Choosing a NP focus: FNP, ANP, ACNP

Specialties NP

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Can some of you speak to the career opportunities that may be unique or specific to each? I am leaning toward an ANP program, but the school also offers ACNP. Am I wrong in assuming that I could probably have a wider range of options with the ANP? I don't know if I'll always live in this area, in fact I doubt it, but at this time, the hospital system here will not credential advanced practice nurses(the medical staff opposes it and the chief of staff says he will leave if they ever do, and he has the largest practice in the county and RULES the roost). Assume I move to a more civilzed part of the country. What would be different ANP vs. ACNP?

As to FNP, I really have ZERO interest in caring for children under 12. I avoid those patients in the ED and CCU where I work (it is a general critical care unit, all diagnoses, all ages) at every turn as it is! Am I shooting myself in the foot by not considering a FNP program? We have 3 NPs in my area and each of them is an FNP. They run the coumadin clinic, work as back up in the doc offices (urgent care stuff). They do not have their own practices or patients.

I am going to put serious strain on our budget to get the MSN, and I want the most bang for my buck. Not the highest salary, but the widest range of options. I don't want to fnish one and wish I'd not pigeonholed myself.

Advice, suggestions, general thoughts? Thanks.

Specializes in Acute/Critical Care.

Iconoclast: I am a graduate of 's ACNP program. I had many years of trauma/ICU RN experience prior to starting the program and thought that I would stay at Vandy afterwards. Infortunately...I have found myself in a very rural area of Idaho...jobless because I can't see peds. Think long and hard about what you want to do. If you want to work in a specialty clinic or non acute setting...ANP may be the way to go for you. Especialy if you want to do a distance course from Vandy. I have been told by the BON of two states, ANCC, and Vanderbilt that ACNPs can only see ages 18 and older. I have read on this forum that other ACNPs see 12+, but I can't be sure about that in my state. ANPs can see 12+ in all states, so I think that may give you a broader range down the line. If I had to do it all over again I would choose the FNP route, but I understand the need for distance ed!

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Specializes in Nephrology, Cardiology, ER, ICU.

And I'm somewhat in the same boat: I'm an adult health CNS in IL. I work in nephrology and sometimes kids appear on my pt list - ugh! Then...I have to explain to doc how I can't see kids. The rest of the mid-levels are FNPs and PAs and don't have this issue.

I too would do the FNP if I had to do it over.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

...and I think that's where those who are planning to become NP's need to be more savvy in choosing the track that will not only satisy their clinical interests but also improve their chances of job prospects. You have to actually know what kinds of jobs are out there in your geographical area if you do not plan to move and go where the jobs are. Living in an urban setting, my ACNP peers have been fortunate to find specialties that are adult-specific and in the acute care settings. However, some FNP's here in this area have been looking into jobs in the acute care settings because there are not many primary care openings aside from urgent care centers and ED's. A good way to find out what's out there is to ask practicing NP's in your area through the local NP association. Newspaper classifieds are not always a good way to get a feel of what openings are available because many jobs are still spread by word of mouth. I also find that many hospital websites, at least in this area, post their NP openings online.

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Specializes in Acute/Critical Care.

TraumaRU, How have you handled this. It's really a problem for me right now. Every interviewer has been completely impressed with my CV and said that they would hire me on the spot if I could see peds. Here, they see approx. 40% peds.

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Specializes in Acute/Critical Care.
You have to actually know what kinds of jobs are out there in your geographical area if you do not plan to move and go where the jobs are. quote]

Absolutely! I had been at a Level I Trauma center for 7+ yrs. They actually paid me to go back to school to work as an "intesivist/hospitalist" for a large surgical group. My relocation was unexpected, so I think I should add to your comment that you should look at all job opportunities in all possible settings that you may ever find yourself now or in the future! I am really in a bad position right now and am actually thinking about going back to staff nursing :cry:

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DaisyRN or any other fellow ACNPs,

Which ACNP program did you attend? I am attracted to University of California-San Francisco School of Nursing's ACNP program for Fall 2010 but don't know if it's worth relocating to an expensive city and paying out-of-state-tuition while graduating with a salary that will be less than the loans I will have to take for graduate school. There is a private college that has an ACNP program near where I live that will cost less than half of what UCSF would cost me. I just want to see what your opinions/advice are about good ACNP programs out there. Thanks so much for your time.

Rekka

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And I'm somewhat in the same boat: I'm an adult health CNS in IL. I work in nephrology and sometimes kids appear on my pt list - ugh! Then...I have to explain to doc how I can't see kids. The rest of the mid-levels are FNPs and PAs and don't have this issue.

I too would do the FNP if I had to do it over.

Can't you do some postgraduate work and obtain that credential?

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Specializes in Nephrology, Cardiology, ER, ICU.

This was kinda an old post: I went back to school (yet again) in August 2009 for a peds CNS and will graduate in July 2010.

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Like many of you, I am struggling with the decision of Adult NP or FNP. I have always wanted FNP but was not accepted to my first choice school for FNP but am accepted for Adult NP. I'm still waiting to hear from my 2nd choice (only applied to 2, not realizing how difficult it would be!). When I talked to my 1st choice school about wanting FNP, I was informed that they did a study last year about why people choose FNP and the response was it made them marketable. They researched it and determined it was not true and that the flood of FNP's has driven their salaries down.

Unlike many of you, I do like working with children and really like the idea of FNP for that reason. I would even consider Peds NP but don't think there are enough clinical resources in my area to get what I need.

So now I'm struggling with whether to wait it out, apply to more schools that will cost more or take what I have available to me right now. And if I choose to go the Adult route, should I do a dual Adult/Women's Health? It's very frustrating and I'm inclined to take what I have and run with it although I'm not sure this is the right way to plan the future of my career!!

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Does anyone know what the likelihood of obtaining an ICU or other critical care position is as an Adult Nurse Practitioner. I'm trying to decide on a masters program. The school I'm interested offers a masters in nursing for people with a non nursing bachelors, but it's only available in ANP, FNP, or pscyh. I want to be able to work in the ICU. Would this be possible as an ANP or do they only hire ACNP?

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Hi guys,

I have two questions:

First, I am in a simlilar situation: waffling between ANP and FNP.... I am half way through ANP program but it is definitely not too late yet to change my program. My dream is to work in outpatient cardiology as an NP but, my concern is the job availability in such a narrow area as a cardilogy....Would FNP be a a fail safe in this case? Peds do not scare me as much since I have my own kids now....Yeah, the parents could ba a pain, I can imagine.....

And, my second question is: to be hired as an outpatient cardilogy NP what RN experience is optimal: telemetry, step down, CCU....?

Many thanks in advance!

GrnRN

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Specializes in CT ICU, OR, Orthopedic.
Does anyone know what the likelihood of obtaining an ICU or other critical care position is as an Adult Nurse Practitioner. I'm trying to decide on a masters program. The school I'm interested offers a masters in nursing for people with a non nursing bachelors, but it's only available in ANP, FNP, or pscyh. I want to be able to work in the ICU. Would this be possible as an ANP or do they only hire ACNP?

I am sure that it depends on your state, but my understanding is that you need to be an ACNP to work acute or critical care. I do know however, that you will see other NPs there. I think it's bc they were grandfathered in...

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