry, can't answer that one. But I can say that for me, I *love* (like, delighted beyond belief) that I don't have to deal with crisis management like I had to in acute care.
On 7/8/2019 at 2:03 PM, ccuRN24 said:
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).
Nursing was my third career (BSN was my second degree) and I worked through my MSN program and boy, am I glad I did! I have zero (yes, zero) debt from grad school because I worked like a dog to pay for it. I went to school part-time and worked full-time until clinicals came around; then I worked part-time. I did have some debt from my BSN program but while I was in grad school, I paid it off little by little.
I was enrolled in an online program. Like anything, there were positives and negatives to it. I liked not having to spend time commuting to school, and I liked being able to do most of my schoolwork at any time that I wanted to. I did miss having face-to-face interaction with my peers and professors though; I felt like I was studying in a bubble at times.
Rionoir, ADN, RN
674 Posts
For what it’s worth, I have a few friends who are critical care NPs and all three of them say they wish they had gone FNP. They’ve mentioned the pediatric component of FNP and said they’d have more job options with FNP vs critical care NP.