I have been a nurse practitioner (NP) in the adult cardiovascular surgical intensive care unit (CVICU) for over six years, and I often get asked how I was able to begin working there as a new NP. There are multiple paths to becoming an NP in the CVICU, but there are a few key components to achieving this final goal that can never be skipped no matter the path one should choose. The following are the steps that must be completed to become a CVICU NP.
Earn Your Acute Care Nurse Practitioner Certification
There are so many paths to gaining certification as an NP, but to work in the CVICU, one must pass the Acute Care Nurse Practitioner (ACNP) exam. The great majority of medical centers have transitioned to requiring this certification because the clinical experiences within the certification are in acute care settings, such as, consult services, intensive care units, and inpatient hospital floors. These clinical experiences are much more applicable than those within a Family Nurse Practitioner certification, which would typically include outpatient clinicals, or any other certification.
Of note, to work in any area of practice with adult patients, an NP must have an adult certification. To work in pediatrics, the NP must have a pediatric specified certification. If you are preparing for your ACNP board review exam, consider the board review question bank from BoardVitals (I used this to prepare for mine).
Earn a Master’s Degree or Doctorate Degree
Like becoming certified as an ACNP, earning a masters or doctoral degree in nursing is a requirement. There are many different pathways to being admitted to NP programs. Some nurses choose to do direct entry programs, some choose to do second degree programs, but to be eligible for ACNP certification, one must complete a masters or doctoral degree that contains the coursework required to sit for the ACNP certification exam. Programs that contain this specific coursework are in nursing specific degrees.
Gain ICU Bedside Nursing Experience (strongly suggested)
While ICU experience is not technically required, it is strongly suggested for several reasons. First, reputable NP programs will likely require at least one year of bedside nursing experience prior to admittance to an ACNP program. If one plans to work in the CVICU post-graduation, bedside experience in the CVICU will greatly benefit a new NP. Because training for NPs is very general, having an understanding of the culture and patient population of the CVICU will give a new NP a substantial advantage. Finally, when job searching, having ICU experience, particularly CVICU experience, will make the new NP a more desirable candidate.
Of note, I worked for seven years as a CVICU bedside registered nurse prior to earning my job as a CVICU NP. Within my ACNP doctoral program, only one student did not have ICU experience and in my current ACNP position, we have never hired anyone without ICU experience. Therefore, while ICU experience is not a technical requirement, it is extremely beneficial to this career path.
Complete ICU Clinical Experience (strongly suggested)
While ICU clinical experience is not a technical requirement, this is another aspect of most resumes we examine for new NP graduates. The new NP is learning how to manage patients from a different perspective than was done as a bedside nurse. Even though lack of ICU clinical experience does not always exclude a new applicant, it can be the difference between getting the job and not.
During my educational course, despite the fact that my program was very reputable, they only had me scheduled for one ICU clinical. I knew I wanted to work in the CVICU post-graduation, so I took it upon myself to arrange clinicals in the CVICU by finding preceptors and coordinating with the institution. I specifically remember this being a momentous benefit during my application process.
Final Suggestions
Once one has completed all of the above steps, some final tips to working as a new graduate NP in the CVICU include having a solid curriculum vitae, that has simple formatting and has been triple checked for spelling errors, requesting shadow time throughout the interview process to ensure the job is actually desirable and a good fit, and having very strong references from professors and clinical instructors.
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