Considering career as NP

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Hey all! I'm an RN currently working in specialized cardiac hospital on tele/step down unit. I've been an RN for almost 2 years now. I'm considering making a career move as an NP in the next couple of years before it changes over to a doctoral degree. I'm just having difficulty deciding what specialty to go with. I know for a fact I don't want family practice unless I deal with adults only, I have no interest in dealing with children at all and don't have any experience with it anyway. I have no experience working in ER or ICU, but these areas definitely appeal to me. I'm thinking of maybe going with the acute care program just because it seems like there would be several options. I don't know that I'd want to be a full blown ER NP, that just seems stressful, but an Urgent Care Center seems like it would be a good place to work. Basically I'm just wondering what your job options are for the different specialties, particularly the Adult NP vs Acute Care NP. I have no interest in women's care or peds.

I love working in an acute setting as an RN, but am not sure if I want to be the one calling the shots necessarily, so that's the only thing about working in the hospital setting as an NP that doesn't appeal to me. Maybe I just need to not be afraid and limit my abilities so much. So NP's just explain your different roles that you do and the specialty that you went with.

Specializes in Med-Surg, Telemetry, Oncology.
Just a word of warning to you. If you go through UTA's FNP program you will NOT be prepared to work in an ER or in a hospital. You CAN do that, but you will not be clinically prepared to do it and I would HIGHLY caution against it.

WOW. ! I didn't know this about UTA's FNP program. POINT WELL TAKEN. I'm glad I do NOT want to work in a hospital or ER. But this is good to know for all for those wanting to be FNPs & work in the hospital & are looking for schools.

So were all your clinicals at UTA in clinics? Why do u say you will not be clinically prepared?

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WOW. ! I didn't know this about UTA's FNP program. POINT WELL TAKEN. I'm glad I do NOT want to work in a hospital or ER. But this is good to know for all for those wanting to be FNPs & work in the hospital & are looking for schools.

So were all your clinicals at UTA in clinics? Why do u say you will not be clinically prepared?

I would imagine the same is true for TWU as well. FNPs are trained for outpatient clinical care, prevention, etc. We did not have classes in all of the flashy procedures that some want to do. If you want to work in a hospital, do Acute Care. They are well trained and have a great clinical mix IN the hospitals.

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Specializes in critical care.
I would imagine the same is true for TWU as well. FNPs are trained for outpatient clinical care, prevention, etc. We did not have classes in all of the flashy procedures that some want to do. If you want to work in a hospital, do Acute Care. They are well trained and have a great clinical mix IN the hospitals.

Are you talking about Texas schools? I thought I read that in Texas, ACNP was required for NPs in the ER. Don't quote me on that, but it would explain why those schools don't prepare FNPs for the hospital setting. It seems that in other states, FNP is in fact preferred for the ER setting because they can see kids under 13, but Texas is a different story.

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Specializes in FNP-C.
Are you talking about Texas schools? I thought I read that in Texas, ACNP was required for NPs in the ER. Don't quote me on that, but it would explain why those schools don't prepare FNPs for the hospital setting. It seems that in other states, FNP is in fact preferred for the ER setting because they can see kids under 13, but Texas is a different story.

Not to demean any program but it may because of differing state laws, BON rules, etc. In Hawaii, FNP can be trained while in school to work in EDs provided they got enough training in primary care and met requirements to gain adequate credits in primary care...not sure how much that is. An ICU nurse (5 years experienced) trained to be an FNP and is now an intensivist in her unit and she was trained pretty well with the CC/MDA fellows and attendings. She does almost everything they do except major invasive procedures. This may be due to the face that physicians pay such a ridiculous malpractice premium and they usually leave the state to go mainland. Plus cost of living here is ridiculous compared to other states. That's Hawaii for you...it's all about da life style braddah!

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Specializes in ICU, ER, OR, FNP.
...trained to be an fnp and is now an intensivist

wow. note to self - stay healthy if vacationing in hawaii. i was trained as an fnp, but maybe i'll be a cardiothoracic surgeon instead or a pulmonologist; depends on which tie i pick that day.

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Specializes in Family NP, OB Nursing.
wow. note to self - stay healthy if vacationing in hawaii. i was trained as an fnp, but maybe i'll be a cardiothoracic surgeon instead or a pulmonologist; depends on which tie i pick that day.

ok, that made me :lol2: :lol2: :lol2:!

i agree with your wow. i work in ohio and the bon has made a few statements about the fnp role in inpatient medicine. they haven't officially stated that fnps can't work in certain areas, but they did say that the hospital and the np must be careful that practice does not exceed role. in other words, if something happens and the bon feels it is the result of the np exceeding training/role, the bon can hand out discipline.

when the statements were made, many hospitals that had fnps working in icus, as hospitalists and other specialized areas decided that those nps needed to either find other positions or add acute care certification. fnps still work in ers, and depending on the hospital can still admit/treat their own patients, but for icu or specialized units most hospitals have gone to acnp...which is who should be working in those areas in my opinion.

my training covered primary care, sure my rn experience is in ob, but that doesn't mean i can deliver babies. just because you're an fnp with icu experience doesn't mean you should care for critically ill icu patients as an np.

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Specializes in Nephrology, Cardiology, ER, ICU.

And...when you are looking at being credentialed at hospitals, aren't they all asking for a list of specific training that you have undertaken/been provided to you for these invasive procedures? We also have to have check offs completed with date/initials of pts, signature of attending, etc., prior to us being allowed to do invasive procedures.

I'm credentialed at multiple hospitals and this is the case in all of them.

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Specializes in FNP-C.

Just got clarification about that FNP in the icu. She also got the ACNP cert soon after the FNP through a postmasters option at a school in the mainland... Which makes sense.

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CRF250Xpert, can you clarify your "Adult is going to disappear" comment? If A-NP is going to disappear, whats going to happen to those with this degree?

Thanks in advance for your comments!

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Specializes in Emergency, MCCU, Surgical/ENT, Hep Trans.

What? ANP's disappear? oh me, hope not! I've just begun to have a blast, and now...I'm going to disappear!!! Yikes, don't tell my wife :lol2:

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I think, more probably, Geriatric will dissapear and be consumed within Adult. At least that's what is happening at UCSF - there getting rid of their geriatric degree and lumping it into the Adult curriculum.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
I think, more probably, Geriatric will dissapear and be consumed within Adult. At least that's what is happening at UCSF - there getting rid of their geriatric degree and lumping it into the Adult curriculum.

That's not just UCSF. It's a trend that is being mandated by the Consensus Model which is endorsed by all the NP groups and the state boards of nursing. By 2015 all Gero tracks will be merged with all the Adult tracks and will result in a combined certification process.

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