traumanightsRN

I think SICU is a great choice. I spent my entire bedside career in a STICU and loved it! You get a lot of different type of surgical patients so it's not the same thing over and over again. You will get experience with a lot of drips and different vent modes. Also lots of experience with blood transfusions. You can't really go wrong with any surgical ICU.

It's a tough job. The learning curve is really steep. I worked in primary care for 4 years before going to ortho and definitely was not prepared for the amount of anatomy I did not know. I learn something new every day. I don't hate it but I don't love it either. I think if I was in the OR I might like it more because I'd be in clinic less. It's a typical clinic job of M-F 8-5 with two 4 hour admin sessions a week. Can't complain about that. It's def a tough job but pays better than a lot of specialties because surgery is a money maker. I mostly work on my own, which I don't like. I prefer a team setting. But each job has its pros and cons. I just take it one day at a time.

I work in an outpatient orthopedic surgery clinic. I do not work for any of the surgeons, I do general orthopedics. I see my own patients but also do pre-ops and postop visits. I have zero OR experience and am not an RNFA. It's basically the same as any other clinic job except you will often need to consult the surgeons or have patients make follow up appat with the surgeons. I talk to them frequently if I have questions or need their treatment plan for their postops. What is a pain is they are rarely in clinic so if you need them you have to call or page them and hope they get back to you quickly.

First NP job I had zero admin hours for 2 years then only got 4 hours a month. I was taking weeks to finish notes. It sucked. Current job I get 8 hours a week split as 4 hours on two separate days a week (Tues and Fri). Admin time is the greatest for sure.

First, it’s not you it’s them. It doesn’t seem like being an NP itself is bad, you’ve just worked with some bad actors. Do you live in a state with a lot of NP restrictions? Like others said, try to work for a health system or move to a different area if possible. You became and NP for a reason, so I wouldn’t give up on it right now. Do you have a local or FB NP/PA group you can talk with to see others’ experiences or find new opportunities? Sounds like you might be in a bad area.

First , take a deep breath. You just came off orientation. You’re not going to have critical thinking skills yet. That comes with time and experience. I started as a new grad in an ICU many years ago. It’s def intimidating, but that’s why they give you simple pairs first and then advance you over time to sicker patients. If your unit is like mine was, they put you next to or near your preceptor once you’re on your own so you have them as a resource. And beyond that, look around you…you have an entire unit of nurses and doctors and likely respiratory therapists to learn from. Take advantage of that. Talk to them. In your down time look up things you are unsure about or don’t know. When talking to the doctors just tell them your concerns and ask what they think. Do NOT quit the ICU. You just started. Give yourself some grace. Everything comes with time. You’re going to be fine!

I agree with the above poster. I always put my assessments in first thing and hoped to have both in by 2000-2030. Then chart in real time. I planned my baths and wound care always for 2200. That way if crap hit the fan I had the important stuff in and done. You gotta find your own groove. If I got an admission at the beginning or end of a shift my coworkers would usually put in the initial assessment for me. If you are caught up with a patient always ask for help. But really, really try to get your initial assessment in first thing. That will help tons.

Don’t want to discourage you but I have found most UCs want PAs and not NPs. I have 5 years primary care experience as an NP and 9 years in trauma ICU as an RN. I have applied for multiple UC jobs and have never heard a word back. Even to job postings that were urgently hiring. If you know someone who works in UC get them to put in a word for you.

It really depends on the rules/laws for nurses governing your state. I practice in Virginia and you do not have to take any courses to be an RNFA there. You can get on the job training and that is enough.

I have had multiple interview experiences from them asking typical HR type questions to just having a chat with the unit manager. Honestly there is no reason to be nervous. Just tell them you always wanted to work on critical care but couldn’t get a job in an ICU as a new grad. Say you really enjoyed your critical care rotation in school and it is your passion. Say you’re looking for a unit you can grow in and welcome any opportunity to learn and expand your knowledge. You’ll be fine. Trust in yourself! And if all else fails make up a story about a critical care experience LOL.

Honestly just apply for any and all ICU positions at hospitals in your area. Over the years I’ve noticed many new ICU nurses are new grads but there are plenty of nurses coming from the floor or stepdown unit as well. Just go for it! You can do this!

It’s not that I don’t know what type of test per se but I want to make sure I’m choosing what’s going to get covered by insurance. Also, some things I think I can do a CT for and actually an MRI is recommended and vice versa. It’s a great resource for everyone. I don’t think this plays into the physician argument as much as you think it does. Primary care doc I work with is the one who told me about this website. He says he uses it frequently to make sure he is ordering the right test. ??‍♀️

Here is the website for the ACR Appropriateness Criteria https://acsearch.acr.org/list?_ga=2.5309428.676607075.1601468260-1215318203.1601468260. I use it all the time in primary care. You can go down the list by body part/area you want to image and click on the document under Narrative and Rating Table for that area and it tells you which scan is appropriate to order. I love it.

I did the online Fitzgerald FNP Review course and although I learned a lot, when it came to taking boards I do not feel it helped me at all. I did pass boards on my first try but barely. I felt completely prepared after doing the Fitz review and when I sat down and started taking the Cert Exam I was completely blown away by the questions, i.e. the content was nothing like any information from the review. There were questions that had information I had never even heard of. By the time I got to the end of the exam I felt it was 50-50 whether I passed or failed. I passed but when I got my score in the mail, the lowest passing score is 500 and I got 520. So yes I barely passed. I feel in general Fitz's review helped me understand things but it did not help at all for the certification exam. Just my two cents.

I sent you a PM.