A fnp as a hospitalist?

ryguyRN · Oct 24, 2014

As you probably know the FNP is intended for Primary care so Hospitalist would be outside your scope. Personally I would not feel comfortable going into a position like that, without proper training/certification.

allnurses Guide · Oct 24, 2014

I know lots of FNPs that work as hospitalists. Make sure you talk to the employer about what your orientation program is going to be, you will likely need 3 months.

Most facilities have strict policy about NPs covering the units. My facility requires a physician to see the patient within two hours of any major change in status/admission and cosign orders within 24 hours.

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Trauma Columnist · Oct 24, 2014

BostonFNP is correct - in my area FNPs are the usual ones to be hospitalists especially on night shift - there will be a sleeping resident.

suprmedic · Oct 24, 2014

Google consensus model of APRN's- There are some issues with the FNP doing an acute care NP mostly because of the training of the FNP and acute care NP are so different. Specifically it says that NP practice should be based on training and curriculum and not by their previous experience. That being said- I am a new grad FNP and I have taken a position as a Neuro- critical care NP..... The hiring physician group knows me- has worked with me over the past years and trusts that I will do a good job.

ashonman · Oct 24, 2014

Supermedic Thanks for your comment ..I am very much aware of the consensus model however been a hospitalist does not necessarily mean placing arterial and central lines. I am originally from up north and there are tons of fnp's that practice internal medicine in the hospital setting. If we are to make that argument then one should safely argue that fnp's do not belong in the ER. My concern is taking this position as a new grad and icu coverage, if I do that then I will be practicing out of my scope.

zmansc, ASN, RN · Oct 24, 2014

OP -

I think there are a couple of issues to work through:

1) Is it legal. That would be a question for the state board, scope of practice, etc. I don't know what state your in, but it sounds like you know of others who do it, so my first guess would be it is. In either case, I would suggest verifying legality in your state to determine if you are within your scope.

2) Will you have sufficient support to be able to get timely assistance as needed and provide proper patient care. I think a big part of your question is a concern on this front, and it is a very valid concern. If this position interests you (and I'm assuming it does or you would not have posted here), it could be a very big opening for you, so I would encourage you to continue to try to identify what support you will need and what they are willing to provide for you initially and as you grow into the position.

3) In addition to legal, could you defend your position in a legal proceeding. A slightly different issue than #1. I think I would want some formal training/support from the institution. I.e. in addition to obtaining privileges, I might suggest some sort of formal training logs be maintained (I'm sure they already have to do this for other providers in other areas), so you would have the ability to show that not only did you have your schooling, but you had been trained on specific other areas that were pertinent to your job as a hospitalist.

Good Luck!

BlueDevil, DNP · Oct 24, 2014

All the hospitalists here are FNPs for the most part, as are the ED and ICU APPs. Once in a while you stumble upon a PA, but that is about it. It is pretty much the norm.

globalRN · Oct 27, 2014

I am a FNP and have worked hospitalist NP for 9+yrs.

Prior to that I worked Hem/onc and was a hematology NP for 3 yrs.

Many yrs as a RN before NP.

There was still a steep learning curve for hospitalist NP.

Today, patients are so complex that I can see it is not a job for a new grad NP.

It is not even a job for a physician unless he has relevant hospitalist experience.

The complexity of each of the patients and the multitude nature of their problems requires

an advanced level of experience and expertise to chart an appropriate treatment plan.

ashonman · Oct 27, 2014

Thank you globalRN for your advise and insight. I have decided not to take the position and continue looking. As much as I wanted the position, I also want to provide safe care to the patients I come into contact with. At this point in my career my priority is to find a practice or group that I can grow with. Thank you all for your response and input, it was very much appreciated.

Dranger · Oct 27, 2014

Thank you globalRN for your advise and insight. I have decided not to take the position and continue looking. As much as I wanted the position, I also want to provide safe care to the patients I come into contact with. At this point in my career my priority is to find a practice or group that I can grow with. Thank you all for your response and input, it was very much appreciated.

I would have taken the job as a new ACNP but not as a new FNP. Probably a good decision.

allnurses Guide · Oct 27, 2014

What did they offer you for orientation?

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