FNP vs Acute care NP vs CRNA

Nursing Students NP Students

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Specializes in ICU.

Hello everybody!

I am sure somewhere, somebody asked the same question...so I apologize...I need to make a decision and start planning for applying for a master degree....but I am having a really hard time making a decision! A little about my self: RN BSN, 8 years experience various critical care areas, high GPA, motivated, but...somewhat older 38yo...want to get away from bedside, need a break from the physical part of bedside primary care. I am really, really interested in NP career, but....CRNA comes with almost double the money....sorry I am not greedy...but have o think about, time, effort, and my kids...future...and so on.

I love critical care because it gives me the opportunity of forming a "relationship" with my patients, and their families. I get along with even the most difficult families, demanding and so on....so I believe I could do that while being an NP. I like to help my patients, through education, to take over their health care issues, to become involved and ask pertinent questions...because most of them , at least the less educated ones, become victims of lack of time a physician can offer during visits, or rounds.

In the same time, I do like the critical care part, the"adrenaline rush" to a point...but I am not an adrenaline junkie :uhoh3:. that is why I am having such a hard time deciding...My questions: what path would allow me to build a relationship with my patient but still give me the trill of critical care situation? Does acute care NP differs a lot from FNP? I do not like OB so midwife is out of question. I have not had any Psych experience...so Behav Med does not interests me, do not know how to approach trouble patients or teens.

Any input is appreciated!

Thanks!

Leanne:nurse:

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Specializes in Cardiac, Pulmonary, Anesthesia.

CRNA can build a relationship if you desire. It won't be on the level of an NP, but if you are motivated enough to get a job where you preop and postop evaluate your patients then you can get to know them. FNP will yield almost no "adrenaline" moments, unless you go the emergency NP route and actually make into a main ED, not urgent care. ACNP may yield some moments. CRNA will, of course, have the most exciting moments but with periods of routine.

I really think the decision is based on instant vs delayed gratification. A CRNA will diagnose things quickly in the OR (decrease CO, bronchospasm, etc) or postop (laryngospasm, PE, overdose, abnormal physiology causing drug reaction) and intervene with almost immediate results. If complicated and significant underlying disease process is suspected in preop, they'll refer to the specialty. NP will do the more long term investigation and management.

I like quick results, procedures, and life saving interventions, so I went CRNA. I also choose CRNA because I wanted to take more science classes than offered by NP programs (gross anatomy, 3 pharm classes, medical physiology and a patho course to name a few).

Money isn't bad but either, but I would make that a low priority with the future of healthcare.

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I am curious as to what you decided. Your post sounds like my type of questions, I am really struggling the same question but I am older than you. Would like to know what you chose as a specialty and why? Thanks, MBARN

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Specializes in CTICU.

Based on what you said, I'd think CRNA then ACNP for you. ACNP can look after high acuity patients in critical care if you want, but it sounds like CRNA is a better mix of acuity and career features that you want.

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Specializes in ICU.

Thanks for all the postings! I will pursue the NP route, first family than a post master certification for acute care...that way I can work outpatient or inpatient. I have been thinking a lot about both options, and I believe my choice is also based on my age. I would have definitely chosen CRNA 10 years ago, but now I think NP will give me a better return to my investment:-) I can be working more years in an office seeing patients, and do not have to be "sweating bullets" because of a difficult patient. Also the area I live in is getting saturated with CRNA (only 1 major trauma center)....but is in desperate need of primary care NP. This path will allow me more time with my family, less stressful job, and....less money:-):uhoh3:but money is not the reason I am going to grad school.

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but money is not the reason I am going to grad school.

Good reply! I too was heading in the path of CRNA school and have many friends who took that route they love school, and will most likely love their career. I am proud of them! For me I was looking at the dollar amount (double the money I would make as a FNP) so I am starting a FNP program in a week:yeah:! I am happy for my career choice it will be challenging just as any master degree but I am at peace with my choice. Good luck to you and your family and it will all make sense as you go along!:)

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Great analysis and great reasons for grad school!

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Specializes in Trauma, Emergency, Urgent Care.

If you want the undifferentiated patient consider the FNP. There is plenty of adrenaline in the ED and in rural urgent care settings (especially solo coverage positions). When a patient comes through the door with SVT or significant BSA burns......the adrenaline flows. Follow this with the ACNP as a post-masters certificate. If your goal is ED work, you will probably have an easier time finding a position with the FNP first as few EDs will hire ACNPs who cannot see the entire population.

Oh, and don't lament the money thing too much. Making six figures while only working 12-13 shifts/month if very doable as an ENP.

just 2 cents

good luck

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Specializes in ED/Critical Care/ACLS Instructor/Travel.

I too wish we could fix the problems of the FNP/ACNP programs. Okay maybe not problems, but for those of us who want challenging positions, demanding cases which would probably lead to more money due to more responsibility, and therefore more job satisfaction by the challenge. Why can't ACNP, whether post degree or degree, have more classes like the CRNA tract would have? Why can't the current FNP/ACNP demand more money for the challenge their job creates?

Time and time again I see NPs who work in academic medical centers (where the challenging cases are) who work 9-5, and all they do is scribe for the docs or take care of minimal insignificant tasks that the docs are too busy to do.

Now is your time NPs, in the next five years the government is going to be calling on NPs to step up and NPs should demand more responsibility and reimbursement for that risk. Don't just make it an alternative to and 12 hr 3 day a week career. That ruins it for the rest of us and by the rest of us I mean those with a MSN and without.

Just my two cents.

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I too wish we could fix the problems of the FNP/ACNP programs. Okay maybe not problems, but for those of us who want challenging positions, demanding cases which would probably lead to more money due to more responsibility, and therefore more job satisfaction by the challenge. Why can't ACNP, whether post degree or degree, have more classes like the CRNA tract would have? Why can't the current FNP/ACNP demand more money for the challenge their job creates?

Time and time again I see NPs who work in academic medical centers (where the challenging cases are) who work 9-5, and all they do is scribe for the docs or take care of minimal insignificant tasks that the docs are too busy to do.

Now is your time NPs, in the next five years the government is going to be calling on NPs to step up and NPs should demand more responsibility and reimbursement for that risk. Don't just make it an alternative to and 12 hr 3 day a week career. That ruins it for the rest of us and by the rest of us I mean those with a MSN and without.

Just my two cents.

Agreed, they get no respect and I would like someone to tell me why they get paid less than PA's? Eventhough you can be an NP doing part time to school, it is still 4 years of full time working and part time school and then you only make what you can make as a nurse with some overtime?? Not right. NP's need to get up and fight!

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Out of curiosity, what are the beginning salaries of NP's and also the salaries after about 5 years of experience? Thanks

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Specializes in PICU.

Where I'm at NPs start at $84,000 a year. Experienced RNs and float pool RNs working nights make more than that without overtime. It's sad given the fact that the NPs work way more than 36 hours a week plus they are on call all night.

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