thank you for your response. there are not enough words in my lexicon to describe just how much i despise
caring for pedi pts (and their parents). i do it all the time, and no one knows how much i hate it, i'd never let it show. so i could do it if i had to, and i don't want to find myself marginalized careerwise by closing that door.
my dream job would be np in a university health clinic. second to that my preference would be to see adults in hospital, but in my area neither is a likely option in the next ten years. i'd like to move to a more urban area, but my husband likes the rural south, so unless i get divorced, i don't know that i could find employment as an acnp within 2 hours of here. or can an acnp see pts in a clinic/office setting?
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yes, acnps are trained to treat acute and chronic complex illnesses. think: diabetes, heart failure, not sore throats and conjunctivitis. however, in my acnp program and many others, we were required to do an outpatient internal medicine rotation, so im is within scope of acnp, as long as no pedi or preggo patients.
i guess what i really need to understand is how much crossover there is between them. who has the most flexibility? physicians cross over all the time. my ed is staffed with emergency med guys, family practice, and an internal medicine doc (who does see the kids who come in). does ap nursing offer that flexibility, or is it far more specific? if i do anp, no doc is going to hire me into his/her family practice, and that is pretty much all we have around here. there are no specialists in town (except a urologist one day a week and a neurologist that sees chronic headaches -oh joy- in a rented trailer office twice a month).
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no, the problem with apns is that we do
have to choose a specialty (acute care, family, adult, pediatric, geriatric, etc.) and do not have much crossover. in the future, according to linda rounds texas bon president, they are trying to figure out a plan for apns that is more like that of a pa program: generalized training for all, so there is no question of scope... with specialized training afterwards, kind of like residencies for medical students.
for me, i am an acnp and work for a cardiology group. i see patients in the clinic for hospital follow ups (status post pacemaker insertions, cabgs, ptca, etc.), outpatient consults, chest pain/heart failure follow ups, etc. plus, i go to the hospital and help with seeing consults/writing orders/discharging pts, supervising stress testing, etc. so, i get it all with my acnp degree... and i love it. (for those of you that have read my dramatic posts regarding my job may not believe that i love my job... but i do truly love what i do... i just don't love my supervising doc/her situation.)
you will be broader with fnp... just think about what kind of patients you want to see (how sick, how old, what setting)... and that will help you decide.
if i do fnp, i'm broader, but only to include a subset of patients i can't stand and it will require going to a different program that will take, in effect, two years longer due to it's set up and my schedule, etc.
i have to make a choice by this fall so as to get applications in on time and other than ruling out psych, lol, i'm nowhere.
all comments are appreciated!