MarshaRabbit

Everywhere you work is going to have its pros and cons. However I think Tulane Medical Center offers a supportive work environment (good coworkers!), sufficient training through the STARRN program, and is very friendly to new grads. This is the only one I have experience with : it's not perfect, but it's better than terrible ?

Hi! I'm finishing my first year as an RN and went directly to ICU. I have no regrets, and some days I'm so thankful for going directly to ICU because I know it's where I want to be. I think I would have been fairly miserable in med surg, just waiting to transition to ICU. The transition into nursing is difficult/intimidating any route you take. So my opinion is that if you know you love ICU go for it. PS Tulane Medical Center hires new grads into critical care if you complete the STARRN

Update: A couple months ago I got a part time RN position at a nursing facility, working with a combination of long-term care a rehab patients! I am really enjoying it. I have a supportive working environment, and feel it is an excellent learning and growth opportunity. After graduation in a few months I will go full time. There are a lot of exciting long-term goals in the works as well :) Thanks

That (NP residency) is also under consideration! There is one in DC that has peeked my interest. It certainly doesn't make sense financially to work as an RN when I have my masters to pay off, but there are income-based payment plans and since money isn't my primary motivator I'm not too worried about that part. I'm going to seek counsel with my mentors in regards to taking time "off" from the APRN role. I have heard of some students doing this before and it went well, and others go straight into practice and that goes well too. I'm hoping that whatever job I find now will take me on as full time in August, as you mentioned credentialing will take time. I am also considering either an RN or NP residency. Being a full time RN post-graduation is more of a personal choice, because I do agree with many of the posters here that the experience is important. And I really just want it, all logic aside, I really really want it lol. I have a lot of thinking to do on this. One thing I love about nursing is the sea of options

Libby, taking time off is an option between the BSN and MSN portion, but I graduate in August and do not want to disrupt my current preceptorship. I plan to take some time working full time as an RN after graduation in August (more details about this in previous comments).

Guys I don't want to keep blowing up this thread repeating what I have already said. Ali I have specifically addressed all of your bullet points, except your aside: My institution tracks our NPs, and we get a lot of decent data on that. Also, many of them work in the local hospitals and I'd go under their care any day. One last time y'all: the purpose of this thread was to help me explore alternative ways to get my foot in the door at the hospital I want to work at. It has turned into this, which is fine, but I don't need to keep repeating what I've already said. A lot of you have a problem with my educational preparation. got it. I hope to increase my RN skills and experience. I hope to be a great provider. I'm doing the best I can, and will continue to do so.

Assuming I have grievances placed against me, sure that would be worrisome. I think in the event that I provide unsafe care of the issue would not be that I didn't work as an RN but that I provided unsafe care. If someone were to have a problem with my career path then I'd help them find a provider they feel more comfortable working with. If you mean that I might run into the issue of patients complaining about my preparation in the absence of unsafe care, then my employer will already be aware of my background, and help accommodate the patient's/families needs with me. I have not heard of this particular issue occurring yet, but I'm sure it could. I'm not going into this on an island. I will choose a supportive training environment for my first NP position (if not an actual NP residency) to ease my transition and maximize chances of success. Again, I hear that you guys have concerns, I can't go back in time and am proactively trying to gain experience now. Some of the ACNPs I work with from clinical were also from my program, and they are brilliant, competent providers.

Yes I understand their concerns. I know it's a long thread, but I've reiterated repeatedly that I have nothing but respect for nurses, and a whole lot to learn from them, as well as other professionals within the healthcare team. Also, I will be switching to full time status as soon as I can in my RN job, in August. I didn't mean to imply that I will need to consult with RNs to provide care. I was saying that in the event another RN has a clinical concern it would be foolish to steamroll them because of my title, which doesn't make me smarter or better than nurses without advanced training. I am reminded of a time when I was working as a CNA and went to the nurses to tell them there was something wrong with a patient, but they responded "their vitals are fine" and didn't particularly take my concerns into consideration. I kept going back to the nurses station and being polite wasn't working. I remember the moment clearly when I finally burst out "I don't care what her vitals are, something's wrong!" And my nurses eyes widened. Poor woman was having TIAs and it took three days to convince somebody to hospitalize her. That's the situation I am referring to, I know that nurses have well tuned ears and eyes and some kind of sixth sense and I'd be foolish to ignore that. I hear that you all have concerns. I will continue to do the best I can to be the best nurse I can be, I don't know what else to say. I started this thread because I want more nursing experience and am having trouble finding a position in high acuity care, which is most relevant to my career path. I'll probably work at a SNF for now (will keep you guys updated!) And go from there. All I can do is work with what I've got. This is how I was able to become a nurse. I'm here, trying to get experience. Not sure what else I can say.

In regards to "NETY", I will be more careful with my choice of words in the future.

Dtwriter- can you expand on the part about being careful where I work so as not to put my license at risk? Thanks

Yessir/ma'am! I wasn't planing on a nurse residency, but right now am seriously considering it, and again I thank you, something about the way you put it was very helpful. Or hopefully, my current job search for a hospital position will be fruitful, and I can just stick around for a while instead of enetering a formal residency. If I don't land a critical care job for now, I can continue to work PRN at a SNF (fairly confident my experience will land me a job at one of the places I have applied) and begin a residency in one of the teaching hospitals here.

