[Boston-RN]

I am an RN on a thoracic surgery/medical tele floor in a large teaching hospital in Boston. I am wondering which would be better experience/foundation for NP. I'm not sure if I want ACNP or FNP or in what setting. From what I have read here FNP has more avenues available but that is just from what I read here. I'm thinking ED you get a broader range of experience with all body systems different age groups etc. but in the ICU you get a deeper experience. So is ED better for FNP and ICU better for ACNP? Any advice would be great. My hospital hires NP's in pretty much every specialty. Thanks in advance. I am currently in RN-MSN track and will get NP cert afterwards so I have a ways to go.

[DaisyRN, ACNP]

Well, from my perspective... and I am a new ACNP grad that had only ER experience, I wish I had some ICU in my background. Not that I did poorly in the program, but it would have been easier had I been exposed to the ICU more. And do not be fooled, the ACNP program is not *all* critical care. We discuss diabetes from an outpt perspective and also delve into diabetes insipidus and diabetic ketoacidosis. It's a program designed to prepare NPs to take care of acute and complex chronic illnesses, and exacerbations there of. Family NP programs cover a broader spectrum of patients (pedi/ob) without as much focus on the acute issues or exacerbations. So, ER would be appropriate for either... ICU would not help as much with FNP as it would ACNP.

Hope this helps...

[Boston-RN]

It helps a lot thank you. If you don't mind me asking what made you choose ACNP over FNP. I'm teetering on that decision myself (I have quite some time to decide) but I hear that FNP's can work in a acute care but ACNP's cannot do anything other than adult. Did it limit any choices for you?

[DaisyRN, ACNP]

Just FYI:THIS post does not refer to FNPs in ER settings.

I chose Acute Care because, for my goals, it provided more opportunities. I wanted to be in the hospital setting (or at least have the option), plus I wanted to care for sicker patients than FNPs usually care for. Generally speaking, the FNP is NOT trained to focus on acute illness. This is not to say you will not find FNPs in the acute care setting, but as I have stated in several postings, the boards of nursing are starting to look at NPs' scopes of practice. So, take caution when you are thinking of being an FNP in an acute care setting.

Also, I enjoyed what I learned in my program because it was fairly in depth regarding disease processes, whereas the FNP program just brushes over more topics with less detail, because FNPs will not manage IV fluids/drips/meds/diseases/stabilization measures in the outpatient setting. My friends from the FNP program kept me up to date on what they were talking about and how it compared to what we were discussing, so I am not simply making assumptions about the different programs.

As for adults only, you are right, I cannot see anyone under the age of 12, and I actually liked pediatric patients in the ER, but I have yet to feel deprived. Nor have I regretted going into Acute Care over FNP.

The key differences are:
1. Setting - Hospital vs. Outpatient (or a combination of the two)
2. Population - Pediatric vs. Adult