I am a veteran ED nurse leader. I am an assistant manager in my department, a CEN, a former paramedic, (prior to becoming an RN) and have extensive specialty training in trauma, etc. I am an instructor.educator for all the "normal" critical care stuff, like ACLS, PALS, TNCC, and so forth. I am 28 years old, and have decided that I will never get any further than my current level without going back to school. I have been contemplating pursuing training as an NP.
I realize that the answer to this question may vary from state to state, and thus answers to it here may not be entirely accurate to my specific situation. Still, I am interested in hearing what people have to share. From my experience, most nurse practitioner training declares that the candidate will be trained as an FNP, or "family" nurse practitioner. As you can probably assume from the above paragraph, the last thing I ever want to be is somebody's primary care provider. I have looked up the PA programs in my area, and some of them offer a specialty in Emergency Medicine. The only NP programs in this area are so called "FNP" programs. Will these programs limit me to practice in primary care settings?
I have also had in the back of my mind the notion that I may want to get involved in some sort of surgical field. Ortho, plastics, trauma surg, general surg, etc all hold a certain appeal to me as well. If this is a field I were looking to enter, would that be possible for me as an NP? Are there some things that are "PA only?" I have read in lots of places that "an NP can do more" but I'm not entirely sure what that actually means with regards to scope of practice and career path. I have many PA friends who have explained the versatility of the PA role to me but, sadly, I have no NP friends to ask for the other side of the story.
Any help would be much appreciated.
Thanks very much!
There are a few NP programs that prepare for the NP for trauma or ER work. University of Maryland, Loyola University Chicago, Vanderbilt, University of South Alabama to name a few. I think the time of "a FNP can do anything" is ending. A number of the admission counselors I spoke with were very specific when ascertaining career goals and pairing them with prospective programs. They are not allowing FNPs to take inpatient clinicals and they are not provided training in acute care unless they are enrolled in a dual program. I know that one of my former coworkers approached our intensivists about a NP job when she completed her FNP but they would not hire her because they felt she did not have the appropriate training although she had years of ICU nursing experience.
I don't think it is as easy to get certified as a critical care NP as was implied. An ANP may be able to get a CCRN certification but must be able to provide proof of current critical care nursing experience. I'm pretty sure one must complete an ACNP program (either MSN, post-masters, DNP) to obtain an ACNP certification.
I work in a level II trauma center and trauma services just hired an ACNP who is a Rush grad. She has a couple of yrs experience and has definitely hit the ground running. I know she was hired over FNPs with critical care nursing experience (even one who had worked in our unit) because of her training in acute care. She rounds on all of our trauma pts. Most of our involved peds trauma cases are transferred out since were are certified in peds trauma as we don't have a peds surgeon so her lack of peds training is not an issue. One of my friends is a NP and works with an ortho group in the OR as 1st assist. He worked with them prior to his FNP program so they were willing to hire him as their NP/1st assist. Our cardiothoracic surgeons all have PAs that round on pts and 1st assist in OR (I'm not sure if they are open to using a NP, I'll have to check). I also know of another recent FNP who did clinicals with an ortho doc. He used her clinical time train her as 1st assist and post op evaluation with the intent of hiring her as his NP/1st assist after graduation. Most of the recent FNP grads in our area have been offered outpatient positions.
I chose an ACNP program because like you, I don't have any desire to provide primary care and I don't want bust my butt completing a master's to learn primary care either (no offense to those who have chosen to do so). I want to work in critical care or trauma services after graduation. I think the ACNP will better prepare me for those roles. I wish there were combined adult/peds ACNP programs out there because I definitely would've signed up for it! Maybe I will complete a post masters in Peds acute care later on. My advice would be to seek the education that will best prepare you for your career goals. I don't see how a FNP would do that.
Last edit by CCRNDiva on Aug 27, '11