What are good area's of RN experience for FNP??

SoundofMusic · Dec 8, 2009

I just went to an orientation session, and nothing specific was really mentioned. They said you get the specific clinical training through the NP degree program, but I feel any experience in nursing would help. What they stated to us is that anywhere you are communicating w/ patients and families! I mean -- that didn't do too much for those in ICU or the OR, although the ICU nurses really need to communicate w/ families.

I am looking at a part time job in a free standing ER clinic, just to hone my assessment skills. It's either that, or I'm staying right on the floor where I've been for 2 years and am comfortable w/ most of the staff and the procedures. I just need a place to be where I can be on autopilot while in school.

That said, I'm interested in hearing what the experiences of others have been. I've seen job ads where they desire ICU experience on top of the NP degree, but there are some here who go direct entry who never obtain that experience.

Eagerly awaiting replies to this.

carachel2 · Dec 8, 2009

I forced myself to switch from CCU and cardiac rehab to the ER just to see how things like abdominal pain and lady partsl bleeding and derm issues were assessed and treated. None of that ever happened in the CCU! Did I like the ER? NO. But I am totally glad I did it...I feel like it really helped prepare me for things I see in the office all the time.

I lasted less than 2 years in the ER and I was DONE! I hated it that much. I don't mind treating acute problems, but I just hate the ER environment.

SoundofMusic · Dec 8, 2009

This is why I want to make a switch to an ER. Not the major trauma center we have, but just something more local and "freestanding" -- if that is what you call them.

I feel I see the same things over and over on my unit -- and it's treated immediately and acutely. I don't see how that would help me in a primary care setting. It's helpful to know because I see the end result of people who don't get good primary care!

I wonder if just working in an internists office or something of that nature would be beneficial? There is a job offer in my area for an RN who will "work with patients" in a busy internists office? I wonder if something like THAT would actually also be great experience?

carachel2 · Dec 8, 2009

This is why I want to make a switch to an ER. Not the major trauma center we have, but just something more local and "freestanding" -- if that is what you call them.
I feel I see the same things over and over on my unit -- and it's treated immediately and acutely. I don't see how that would help me in a primary care setting. It's helpful to know because I see the end result of people who don't get good primary care!
I wonder if just working in an internists office or something of that nature would be beneficial? There is a job offer in my area for an RN who will "work with patients" in a busy internists office? I wonder if something like THAT would actually also be great experience?

Hmmm...one thing I liked about the ER was how much autonomy you can have. If you bring a patient back with a cough, SOB and a fever the docs EXPECT you to hook them up and be thinking about what comes next i.e. get a line in, get cultures, order the Xray and call RT for a treatment. In my opinion, the critical thinking needed in the ER was a *great* foundation for the thinking you are going to need in school.

In an IM office I think you would miss out on a lot of that. A huge % of cases seen in IM are chronic disease management counseling type of issues and you probably won't be in the room for that.

USN2UNC · Dec 13, 2009

Anyone else that would like to chime in?

BmoreCRNP · Dec 16, 2009

Well I have mostly PACU experience. The assessment skills, some of the meds, and dealing with acute problems helped me somewhat. Also, being exposed to patients with different chronic illnesses and being familiar with how those illnesses present, the meds they usually take, etc. was helpful. However, what you will do as an NP is very different from what you did as an RN. There is a big difference when you are actually responsible for making a diagnosis, ordering the appropriate tests and treatments, and doing the follow up. Even though your RN experience will help with exposure, you will still have a lot to learn once you start your new role as an NP. Trust me.

Trauma Columnist · Dec 16, 2009

My nursing experience was 10 years in a level one trauma center, 1 year in adult MICU, 1 year in med-surg when I became an APN. The ER exp definitely helped.

Purple_Scrubs, BSN, RN · Dec 16, 2009

I have been wondering this same thing. I am currently in school nursing, and I know I will need some more acute experience, but I am really not wanting to get into med/surg. I just can't see that helping me as a FNP. I am strongly considering a freestanding urgent care clinic (or doc in the box, as they are called around here :) ). Anyone have any opinions on going into FNP with mostly ambulatory care experience and not much inpatient experience? I want to work in ambulatory care (school based clinic, family practice, or urgent care).

Spacklehead, MSN, NP · Dec 16, 2009

For FNP, I have found that my ER experience has helped tremendously, especially since you see the whole age spectrum (if not a specialized peds hospital) and you see a lot of conditions that could be handled in the office setting. Another good thing about the ER is that you get to see conditions that are appropriate for the ER, so you could learn to recognize them in the office setting and get them shipped out emergently. I also liked that I was able to see lab results, X-rays, EKGs, etc. right there before diagnoses were formally established, and what the appropriate treatment would be.

An urgent care clinic is another good setting that would probably be beneficial.