GNP or FNP?

Specialties NP

Published

Specializes in ICU, Correctional Medicine, Adolescent.

I need some advice from experienced NP's of all specialities. I am enrolled at the University of South Alabama NP on-line program and torn between the GNP and FNP tracks. I work for the Dept of Veterans Affairs in MICU and generally take care of pt's 55 yrs old and older with some very complex health problems. Therefore the GNP program would fit perfectly in with the VA setting, especially when the program has the GNP with a special focus in diabetes management that will allow you to sit for the CDE. The veterans and our general American population is getting older and requiring professionals with specialty training to meet their complex healthcare needs. However, I really don't care to deal with children and pregnant women, but I know that the FNP will make me more marketable. I'm a young nurse with 6 yrs of professional nursing practice under my belt and I don't plan on leaving the VA until I am eligible to retire, which is about 30yrs. If you had this decision to make which would you choose? Keep in mind that the VA is paying off my BSN student loan, paying for my MSN/NP, providing excellent benefits/retirement plan and pay comparable to the private sector from my research. Also did I mention that you can transfer to any VA and practice under your home state's NP license and you are covered under the VA's policy. There are many areas within the VA for both FNP's/GNP's to work autonomously (Geriatric clinic, Diabetes clinic, TCU-TRANSITIONAL CARE UNIT, ECU-EXTENDED CARE UNITS, etc... Catch my drift!! What I'm getting to is that I'm really leaning more towards the GNP track, but I'm open to any suggestions, professional advice and words of wisdom.

congrats on your success so far, taylormade!

it sounds to me like you are very, very clear about your goals. i am not sure what advantage the FNP would give you given your clearly-defined area of interest & plan to stay in the VA system. sounds like you'll have plenty of opportunity w/ the GNP. job satisfaction is part of being successful in your work- it sounds like you just need to make it a priority to find jobs that won't involve peds & OB. if you ever got out of the VA system & hospitals, internal medicine would probably be great for you.

good luck!

I have heard this question bandied-about numerous times as an NP, and while being a student. The main point is that FNP allows you considerable leeway in treating any and all patients that come under your "scope of practice". I have had experience with the VA system and you can get into a "niche" and stay there until the "cow's come home". However, what happens when you get a desire in about ten years or so to treat OB/GYN, or get asked to work in any area that doesn't come under the heading of geriatric? The FNP title allows you to treat from the cradle to the grave, as long as it is in your scope of practice. Why not get the overall licensure and then specialize with a particular certification as necessary? I know that "generic" FNP title is definately more marketable when you are searching for a job. Remember... even working for the government does not mean a "forever" position, you could be "kicking cans down mainstreet looking for a job"depending on who is in power. If and when that occurs the FNP license would be more marketable. Regardless, good luck in your practice.

TaylorMade, how is the program you're in? I'm considering the same one although maybe Psych since my masters is in that area and I'd like to combine it with my bodywork practice in dealing with chronic illness/trauma/abused folks.

I need some advice from experienced NP's of all specialities. I am enrolled at the University of South Alabama NP on-line program and torn between the GNP and FNP tracks. I work for the Dept of Veterans Affairs in MICU and generally take care of pt's 55 yrs old and older with some very complex health problems. Therefore the GNP program would fit perfectly in with the VA setting, especially when the program has the GNP with a special focus in diabetes management that will allow you to sit for the CDE. The veterans and our general American population is getting older and requiring professionals with specialty training to meet their complex healthcare needs. However, I really don't care to deal with children and pregnant women, but I know that the FNP will make me more marketable. I'm a young nurse with 6 yrs of professional nursing practice under my belt and I don't plan on leaving the VA until I am eligible to retire, which is about 30yrs. If you had this decision to make which would you choose? Keep in mind that the VA is paying off my BSN student loan, paying for my MSN/NP, providing excellent benefits/retirement plan and pay comparable to the private sector from my research. Also did I mention that you can transfer to any VA and practice under your home state's NP license and you are covered under the VA's liability insurance policy. There are many areas within the VA for both FNP's/GNP's to work autonomously (Geriatric clinic, Diabetes clinic, TCU-TRANSITIONAL CARE UNIT, ECU-EXTENDED CARE UNITS, etc... Catch my drift!! What I'm getting to is that I'm really leaning more towards the GNP track, but I'm open to any suggestions, professional advice and words of wisdom.

Take my word for it, b/c I've been there and done that, get your FNP CERTIFICATION! Also, I remember there were 2 ANP's in my FNP program and they were both in the military. They said the military doesn't even recognize ANP's, only PNP's and FNP's.

