PNP in the hospital

  1. 0
    Hi there,

    I'm a prospective student of a few direct-entry programs. I'm hoping to become a PNP, however, I have a few questions for those of you who have graduated from such programs or who might simply have any answers/guidance for me. I'm interested in a variety of pediatric settings, however, my eventual goal in the clinical sense is to work within a children's hospital in hematology/oncology. I realize that PNP is specifically primary care, and may not usually lead in this direction, however, is this entirely unheard of? That is, is it impossible to gain employment as a PNP in a specialty clinic (such as oncology) without being an ACNP?

    Thank you in advance for any help that can be thrown in my direction!
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  3. 9 Comments so far...

  4. 1
    NPs are definitely seen in some children's hospitals. I know I have seen them in my clinical experiences, but I think at least some of them had degrees in pediatric acute care, rather than primary care. Depending on your region and types of NP programs available (as well as other types of labor they might use like fellows, PAs, etc.), I think some hospitals allow PNPs to practice in the acute care scope.

    Specific training is out there for those specifically looking to do peds onc at a masters level, though there probably aren't that many...

    http://sklad.cumc.columbia.edu/nursing/programs/onp.php
    http://www.txccc.org/pnp-fellowship/
    http://www.nursing.upenn.edu/academi...il.asp?prid=18
    stupidcancer likes this.
  5. 0
  6. 0
    I think it is entirely possible to work in an H/O clinic as a PNP, but it might be very hard to get a job without H/O RN experience. This is a very popular specialty, so you might want to get RN experience first. Just a thought
  7. 0
    I am a FNP with mainly pediatric experience the last 18 years(over 13 as NP). Currently I work inpatient peds heme/onc covering at night. My coworkers are all PNPs. I love this job!! Now I worked quite a few years in general pediatrics, retail clinics, and ED so I was definitely ready to specialize. I would really recommend that a new NP try some general pediatrics or family practice or even fast track ED for a couple of years before specializing. It just gives you so much variety. Not sure if that helps, just thought I'd share
  8. 0
    This is all excellent advice and also quite reassuring. Thank you! I'd really like to work as an RN before NP even if I have the official PNP credentials. I love the direct-entry program, but I do think it seems vital and incredibly helpful to gain some RN experience before practicing as an NP. Overall, it's great to hear that working as a PNP is entirely possible in the hospital and within specialty clinics.
  9. 2
    I am a PNP in a pediatric hospital and work in urology. I am certified in primary care but the acute care option was not available when I was in school 7 years ago. It is very possible to get a job in a specialty area. I had no prior urology experience but my department was willing to train me. One thing to be wary of with direct entry programs in peds... a lot of pediatric employers want you to have a minimum amount of pediatric experience. With my current job, it was my first one out of grad school but they wanted 5 years of peds experience which I had. Some of my classmates had trouble getting jobs because they did not have any pediatric experience.
    CCRNDiva and shannons1 like this.
  10. 0
    I would consider all my options before making any decisions. If you are truly wanting to end up in an ACUTE CARE setting, then you should persue the ACPNP (acute care) option. This is getting "muddier" every day. This is particularly true when it comes to medical legal issues. More and more nurse practitioners are being named in law suits. If you are put on the stand and a lawyer asks you what is your educational preparation, what would your response be? I recently attended the AANP conference. This was the jest of the discussion. According to the expert panel, your experience as AN RN essentially means nothing, it is your educational preparational as an APN that is curcial. For example, one of my colleagues, who worked in critical care as an RN, obtained his FNP. He began working for a neurosurgeon and was reported to the board of nursing for practicing outside his scope of practice for rounding/caring for patients in the ICU. The board of nursing forbid him from rounding on patient's in the ICU setting. They advised him that further incidences would result in disciplinary action. The expert panel also stated that as time goes on, more and more boards of nursing are putting this into their nurse practice acts. They gave an example of the arizona board of nursing. They essentially said that your experience as an RN nor your supervising physician "signing off" on your orders is acceptable. This is not as articulate as I was hoping but hope it helps. I am an ACNP (adult).
  11. 0
    Quote from rnhunter
    For example, one of my colleagues, who worked in critical care as an RN, obtained his FNP. He began working for a neurosurgeon and was reported to the board of nursing for practicing outside his scope of practice for rounding/caring for patients in the ICU. The board of nursing forbid him from rounding on patient's in the ICU setting. They advised him that further incidences would result in disciplinary action.
    That is really interesting. Do you live in one of the states where the BoN already requires acute care certification to be able to work in acute care?
  12. 0
    Quote from rnsrgr8t
    I am a PNP in a pediatric hospital and work in urology. I am certified in primary care but the acute care option was not available when I was in school 7 years ago. It is very possible to get a job in a specialty area. I had no prior urology experience but my department was willing to train me. One thing to be wary of with direct entry programs in peds... a lot of pediatric employers want you to have a minimum amount of pediatric experience. With my current job, it was my first one out of grad school but they wanted 5 years of peds experience which I had. Some of my classmates had trouble getting jobs because they did not have any pediatric experience.
    This is good to know because some of the schools I am applying to just have a primary care pediatric NP program and I want to do more specialized/critical care work. I too would probably work as an RN for a bit before I work as an NP and preferably in a PICU.


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