Should FNP be required for all APN's?

  1. I'm interested in becoming a Psych NP; however, numerous FNP's tell me that I should become an FNP first. Then I can treat all across the spectrum with all ages.

    I am generally cautioned about narrowing my advanced practice knowledge and skills by choosing a specific track like psych, peds, or women's health.

    I am told an FNP is much more marketable. Any thoughts?
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  2. 13 Comments

  3. by   sirI
    Hello, rkmoyers and welcome to allnurses.com

    Glad to have you with us.

    Required? No. It is an individual choice that should be made after extensive research of the area in which the NP wishes to be employed coupled with self-interest.

    Is FNP more marketable? Possibly and again, that depends on the area demand(s).

    But, Family Practice is not for all, just like PNP isn't for all. I'd NEVER consider peds as APN specialty for that is just not my cup of tea, so to speak. By the same token, I'd never consider Psych NP for that is/was never my interest. That is the beauty of this profession (Advanced Practice).....many specialties to tailor to your individual interests, desires and expectations of healthcare.

    I was OB-GYN for years and added FNP for better marketability. Just worked for me and in my area.

    General "cautionary" advice is okay, but consider what the market will bear - check out your area and wherein your interests lie.

    Enjoy the site here at allnurses.com!!
  4. by   romie
    One of the major regional hospitals in my city just fired all their FNPs due to budget cuts. Also, I have heard through various sources that California is impacted with FNPs. I think you might have the best marketability as a Geriatric or Adult NP, possibly Occupational Health NP. I myself am going the PMHNP route myself as it is what I want to do and figure I can always have a job as a nurse no matter what.
  5. by   traumaRUs
    Romie - like Siri said -it depends on the market where you live or if you live in an APN-poor market, are you willing to move?
  6. by   core0
    Quote from siri
    Hello, rkmoyers and welcome to allnurses.com

    Glad to have you with us.

    Required? No. It is an individual choice that should be made after extensive research of the area in which the NP wishes to be employed coupled with self-interest.

    Is FNP more marketable? Possibly and again, that depends on the area demand(s).

    But, Family Practice is not for all, just like PNP isn't for all. I'd NEVER consider peds as APN specialty for that is just not my cup of tea, so to speak. By the same token, I'd never consider Psych NP for that is/was never my interest. That is the beauty of this profession (Advanced Practice).....many specialties to tailor to your individual interests, desires and expectations of healthcare.

    I was OB-GYN for years and added FNP for better marketability. Just worked for me and in my area.

    General "cautionary" advice is okay, but consider what the market will bear - check out your area and wherein your interests lie.

    Enjoy the site here at allnurses.com!!
    Peripherally involved is the concept being considered by the NCSBN.
    https://www.ncsbn.org/Draft_APRN_Vision_Paper.pdf
    The concept is that all they do away with CNS and all NP's are trained in a generalist manner then do additional specialist training. Basically NP training plus a residency. This is an interesting concept. Not sure where they are going to get the money to do it or get buyoff from other organizations.

    David Carpenter, PA-C
  7. by   Psychaprn
    Requiring you be an FNP before being a Psych APRN makes no sense to me. Why not have all FNP's become Psych NP's first so they can treat all ages who need psych care?!Pediatricians don't need to be Gasteroenterologists first. Actually I think it's just a put down of Psych Np's to say you should be an FNP first-I don't want to treat families-why be an FNP first?
  8. by   beckinben
    Quote from core0
    Peripherally involved is the concept being considered by the NCSBN.
    https://www.ncsbn.org/Draft_APRN_Vision_Paper.pdf
    The concept is that all they do away with CNS and all NP's are trained in a generalist manner then do additional specialist training. Basically NP training plus a residency. This is an interesting concept. Not sure where they are going to get the money to do it or get buyoff from other organizations.

    David Carpenter, PA-C
    Very interesting read - glad to see they still consider us CNMs separate to some extent. I for one have no desire to have men in my scope of practice (no offense to David or any other men out there), so I wouldn't want to be forced into a FNP-style program first. They do suggest the residencies for CNMs, too, which is an interesting, but probably not viable idea.

    Becki (CNM)
  9. by   core0
    Quote from beckinben
    Very interesting read - glad to see they still consider us CNMs separate to some extent. I for one have no desire to have men in my scope of practice (no offense to David or any other men out there), so I wouldn't want to be forced into a FNP-style program first. They do suggest the residencies for CNMs, too, which is an interesting, but probably not viable idea.

    Becki (CNM)
    No offense, I did my OB-GYN rotation. Did some pelvics, delivered some baby's NEVER want to do that again. Glad someone likes it. Not my cup of tea:smilecoffeecup:.

