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Should I get ICU experience bfore ACNP

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I graduated in Dec 07 as an RN. Started out as a new grad in a level 1 SICU for 3 months and quit. The combination of the cut throat staff and my scared to death new grad mentality caused me so much stress; so I quit and moved to an oncology floor. I'm currently in an ACNP program doing my core classes and will start my clinical next fall 09.

Should I go back to ICU to prepare myself for my upcoming clinicals?

My 3 mos experience in SICU left a bad memory though I loved the intensity of it. and despite the 7 mos on oncology, I still feel so unsure of myself. I really want to get my ACNP degree but very nervous that I won't make it if I don't have ICU experience. Any suggestions would be appreciated.

ghillbert, MSN, NP

Specializes in CTICU. Has 20 years experience.

Where do you want to work when you're done? ACNP doesn't only mean ICU. It can be any acute care area, including oncology floors. If you don't want to work in critical care eventually, and you're not required to do clinicals there, I wouldn't worry about it. If you feel your acute experience has given you more confidence and ability to try ICU again, it is a great learning experience (depending on the unit staff and support) and could only help you. Might be worth asking your academic advisor for some input too.

I graduated in Dec 07 as an RN. Started out as a new grad in a level 1 SICU for 3 months and quit. The combination of the cut throat staff and my scared to death new grad mentality caused me so much stress; so I quit and moved to an oncology floor. I'm currently in an ACNP program doing my core classes and will start my clinical next fall 09.

Should I go back to ICU to prepare myself for my upcoming clinicals?

My 3 mos experience in SICU left a bad memory though I loved the intensity of it. and despite the 7 mos on oncology, I still feel so unsure of myself. I really want to get my ACNP degree but very nervous that I won't make it if I don't have ICU experience. Any suggestions would be appreciated.

Honestly, if you feel unsure of yourself as a nurse, the last thing you want to do is become a NP.

YellowBoneRN

Specializes in ER, ICU, Med/Surg, Pedi.

You can always try another ICU. Usually bigger ICU's like at trauma hospitals or really really busy hospitals are less "messy" and the nurse are too busy to be "messy" like that. Try another ICU and get that valuable experience. Ignore them get it for you and your patients. Go in the with don't *#$% with me attitude. They will leave you alone.

Send me a email for more advice of how to survive amongst cut throat nurses.

My vote is to try to get some ICU experience. I would vote for MICU rather than SICU given your previous experiences. When I worked in the ICUs often MICU had longer stays and more controlled enviroment.

Spend that time gaining an understanding and clinical proficency at the RN for vasoactive gtts, airway management, rythms, labs, fluid management and assessing sick patients.

That way even if you never work in the IUC as an ACNP you will have a better foundation for cardiac patients, codes, chronic vent patients or even really sick patients,

Jeremy

I have a question on ACNP. Besides working in an acute setting in the hospital, such as the ICU, ER or any other floors in the hospitals, where else can ACNP work?

Thanks in advance!

ghillbert, MSN, NP

Specializes in CTICU. Has 20 years experience.

Anywhere there are acutely ill patients.. outpatient cardiology, other clinics etc. Basically anything apart from primary or "preventative" care for well patients.

What's the different between an Acute Care NP and Adult-Geriatric NP? Can AGNP work in acute care? Does that mean that AGNP has a broader job spectrum? Also, do ACNPs have to learn both adults and pediatric in their program?

Thanks in advance!

What's the different between an Acute Care NP and Adult-Geriatric NP? Can AGNP work in acute care? Does that mean that AGNP has a broader job spectrum? Also, do ACNPs have to learn both adults and pediatric in their program?

Thanks in advance!

