FNP, ACNP, CRNA What is everyones opinion?

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Hello everyone,

I am currently an accelerated student and Johns Hopkins and have been accepted into the NP program, though I haven't specifically decided on an area of focus.

Thus far I'm most interested in ACNP and FNP; but recently I've began considering CRNA. However, JHU doesn't offer the CRNA option.

I am planning on moving back to the Pacific Northwest, preferably Washington to practice. However, I am extremely concerned about job outlook and salary. I would prefer it if people didn't tell me to do what I love in spite of salary because love doesn't pay the bills. Also, I chose nursing because of the limitless opportunities it offers.

I know I need at least 1 year of ICU experience to become a CRNA. However, I'm concerned if I chose to forgo my NP option here I may never be accepted into a CRNA program (I have a 3.9 in my science courses) because they are extremely competitive.

Upon recent investigation I've also noticed NP's don't seem to make much more than general RN's, especially RN's with a specialty focus. Is this true? If so I'm not sure I can justify the immense debt I would be undertaking for my masters just to earn $3 more an hour!

Thus, I'm most interested in gaining information about salary, job outlook, and information that relates to these subjects. All perspectives are appreciated.

Specializes in ICU.

I think you concerns are valid and wish I had some adivice or info to offer. I'm still in nursing school, but an advanced degree has always been in the picture for me and I have wondered about some of the same things as well. This may not apply to you since it sounds like you are in a masters program, but the NP route has become less palatable to me since it is being transitioned over to the DNP, but others are quite pleased that it has and are willing to invest in the extra time spent towards that degree.

Specializes in allergy and asthma, urgent care.

I have no great wisdom to offer, but I would advise also looking at the lifestyle (not the $$) that each job demands. ACNP and CRNA are usually in-patient hospital jobs, that may require nights, evenings, holidays and on-call. There are CRNA jobs in surgi-centers, which could give you more of a regular schedule. Many FNP jobs are outpatient, which can offer a more regular schedule, with little to no off hours commitment. Just something to consider.....

The large amount of debt you'll incur is a valid concern. I went to an expensive school and would have had a mountain of debt, but chose to take a position through the National Health Service Corps. I work with an underserved population in a community health center. In return for a two year commitment, they gave me $50,000 towards my loans (above and beyond my salary). I'm eligible for an additional $35,000 if I stay another year. This "deal" is only offered to NPs who work in primary care (FNP, PNP, ANP, PMHNP, WHNP, and CNMs). I'm not aware of any similar programs for ACNPs or CRNAs. My job isn't my absolute dream job, but I'm learning a tremendous amount and have a great deal of autonomy. And.....no debt!!!:)

Good luck with making your decision.

Specializes in Nephrology, Cardiology, ER, ICU.

Is there a way to talk with or shadow an

NP? I think it's hard to choose a focus without some more experience. I ended up choosing the CNS route because that is what was readily available. However in reality the NP rooute is what I should have chosen. I wish I had researched it more.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

I wouldn't worry about getting into CRNA schoo. Every single nurse I know that applied got in on thier first of second try. Apply in stated that have many programs like PA & FL, As for jobs google "gaswork" and search.

Specializes in SICU, MICU, Med/Surg, ER, Private Duty.

all i have to say, if you want to get into the CRNA... than go for it! you stated that John Hopkins doesn't offer CRNA. So apply to a school in the pacific north (you said that you are planning on moving back)

nothing wrong with applying to multiple schools!

also you are right, NPs don't don't get paid that much more... it depends on where you go.. and thats a Fact..

on the other hand CRNA gets PAID!!! typical starting salary is 150k...

so make that sacrifice, when you move baack to the pacific north area, work in an ICU for a good one-two years... ur gpa is 3.9 ?? superb!! so in two years apply for CRNA... it will eventually pay off!!

From the research I have done, NP's start out making about as much as RN's who work nights and overtime. This info is from talking to NP's, salary.com, payscale.com, etc. They dont make a ton, like CRNA's, but if you are interested in not having to work nights and overtime shifts, while having a better quality of life, NP may be an option....not sure how much money annually you want to make. For me, when I was working nights and overtime as an RN I had more than enough income to pay bills and buy whatever I wanted, I just dont want to work nights and overtime anymore!!!! :) So for me, an NP salary would be perfectly comfortable while also giving me the job satisfaction that I want!

Scheduling and call is not very different between crna's and np's. Unless you work at a small rural hospital with only a couple of crna's. Call for them might be every other day, but they almost never get called in. I work at a very large hospital. I take less call than np here. Typically crna do one nighat a month, one weekend every four months. NP do an entire weekend every month, with a few weekday calls a month. Depends alot on where you work. I would not consider call as something you need to consider between np and crna, it all differs on where you work. If you work shifts it is easier to get a more set schedule. If you wanted to you get a job with no call, would have to be flexible on where you worked for that. But there are plenty of places with no call, especially surgery centers.

You can even get a more regualr schedule by working shifts, just as you did working as an rn. I work two days a week and still get paid more than a np, and since I am part time I only do three weekends every year for call. 6 days isnt bad at all.

Specializes in Critical Care, Orthopedics, Hospitalists.

My 2 cents:

Sure, a starting NP makes about what an experience RN travelling / working nights / weekends / OT can make. However, that's starting with room to go up. Once you hit all of the above as an RN, you're pretty much maxed out. Plus you have to work crappy shifts (unless you like nights & w/e for the rest of your life). I say this as a former weekender x 3 years + nights x 6 months.

The good thing about the NP / CNS again is that you've got more room to grow and can generally get a 9-5 job making very good $$. Or you can get a shift job and make more $$. CRNA's are at the top of the APN tower, but I looked at their job description and was like uhh, yeah, not for me!

I'd do like TraumaRUS said and do some job shadowing and figure out what you like to do. All the money in the world isn't worth it if you hate your job and your shift and have no time to spend all that money you're making!

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