kayceeACNP

I didn't work in a Neuro ICU as an RN but always in an ICU. I actually worked in the Medicine/Transplant ICU at the same hospital I am at now. I agree with jaun de la cruz that networking and experience are very important. A good critical care background will make you a better candidate, additionally more and more hospitals are requiring an ACNP for their inpatient positions, especially in critical care. Additionally, if you can get rotations in these settings as a student that's a good foot in the door. As I said, I didn't work in the Neuro ICU as a nurse but I knew the medical director of the unit through the hemodynamics committee at the hospital and he knew I was in school so it was a nice step in the door. So, I would highly recommend joining committees and taking those opportunities to network as Juan said.

I actually am an ACNP in a Neuro ICU in a large academic center. We have 5 NPs on our team (working on getting up to 8). We, along with the senior residents who join us monthly from Neurology and Anesthesia are responsible for the 24/7 in-house call coverage of our unit. Meaning, sometimes we are on days and take part in academic rounds and note writing with the entire team or we are the night person and cover the unit for overnights. On days we divide the patients based on the number of people that are on and we all have patients we are the primary provider for. We write the daily note and we bill for our services in critical care time. We are a primary service that admits our patients, those with primary neuro injury (status epilepticus, neuromuscular patients requiring intubation or other critical care needs, ICHs, and ischemic strokes). We also act as a critical care consult service to the neurosurgeons and manage pressors, ventilation, and other critical care needs for those patients, the things that make you an intensivist (FASTHUGSBID) :) hehe. We do procedures (and bill for them). We work very closely with neurosurgery, neurology, and stroke neurology teams, depending on the patient. We are the first contact for issues on patients admitted on the unit as we are the call person that is there and someone from our team is there 24/7. Hope this is helpful. -KC

I know this is late and probably after your interview but I agree with all of what Juan said. I was hired into an intensivist group as the first NP in the group with the 2nd hired shortly after me with me not having much say in that hire (fortunately her and I work VERY well together). However, we have since then been attempting to expand our team to 4 NPs and our attendings gave myself and the other established NP final say in the decision telling us 'we want you two to feel like they could be good members of your team'. We have hired the 3rd and the decision was ultimately up to the two of us. We are still searching for number 4 but we'll find the right person. Our most recent hire has been here a few months and he has recently confessed to us that we (the NPs) were harder on him during the interview than HR, our administrators, our docs, etc. Anyway, I hope your interview went well and congrats on getting through school

So I am a Neuro ICU NP. Our team admits our own patients to the Neuro unit (seizures, Myasthenia, MS, Stroke, etc) but then we are also the critical care consult for all of Neurosurgeries patients and co-manage them while they are in the ICU. I love my job because I am only in the ICU. I'm an ICU from before my NP days and can't imagine being anywhere but in an ICU. I had NO desire to do clinic time, but admit that sometimes I wish I got some OR time. I get to do bedside procedures up in the unit (LPs, Central line, arterial line, etc) but I don't actually get to go to the OR and even our bedside EVDs are placed by neurosurgery. My advice would be pick the job that sounds better for you. Are you okay with doing some clinic time and being out of the ICU to go see Neurosurgery consults? If you are then If you want to add OR skill and EVDs to your skill set then go for it! I know I would enjoy the OR time and EVDs but I would not enjoy seeing the neurosurgical population once they are out of the ICU (but I wouldn't enjoy seeing anyone outside of an ICU) So, weigh the pros and cons of each decide which one has more of the things you want in a job

If anyone is interesting in critical care in the Midwest we are hiring for NPs in a Neuro ICU, really an intensivist role with comprehensive care

I personally got my clearance to test and scheduled my exam for 3 weeks later and told myself I would study hard in that time. I will tell you that at about the two week mark I was wishing I had scheduled my test for then. I felt ready and was burnt out from studying. That last week I dint feel did anything for me. Good luck whatever you decide

I didnt take the FNP exam but I took the ANCC ACNP exam and I would say definetely review your ethical terms. Having a clear understanding of the definitions will help decipher the questions. As for a rewiew for those areas I dont know. The review course I took focused mostly on the clinical questions

Perhaps look into taking a class or going to a lecture/conference related to case management. I' not in case management so I don't know what is out there but I'm sure there is something. Without experience in the area you are probably losing out to people that have case management experience. I'd look into a class or something so you could show employers you really are interested

