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!

lj774263, thank you so much for your awesome response. I have a friend who did the Barkley course and has the CD's - she was going to give those to me. I will look into the other book you spoke about. I am so sorry that job in the ICU went like that for you. That is AWFUL! Where are you working now? I passed my CCRN after studying about a week with the Pass CCRN book. I was hoping the questions would be much like what was in that book!

Hi Mike, I thought the program was very do-able. I started out in the dual FNP/AGACNP program and then switched to just the AGACNP as I didn't want to do peds or OB. The workload hasn't been bad. I was able to work full time up until this last summer when I had 180 hours of clinicals to complete in 8 weeks. They have since changed the hours around for the better starting with this next year. Each writing class has 3-4 papers plus a few discussion board posts. It is what you make it. This program is best for a self-starter. I put a lot of time into studying and learning and obtained a network of good preceptors and specialists to help. I think that has been the key to my success.

Sorry to hear this! You are freaking me out now!! I am graduating in December and will take the AACN exam in January. How are you studying for these exams? I'll let you know if I find out anything good about study tips.

TokyoD_RN I am graduating this December 9 in the AGACNP track at USA. I used the Macbook the whole time and had no issues. I know that others did, but their issue occurred when they upgraded their iOS to Yosemite. I haven't upgraded mine yet. Good luck!

I am currently enrolled at University of South Alabama, graduating in approximately 30 days. This school is affordable as I didn't want to add to my existing loans. I was able to pay out of pocket as I went. It is great for a self starter, online and you are able to complete clinicals in your hometown. I would recommend this school if you are able to secure a good preceptor site. I am already proficient at central line placement, arterial line placement and intubations (as they require 10 of each to be signed off at the hospital I will be working at when I graduate). Another new ACNP I was hired with came from Georgetown. Her student loan debt is astronomical, she had not done any procedures during her time as a student, and we make the same money.

Hi everyone, I am set to graduate as an AGACNP in December. I have applied to take the AACN certification sometime in January/February. I haven't seen much out there other than a few practice questions and a review course posted by AACN. Does anyone have experience passing this exam, and if so - what did you study? Thanks in advance!

I feel 100% exactly like you. I just took my AACN Acute care AG NP exam on Oct 22, 2016. I didnt think I would pass, but i did. I needed 107, I scored 111. I was prepared to retake this exam after Xmas. So I feel just like you. My internship was very choppy, that I had to put together myself, as a result, my clinical experience was subpar compared to PA internship. Lucky for me, I work CVICU, and ICU float pool so my clinical judgement is pretty good. But I am still very nervous and unsure in my ability to be a top level provider. I know I will miss small things, but I wont miss any serious issues because I will be strictly following the standards of care guidelines on all the major health conditions. And I will have a systematic approach to providing care. This part I am confident. You and I, and others felt these same sentiments as new RN's, and many years later, we mastered that role. So we shall master this NP role as well. We will do fine, like someone said we can lean on the more experienced providers when we are in doubt. Blessings to you, and all the new NP's experiencing doubt in this new provider role Hi lj774263 - I am taking the AACN acute care NP cert sometime in Jan/Feb after I finish the program in Dec. Super nervous about it as it doesn't seem like there is much info out there. What did you use to prep for the exam and it is similar to CCRN? Also to the OP, my husband has been an ER doc forever. I always tell him how nervous I am to get out and practice. Thankfully as a critical care NP I will always have an intensivist there. But I am still nervous. He tells me that is what makes me a safe provider. If I have a question, I will speak up. He says the ones who do things from memory are the ones who are dangerous. Look it up. UpToDate is gold. Good luck to you!

Not sure where you live that you couldn't work outpatient. There are quite a few acute care NP's that work in outpatient clinics, mainly specialty (cardiology, pulmonology, neurology) clinics. From the research I have done (I'm in the acute care track, graduating this Dec) - it seems that most hospitals are reluctant to hire FNP's as they are not hospital based. Going with the acute care NP affords you to work in an inpatient and outpatient setting. I chose acute care as I didn't want to do pediatrics or OB !! Good luck to you!

You both have good points here (traumaRUs & MedicFireRN). I have helped start this program, so it's sort of my baby too, and I'm invested in it. He wants me to help develop another program once I am done with NP school. Our call commitment is due to lack of admin wanting to spend money on hiring more nurses. I am not going to take call for the lab once I am done, but may for cardiology patients in the hospital. One of the reasons I was doing NP was so I could have regular hours and no real call to speak of (at least not with a 20 minute response time). The place I have been doing clinicals at has offered me a full time job working side by side with intensivists in the ICU once I am done. It is looking better and better, despite the fact that it is a 45 mile commute. Thanks for your thoughts, and good points!

Thank you so much for all the good advice. Trying not to be emotional about it, but I have grown close to my coworkers and it is really like a family. Glad I am not the unreasonable one -it's hard to see the forest for the trees when you are smack dab in the middle of it. I just need to finish my NP quickly!!!