ICU2NP

I work in LTC/TCU/AL settings. We have moved to mostly tele-health visits via the previously mentioned Doxy app- but it has been slow so we are also using FaceTime. Tele-health restrictions have gone out the window, so luckily I can work from home but still take care of my patients and screen those who are high risk. The nursing homes have been great about assisting us with this. Right now I am going through my 80+ resident building and screening everyone with quick visits, and updating POLSTs as we are already having shortage of ventilators where I live so we want to know who is a DNI for sure.

Yes I work for a private company that is local to where I live, they contract with the facilities (I do not work for the facilities). Many of the larger hospitals also have contracts with them. I believe if you just search LinkedIn, Glassdoor, etc. you could find some companies. There are multiple companies hiring in this setting where I live right now. Good luck!

Wow how awful!!! You will find something great, I'm sure ? Good luck and keep us updated!

I agree with Dodongo... go outpatient and work in a specialty clinic. I think they get longer appointment times than in primary care, also. While I was applying for jobs I saw pulmonology clinics looking for acute care experience. I've heard this is a low stress specialty from an outpt standpoint (chronic management of asthma, COPD, & OSA).

I think derm is pretty fast-paced also. An NP I am working with now did derm for awhile, and she said it was patients every 10-15 minutes. So she took a 50K pay cut to leave because it was too much. I am in the TCU, LTC, and AL setting. It is pretty go-at-your-own pace. I love that I can prep the patients when I want (at 5am with coffee on my couch), then go in and round on my patients at leisure, then sit with my lunch and chart. Then go see a few more, and either chart there or head out & chart elsewhere. Done by 3pm. Love it.

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!

I'm not familiar with pediatrics, but is there some type of home care you can do in peds as an NP? I am working in different nursing facilities (LTC, TCU, assisted living) and somewhat making your own hours and not having set appointment times right after another is really enjoyable. Or maybe a specialty clinic in peds would offer you longer appointment times w/each patient, therefore hopefully reducing burn out? Good luck!

I had good luck with Glassdoor and LinkedIn.

Could you expand on why? I'm not seeing anything written that discusses potential harm to patients.

Are you a primary care focused cohort? That’s probably why they are discouraging inpatient rotations? We weren’t really supposed to do inpatient rotations either, as we are primary care (AGNP). I learned the most in TCUs that had high acuity (not just elders needing rehab post-knee replacement). It felt very acute care-ish at times, with multiple comorbidities to manage. Some of those people who are getting discharged from the hospitals are SICK.

I spent the summer doing every activity possible with my kids, drank a lot of wine, and slept in Then I went casual at work (best idea ever), and figured out ahead of time when would be the best time to study. For me, it was to wake up at 5am and get a solid 2 hours in every day before my kids woke up. To have that plan in place worked out well. Enjoy the summer!!

I'm not officially an AGNP yet (graduate May 11) but I'll answer anyways... 1) I just signed a contract with a company that goes into various SNF, TCU, and assisted living facilities. 2) My area is saturated, so I was unable to find a job in a primary care clinic which is what I originally wanted. They all wanted 2-3+ years experience and it seems d/t the saturation they could afford to be picky. 3) Can't answer this one yet, sorry. 4) The AGNP preceptors I've had/friends I have that are AGNPs have worked in SNF/TCU/AL, inpatient specialties (pulmonary, ortho, oncology, palliative & CV are the ones I have personal experience with), outpatient family practice and internal medicine clinics, outpatient specialty clinics, and hospice home care.

I don't know if that is typical of NP residencies, but no guarantee of a position afterwards? I don't know if I'd like that. I guess it depends on how saturated the market is with NPs in your area. If it's super saturated, I might be more inclined to do the residency to be a more attractive candidate. But if not... I think I'd get a job elsewhere.

I would, and we have been using part of the student loans for some living expenses so that I could go casual at work and concentrate full time on school. I need to give my full attention to my studies, I owe that to my future patients. The last two semesters were a beast with 3 days of clinicals, 4 classes and now our independent study and studying for boards. If I were you I would absolutely do it.

Women's health yes, OB no. I am interested in women's health but every women's health job I've come across so far also has an OB aspect... so unfortunately I can't apply to those.

I agree, if you are not already a nurse then I would go the PA route for sure. Especially if you have no desire to actually be a nurse, which is the initial foundation of a nurse practitioner. I have talked with various respiratory therapists who go on to PA school when they want to become a provider and advance their career, and it works out well for them.

I agree about finding continuing education for procedures - they are obviously live in person but I found out about them by searching online in my area. I was initially interested in urgent care and looked into those since my school offers no training in that - but I'm adult/gero so there's no way I'll get hired so that dream went to the wayside real quick. Anyways, I found all sorts by googling. Good luck!

I'll just offer a different perspective from the previous reply - I believe that my inpatient RN experience has been EXTREMELY helpful for my NP education, mostly due to my assessment skills. As an ICU RN, I am doing full head to toe assessment q4h every time I'm at work. Plus appropriate focused assessment PRN if I see changes. I was able to see norms but also assess subtle changes and not so subtle changes; this experience has been invaluable. I'm not saying you have to go back & do ICU, but inpatient RN assessments provide great experience for when you expand to advanced provider assessment. That said - I can COMPLETELY understand not wanting to go back inpatient once you have left!! The more I am working outpatient in my clinicals, the less I want to go back to my inpatient RN job? Also why I chose primary care NP instead of acute care - I want to get away from inpatient. So, I'm sure you will do fine continuing to work in your outpatient RN job! Good luck!

Congrats! How nice to be able to choose exactly which job you would like. From the information you presented, I believe I would be choosing B. To me, in house resources and appropriate ancillary staff win out. Although, I am still in school so take that with a grain of salt.... but, I've been lucky to have a great variety of clinical sites and the ones that don't have appropriate resources or staff were just, not great experiences. Good luck!

The question I always get is: "But what's the difference between an NP and PA??" Then I explain (and keep it brief), and then they always ask again at a later date (aka my mother-in-law. OMG. I think she's asked me 3 times).

Meh, I would just worry about finding a place to work where you can get hours that will be conducive to doing clinicals, or a place where you can go casual or is low stress. I worked strictly ICU before going to AGPCNP and it didn't help much. It's an entire different world. I knew none of the meds in primary care because we stopped all their home meds when they were in ICU. I knew none of the outpatient antibiotics because we were giving broad spectrum IV antibiotics for resistant and rare bugs. Only worry about changing jobs to head to ICU if you are gonna do acute care and stay inpatient.

So have you finished all your clinicals required for adult/gero then? I would switch. But I'm partial - I'm in an AGPC program :) There are tons of jobs out there for me, but I suppose it depends on your area. I check on jobs in my area on a weekly basis right now and the only jobs I've found that they won't accept adult is in urgent care. Otherwise, even in family practice, they state they will hire family, adult or a PA usually.

Every area of nursing is a specialty, essentially. You'll train to learn how to work on that unit with that population. Apply to and work where YOU want to work. I started in ICU straight out of school. I've heard from our preceptors, and now that I've been a preceptor for 11+ years, I prefer to train brand new nurses to the ICU because we can shape them how we want them! No changing bad habits or refocusing what we want them concentrating on. If you think that YOU want to start on med/surg then go from there... do that. But only if you want to. If you don't - apply to where you want to work.

PS I wish there were more posts like this in this forum... instead of just everyone asking about a specific school.

I am SO with you. Been having increase in migraines d/t this semester + clinicals + ICU work. 178 days...