Retaining Clinical Skills as a PNP

NurseLeah · Nov 16, 2004

Brina,

You've probably heard this before, but it sounds like regardless of what you decide you would like to do it might make a lot of sense for you to take a year or two after graduation and work as a nurse on a general pediatric floor or PICU. This will give you a chance to find out what types of pts and work really interest you and what you should avoid. You can make sure that working pediatrics lives up to your expectations and then start grad school armed with some valuable clinical experience (many schools require 1-2 yrs of clinical experience from applicants anyway). In the meantime you may want to try shadowing PNPs from various settings to get a feel for what they do and what options you have. Many PNPs do work in inpatient settings, including PICU and NICU. You may want to contact those floors at a hospital near you to see if they could help you get in contact with someone you could shadow. Good luck!

Leah

llg, PhD, RN · Nov 16, 2004

I have been an advanced practice nurse for about 25 years (in a variety of roles) and have seen many people struggle with the same questions that you are now asking. One thing they often forget is that we all have to make choices in life ... and when we choose to focus on one type of activity (or one job role or one patient population) we are, by necessity, "letting go" a little of the others. No one can be an expert in everything and maintain all of the knowledge and skills that go with each and every possible role in life. We all have to choose how we will invest our time and our focus -- choosing to focus on some things and not others.

The previous response contained some good advice. Focus on what you are doing NOW. Focus on doing it well and graduate. Then get some clinical experience and find out where your talents lie and what type of work you enjoy doing most. Explore the many possible roles out there that might fit well with your particular interests and talents.

Then (and only then) choose a graduate program that will prepare you for future jobs that will suit you well.

llg

brina · Nov 27, 2004

Thank you both so much for your advice. I will begin my Peds and OB rotation in January, and I am looking so forward to it! I have been hearing more and more about doing 1 yr. on a Med/Surg unit after I graduate. I really would like to go straight to Pediatrics or the PICU. In you all's opinion, do you think that would hinder me in transitioning from Graduate Nurse to Registered Nurse? Thanks again!

youngRNstudent · Dec 4, 2004

In you all's opinion, do you think that would hinder me in transitioning from Graduate Nurse to Registered Nurse? Thanks again!

I don't know exactly what you are asking about Graduate Nurse to RN? I am confused.

I just finished my last semester of RN school and I will be starting in a PICU straight out of nursing school. A lot of people feel you should have 1 year of med/surg before choosing a specialty, but I think if you are ready for it, you will be wasting time on a med/surg floor. If peds is what you love (and you won't know until your rotation is over) then do THAT and don't feel you need med/surg because a pediatric floor is just like a med/surg floor but with a younger population. A PICU is just like a regular ICU but with a younger population.

GOOD LUCK!!!!!!!:balloons:

PA-C in Texas · Jan 4, 2005

I am not sure what opportunities exist for PNP's working in a hospital, but there has to be something out there.

I have worked in small ED's most of my career, and I basically chose what I wanted to do when we weren't busy. For instance, I made it a point to start an IV ever day. When we only had a couple of patients, I would tell the nurses to sit down, put their feet up, and have some coffee or something. At first I was worried that they would feel like I was infringing on their turf, and they probably thought I was nuts, but actually they really appreciated it.

I spent most of my time sitting down and charting, talking on the phone, or dictating anyway. I wasn't able to have the same level of patient contact as I did when I was a paramedic, but I stayed proficient in my skills, got to spend a little more time providing direct patient care, and it gave the staff a well-deserved break.

Don't fret about it. It sounds like you really enjoy practicing the foundations of nursing, and that will make you an excellent APN. Good luck.

HazelLPN, LPN · Apr 23, 2005

You could always work contingent for the hospital and work "as needed". I semi retired and am only budgeted .2 (8 hours/week) in MICU, but work contingent for all the critical care units to keep my skills up and to earn some extra cash. Sometimes I work as much as 40 hours a week, sometimes as little as 8.

We have a peds nursing instructor from one of the universities who works contingent in the PICU and it works out very well for her. She works a lot during the summers and holidays, but only a few shifts a month during the school year.

With staffing the way it is..and the way it has been for the past 50 years....I'm sure you can keep your foot in the door of beside nursing if you want to!