ACNPmomof2

Yes. The rural ER I worked at was more ICU -ish anyway as we shipped everything out. Our ICU was more of a step down. The ER experience made me great at re-assessments and knowing triage - and also handling several things at the same time. I am now an ICU nurse practitioner and my ER experience is invaluable when assessing patients on the floor for possible transfer to ICU due to decompensation. Go for it!

I would imagine it was the cath lab or maybe the cardiac stress testing with the nuclear medicine myocardial perfusion studies.

Hey all, just wanted to give an update and thank you all for your input. I finished my NP program. I quit that joker place over last summer and I start as an ICU NP as soon as I pass boards Sanity is intact!!

Oh man I could tell you some stories!!! I'm not an "older" nurse but mid career. Orienting a new grad to the cath lab. Of course I didn't know anything and she knew everything. First time the patient went into vtach I thought she was going to pee her pants. It was excellent. She was a bit more receptive to my instruction after that.

Hi there! I did Pass CCRN and passed the first time. I skimmed through the sections unfamiliar to me and focused on doing the questions over and over again. My advice is to just buckle down and memorize the hemodynamics :-) That's a hard one! You can do the question analysis that comes with the book - that is what I did and focused on the areas/rationales - I found it was very helpful for the exam. Best of luck to you!

Again, you are missing the point. You stated you are more aware of the expectations of other nurses but you do not agree with them. It is expected that you follow orders as prescribed. In the ICU, this is not something that can be taken lightly. As another RN noted, you have the ability to easily kill or seriously harm patients as they are critical. If you don't agree with that type of expectation then the ICU is not the place for you. Best wishes as you find the unit you are better suited to.

I agree with the others regarding the patient safety issue and levophed. There is a reason this patient was on a pressor. The continuous infusion of vasopressors is an expectation of the physician or advanced practice nurse. It is an expectation that you will follow an order as prescribed. Critical care is less task based and requires a lot of critical thinking. Just because you completed your documentation on time does not mean that your patients were safe. I think you are failing to see your portion of the problem still as evidenced by your last statement. I am not excusing the actions of your preceptor or the hostility by the staff. It sounds more like a management issue than anything. But I can tell you that when I worked ICU, I didn't like to follow incompetent nurses as I was cleaning up after them the whole shift. It gets to be frustrating.

You will learn no matter what floor/job you take. You just graduated this year. I went to a rural hospital straight out of nursing school and was thrown all over the place. BEST experience ever. I learned a lot about everything and it helped me become more well rounded. Don't discount an experience because you already have a pre-existing bias. My advice is to shadow each department and pick the one with the best management, support and team camaraderie. That will make or break your experiences and development.

I worked cath lab for 3 years and I agree with the previous 2 posters. Talk to the nurses in the cath lab regarding call now. What are the management thought expectations vs. the actual reality? I took call 24 days a month. Yes...24 DAYS. I had no life, could not even go for a walk through my neighborhood, getting groceries sent me into a panic and could not go through a drive through starbucks line. I am thankful to be done with that environment. I loved our team and it was fun saving lives, but it wasn't worth the $3/hr for the stress on me and my family with that much call.

I worked cath lab for 3 years and IMO it depends on your style as a nurse more than your experience. I had seasoned ICU nurses train under me who were terrible cath lab nurses and a brand new grad who trained for a LONG time who picked up things quicker. As long as you have a lengthy training and are able to precept under some great nurses I think you will be just fine.

Nursing theory is the WORST. I can't tell you how many glasses of wine I had to drink to get through that class. But you will get through it. And wine is your friend. You can pontify so much with a great bottle of wine. I just got through business and legal aspects of nursing. That was a bunch of garbage too. At least it was somewhat relevant, but as someone who has absolutely NO DESIRE to go into admin or politics it was a waste of time. Just suck it up, take it one quarter (or semester) at a time, get through it and be done. If you switch programs it will take even more time and you'll have to go through the headache of transcripts being sent, etc. Good luck to you. I am happy to say I am done and never have to write another paper. It's a great feeling.

My state is independent and we are not required to have a physician cosign orders. However, no one has any qualms about asking when help is needed. Great teamwork is the key.

They were not practicing outside the scope based on state mandates. They both had extra training and there are requirements and competencies to be met in the ICU. At this point, it all depends where/how you obtain your training at least in my state. Even had a TJC visit while I was doing rotations and the ACNP who was with TJC (new grad, never practiced) was all over the fact that our NP was a FNP, except this FNP I was precepting with kept careful records of all her procedures. They knew their limitations, and always consulted with the intensivist should the need arise.

Both of my preceptors in the ICU were FNP. They were amazing. I graduate next week with my AGACNP.

Yosemite is just the name of the operating system. It may be different now, but I didn't have any issues at all when I kept my older operating system. I took 2 classes my first-third semester. Then I added the cardiovascular subspecialty - so my load increased to 3 classes my 4th, 5th, 6th semester. This semester (7th) I have 3 as well with the policy class (NU 610). I recommend doubling up in the beginning with the didactics before you take your clinical rotations as those are papers and open book tests. Much easier than the closed book tests you take once you go into your track-specific classes. The last semester it is nice to focus on your track course and begin studying for boards. I am tired of papers, etc. and this policy class is a pain!