    The problem seems to be the overlap of CNS and NP. Some states recognize CNS as a APRN and some don't. Part of the nursing compact is to make the rules the same across all states in the compact.

    You do something similar to a residency in any APRN program, you just don't get paid for it (which is probably the most descriptive factor in a residency). This is the biggest non starter here. No one shows where the money is going to come from (and they're not discussing a small amount). This would also make the clinical year full time allowing the expansion of clinical hours described in the DNP. Also the hope is that an expansion in clinical hours and pharmacology didactics will allow the compact to get rid of practice parameters that limit new grads from prescribing in some states.

    David Carpenter, PA-C
    Last edit by core0 on Mar 3, '07
  10. by   beckinben
    Quote from core0
    The problem seems to be the overlap of CNS and NP. Some states recognize CNS as a APRN and some don't. Part of the nursing compact is to make the rules the same across all states in the compact.

    You do something similar to a residency in any APRN program, you just don't get paid for it (which is probably the most descriptive factor in a residency). This is the biggest non starter here. No one shows where the money is going to come from (and they're not discussing a small amount). This would also make the clinical year full time allowing the expansion of clinical hours described in the DNP. Also the hope is that an expansion in clinical hours and pharmacology didactics will allow the compact to get rid of practice parameters that limit new grads from prescribing in some states.

    David Carpenter, PA-C
    Yes, I did something similar to a residency- CNM programs call it integration - it was a summer of being on call for births 24/7 and working about 80 hours each of those weeks, all while trying to pay for my child care on student loan money because working was totally out of the question. A paid residency would have been better, at least financially, for me. But I don't see it happening.

    And I live in one of those bad states with the supervised practice requirement for new grads before we get prescriptive authority, so anything to improve that, I would be in favor of.

    But the biggest problem I see with their "Vision Paper" is that many CNMs are going to resist NCSBN trying to make rules for us, when not all CNMs are under the authority of state nursing boards in the first place.

    Becki
  11. by   SteveNNP
    I don't understand what the point would be for me to have to get my FNP in order to be a NNP! I would never care for anyone over 2 y/o!!!
  12. by   core0
    Quote from SteveRN21
    I don't understand what the point would be for me to have to get my FNP in order to be a NNP! I would never care for anyone over 2 y/o!!!
    I would agree. It all depends if that is the only thing that you ever want to do.

    David Carpenter, PA-C
  13. by   Uberman5000
    Quote from rkmoyers
    I'm interested in becoming a Psych NP; however, numerous FNP's tell me that I should become an FNP first. Then I can treat all across the spectrum with all ages.

    I am generally cautioned about narrowing my advanced practice knowledge and skills by choosing a specific track like psych, peds, or women's health.

    I am told an FNP is much more marketable. Any thoughts?
    That is stupid....listen its simple, if you want to go into Psych, get your Psych NP, dont listen to other people telling you to get your FNP first and then get you psych NP, that is a complete waste of time, arent you sick of the ivory tower? You dont learn anything in school anyway just get out there and do it....
  14. by   core0
    Quote from Uberman5000
    That is stupid....listen its simple, if you want to go into Psych, get your Psych NP, dont listen to other people telling you to get your FNP first and then get you psych NP, that is a complete waste of time, arent you sick of the ivory tower? You dont learn anything in school anyway just get out there and do it....
    Part of it depends on what you want to do with your degree. I will admit I am not as familar with the scope of practice for psych NP as some of the others, however, NONPF competencies talk about psychiatric services. I do not think that the FNP will allow you to treat all ages as far as psych. This seems to be tied to the training and competencies as a psych NP. What the FNP does do is open up additional options. I would use Siri as an example. You also have to look at what the job market is. If you anticipate only seeing patients for psychiatric problems or working in an environment where there is someone else to see the patient for non-psychiatric problems then that's all you need (if your perceived job market will support that). On the other hand, if you want to work in a wider area or do more with the position then consider a dual certification. You have to remember that 20% of primary care encounters are psychiatric. There is probably a pretty nice position there somewhere. I have a friend that makes a nice living as a PA on a locked inpatient psych unit. The Psychiatrist doesn't want to (can't:wink2 handle the patients medical problems (and patient in an inpatient unit have all the normal medical problems). So she does the H&P's, handles the HTN etc. Gets home to see her kids home from school. I would imagine that a combined FNP Psych NP could do something similar.

    You have to make the decision based on what you want to do. Also you can always do the thing that you want and get a post master's certificate if it doesn't work.

    David Carpenter, PA-C

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