Thanks Mursejj... you input has me thinking about a nurse residency post-grad (I actually graduate in August, just really want more RN experience even though I will be n NP soon)... I am hoping the externship could lead to an RN position, as the externship is only 8 weeks. The hospitals around here are all run by a particular corporation, and their recruitment team has made it pretty clear that my application is not under consideration (It gets rejected within hours of submission). Thus the nurse externship was me thinking a little out of the box because I do want a particular hospital, and I'm hitting a wall with them. I agree the part-time status is killing my application. I will have to do some research as to the benefits vs harm for delaying an NP position after graduation for RN work, but it's what I want and I think I can make it work. Also, without being too specific, my institution and program are very highly ranked, and the brand-name tends to come with a degree of recognition (not without good cause too, they work us to the bone), so that doesn't hurt the future NP job search- my peers don't seem to have problems finding valuable employment after graduation. So I think it would be OK if not beneficial for me to take a little time "off" for bedside nursing, However, there is 1 hospital within a reasonable driving distance that isn't run by that particular corporation, and my application to their ICU has actually been in consideration since Wednesday! Small victories lol. But the reason I am writing this response is to genuinely thank you, because your comment just then may have had a larger impact on my career path than you might know. I couldn't agree more that the bedside nursing is invaluable. Although the "bridge student" NPs from my program are safe/competent, I really want to be the best nurse I can be, and would be missing out without direct critical care RN experience. Good luck to your too on your ambitions to become an ACNP! The schooling is at times unbelievably difficult, but the fact that you are a a nurse says you are up to the challenge. Thanks again.

Hey RUby. THanks for your input. It helped me articulate that a nurse externship is more for bridging externs to CNA work rather than RN work. My plan is to go ahead and apply, and should I land and interview talk all this out with them. I really do want experience as an RN. I know enough to know I know nothing at this point, and I appreciate the way you articulate you concerns: That I may not listen to experienced nurses because I'm an NP. For the record, I hope that's not the case. As I've already stated I have a lifetime of learning ahead of my and respect nurses just about more than anybody. I'm sorry if you guys have had bad experiences with NPs from non-traditional tracks such as mine- that would very much be frustrating. And yes I probably won't work full time as an RN for five years, but I hope to stay PRN after 2. Honestly I just love it so much, all of it, but bedside nursing is my favorite (yes even over the NP stuff... it's been really strange for me to learn "brevity" and not really get to spend the time getting to know the patient... I already miss that.) As far as being short sighted/bozo/whatever else, well, as I've already said I'm done trying to defend myself to the nonproductive criticism on this thread (to be clear, there is also a lot of productive criticism on here which I appreciate very much). Being inexperienced is literally my biggest insecurity, as I am extremely career driven and passionate about nursing. The reason I became defensive was primarily the guy who said "the check cleared" which was both condescending and incorrect. Even if y'all have reservations about my career path, I'd ask that you try not to assume things- like my worth is based off my tuition, or that I wouldn't listen to nurses. Hopefully I've been clear that nurses know their stuff, and not to listen to their concerns in a clinical situation would be both foolish and dangerous . Even though I don't have nursing experience (other than CNA work, which I did for years) I don't regret saying something at that point, when the dude said we are here because the check cleared. We all gotta stand up for ourselves sometime. And to be honest I'm trying to learn where that line is right now in life- when to stand up for myself vs when to remain quiet and respect others. I tend to do the latter too often and sometimes regret not having voiced my concerns. Other times I regret saying anything :) Still working on it/learning. I'm sure this will be a very important skill as a new nurse, and as someone who is quicker prone to tears than anger. I've been able to make gains in this at my clinical site (a MICU), but still have a long way to go. Thanks again for your input everybody, especially those who address my topic, and to the naysayers like I said before it's good to know what you think, because people aren't usually this honest in person. I know it will take years, but am also confident that I will be an effective, safe RN and NP. It's amazing how much I learn and grow from my clinical experiences, but also intimidating when I consider there is still a lifetime of learning ahead. I'm sure you guys can relate to that as having once been a new nurse too. I'd better get to some school work :/

Thank you Cleback! I'm getting excited about the SNF, and going to apply to the nurse externship as well. I can discuss many of these things in the interview, should I obtain one, and see what the hospital's viewpoint on all this is. Great ideas (unfortunately my clinical site only hires new nurses full time, but you bet I'm shaking hands with everyone I meet lol).

Julius thank you so much for bringing this back around. You're right I may have been a *tad* defensive I think it was the accumulative result of the negative comments throughout the thread. It is actually good for me to hear the general dissent people wouldn't usually say in person, gives me an idea of how much more uphill I will have to climb to gain the confidence of others. So, good deal. I do still need part-time work when the externship ends, and I thank you kindly for bringing that up because I hadn't considered they still might not hire me because of the part time situation. They are hiring part-time positions, but perhaps they would be more reluctant still because I need more full-time training. I think my best chance in that endeavor is to gain the confidence of the nursing team, and if I am successful they will advocate for me to be hired. Thanks, getting excited about the SNF! There is a really great one hiring near by too; I finished a 3-hour application with them last night (hey at least I know they care enough to assess my personality... over, and over, and over lol).