FNP working with Peds?

Trauma Columnist · Oct 13, 2009

I'm completing a peds CNS and did some clinical time with an FNP in a peds office - she had always loved peds but wanted the flexibility of an FNP.

In this day and age, diversity is the key. I have another friend who is a peds CNS and doesn't have a job - and she graduated in Dec 08.

The more types of patients you can see, the better you are set up for in the future.

Jolie, BSN · Oct 13, 2009

When we lived in PA, my girls' health care provider was a FNP working in a peds practice. It was the only type of work she had ever done, and she was excellent.

I seem to remember reading somewhere that certification agencies and state licensing boards were beginning to require candidates to sit for the exam that most closely aligned with their educational program, so I'm not sure if it is still possible to practice in a related field.

core0 · Oct 13, 2009

Hi! This is my first post but I have lurked off and on for a while now.
I am looking into NP eduction options that are available in my area. I had always thought I would go the PNP route, but recently a friend that is applying for FNP school told me that it would possible to get a job in a pediatric related field with a FNP degree since it is covered in clinicals. I can see where this makes sense, but I was wondering what actually happened in the real world. I have 11 years of NICU experience and a M.S. in Family and Child Science.......Anyway, just doing some snooping and wondering if anyone else had any thoughts on the matter.
TIA!!!

In addition to the suggestions above consider where you want to work. If you want to work in a dedicated childrens hospital its pretty much going to require a PNP and most likely an ACPNP.

David Carpenter, PA-C

shonda13 · Oct 14, 2009

Thank you! You all have given me some great directions to explore.

I can see myself working in an office setting. I have worked in a hospital since 1997 and would love to be in a smaller setting like a physician office, but as a nurse I could never afford it. At this point I am not in a position to take such a paycut just to try out an office setting. I have looked into other very flexible career moves (David I recognize you from other forums...good to see you.) but they are not possible given my current family situation. Thanks Jolie for the tip...I am going to check out my states regulations and see if I can find any info. I am not at all opposed to working with adults, it is just with so much peds in my background it seems like a good fit.

Anyway....thanks again!

ivanh3 · Oct 14, 2009

A lot of this is going to depend on you and your ability to sell yourself. If you go the FNP route and still want to work in a peds only seting, I am pretty sure your RN experience will be relevant. I work in both of the pediatric hospitals in my area (NICU and PICU) and we have FNPs as well as PNPs who are working in the NICU and PICU.

Advanced Practice Columnist / Guide · Oct 14, 2009

Most likely, you won't have a problem working in a peds clinic as a FNP if that's your goal. You also may be able to "sell yourself" and be hired in a high acuity peds setting such as a PICU or NICU. However, I caution you to research your state regulations before doing that. There are states that have enforced restrictions on "primary care" trained NP's such as FNP's working in high acuity settings. If your state is not one of them, you may be OK. But again, remember that what you did as an RN is not the same as what you will be doing as an NP. If your competence is questioned regarding an issue of professional liability, how do you prove that you had graduate-level training in a high acuity environment?

shonda13 · Oct 15, 2009

Thanks, those are good points.....the school I am currently looking into states 100 hours of peds clinical time. Does anyone know (generally speaking of course) how much flexibility exists in clinical experiences? Could I do some time in a PICU/NICU or maybe as an elective? Although 100 hours really isn't that much. Unfortunately the above mentioned school is currently revamping their program and website so there is not much information available. I emailed the advisor but haven't heard anything yet.

I imagine proving it would be tricky for sure unless I worked with a doc that would back me up with the training. As a nurse I have acutally been able to get some extra training...intubations, umbillical lines, needle aspirations/chest tubes and PICCs, so maybe if I had a doc that knew me it would be a little easier. Skills are one thing though and relatively easy to learn.

I really love NICU, but I see working in an office setting as potentially a better use of my Master's degree. Why does it seem so hard to pick a direction?!? LOL Seriously I am not usually like this. It is just such a big committment to go back to school and put my family though all that and not like it or not be able to get a job. I just want to be marketable and I really want to go to a state school to save some money, so that limits my choices some.

Oh well, thanks everyone for all the info. I appreciate it! I look forward to learning a lot more on the boards.

ivanh3 · Oct 15, 2009

Thanks, those are good points.....the school I am currently looking into states 100 hours of peds clinical time. Does anyone know (generally speaking of course) how much flexibility exists in clinical experiences? Could I do some time in a PICU/NICU or maybe as an elective? Although 100 hours really isn't that much. Unfortunately the above mentioned school is currently revamping their program and website so there is not much information available. I emailed the advisor but haven't heard anything yet.

For an FNP program that seems light on the peds time. Usually there are about 665 hours or so of required clinical time total. In my program I have done half of that in peds (over 300 hours). In that 300 hours I had to pick a site that had a good mix of acute, chronic, and well visits. I was able to get all of those patient types in one location, but you might find that a clinic site might not live up to your expectations and end up trying to find another.

Schools will vary on clinical requirements, but you need to get a good mix of adult, peds, and women's health. Then among that you need to get a mix of acute, chronic and well check. I know I had the option to use 80 hours for "specialty" and they were going to let me work in a cardiologist office. I ended up not doing it because I got lazy in the end and didn't want to set up another contract. YMMV.

shonda13 · Oct 15, 2009

this is what the website currently says. ok, it does mention the total of 660 hours which sounds right with what you said.....but with the other minimums being 100 hours, maybe there is a bit of flexibility in the other hours. i certainly don't want to short change myself by not getting a well rounded clinical education...it is a lot to learn in just 660 hours....but i hope that it might work out to slant it towards peds. i hear ya about opting out of the "specialty" hours....i am getting geared up for the work involved with going back to school and working full time (oh yeah and two kids! lol), but i am not out to make extra work for myself either. :specs:

family nurse practitioner (fnp)

introduction to the family nurse practitioner track

this concentration provides graduates with advanced practice role preparation, knowledge and skills in the care of children and adults across all ages within a family framework. health promotion, disease prevention and management of common acute and chronic long-term health alterations in primary care settings are the foci of this concentration. minimally, 100 clinical hours must be in a pediatric setting, 100 hours in women's health (50 hours

MSPRN01 · Oct 19, 2009

Hi Shonda13,

I am in a similar situation such as yourself. I have been a NICU nurse for a little over 8 years. I want to be an FNP because my long term goal is to establish a clinic for teens and teen families in my community. I, like you, don't mind the adult care aspect, plus you do what you have to do to get through clinicals and learn/relearn the material.

I decided to apply to a couple of FNP programs, so I will see how it goes. I just completed my BSN, so I was able to revisit my passion within the adult/primary care setting, which is patient teaching. I love the NICU, but I wish I had sought out other nursing experiences as well. I enjoy the technical aspects of the NICU such as placing PICC's , etc., but I am ready for grad school/change.

The program admissions counselors I spoke with didn't seem to be bothered by my specialized nursing experience due to the different role of the FNP versus the staff RN. As many have stated it depends on what you want to do when you become an FNP and what your goals are. I wish you the best in your decision- making process.