J&B-RN

Hi there, Update- I stayed in pain management for one year. That was plenty long enough. While I did learn a lot, and overall it helped me settle into the role of an advance practice provider… I would never ever do pain management again. The clinic I worked at was actually wonderful. My boss we great and very hands off, my MA was awesome, and the other APPs were very experienced and incredibly helpful. It was a great office/learning environment. But… (and it’s a big but) I wasn’t happy, I did not feel safe prescribing the doses my patients were on, I was yelled at more in this job then any other job by upset patients when I would not prescribe what they were requesting. I caught numerous patients abusing, selling, buying, mixing, and all sorts of other issues. I left that place feeling like I wasn’t actually helping patients, and was in fact actually hurting some patients. I have since moved on to much better places. I work inpatient at a pediatric hospital on a surgical service and absolutely love it!! I will say I miss those pain clinic hours and the 1 year I put in there did help me land my dream job, so overall it was the right job for me at the time.

Thank you for the words of advice! So far I’ve survive nearly 2 weeks on my own. It’s been stressful and hard. I see 13 patients a day for now and it’s busy. I feel like I’m learning from the ground up. But the support is there. I’ve been reading all the previous visit Notes and find that is really helpful. And the other providers are always on hand for questions. For the most part I am only seeing patients who are established and on a current plan. So that keeps it a bit simpler to figure things out. It’s scary... but I guess any new job is. I know I haven’t really given pain management a chance, but I am fairly certain this is not the role for me. That being said, I plan to just dive into this and learn all I can. Hopefully something that is more my passion will pop up soon and maybe this experience will get me where I want to go. Now if my dream job could just magically fall into my lap that would be awesome!

How did you know exactly what to say!! thank you ?? I’ve been so stressed about working in pain management and then when I lost the rest of my orientation weeks I just panicked. It’s hard to be new... and even harder when it’s been 2 years... and even harder when I don’t think I’ll fit well in pain management! but my husband said the same thing. Just learn what you can and use it to your advantage and in 6 months apply to your dream jobs. I guess he sometimes has good ideas ??‍♀️ thank you for easing some stress! Now if I can just survive my first day on my own tomorrow.

OK so to make a long story short... I’m a new grad, sort of, I graduated 2 years ago and I am finally starting my first NP job. (I was sick for a year and couldn’t work, postpartum depression is real people ?). So I have a dual degree FNP/AGACNP, but of course with covid nonsense I have not been able to land any inpatient jobs. There have been 50-100+ applicants for every job I applied for. Granted half the hospital in the area have been on hiring freezes for over a year... After months of no success I moved on to the outpatient world and landed a job in pain management. Seems like pain management jobs are a dime a dozen right now and I’m beginning to think there’s a good reason for that. I’ve had 7 days of training and will start seeing patients on my own tomorrow. I am beyond stressed!! I was promised a 6 week orientation and that didn’t happen because the provider I was to replace up and just left (who does this?? Isn’t that patient abandonment??). So now I received 2 weeks of orientation and that’s all they can do. Beyond stressed about this. It just seems crazy to me. I have NO idea what I am doing, my back ground as a bedside RN is ICU and basically all my NP training was ICU and family medicine (which family med I completed 3 years ago.. soooo I can’t remember a damn thing from that). I want to work inpatient. I want to work in the acute care world. But I need a job! I plan on continuing to apply to inpatient positions, but is this pain management job even going to be worth it? I will get no training, be stressed AF, to do a job in an area of medicine I do not like. (Who actually likes pain management??) I am worried I am going to get stuck in the outpatient setting. I need experience, I need a job, but is working in pain management going to hurt my chances of ever getting into the hospital setting? All these hospitals want NP experience but is pain management even going to count?

I haven’t tried sound or Apogee yet. I am really trying to avoid that brutal 7 on 7 off schedule. Been there done that as a bedside ICU nurse and it about killed me. I think I’d rather do family med then that schedule again! I’ll start searching all the critical access hospitals in WA and OR and see what I can come up with. I’m sure I will find something but I think it’s going to take me longer then I anticipated. I was thinking 3-4 months but it’s looking more like 6-8 months by the time I actually start. It’s just hard to go back to square one. I did this once before as a new grad RN. Had to do a year in a nursing home and a year on med/surg before I got my dream ICU job. Looks like it’s going to be the same process. I just need settle in for the ride. Thanks for the advice!!

