Should I get ICU experience bfore ACNP

Specialties NP

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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.

Specializes in CTICU.

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

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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.

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Specializes in Acute Care - Cardiology.
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.

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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

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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.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
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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Specializes in ACNP-BC, CCRN-CMC (critical care).

I agree with the 2 NPs who worry about you already having started your NP program with no ICU (well, very little) experience. If you're not even confident in your abilities to do a basic assessment and be able to think through the reasons why you're doing interventions, you're probably not ready to start thinking like a NP.

Frankly, I'm surprised your NP program didn't require a minimum 1 year ICU or critical care experience before you could start the program, as many of them do. Personally, I was in an entry to practice program (combined BS to MS program) and withdrew to work for a few years first, because I felt the same stress and fear as you do and knew it was a bad idea to try putting NP school on top of all that. I have friends who went straight through the program with only the minimum required ICU experience who had a really rough time of it.

When you can walk through the doors at work (in an ICU) and be confident that you can handle whatever patient they're gonna throw at you (or at least that you're at a place where you're comfortable using your knowledge and resources to give the best care possible even if you're put in a situation where you don't know the disease, the medication, or the intervention well), then you're probably more ready to think about ACNP school.

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Specializes in Acute Care - Cardiology.
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.

that's a good point. and actually, adolescents were included in our health assessment course and we did learn tanner staging as well as headss, etc. i'm not saying that i would feel comfortable with it, but i was just curious if anyone knew of a specific "rule." no biggie. and i'm with you... if i wasn't trained in it, i'm not qualified. thanks.

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I agree with the 2 NPs who worry about you already having started your NP program with no ICU (well, very little) experience. If you're not even confident in your abilities to do a basic assessment and be able to think through the reasons why you're doing interventions, you're probably not ready to start thinking like a NP.

When you can walk through the doors at work (in an ICU) and be confident that you can handle whatever patient they're gonna throw at you (or at least that you're at a place where you're comfortable using your knowledge and resources to give the best care possible even if you're put in a situation where you don't know the disease, the medication, or the intervention well), then you're probably more ready to think about ACNP school.

WOW- that is great advice!

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Specializes in Telemetry, ICU, Psych.

Don't feel bad about not being confident as a new nurse- most of us went - and are still going - through it.

Although many schools require at least a year of ICU experience before an ACNP program, you are already in the program. I recommend that you look for a job in an Medical ICU somewhere to get your feet wet. I'm in a CCU that takes MANY MICU and other ICU overflow patients. The Medical patients can be very sick, but the pace is slow enough to learn a great deal. In the SICU's it is very fast paced, and not always the best place for a new grad.

Keep us posted!

CrazyPremed

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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.

for some reasons, i'm not getting email alerts on responses to my email, so i'm a little late to respond to my own thread.

thank you all for your inputs. i now have over a year under my belt with oncology and still want to do acnp. i've been looking for icu positions for the last two months. the problem is, with the poor economic outlook, many hospitals have hiring freezes. positions are scarce and critical units want experienced icu rns. furthermore, transfer out of my unit is almost impossible. for some reasons, my manager takes a personal offense if you want out of the unit. the hospital i work for almost has a monopoly of hospitals in my area (owning 4 out of 8 hospital in a 40 mile radius), thus any transfers will most likely be intervened. though my confidence has improved tremendously, i still feel i need critical care experience. getting frustrated since i have only a few months before clinical starts... my part time program starts only once a year, and i would hate to have to wait for another year to start. age is not on my side. i'm 47.

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Specializes in SICU,CVICU,ER,PACU.
for some reasons, i'm not getting email alerts on responses to my email, so i'm a little late to respond to my own thread.

thank you all for your inputs. i now have over a year under my belt with oncology and still want to do acnp. i've been looking for icu positions for the last two months. the problem is, with the poor economic outlook, many hospitals have hiring freezes. positions are scarce and critical units want experienced icu rns. furthermore, transfer out of my unit is almost impossible. for some reasons, my manager takes a personal offense if you want out of the unit. the hospital i work for almost has a monopoly of hospitals in my area (owning 4 out of 8 hospital in a 40 mile radius), thus any transfers will most likely be intervened. though my confidence has improved tremendously, i still feel i need critical care experience. getting frustrated since i have only a few months before clinical starts... my part time program starts only once a year, and i would hate to have to wait for another year to start. age is not on my side. i'm 47.

if finding a micu position is difficult because they only want experienced icu rns, you may be able to befriend the icu nurses/manager if you ask to shadow there (for free). it would allow you to get some experience (very little though) but more importantly, it may allow you to put a foot in the door. once you get to know the team and their manager, you can try asking for a position (or even to take prn icu shifts) directly to the icu manager~ this way you know that you have that manager's support before putting your request in to be transferred. the downfall of that theory is mostly time.... it would likely require for you to invest unpaid time in order to gain the network that will support you in your future request. maybe worth a try all the same?

good luck to you and keep us posted!

h~

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