Where can FNP's work?

[Catch22Personified]

I work at a small ER and we a have a few NP's that take primarily fast track patients and the occasional patient where the ESI is 3, I don't think they ever take the critical patients. I talked to an admissions person at one of the schools and told me that FNP's do not work in the hospital setting and are primarily for outpatient. So I guess my question is, if I decide to go to the family route I cannot work in a hospital as an NP at all?

[BostonFNP, APRN]

Depends on the state and the facility.

If you only want to work as a Hospitalist/Intensivist then the ACNP specially is a better fit for you.

The FNP speciality is designed primarily as a outpatient practitioner. Many FNPs do work in the hospital (including me) but the focus on training in FNP speciality is not inpatient care. You can also post-master in acute care in addition to your FNP.

Sent from my iPhone.

[ryguyRN]

Just like Boston mentioned the FNP IS a primary care specialty but they have been known to fill in the gap in ERs and other areas. Urgent care is common place to see the FNP because they see kids and adults. I plan to do a NP ER fellowship after I graduate it is a year long ER specific training and to gain experience working independently as well as with a mentor. And I plan to pursue a DNP in Acute Care.

[hopefulwhoop]

You can work in the hospital as an FNP. I am an FNP and work in a surgical specialty in the hospital. I do think tbat FNPs are not the ideal choice for this position and that this position is better suited for an ACNP, but I'm learning as much as I can on the job. It also helps that I work at an academic institution with excellent PAs and surgeons who provide a great deal of teaching.

[canchaser, BSN, RN]

Ryguy, which fellowship are you looking at?

[f3rr0]

Yes, you can. As mentioned earlier FNP is designed to practice in primary care settings. However, it varies between facilities and states.

[Riburn3, BSN, MSN, APRN, NP]

You will find FNPs working in ERs all over the country because of their ability to see all patient populations and perform minor procedures like suturing and abscess I&D. Like you said, it will usually be fast track patients and ESI 3. Basically what you would be doing in an urgent care.

Each state will have different rules and practice cultures on where an FNP is typically seen and what they do.

[zmansc, ASN, RN]

My local hospital has had NP/PA providers 12hr/day and physician providers 24hr/day. All of the NPs are FNPs, they looked into hiring an ACNP and didn't. I know the age limit was an issue, but I think other issues precluded the hiring.

Each provider sees what they are competent to see. In other words, the providers decide among themselves who will see what patient. Some physician providers want to see all L1 & L2 pts, others who know the capabilities of the non-physician provider they are assigned to work with on that day will more equally split the load. We have been very lucky to have some excellent non-physician providers that the physicians feel more than comfortable handing off L1 & L2 pts to. Also, when you have two providers and two L1 pts come in at the same time, well, that's the way it goes!

We do operate a quasi fasttrack during the hours when we have two providers. The non-physician provider takes the majority of the fasttrack pts who are all L4-L5. The non-physician provider also takes a good mix of the L3. Some pairings the non-physician provider is 2-3x faster than the physician, and other pairings it is the exact opposite, just depends on the providers on that particular day. So assignments are really done on a who is capable and available basis more than a particular title.

A new provider group is going to take over, and they have plans to change this, but from what I understand they will be expanding the non-physician providers to 24x7, and from talking to the CEO of the group, I think they will be sharing the workload in much the same way. He mentioned that this is how he runs all of the ERs they are the provider group for. They have ERs in TX, NM, AZ, CO, and probably other states too, so I would assume he believes it's legal to have FNPs work in that condition in each of those states, but if I was going to do it, I would check with a lawyer, the BON, or some higher authority just to make sure I was on the right side of the law.

[traumaRUs, MSN, APRN]

And don't forget the ever present (and encroaching) ANCC Consensus Model:

APRN Consensus Model

[ryguyRN]

canchaser, Carilion Clinic in Roanoke, VA has a NP/PA Emergency medicine fellowship, I am familiar with the area and interested in moving back.

[AZ-RN]

And don't forget the ever present (and encroaching) ANCC Consensus Model:

APRN Consensus Model

Thanks for posting that, hadn't been to that site in a while. I am in a similar boat as the OP, my ER's provider group uses FNP's and PA's for less acute patients, but the rest of the hospital hasn't quite made a decision on what roles they want NP's performing in the acute setting. I still think an FNP degree is a great way to go because you can practice across the spectrum, but after graduation a post masters in acute care may be a good option to slowly work towards.