I just graduated with a dual AGACNP/FNP a few months ago and job hunting has been zero fun!! I did not enjoy family med and want to avoid that area of medicine completely but it seems like those are the only jobs available!! Everywhere that is acute care or hospital based wants 2-5 years of experience. I’ve had a couple interviews only to be lead on and the job ultimately given to “someone with more experience”. I live in Seattle but applying all over WA, OR, ID and northern Nevada. Where are the acute care jobs?? I just don’t want to be in a clinic full time. I wouldn’t mind something that did clinic, hospital rounding, and OR time! Dream job! but alas... I have no experience. Did anyone start out in family med or some other clinic (renal/GI seems to be in demand) and then transition to the hospital after a couple years? How are new grads getting acute care jobs these days?? If I were to start out in the clinics would it Be better to do family med or a speciality (like renal/GI/wound care) If I plan I transitioning to the acute care setting ASAP? Any other new grads having the same issue?

I went from a general SICU in a level 1 facility with a large variety of patients (truama, neuro, sicu, cardiothoracic, picu, open bellies, open chests, crrt, balloon pump, etc) to a burn and pediatric truama ICU again at a level 1 facility. I would kill to go back to my last job. Burns, suck. Truama is better but I find that I'm losing my critical thinking skills. Truama is sick when the first come in, and then it's just a long drawn out sad process. I feel like most of the time I'm taking care of step down patients. I always loved truama at my last job, but maybe because I got to do all the other fun patients along with it. Having done what you are doing "trying to find the sickest of the sick" and now I'm stuck bored and frustrated, be careful with truama, maybe it's just my opinion but I felt a lot more challenged in a general SICU then I have in the pediatric truama ICU.

I am literally in this same exact boat. Except I've been at the new job for about 6 months now. And I am bored out of my mind!! Ive only ever worked in level 1 trauma/surgical ICU's and I recently took a job in a large level 1 burn ICU. And I hate it. I leave everyday frustrated. It's so boring. The patients arent anywhere near as sick as I am use to. It's not that I don't get those sick patients it's that the unit doesn't get those sick patients. Burns are boring!! And sad. I moved to a bigger city, a bigger hospital, because I wanted more challenges, and all I've gotten is more frustrated. The orientation process was the worst part tho, mine was short only a few weeks but I left everyday frustrated. It's really hard to learn a new way of doing things, learn a new hospital/unit/people/policies/flow. Once I got past that I was looking forward to learning a new patient population, but now 6 months later... it still sucks. My only suggestion is to stick it out, hopefully (it sounds like your unit at least gets sick patients) you'll get to work with those patients soon. And if in a year you still hate it, try something new.

0Because of many reasons I moved to an entirely new city and took up a new job. I have over 4 years of surgical trauma ICU experience in a large level 1 facility that was a very fast paced ICU with really sick busy patients. We did everything from trauma to open hearts to transplants to burns to PICU. (It was a really unique unit that I absolutely loved!!) but I had to make a move to a new city. I applied to many jobs, but chose another level 1 trauma center (because I thought it would be the most exciting busiest ICU) and ended up in the adult Burn ICU and pediatric trauma ICU. I have very little burn experience (even tho my last job did burns they were not very common). Well I chose wrong. I am so incredibly bored!! I thought it being the only level 1 in the area I'd get to see a lot of interesting pediatric traumas and a lot of really interesting burns. But that just isn't the case. (Occasionally the peds traumas are very intense and interesting but also really sad so I don't get to excited about those and they aren't that common which is a good thing!) the majority of my patients are burns and they are boring. I want to go back to my open bellys on 14 drips and crrt and balloon pump and cracking open chests at the bedside. I've only been at the new job 6 months and I feel like I have completely lost all my critical care skills. Most burns are walking and talking and just need pain meds. I feel like I am wasting away in here! Its just frustrating but I don't want to quit when I've only been here 6 months. My coworkers are great, the pay is good, and the unit is well ran so it does have that going for it. Im also in school full time for a dual FNP/AGACNP, which I don't graduate for 2 more years, but I'm not sure it's worth it to switch jobs... especially since at some point I will need to cut back my hours. And even if I switched jobs I have no idea which other hospital or ICU would be more like what I'm looking for... Basically I just wanted to whine because I'm bored and I don't like burns and I miss how intense my old unit was and I'm just disappointed. I love bedside nursing and ICU nursing and I really wanted to love my new job (since it was going to be my last before I transition into an NP role) and I just don't. Not really sure where to go from here...

