ACNP vs FNP

Advanced Practice Columnist / Guide · Mar 20, 2009

If you know for a fact that ACNP jobs are harder to come by where you wish to work, then definitely consider FNP if that would help you find better prospects for employment. It seems like the trend for critical care and acute care specialty positions for NP's are concentrated in urban or large city settings. Unless you are willing to relocate, do not pursue the route where any specialized skills you'll learn will not be utilized.

dgclough · Mar 20, 2009

I'm ok to transfer, my kids are grown and I would like to do some 'seeing the world'...but I guess it's fear...The FNP's that I know were like, you'll be ok since you're getting the FNP certification...which scares me, are they saying that because FNP is so diversified or because they don't want me to be ACNP or feel that it's wrong for me (job prospects or whatever...) I currently work in SICU so I know the ICU scene and enjoy it within this scope of practice and try to get my head in a room for anything above my level and enjoy watching and wishing I could do it...But....don't know...

Trauma Columnist · Mar 20, 2009

If you want to work in the ER/ICU (some place acute), an ACNP might be the way to go. You could always do a Peds NP after the ACNP in order to see kids.

I'm an adult health CNS (I see people >16years). However, that is too restrictive for the ER where I work part time, so I'm going back to school in the fall for a peds/family CNS.

JDCitizen · Mar 20, 2009

How soon will you be starting?

When you say you are willing to transfer (after or before school)???

How much research have you done with schools, jobs in other cities/states?

FNP alone with in hospital jobs can be tricky some states don't allow, some hospitals don't allow or limit. Although some schools are starting to merge FNP with other specialty training...

ACNP limited by age group and specific training. I have not researched how the certification agencies or states limit ACNP overall practice scopes...

Your question made me think: ACNP other than hospital based anyone work both hospital and office/clinic with ACNP???

You have already recognized the catch 22:

1) FNP and be unable to get the type job you want.

2) ACNP and be unable to get the type job you want.

Although I think to FNP route gives you a little more wiggle room for work so you can go back to school for postmasters...

Advanced Practice Columnist / Guide · Mar 20, 2009

I'm ok to transfer, my kids are grown and I would like to do some 'seeing the world'...but I guess it's fear...The FNP's that I know were like, you'll be ok since you're getting the FNP certification...which scares me, are they saying that because FNP is so diversified or because they don't want me to be ACNP or feel that it's wrong for me (job prospects or whatever...) I currently work in SICU so I know the ICU scene and enjoy it within this scope of practice and try to get my head in a room for anything above my level and enjoy watching and wishing I could do it...But....don't know...

I don't know what the FNP's meant when they said "you'll be OK since you're getting the FNP certification". Do they work in family practice or are they employed in a hospital-based specialty? You see, a lot of people will tell you that FNP is very flexible and you can work anywhere. However, be careful with that assumption as some states do have limitations on FNP practice when it comes to working in acute care specialties.

You'll have to follow what your heart tells you. If you know you like acute care especially the critical care aspect of it, then maybe ACNP is the way to go given your nursing background. What I've realized in my five years as an Acute Care NP is that one's success in job prospects depends greatly on what you can offer in terms of your past work experience as a nurse. In the SICU where I work, we only hire ACNP's and we only hire ACNP's with critical care experience. Again, this route is a good way to build up on your current critical care nursing background and a prospective employer would probably see you as a strong candidate for a position requiring acute care skills.

However, if you're a critical care nurse who desires to shift course and venture into primary care as a way of helping patients stay away from hospitalization by managing their own health, then this sounds more like an FNP mission to me. But to say that FNP is better for someone who is unsure about where they'll end up working in as a nurse practitioner because FNP's can work anywhere is a statement that doesn't do much service to advanced practice nursing professions in my opinion. Let's give each NP track the credit they deserve for the training they are intended for.

Regarding your first question whether to do FNP to ACNP or ACNP to FNP, again, the answer depends on what direction you want your career to take. Unfortunately, there is no straight answer as with most NP issues. You'll have to do what feels right for you.

allnurses Guide · Mar 20, 2009

I have not heard that ACNP jobs are hard to come by - in fact, we can't get enough ACNPs at my hospital. Guess it's area-dependent. I'd do whichever one you want.

Sarcolemma · Mar 20, 2009

my understanding was that FNP degrees are more flexible as they cover the cradle-grave, whereas ACNP only covers adults.

allnurses Guide · Mar 21, 2009

Depends what you want to do - ACNP covers all acute care areas, while FNP technically covers only primary/preventative care.

JDCitizen · Mar 21, 2009

Depends what you want to do - ACNP covers all acute care areas, while FNP technically covers only primary/preventative care.

Age limit in Georgia. Thats one of the reasons I believe some programs are combining the two....

dgclough · Mar 21, 2009

My indecision comes from an old job where I worked at an Urgent Care Clinic. I worked with FNP's and really liked working with them. Then once I graduated RN school, I started working in a NTICU then since then have transferred over to SICU. I really like the ICU but I also enjoyed the Urgent Care. I really don't want to limit myself to just one thing, right now I want ICU but what about in the future, will I want to 'slow down' and do primary practice or urgent care...

For Ghillbert: what state do you work in that ACNP's jobs are prevalent...my area (southern, rural Missouri) there are NONE

For NP Gilly: Where do you work that a SICU only hires ACNP's...and what do you do?

I start in August 09 at SLU and I guess at this point (rather than reapplying for another program) is to start and complete the ACNP and then do the FNP certificate afterwards...At that point, I should be able to do both worlds as I want/need...

Thanks guys for your advice!

If anyone out there went to SLU, can you give me a headsup on the types of classes/clinicals, anything that would help me to plan for the next few years of my life...Looking forward to it but SCARED to death!!!

ivanh3 · Mar 21, 2009

I work with FNPs who work in the ICUs. All of them had ICU backgrounds as RNs, and they are all really sharp practitioners. I would go with what has more jobs in the geographic area you are in now. That way if you move, you will have less of a chance of paying out of state tuition (if you pick a state school).

Consider also what contacts you have in the area you live now. Many schools want you to find your own preceptor/clinical sites and moving might make that more difficult.

Also, what do you feel stronger in? Your ICU skills or your urgent care background? That might be a consideration. My wife works for a university hospital, and if we don't relocate after graduation (FNP) I am considering applying for their ACNP program. I do think it would be an excellent combo to have.