YES! This! Juan- It sounds like you have a great set up for the orientation and training of ACNPs. I wish we had that going on where I am. Unfortunately, we don't have a lot of ACNPs in my area because the closest program is 180 miles away. In fact, I find that a lot of people in my area don't even know what an ACNP. It sounds very structured and like a great place for ACNPs to be clinicals. I'm jealous. :)

I happened to be on my alma mater's website, and I noticed that they have completely gotten rid of all of their MSN level Nurse Practitioner programs and have turned them into a DNP. I'm assuming this is because of the recommendation of the AACN, however I was not under the impression it was required at this time. I quickly did some research of other local nursing schools and found that they are still offering the degree at an MSN level. So, I can't help but look at this situation and think that this is just the school trying to get more tuition money from people. I personally have no desire to pursue a DNP and I think it's because I don't feel like it will make me a better bedside clinician. For lack of a better way to say this; the curriculum seems geared towards the 'academic type' and not the 'clinician type'. But, I think I need to do some more research so I have a few questions: 1. In your area are the nursing schools transitioning the NP from an MSN to a required DNP? 2. If you are an MSN prepared NP are you pursuing or considering pursuing a DNP? If yes, why? I look forward to hearing others thoughts on this matter.

As mentioned before the PTO option is there but you could also look into taking a leave of absence when clinical hours are the heaviest.

Ha! incredible, incredibly.....thats what I get for posting when I've been up for a long time! Clinicals are really what you make of them. We had to find our own preceptors so I was sure to find things I was interested in. We had to do some general stuff each semester like make sure we had a medicine rotation, a surgical rotation and then some ER hours but really beyond those requirements it was up to us. I know some people I went to school with took the easy road and were specifically looking for easier rotations but they pretty much got out of them what they were willing to put into them. While I was in school I had one clinical site that wouldn't let me do any procedures and then the rest of them it was up to my preceptors what they were comfortable letting me do. I got a lot of procedures during my ER and ICU rotations. At my job, it was a matter of doing so many with my collaborating physicians and then I was allowed to do them independently. I think telling a perspective employer could go either way. If it were me I would want nurses that were interested in going to school and becoming better care providers, but some may not want to put the resources into orienting someone that is going to leave. I know I mentioned it because the job had a tuition reimbursement benefit that I intended to use so they were going to find out anyway.

Yes, there are programs that go from an RN to MSN, they are just few and far between I believe. I am aware of a program in the midwest that has an RN to MSN program, its a private school in Omaha. RN to MSN - Clarkson College

Hi! I think the ACNP is a great route for you if you want to stay in the critical care environment. So, here's my answer to your questions: 1.) Are you happy choosing this route instead of FNP? Yes, incredible happy! 2.) What made you choose this route? I was an ICU nurse prior to becoming an ACNP and knew I wanted to stay in the ICU. When I was looking to go back to school I knew a few things I wanted in a future job, they were; 1. no clinic, 2. not working 5 days a week, 3. stay in the critical care environment. I thought the best option for me was to become an ACNP and so far that seems to be true. 3.) What is the job market like? What setting do you practice in? Honestly, I thought the job market was fine (and only going to get better in my opinion) I graduated in Dec of 2011 and honestly only applied for 3 jobs because they were what I wanted to do (meaning ICU). Well, I interviewed for all 3 and got offered 2 of them, then withdrew my application for the 3rd because I had accepted one of the first two. I work as an Intensivist in a Neuro ICU and really love it. 4.) How many years did you work as a nurse before going back to school? Is it difficult getting back into the school routine? I worked as an RN in an ICU for 2 years before I started school again and then worked all the way through school. At times I found it difficult to get back into the school routine, especially with the boring introductory courses like research and theory but really actually enjoyed school once it got to clinicals. 5.) What do you like/dislike about your career? Likes: the patient population, the autonomy I have in my practice, the opportunites for continued learning, the fact that I get to do procedures Dislikes: the schedule (and only SOMETIMES) It gets old working my share of weekends and holidays but I get lots of days off and that was something I knew would be the case when I went into this field. The ICU doesn't close on weekends and holidays so if you want to work there you probably better accept working your share of that time

Congrats. I dont think you will regret the decision to go back to school at all. I just finished my ACNP in December and have recently passed the ANCC certification exam and am starting my new job and could not be happier. Now I am finally feeling like all the hard work and hoops I had to jump through were worth it. I hope you feel the same way when you are done.