Should I take ICU residency or start FNP program?

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Hi Nurse Beth, I've worked in healthcare for over five years now, one year as a registered nurse. During nursing school, I completed a clinical rotation in the Neurosciences ICU of a top-area hospital, and I loved it! I was offered a job, but I could not accept it because of my scholarship (HRSA Nurse Corps), which required me to work at eligible facilities only. I currently work 5, 8 hours shifts at a small FQHC, and I am bored! On a great day I have 4-5 patients on my schedule and some days I have none. I was offered an ICU residency at an eligible facility 50 miles from my home. Pay is better nearly $20/hr more than my current wage and they offered a large sign-on bonus. I'm willing to make the commute (hybrid vehicle) for those 3, 12-hour shifts. Here is the predicament, I was recently accepted into Georgetown's FNP program - and it makes sense to stick with the FQHC for this reason, but I'm concerned I'll never get the chance to step back into the ICU if I don't go for it now. What should I do, or consider further before I make the decision?

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Specializes in Tele, ICU, Staff Development.

Congrats on being accepted to Georgetown's FNP program! You are a go-getter for sure, what with landing an HRSA scholarship and needing to be professionally challenged.

You have multiple factors to consider, and it's important to weigh the pros and cons based on your personal and professional goals. Here are some considerations to help you decide, with the assumption you are going into the FNP program:

  • Clarify your long-term career goals. If becoming a Family Nurse Practitioner (FNP) is your primary objective, staying at the Federally Qualified Health Center (FQHC) aligns with that goal. ICU experience is not going to benefit you directly as an FNP.
  • On the other hand, if you strongly desire to work in the ICU, gaining that experience now might be valuable for your overall career satisfaction. However, it's a detour if FNP is your end goal.
  • Once you're in the FNP program, your academic obligations take precedence. Balancing the commute and the steep learning curve of the ICU with your academic responsibilities would be difficult. Ensuring that your work commitments won't jeopardize your success in the FNP program is essential.
  • Turning down a significant pay raise can be a tough decision. However, sign-on bonuses offered to new graduates could indicate a desperate company or an unfavorable work environment. It's important to know the tenure you are required to work to fulfill your hiring contract. Additionally, you should consider the new tax bracket you'll fall into.
  • Assess the impact of the 50-mile commute on your work-life balance. Consider the time spent commuting, potential fatigue, weather, safety, and the overall toll on your well-being. A 50-mile commute after working 12 or 13 hours can be brutal, especially if you have to return the next day or night. Some nurses spend the night in such cases, but that cuts into your expenses.
  • Investigate if there are opportunities for professional growth within your current FQHC position. Are there chances to diversify your experiences or take on additional responsibilities that align with your career goals?
  • Research the job market for FNPs in your desired location. 

Consider the potential for networking and mentorship in both settings. Working in the ICU may provide exposure to experienced critical care nurses and physicians who can offer guidance. At the same time, the FQHC setting may have its own set of mentors and networking opportunities.

Ultimately, the decision will depend on your priorities and the balance you want to strike between gaining diverse clinical experiences and staying focused on your FNP program.

Best wishes in your decision,

Nurse Beth

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