Specializes in Acute Care - Cardiology.

hey taylormade (love your hats by the way... :))

as you are also from texas, i tell you this with confidence... if you are planning on remaining in the hospital/acute care setting, i would recommend you strongly consider against fnp. you will be qualified to care for diabetic patients and do education for the patients as an fnp, but if you are thinking at all, that you would like to remain inpatient, don't do fnp. linda rounds, pres. texas bon met with us at utmb-galveston (where she is faculty)... and said texas bon is buckling down on nps functioning outside of their scopes. in texas, esp houston, you will not find problems with job security as any np... so why not do what you are most interested in... and best fitting for your career plans? :)

this "debate" is similar to the idea that new nurses should work med surg first... (to give you a broad perspective of patients for future jobs, etc. etc. etc.) i personally do not agree, as i worked er first (but that isnt the point). i think, if given the opp, do what you want to do... and everything happens for a reason. i do not think you will be shooting yourself in the foot, with either route you choose, you just have to think about scope of practice for each specialty and your goals. :twocents:

people that are so set on fnp... often come from areas that aren't as populated with the other specialties, i.e. acnp, gnp, anp... unlike houston.

best wishes!

hey taylormade (love your hats by the way... :))

as you are also from texas, i tell you this with confidence... if you are planning on remaining in the hospital/acute care setting, i would recommend you strongly consider against fnp. you will be qualified to care for diabetic patients and do education for the patients as an fnp, but if you are thinking at all, that you would like to remain inpatient, don't do fnp. linda rounds, pres. texas bon met with us at utmb-galveston (where she is faculty)... and said texas bon is buckling down on nps functioning outside of their scopes. in texas, esp houston, you will not find problems with job security as any np... so why not do what you are most interested in... and best fitting for your career plans? :)

this "debate" is similar to the idea that new nurses should work med surg first... (to give you a broad perspective of patients for future jobs, etc. etc. etc.) i personally do not agree, as i worked er first (but that isnt the point). i think, if given the opp, do what you want to do... and everything happens for a reason. i do not think you will be shooting yourself in the foot, with either route you choose, you just have to think about scope of practice for each specialty and your goals. :twocents:

people that are so set on fnp... often come from areas that aren't as populated with the other specialties, i.e. acnp, gnp, anp... unlike houston.

best wishes!

you are 100% right! i did the anp/gnp and found out that it severely limited my job opportunites in my neck of the woods, so i went back to ut-houston to get my fnp. if i lived in houston, i would have never bothered with the fnp b/c there are so many opportunities there. in fact, i have found that the more "specialized" np's get more $$$.

our professors at ut-houston also mentioned the tx bon rules that prohibit fnp's from working in the hospital. they told us that 17 fnp's were fired from tx children's b/c the bon deemed they were practicing outside of their scope. i'm glad to see they are cracking down on this b/c this definitely puts the patients at risk. we were also told that the tx bon was "looking the other way" when it came to anp's working in the hospital setting, but they are really trained for the primary care arena. i did 90 hours of clinicals in the hospital when i did my anp/gnp program and i'm credentialed at all the local hospitals, but i worry about liability issues, regardless of what the tx bon determines. i'm really surprised to read these posts about all these fnp's working in the hospital. i'm really shocked that their insurance carriers even cover them to practice outside of their certification.

Specializes in Nephrology, Cardiology, ER, ICU.

Wow - learn something new everyday! Thanks for the input about TX. Here in IL, the FNP is the only way to go! ACNPs are rarely hired anywhere, GNPs are still working as staff nurses because no one will hire them, ANPs are a last resort. However, if you are an FNP, you can call the shots...

Specializes in NP Business Coach, Mentor, Business Ed..

My first NP is as a GNP (certificate). I really didn't want to do FNP, but I did because it gave me more options.

I'm very glad now I did. Get your FNP. You can always sub-specialize.

BarbaraNP

the VA has generous tuition reimbursement, so look into getting one of the certifications first (GNP or FNP) and then a little later, get the other as a post-master's?

Specializes in Nephrology, Cardiology, ER, ICU.

Still, why do both? Why not go for the FNP FIRST because with that, you can see the full age spectrum.

Wow - learn something new everyday! Thanks for the input about TX. Here in IL, the FNP is the only way to go! ACNPs are rarely hired anywhere, GNPs are still working as staff nurses because no one will hire them, ANPs are a last resort. However, if you are an FNP, you can call the shots...

Wow, so how on earth does one go about figuring out what's the best specialty in their state? I'm just beginning school (direct-entry program) in the fall, and the FNP vs. ACNP debate has been heavily on my mind. . . . I plan to work in California when I finish, and want to be sure that I can get a job!

Thanks,

Kens

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