Great answers! I wish I could be so eloquent! I just have one thing to add, I agree that most of my job is medicaly oriented but I feel that I do most things (even writing orders) with a nursing perspective. For eg. I am constantly having to remind the docs that they must consider the whole patient not just their area of expertise. I feel that my basic nursing training still colors much of what I do and how I treat and approach my patients and that my NP training has just added another dimension to the job instead of replacing it with another model. I still do thorough assessments as I did as an RN, maybe not give the patient the right med by the right route etc. but make sure it is ordered that way, look at nutrition and comfort issues, pull together the whole multidisciplinary team when needed, in short I feel that I am the bedside RN's resource and partner in the care of our patient.
Yes I do see 12-15 patients a day and sometimes this can be hectic, maybe since I work with Cardiac patients and some of the management can be fairly routine, I have time to practice this way. I do work in a smaller community hospital and that may help me have more time (we refer many patients needing complex procedures to other facilities) but that is why I chose this facility over a larger urban setting because I did not want to become just a 'physician extender'. So I have to disagree with you, I think that yes, NP's are still nurses, just with an added dimension.
and Matt, you're best bet as to the ability of ACNP's to practice in your state is best addressed by your state Board of Nursing. Give them a call!