Accepted to FNP program but having change of heart

[phoenixrn]

Greetings APNs! I could really use your advice.

I was just accepted into an FNP program at a well-respected four year university. It will be dirt cheap (subsidized in-state tuition, employer tuition assistance), part time over 3 years so I can continue working and supporting MY kid who is also college bound, and mostly online coursework, although the university is within 30 miles of my home for on campus seminars and such.

Sound absolutely perfect, right?

Here's the thing.... I'm currently working in an Burn ICU and I absolutely love this specialty. I'm thinking that I'm not ready to leave acute care yet, and might be more inspired by an ACNP track. I'd love to work as an APN in burn care. We don't have PAs or APNs in my burn unit, and I can see the desperate need for them (Surgeons and the facility can't agree on who would pay for them). Other burn units have APNs, and it seems like they'll take any APN who at least has a critical care background of some sort. So an MSN-FNP might be enough to achieve that goal since I have direct experience as a bedside RN in the ICB.

... but then I think about time spent on clinicals, research projects, academic rigor, etc...... and then I wonder again if I should just shoot for the stars and get more critical care and trauma training while pursuing a masters degree.

Another option: do the FNP track, then do a post-masters certificate for ACNP.

Advice is greatly appreciated!!

[Dodongo, APRN, NP]

If you search yourself and find there is absolutely no desire to work primary care, skip the FNP and do the ACNP. I knew I wanted to learn inpatient/critical care/specialty practice. I would rather stay a RN than work in primary care. If your goal is to work inpatient at all, especially ICU, then do the ACNP.

I think people are sometimes fooled a bit by thinking FNPs have so much laterality, that they forget the training is vastly differently. I have friends in FNP programs and the things they are learning and doing are very different.

Think of it this way an FNP can work in peds, can work inpatient, can work women's health. But a PNP is preferred for peds. An ACNP is preferred for inpatient. A WHNP is preferred for women's health. It's a jack of all trades, master of none situation.

[WestCoastSunRN, MSN, CNS]

Pheonixrn,

I could have written your post! I have worked ICU for years but recently went into burns. I, too, am really loving it. I, too, have been accepted to an FNP program that I, too, am now questioning. We see peds in our unit and we do both ICU and step-down. Before I got this job I was sure I wanted to do FNP, but now... I'm really conflicted. I think about not only how I like the burn specialty, but also how I like my 12 hour shifts. I like the flexibility. I like having a life outside of work (because burns is hard work). I do like school... but I like not being in school, too! I like being a critical care nurse and there is still lots of ways for me to grow in just that. I thought about how it would be so cool to be an APN in a burn unit like mine... but I don't know what would be more appropriate... FNP or ACNP. You have to be able to see pediatric patients AND adults. but it's acute care. I can imagine competency with line placements and such would be important.... FNPs don't get that (but a surgeon could train them). And yes, the medicine is different.... but honestly, burns is such a narrow niche, that no one is really prepared for it, provider wise, until they start doing it.

So I'm no help, but thought I would share that I'm in a similar spot as you. And also to say, yeah... burns is a great specialty. I wish I would have gotten into it earlier.

[birdie22]

I dont think there is one track that is the "right track". Whichever one you do is the choice for you. Im currently in an ACNP program and self doubting my choice often. Like you mentioned, you can do a post-cert in ACNP or you could also go for the ACNP and then do a FNP post-cert. Personally, I think the schools have WAY to much stake in the education game for NPs and control so much politically in terms of limiting NPs practices to locations. PAs go for one standard degree and can practice in any location, why do NPs have to specialize? Its limiting in my opinion. How is one supposed to know the exact place they want to work for the next 30+ years?

[BirkieGirl]

I too have struggled with the right choice for my future. it's a hard choice. I guess one factor that COULD be considered is whether your facility will hire FNPs for acute care. SOME will. The hospital that I work at hires FNP grads for their ED, CCU on a consistent basis because there are no adult programs around. The FNPs do a great job. That may help you to decide. Whatever you decide, good luck.

[phoenixrn]

Well hello my fellow burn nurse!! We certainly are in a niche, aren't we? You either love our specialty.... or you don't touch it with a ten foot pole.

[phoenixrn]

Update: I've accepted my admission. It's a State school (hella cheap tuition, and my facility will pay a chunk of it). Mostly online classes, but driving distance for on campus seminars and orientations. Part time track for me to chip away over the next 3 years. Well respected University. I'll be working on my Masters, working on getting my CCRN, and maybe floating around to some new ICU specialities to round out my experience. After the 3 years are up.... I'll probably know more about what direction to go in.