Hey travel nurses! I was just wondering what your favorite ICU you've traveled to is?? what's the most intense, interesting, sickest, most challenging, assignment you've ever taken?? In a good way! Ive recently started in a new ICU and I'm bored out of my mind!! I went from a really big intense ICU to a small specialized ICU that just doesn't have the acuity of patients I'm use to. Trying to figure out where all the intense ICU's are at. I'm ready for a challenge.

I have taken care of an 80% burn. Do you work days or nights? That makes a big difference. I work nights and we don't do burn care at night. So it's just turn and base and pain meds. They become chronic sick stable pts pretty quickly. Although I enjoy having awake patients and really getting to know them more, it's just not very challenging.

I've only ever worked in large level 1 Truama ICU's and both jobs the ICU's have both adult and peds. They are out there if you look for them.

Because of many reasons I moved to an entirely new city and took up a new job. I have over 4 years of surgical trauma ICU experience in a large level 1 facility that was a very fast paced ICU with really sick busy patients. We did everything from trauma to open hearts to transplants to burns to PICU. (It was a really unique unit that I absolutely loved!!) but I had to make a move to a new city. I applied to many jobs, but chose another level 1 trauma center (because I thought it would be the most exciting busiest ICU) and ended up in the adult Burn ICU and pediatric trauma ICU. I have very little burn experience (even tho my last job did burns they were not very common). Well I chose wrong. I am so incredibly bored!! I thought it being the only level 1 in the area I'd get to see a lot of interesting pediatric traumas and a lot of really interesting burns. But that just isn't the case. (Occasionally the peds traumas are very intense and interesting but also really sad so I don't get to excited about those and they aren't that common which is a good thing!) the majority of my patients are burns and they are boring. I want to go back to my open bellys on 14 drips and crrt and balloon pump and cracking open chests at the bedside. I've only been at the new job 6 months and I feel like I have completely lost all my critical care skills. Most burns are walking and talking and just need pain meds. I feel like I am wasting away in here! Its just frustrating but I don't want to quit when I've only been here 6 months. My coworkers are great, the pay is good, and the unit is well ran so it does have that going for it. Im also in school full time for a dual FNP/AGACNP, which I don't graduate for 2 more years, but I'm not sure it's worth it to switch jobs... especially since at some point I will need to cut back my hours. And even if I switched jobs I have no idea which other hospital or ICU would be more like what I'm looking for... Basically I just wanted to whine because I'm bored and I don't like burns and I miss how intense my old unit was and I'm just disappointed. I love bedside nursing and ICU nursing and I really wanted to love my new job (since it was going to be my last before I transition into an NP role) and I just don't. Not really sure where to go from here...

Do any of the hospital in WA actually use ACNPs in their ICU's? Thinking of moving to WA and planning on getting my ACNP within the next 2 years. I want to end up in an ICU as an NP.

Hello everyone! So the hubby and I are thinking of relocating from Vermont to Seattle. I am going to be starting in an acute care NP online program this fall. I currently work in a SICU as an RN. I was wondering if any of the hospital in the Seattle area have acute care Np's working in them. I plan on continuing to work part time in and ICU as an RN while I'm in NP school and since I have to set up all my own clinical's I am hoping I can use my job to make connections. I'm hoping to do most of my shadowing in the ICU and ER so I want to get into a hospital that really utilizes acute care NPs. Here in Vermont since we are a level 1 Truama center we don't have any NP's or PA's working in the ICUs and very few in the ED's because of all the residents. That's part of the reason we want to relocate. Any info is great appreciated! Thanks!