ANP vs. ACNP...quick question

Advanced Practice Columnist / Guide · Nov 4, 2007

Hello!!!
I am currently enrolled in a MSN program-ANP-Primary Care option. As a ANP, would I be restricted to primary care in urgent care clinics for the adult population, or would I have the option to work with a physician within a practice(Internal Med, Cardiology, Nephrology, etc.). I am asking these things because I would like to work with a cardiologist and I am confused as can be thinking that maybe I should be enrolled in the ACNP option instead of the ANP-Primary care. This is my first semester, so I am trying to gather a little more information before next semester.
I am very much concerned about marketability. I am interested in primary care because I like the idea of trying to assist in prevention of disease processes and education of doing so, but I also want to be able to find a job after I graduate.
Any information out there that would assist me in this will be GREATLY appreciated, and if there are any ANP's or ACNP's out there, please let me know about your satisfaction as a ANP/ACNP, what your days consist of, and pay ranges:nono:....I know its taboo, Sorry!!
Thanks,
RN4U2C:balloons:

First off, I'm an ACNP. It was a choice I made before applying to an NP program because I like working with adults only and in hospital settings. Second, your question was recently a topic of heated discussion in a yahoo group called "Advanced Nursing Practice in Acute and Critical Care", a forum started by faculty from the University of Pennsylvania. Many faculty members and directors from ACNP programs posted and gave their opinions on the matter. If you are interested to read them, do a yahoo group search and apply to become a member of the group once you arrive at the site.

I have the opinion, however, that both ANP's and ACNP's can be employed in hospital settings in Internal Medicine, General Surgery, as well as any of the adult subspeciaties. There is a popular opinion that only ACNP's are best suited for ICU positions for nurse practitioners. Critical care content is part of the ACNP curriculum and is also included in ANCC's ACNP certification exam. Health care maintenance and disease prevention are included in both the curricula of ACNP and ANP but ANP has a bigger focus on the issue in terms of their curriculum.

Clinical rotations for ACNP's are spent on a larger percentage in acute care settings while ANP's tend to have more clinical rotations in out-patient settings. However, this is just the typical program arrangement. There are exceptions and there are also programs that allow greater flexibility to suit the student's goals as long as available clinical settings can be obtained for the specialty the student wishes to rotate in.

As far as clinical practice in the real world, state BON's have their own opinion on this. Check with your BON in terms of being rigid when it comes to how the NP specializations are delineated. Some states are very strict when it comes to NP's practicing within their education and training. Some seem to thinks that an NP is an NP and have no set rules on the matter and Michigan is one such state. In our ICU group, we have four ACNP's, two ANP's, and one PA-C. An FNP almost joined our group but backed out at the last minute (family issues were given as the reason for not accepting the job). We are still looking for the last candidate and who knows what this one is going to turn out to be.