Quote from DaisyRN
Just FYI: the ACNP *can* do the outpatient setting in an Internal Medicine or specialist office, i.e. pulm/cardi/GI, etc. Just no Family Medicine... and that may have been what you meant when you said,
"depending on which particular certification." Just wanted to clarify for others...
I thought the same thing until I got into the program... and I just finished my Internal Medicine rotation...
I was under the impression that they could only see acute and critically ill patients. The local program here is a ANP/ACNP program. The instructors are stating that outpatient work is outside the scope of practice of an ACNP. There seems to be some overlap in urgent care. If you look at the CCRN ACNP certification it does not mention outpatient treatment of chronic disease:
"The ACNP practices in any setting in which patient care requirements include complex monitoring and therapies, high-intensity nursing intervention, or continuous nursing vigilance within the range of high-acuity care. While most ACNPs practice in acute care and hospital based settings including sub-acute care, emergency care, and intensive care settings, the continuum of acute care services spans the geographic settings of home, ambulatory care, urgent care, and rehabilitative care."
I guess you could interpret amublatory care as outpatient and the joint comission lists physician offices as one of the many types of amublatory care office. I would have a problem describing most IM or even specialty care as high acuity care.
The ANCC is much more open on thier interpretation:
"The Acute Care Nurse Practitioner (ACNP) is a registered nurse prepared in a graduate level acute care nurse practitioner program to provide and manage health care of acutely ill, critically or chronically ill adult patients in a wide range of settings."
So I guess it depends on which certification you get not your training which seems odd.
Also I will point you at this article:
In particular this response:
Should an NP who is educationally prepared as an acute care NP work in an adult primary care setting?
The answer is no. The acute care NP program prepares graduates for a specialty focus in acute, episodic, and critical conditions that are primarily managed in a hospital-based setting. The program of study does not contain adequate clinical and didactic content to support the ACNP for a broader role in outpatient primary care diagnosis, treatment, and follow-up. Diagnosis and outpatient management of stable and unstable chronic illness, as well as directing health maintenance of a wide range of conditions, is a required competency for practice in the primary care role.
Additionally, professional licensure and certification will reflect validation that the provider has met criteria for practice in a focused, rather than broad, scope of practice. Finally, the environment of primary care is not congruent with the acute care secondary or tertiary care training focus. A lack of congruence between the practice environment and level of expertise results in a decreased level of safety for the patient and increased risk of liability for the NP.
I think this would leave open wether you could work in specialty practice. Internal medicine is usually regarded as primary care. If you look at the article that Sari posted on PNP there seems to be some agreement to divide APN along a primary care or acute care practice line. If you could see internal medicine why couldn't you see adult FP patients? They are essentially the same population.
David Carpenter, PA-C