Basically, in a GNP program, you focus on patients 55 yrs and older. I did my clinicals with a gerontologist and saw patients both in the clinic and the nursing homes. In the Adult NP program I attended, we focused on patients over the age of 12, excluding OB patients. I did the majority of my clinicals in an internal medicine clinic and I completed 90 hours in a hospital setting. Per the Board of Nursing in TX, I'm elgible to work with inpatients as an Adult NP, but this doesn't include inpatient psych or the ICU. I'm also board certified as a FNP, but I'm only allowed to work in the ER "fast track" in a hospital.

ACNP's are allowed to see patients over the age of 18. If they wish to see patients under that age in an acute care setting, they need to complete an Acute Care Pediatric program.

DaisyRN, ACNP

Specializes in Acute Care - Cardiology. Has 5 years experience.

i graduated in dec 07 as an rn. started out as a new grad in a level 1 sicu for 3 months and quit. the combination of the cut throat staff and my scared to death new grad mentality caused me so much stress; so i quit and moved to an oncology floor. i'm currently in an acnp program doing my core classes and will start my clinical next fall 09.

should i go back to icu to prepare myself for my upcoming clinicals?

my 3 mos experience in sicu left a bad memory though i loved the intensity of it. and despite the 7 mos on oncology, i still feel so unsure of myself. i really want to get my acnp degree but very nervous that i won't make it if i don't have icu experience. any suggestions would be appreciated.

hey there,

i'm an acnp that did not have any icu experience and throughout my program, i regreted it. i had an er background which provides a more diverse experience than oncology and i still struggled at times. i would highly suggest that you get icu experience. i agree that micu may be more beneficial than sicu. you learn things as an rn in icu that cannot even begin to compare to an np; things that will put you ahead of the game. even if you get a broad experience in a unit like the er, that will help you. oncology is very specialized and good to know, but to be successful in an acnp program, you will need more. you can only learn so much in a textbook, and you might do fine, but you will find struggles like i did if you don't branch out.

like anpfnpgnp said, i worry about you becoming an np so new out of school and lacking confidence in yourself as an rn. i understand that your confidence will build while you are working during your program, but acnp's generally require a certain type of "attitude" and self-confidence to be successful. all of my classmates had it and i was only an rn for 4 years before starting, but those 3 years gave me the boost i needed. the program was not easy (and it shouldn't be) for me having only 3 years experience (and i'm not an idiot), and i certainly wouldn't recommend it to anyone without at least 1 year acute experience... which is what most programs require anyway. it's very surprising to me that you were accepted without the 1 year requirement.

juan de la cruz, MSN, RN, NP

Specializes in APRN, Adult Critical Care, General Cardiology. Has 27 years experience.

What's the different between an Acute Care NP and Adult-Geriatric NP? Can AGNP work in acute care? Does that mean that AGNP has a broader job spectrum? Also, do ACNPs have to learn both adults and pediatric in their program?

Thanks in advance!

Here's a summary of all the NP specialties:

https://allnurses.com/forums/3144451-post2.html

DaisyRN, ACNP

Specializes in Acute Care - Cardiology. Has 5 years experience.

basically, in a gnp program, you focus on patients 55 yrs and older. i did my clinicals with a gerontologist and saw patients both in the clinic and the nursing homes. in the adult np program i attended, we focused on patients over the age of 12, excluding ob patients. i did the majority of my clinicals in an internal medicine clinic and i completed 90 hours in a hospital setting. per the board of nursing in tx, i'm elgible to work with inpatients as an adult np, but this doesn't include inpatient psych or the icu. i'm also board certified as a fnp, but i'm only allowed to work in the er "fast track" in a hospital.

acnp's are allowed to see patients over the age of 18. if they wish to see patients under that age in an acute care setting, they need to complete an acute care pediatric program.

i actually think age 12 is the cut off for acnps, but there's no clear cut guidelines. because age 12 is the cut off for adult, isn't it? that is what a former anp preceptor told me. just curious.

ghillbert, MSN, NP

Specializes in CTICU. Has 20 years experience.

