Those of you in inpatient/specialty practices...

[Joe NightingMale, MSN, RN]

What is your training?

I'm bouncing back and forth between FNP and ACNP.

I'm pretty sure I don't want to do a high-volume primary care practice. I'd like fewer patients and I'd like to specialize. Specialize in what, I don't know. Cardio has been interesting to me, as well as emergency medicine, but for some reason dermatology has caught my eye as well...

That could obviously be an ACNP, who primarily do inpatient stuff. Be a bit trickier education-wise...there are fewer ACNP programs than FNP programs...but I could manage it.

However, I know that FNPs also work in specialty practices, and even in inpatient settings like the ER. And it'd be easier to obtain the degree.

Or I could start in FNP and then switch to ACNP, if I desired. I guess I could even become a PA, although since I already have an MSN the NP role would probably be the more logical one...

So I'm a little lost here. I was hoping that those of you who do inpatient or specialty practice could inform me as to how you got to where you are.

Thanks!

[TX RN]

My formal training is as an ACNP. RN experience is in ICU.

My current specialty is thoracic surgery. I enjoy low volume clinic days but make up for it with sometimes high acuity inpatient rounds.

I got into this specialty by networking. The surgeon I work with knew about me before I completed my NP program and agreed to have me follow her as a student. I enjoyed the rotation and before I graduated I had a job offer. I was lucky. I also think just letting people know what it is you're looking for and are currently working on will help you make those important contacts when you network.

Best of luck.

[sandnnw, BSN, MSN, EMT-B, APRN]

My job found me, literally.

I was semi-stuck in an MCCU ho-humming after 5 years there, 10 years from a surgical specialty unit/step-down/transplant of which the last 4 years in mgmt. So at the 15 year mark, I decided to get my act together and go back to school. Chose ANP (no kids) and *thought* I would land in a internists office of course. I also took a risk and transferred out of the ICU, thinking to myself, "How do you interview intubated patients?" and landing ever so gently into the ED. But...

I also was an Air Force Reservist, so had to rotate thru Iraq few times and finally semi-retired when I was pegged right after graduation for my last tour. I was being a little picky (cocky) after graduation and stumbled upon a hybrid walk-in clinic. By that time, I had almost four years in the ED and had finished grad school, plus gotten all my testing and credentials in a rather svelte looking, leather-bound portfolio. Little did I know where this hybrid walk-in clinic would lead me.

Within the next year, our ED director approached me, having listened to all my neat stories about folks walking in with knives, cuts, fractures, COPD exacerbations, chest pain, bites, literally you name it and he wanted to HIRE me as his new mid-level in the ED.

ME!??!

So my story goes to prove a point/send a message/give inspiration to those who say it can't be done. Healthcare will take you places you never expect it will. Work hard, learn harder, have patience/faith, explore everything/where...you NEVER KNOW WHERE you are going to land. Chaos, I love it!!!

[Corey Narry, MSN, RN, NP]

As a bedside nurse, I've worked in various settings from Long Term Care to Med-Surg, ED to ICU. When I started thinking of being an NP, my role models were in-patient NP's I met through my previous jobs. Many were ACNP's and were speaking quite positively about the program they attended. I eventually followed their advise and completed my program in 2003 and was certified as an ACNP'S a few months later. I found a job right away in an in-pt acute rehab setting and thought I would like the pace but ended up missing the high acuity in the ICU. I left that job after a year and a half and found an ICU position through a classmate in the program. I've been in ICU since.