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Transitioning to acute care


Hi all!

I'm an FNP in Massachusetts. I've been practicing for 9 years in a variety of roles (SNF, Pre-admission testing, GI outpatient clinic). Before that I was an RN on a Med/surg floor with some telemetry (half the floor) and I was a homecare nurse. I've always wanted to be an acute care NP and since I've been laid off....now seems like a good time to look into programs. I'm thinking about applying to several adult gerontology acute care post grad certificate programs, but I don't think I have enough hands on acute care experience. I think its best if I go back to being an RN for a while in an acute care role. Any tips on how to get a job in that setting after being away from the bedside since 2010? I'd be up for ICU/MICU/SICU/ED. All suggestions are welcome! Thank you in advance, hope you're staying safe and sane!

brookalyn, BSN, RN

Specializes in MICU/SICU. Has 4 years experience.

No matter if you're a new RN grad, been away from the bedside, etc., you should probably start in an ICU under a preceptorship or new grad residency. This is where they will take you under their wings and teach you ICU RN skills while at the bedside. Every region in the country is different, some places are easier to get into the ICU without experience than others, and I know there have been a lot of hiring freezes recently. You won't really know until you apply to places and try! Good luck!


Specializes in ICU, Agency, Travel, Pediatric Home Care, LTAC, Su.

One tip that I have is to do as much ICU Con ED as you can absorb and definitely put the classes, hours, etc on your resume to show your interest. Vents, Central Lines, ABG, COVID-19 patients would be some good classes to take. Also, it wouldnt hurt to get NIHSS certified. Brush up on tele and EKG and think about taking an in person ACLS Class if they r having those in your area yet. Doing some of the above would not only show your interest, your intent, that you are a go getter, but it would help you out A TON, to learn even just a tiny bit of this before coming into the ICU.

Many places are paying signing bonuses even to new grads, yes even in the ICU. If the hospital wants you to sign a contract that u must stay for a certain amount of time or you owe them, run! because they have a "wonderful ICU Program" that they put a lot of money into training new nurses. That is typically a sign that they cannot retain nurses. Feel free to message me if you would like some links for excellent ICU CEU Online resources. Best of skills to you:)

eastsideRN, BSN, MSN, NP

Has 15 years experience.

Why not apply for your Post Masters Certification program and work part time in Acute Care?

PumpkinEater, MSN

Specializes in Neuro/Neurosurgery/General Surgery. Has 14 years experience.

Interesting question. Sorry to hear you were laid off. Was that as a result of COVID? If you're already practicing as an NP I bet you could make the jump to acute care without putting in time as a bedside RN. Not all acute care NPs have hard skills in ICU (lines, drips, vents) right off the bat but make a gradual transition over the course of several years. If, for example, you started in an outpatient clinic affiliated with a major medical center you could eventually find a role in an outpatient surgical clinic, transition to seeing inpatients on said service with a preceptor and then seeing patients in the ICU with the team performing basic tasks. If you excel at this you will, by that point, have enough "street cred" and experience to join an ICU team and start training with one of their NPs. All along the way you can be getting continuing education, attending conferences and, maybe, getting a post masters degree part time (e.g. AGACNP).

All without having to go back to the bedside.

Thank you for your response - very helpful! I did get laid off due to Covid. I was working part time in a GI clinic (partial outpatient/partial inpatient) and they changed my status to per diem due to decreased patient volume... So your comment made me think maybe I am/was on the right track. I am awaiting getting my job back sometime in the Fall (fingers crossed). I was on the surge staffing hospitalist team for my hospital (which they have dismantled now because our numbers are so low) and for part of the time I was seeing all the GI inpatients. I was comfortable with that. So, I guess what I'm saying is your input makes me think perhaps I should just stay the course and eventually transition into the ICU...

We'll see! Still in limbo for my job at the moment.

Thanks for your help!

Edited by allaboutnursing77