TX_ICU_RN

I am a nurse who recently changed from being a Pedi NP to working in an adult ICU as a RN. I have been there for 4 months and can't imagine going to CRNA school with only 1 year of ICU experience as your only nursing experience. The learning curve is simply way too steep.

I did when I first started practicing, but the first time I had to see a patient that REALLY did not want to see a NP changed my mind. The doc had to leave to go to the hospital for an emergency and the mom decided she would "settle". The tension was very high in the room and I had a horrible thought pop into my mind: UNHAPPY PATIENTS/PARENTS ARE MUCH MORE LIKELY TO SUE YOU! THE PEOPLE WHO DON'T WANT TO SEE A NP AND ACTUALLY EXPRESS THERE OPINION ARE DOING ME A GREAT FAVOR!!

Good Luck!! I can't wait until I can say the same. I am actually going to orientation on July 31st for my post master's ACNP program. I am already a PNP, but have switched to the adult arena.

My husband has worked as a NP in the ER for years. His speciality is FNP, which has served well up until lately. The FNP is GREAT if you are doing urgent care/fast track. However, if you want to get into more complex cases and procedures, having both the FNP and ACNP is your best bet. We used to have an ENP program in our area, but they are about to merge it back with the FNP program. The problem is that the ENP limits you to the urgent/emergent setting and there is not a certification exam for ENPs. They actually take the FNP certification exam. So, since you are looking to do urgent care, FNP would be your best bet. Just remember that you may fall in love with some of the higher complexity cases, and you will most likely need your ACNP in order to place lines, intubate, etc.

I am so sorry you had such a bad experience. I just recently found a really good trauma therapist, but I have to pay out-of-pocket. Until last summer, I NEVER would have paid out of pocket for a therapist. However, I was having life-threatening issues with anorexia and it was either "turn things around quickly or go into the hospital". There was not a single ED trained therapist on my plan. So, I started paying out of pocket and got a fantastic therapist. Recently, she and I decided that I had gone as far as I could with her for now and that it was time for serious PTSD work. Again, I could not find anyone worth talking to that was on my insurance. So, I am paying out of pocket again and it is worth every penny.

I agree with the others...south of I-20. With the Rangers, Cowboys, UTA, Six Flags and Hurricane Harbor in central Arlington, it can be a nightmare.

I live in DFW and 5 years of experience should get you $27-30/hour MAX base at most facilities. The cost of living here is significantly less than many other places across the nation. If you have not lived in Texas before, I would visit Houston and other areas you are considering before deciding on Ben Taub. If I lived in Houston and worked in the Med Center, I would commute about 1 1/2 hours each way every day in order to live in an area with good schools and housing...which is totally not worth it to me. The long and short of it is that you have to do what works for you. I just recommend that you look at the whole picture, not just the hourly rate. Look at benefits, commute, cost of living, etc. Good luck!

Hey! I have lived in DFW since I was 7 and love it here. My husband and I met in nursing school and have been married for 12 years. We have three kids, 16 (his daughter from a previous marriage), 11 year old son, and 9 year old daughter. We both got our BSN's in 1997. I worked in Pedi from 1997-2003. I got my MS in 2000 from TWU as a PNP. I worked as an outpt. PNP and taught Nursing School from 2000-2003. I was a stay-at-home-mom from 2004 until March of this year. For a multitude of reasons, I decided to completely change the direction of my career and now work in Adult ICU. I have fallen in love with it and will be going back for my ACNP in the Fall. Since I already have a master's degree it will be a 5 course certificate!! It is nice to meet everyone.

I learned this the REALLY HARD WAY!!! I just went back to work two months ago after taking 4 years off to stay at home with my kids and also to recharge myself. I got Rheumatic Fever in Dec 2003 that resulted in multiple hospitalizations and then ended up with a massive ankle fracture 6 months later (due to not listening to my body) that led to RSD/CRPS. Thanks to great nurses, NP's and docs...I am back to work. However, I will never push myself the way I did before. It is not worth it. When you are a NP, the business side really comes to light. I am rebuilding my career and part of this is trying to get the most money I can for doing what I love. Money is not the reason I do what I do...but it is very important to earn enough to not have to work 80 hours a week. Having been a NP before, approaching this is much easier this time around. The first time, I was scared as hell to negotiate anything. This time, I will fight for everything I need.

I work in the ICU and this frustrates me as well. However, OR deaths are a HUGE issue as far as reporting and I am 99.9% sure that an autopsy is required of anyone who dies in the OR. An autopsy will be done if the patient needs it, but there are many patients who don't need an autopsy that would needlessly be subjected to it (well, there families would). I have prepped patients for the OR knowing they would die for sure without the surgery and that the surgery was a last ditch effort. It sucks for the ICU...but I really believe it is best in the end.

It all depends on the position you are taking. Here are a few tips my husband and I have learned along the way: 1) Productivity bonus - This should be based on any money you bring in after you have "made" your salary for the year. For example: Base Salary = $75000/hr Your Income for the Practice = $150000/year Amount made over your Base Salary = $75000/year Your Productivity Bonus = $7500-$15000/year (based on a 10%-20% after salary scale) 2) Your RN experience before becoming a NP. If you have worked ER, sometimes you can negotiate a slightly higher salary 3) The need for NPs in your area Good Luck!!!

I am about to start my Post-Master's Certification for my Acute Care NP. I spent several years working as a PNP and then took some time off to raise a family. During this time, I spent a lot of time soul-searching on where I wanted my career to go when I re-entered nursing. I started my PhD in nursing and completed 15 hours before deciding that I wanted to stay in clinical practice. I am now working in an adult ICU as a RN to get the experience necessary to become an ACNP. After I become an ACNP in the summer of 2010, I will begin a DNP program. We can talk about the difference in program clinical hours all day long, but there is one thing that people tend to forget about. By the time I receive my DNP, I will have approximately 20,000 clinical hours between work and school. I would never expect or want to perform cardiac surgery, but there are many things my years of nursing bring to the table. I will PROUDLY use the title of Dr. when I receive my DNP because I will have completed approximately 120 hours of post-bacc coursework for that degree.

Laura Gasparis CD review course! I just started studying for the exam and am finally going to break down and buy them. You can put them in your car and on your ipod and listen to them anytime you want.

What length are the shifts you work? I know some hospitals do 3 12 hour shifts one week and then 4 the next. Some hospitals do 5 8's a week and some do 3 12's one week and then 3 12's and 1 8 the next week. I would start by trying to get the topic on the agenda for the next unit meeting. When management really sits down and takes a look at how much agency/travelers are costing them, they usually realize how much more beneficial it is to keep their regular staff happy. Also, I would find out if this is the norm in your area or if your hospital does it differently than others in your area. If others are doing 36 hour weeks, it might be easier to facilitate change.

I am SO excited!!! I used to work as a Pedi NP and then took four years off to raise my kids. In March, I started working in an Adult ICU (I wanted to try something different) and I love it. I have always wanted to do critical care, but I get too attached to my pedi patients to be able to deal with the PICU or NICU. I get attached to my adult patients as well, but it is much easier to handle an 80 year old dying than an 8 year old dying. So, instead of doing the 400 hours to reinstate my PNP, I am going back to school!!! I went to see my advisor today and was shocked at how fast it will happen. I have to do Advanced Assessment and Advanced Patho CEU courses this summer and then start the program in the Fall. Other than one semester, I will only have to take one course a semester and will finish in August 2010. Also, The school is seeking approval for a DNP program to begin sometime next year and I would be able to transition right into that. If all goes as planned, I could have my DNP by May 2012. I can't believe it is falling into place even better than I imagined!!!