Nursing Student work in ICU or ER before becoming ACNP?

TJFRN · Apr 14, 2011

What do you mean "not smart enough to work in an ICU". I have worked both and in the ER you need your wits just as much as in the ICU. In the ER you are taking care of 7 patients at a time and in the ICU 1-2. Although in the ICU I worked in those 1-2 patients were critical you had to be prepared, but you are trained to do just that. However, in the ER you could have 3 or 4 critical patients... you never know... a stable patient can become critical. Also in the ER I worked in they used ICU experience as a stepping stone for the ER. You can do it with good training... I worked in the ICU as my part time job and in the ER per diem. Try that to see what works best and ask the schools you are interested in.

LexSavDav · Apr 15, 2011

I dont know I just feel like those that are hired to the ICU have the highest gpa and its the most competitive. I agree though with the proper training I would be equipped for the ICU or ER. Maybe its just a false believe I have in my head!

TJFRN · Apr 15, 2011

LexyD don't let the GPA thing get to you... The hospital does not know you're GPA. Although you may not be able to recite your textbook does not mean you are not a good nurse. Critical thinking (thinking outside the box or putting the puzzle together) is what you need to do! Get you're experience on a telementry floor (1 yr) then shoot for the ICU. Don't let a bad day define you... mistakes will happen, learn for them and keep going!

:coollook:

apocatastasis · Apr 15, 2011

I'm not an ACNP, but I did go from an inner city ICU where all the patients had every major comorbidity in the book... to a suburban, high volume ER where the patients are overall much, much less sick.

The ER nurses at my hospital, with a couple of exceptions (those being the nurses that also worked ICU and, to a lesser extent, those that have worked in major trauma center ERs) do not have the experience with hemodynamics and management of really sick patients that I had working in a CVICU/SICU. Many of my ER coworkers have between 3 and 10 years of experience and can't/don't titrate drips or coordinate ventilator readings and what's going on with the patient. On the other hand, they are still more proficient than I am with initial reception of STEMIs, strokes, and things I saw less of in ICU.

You will learn things in ER that you won't in ICU and vice versa. I do think that having a strong background in respiratory, cardiovascular, neuro, and renal issues, which I feel you'd probably get more of in ICU that takes truly critical patients, is going to be really valuable experience if you're going to work in a critical care environment as a provider. If I were in the ICU as a patient, I don't think I would want an ACNP taking care of me that had never worked ICU before.

silverbelle · Apr 15, 2011

I work CVICU and ED (part-time in both)....if you want to be a ACNP...go to work in critical care, there are many things you will see there that you won't in the ED and vice versa...gtts, vents, ballon pumps, post surgical patients, what you see in the unit that you cant see in the ED is the progression of the disease process...ie sepsis, ARDS, ARF ect... and surgical outcomes good and bad including complications; unit patients have their care managed and changed on an hourly - daily basis vs the ED where they are assessed,treated,stabelized and sent upstairs then you as the nurse head on to the next patient. In the unit you may treat the same patient for months while their condition changes and evolves. And......Forget the gpa...I have worked with lots of "A" nurses who could could not think critically or manage time well. If you want to do it...do it, believe in yourself and good luck! :heartbeat

SkiBumNP · Apr 15, 2011

I think you should make your decision after you take a good hard look at what you want to do as an ACNP.

If you want to work as a hospitalist or a specialist then i would gain ICU experience.

but if you want to work in the ED as an ACNP then I would make the choice to work in the ED.

And I totally agree with everyone else, don't let your GPA get in your way. I know many Rock Stars who didn't do well in school.

pedroparramo · Apr 16, 2011

Either ICU or ER will provide valuable experience. In fact, contrary to naysayers, you can get your ACNP with floor experience. If you'd be willing to go either way though, I'd go with ICU.

As an aside, some programs won't let an ICU RN train in the ER but will let an ER RN train in the ICU.

Advanced Practice Columnist / Guide · Apr 16, 2011

Hello,
I am a nursing student at the Mayo Clinic/ASU BSN program. I will be graduating in December and my dream is to go on to become an Acute Care Nurse Practitioner! With my preceptorship coming up and my first job, I don't know if the ER or ICU will look better when applying for an ACNP school. I really want to work in the ER, but I have heard through other nursing students that if you want to get into ACNP school they only take nurses with ICU experience. I don't know if I am smart enough to work in the ICU and ER seems to fit my personality and fast paced mentality more. Is this true? Or would they also take someone with just ER experience? Any advise will be helpful! Thankyou!

I've never heard of an ACNP program that only takes nurses with ICU experience. Like another poster already said, you'll get a better understanding of the body system-based approach to patient management in the ICU than in the ER. This approach will help you understand the content of the courses in the ACNP program better in the end. However, my experience in my ACNP program was that students come in with a set goal of where they would like to practice as an NP. If your goal is to work in the ICU, then you have better chance of getting a job in the ICU if you already work there as an RN. However, ER can be tricky because ACNP programs only train in the management of patients aged 13 and up. Many ER jobs for NP's require the ability to provide care to patients of all ages.

LexSavDav · Apr 18, 2011

Thankyou everyone so much for the encouragement and input. I will see where I get placed for my preceptorship as it is out of my hands!

Annaiya, NP · Apr 22, 2011

I agree GPA doesn't necessarily equate to the quality of nurse you will be, but I feel it is still extremely important. I had to submit transcripts from all of the schools I've attended to get my current job, so my employer definitely knew my GPA. Not to mention those people with a lower GPA don't seem to be getting into grad school lately. Everything has become so competitive that GPA makes a difference in getting jobs and getting into grad school. Definitely don't blow off your classes in your class semester.

FWIW, my ACPNP program did not require ICU or ER experience, just acute care experience.

Caranetta · Jul 24, 2017

I am so glad that I found this website!!! Thank you to all of the nurses who responded to LexSavDav's question. I will be a nursing student soon and thinking ahead with what path I want to continue down when I'm done with my training, I was wondering the exact same thing...ER or ICU which option should I use to further my training as a future NP. Your answers were so informative and helpful and I just wanted to say thank you so much!