Does it depend on the state? My instructors told me 18 in PA.

i actually think age 12 is the cut off for acnps, but there's no clear cut guidelines. because age 12 is the cut off for adult, isn't it? that is what a former anp preceptor told me. just curious.

according to the tx bon, it depends on the program. the anp program i attended focused on ages 12 and above, but most anp programs focus on 13 and above. i know of a few programs that focus on 18 and up. i've never heard of an acnp program covering patients under the age of 18 years, unless it was an acute care pediatric np program.

DaisyRN, ACNP

Specializes in Acute Care - Cardiology. Has 5 years experience.

according to the tx bon, it depends on the program. the anp program i attended focused on ages 12 and above, but most anp programs focus on 13 and above. i know of a few programs that focus on 18 and up. i've never heard of an acnp program covering patients under the age of 18 years, unless it was an acute care pediatric np program.

i can't find it in the literature anywhere. i have the acnp scope and standards book and have looked through the bon website and npa. can't find it. and this isn't even the first time i've gone looking for it. i can't even find where it defines the age of a child. that would be the clincher, i think. but... logically, if an anp can treat 12 and up, what's the difference? we're both "adult" providers. i hate that there are so many "vague" topics... you can't really prove any one person is right or wrong if the state bon doesn't identify one way or the other.

i can't find it in the literature anywhere. i have the acnp scope and standards book and have looked through the bon website and npa. can't find it. and this isn't even the first time i've gone looking for it. i can't even find where it defines the age of a child. that would be the clincher, i think. but... logically, if an anp can treat 12 and up, what's the difference? we're both "adult" providers. i hate that there are so many "vague" topics... you can't really prove any one person is right or wrong if the state bon doesn't identify one way or the other.

our hospital credentialing says 18 an up for anp and acnp. not sure where this came from.

david carpenter, pa-c

i can't find it in the literature anywhere. i have the acnp scope and standards book and have looked through the bon website and npa. can't find it. and this isn't even the first time i've gone looking for it. i can't even find where it defines the age of a child. that would be the clincher, i think. but... logically, if an anp can treat 12 and up, what's the difference? we're both "adult" providers. i hate that there are so many "vague" topics... you can't really prove any one person is right or wrong if the state bon doesn't identify one way or the other.

in my adult np program, we had classes devoted exclusively to adolescents. i know 2 acute care np's and they both said they were trained to treat ages 18 and above. i guess it depends on whether your acnp program included classes on adolescents or not. doing a health assessment on an adolescent is very different than an adult. you need to know the tanner stages, all that psycho/social stuff plus there are medications that can't be given to people under the age of 18 (the quinilones). i do tons of school physicals on teenagers in the summer and i always have to review my tanner stages beforehand, b/c a couple of schools have forms where you have to list the stage.

juan de la cruz, MSN, RN, NP

Specializes in APRN, Adult Critical Care, General Cardiology. Has 27 years experience.

In my Adult NP program, we had classes devoted exclusively to adolescents. I know 2 Acute Care NP's and they both said they were trained to treat ages 18 and above. I guess it depends on whether your ACNP program included classes on adolescents or not. Doing a health assessment on an adolescent is very different than an adult. You need to know the Tanner Stages, all that psycho/social stuff plus there are medications that can't be given to people under the age of 18 (the quinilones). I do tons of school physicals on teenagers in the summer and I always have to review my Tanner Stages beforehand, b/c a couple of schools have forms where you have to list the stage.

I have been having a hard time figuring out the age range for ACNP vs ANP either. However, it seems like the answer to this question lies in the content outline for both the ANP and ACNP exam by ANCC.

ANCC's ANP exams covers life span content from ages 13-18 as well as 18 and above: http://www.nursecredentialing.org/Documents/Certification/TestContentOutlines/AdultNPTCO.aspx. ANCC's ACNP exam does not indicate that: http://www.nursecredentialing.org/Documents/Certification/TestContentOutlines/AcuteCareNPTCO.aspx

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