ACNP or DNP?

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Specializes in Trauma and Acute Care Surgery.

Hello everyone!

I'm a senior nursing student in NY pursuing my BSN.

It has been a dream of mine to be involved with the Operating Room team and surgery.

I have the intention of applying for a graduate program in efforts to become a Nurse Practitioner.

This may be a really dumb question, but I would like to know which degree is the highest in terms of educational ladder?

--Is a ACNP higher than a DNP? *Or* Is a DNP higher than a ACNP?

--Which degree can be more involved in the surgical environment?

--Which degree allows easy movement between specialties, and more autonomy? *(I ask this because I also love Hematology/Oncology and would eventually like to work with the Pediatric patient population).

Thank you :-)

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Specializes in CCU, SICU, CVICU.

ACNP is not a degree so much as a concentration. DNP is a Doctoral degree as opposed to an MSN, Masters of Science in Nursing. DNP ranks higher than an MSN, and many MSN programs are transitioning to DNP programs. You can graduate with a DNP and become an ACNP, if that makes sense.

ACNP isn't really going to benefit you at all for OR nursing; I have never heard of an OR NP. ACNPs CAN work with post-operative patients in acute care, which may interest you. You may also want to look into an RNFA (First Assist). But in terms of degree, the NP portion is more of the concentration and not the actual degree. You're better off asking yourself MSN vs DNP.

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Specializes in Trauma and Acute Care Surgery.

Cvepo, thank you for your informative reply! A lot of the faculty at my college are pushing for DNP, so it sounds like I would attend a DNP program and become a DNP, afterwards I would be able to certify as an ACNP. I'm very interested in Surgical ICUs, and post-op care. As you stated, an option for me if I wanted to go into the O.R. could be training for my RNFA; it looks like something I would want to do. Thank you again!

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If your goal is to work in the OR then you should get an ACNP (whether at the master's level or doctorate) and the RNFA certificate to go along with it. The hospital system I work for, and the surgeons I know and talked to, unanimously agreed this was their preferable educational preparation. I am currently pursuing exactly this with the end goal of working on a surgical service both in the OR and pre-post op. You can PM me if you want more info.

If, however, you want to work with peds you'll need the FNP or PNP degree as ACNP can only see 13 and above. The FNP, especially at larger academic institutions, is not as valuable for inpatient work as ACNP. This is a whole separate conversation as what preparation should work in what environment, etc.

Alternatively you can go to PA school and do whatever you want with one degree...

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Specializes in Hospitalist Medicine.

Here's a link to UAB's RNFA program: UAB - School of Nursing - Adult Gerontology Nurse Practitioner - Registered Nurse First Assist

You would do this as a sub-specialty while obtaining your master's in either FNP, ACNP or AGNP.

As far as working in the OR, I've seen both ACNPs and FNPs. The vast majority are ACNPs (work with the trauma & cardiovascular surgery teams). I've seen a few FNPs, but they are more with general surgery. I see way more PAs in the OR than NPs. Might be a better path for you if you only want to do OR.

As far as DNP, it is not a requirement. Just like "everyone is going to need a BSN by 2015" (yeah, didn't happen), so they are pushing for the DNP. It is simply a terminal degree. Up to you whether you want to pursue it or not. Right now, it's not a requirement.

Have you given any thought to becoming a CRNA (nurse anesthetist)?

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Specializes in Trauma and Acute Care Surgery.
If your goal is to work in the OR then you should get an ACNP (whether at the master's level or doctorate) and the RNFA certificate to go along with it. The hospital system I work for, and the surgeons I know and talked to, unanimously agreed this was their preferable educational preparation. I am currently pursuing exactly this with the end goal of working on a surgical service both in the OR and pre-post op. You can PM me if you want more info.

If, however, you want to work with peds you'll need the FNP or PNP degree as ACNP can only see 13 and above. The FNP, especially at larger academic institutions, is not as valuable for inpatient work as ACNP. This is a whole separate conversation as what preparation should work in what environment, etc.

Alternatively you can go to PA school and do whatever you want with one degree...

Thank you! That is a great plan; sounds like that is what I would want to do. Thank you for that advice! Also, I would like to change to pediatrics at another time - as you said, I would need my FNP. Would it make sense to get my DNP as an FNP; certify in ACNP, and have both under my belt?

*PA school could be an option, but I really admire the nursing model of healthcare, being an NP is my true goal; as I intend on opening my own family practice waaaaaayyy down the road in the future.

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Specializes in Trauma and Acute Care Surgery.
Here's a link to UAB's RNFA program: UAB - School of Nursing - Adult Gerontology Nurse Practitioner - Registered Nurse First Assist

You would do this as a sub-specialty while obtaining your master's in either FNP, ACNP or AGNP.

As far as working in the OR, I've seen both ACNPs and FNPs. The vast majority are ACNPs (work with the trauma & cardiovascular surgery teams). I've seen a few FNPs, but they are more with general surgery. I see way more PAs in the OR than NPs. Might be a better path for you if you only want to do OR.

As far as DNP, it is not a requirement. Just like "everyone is going to need a BSN by 2015" (yeah, didn't happen), so they are pushing for the DNP. It is simply a terminal degree. Up to you whether you want to pursue it or not. Right now, it's not a requirement.

Have you given any thought to becoming a CRNA (nurse anesthetist)?

Thank you for the link and your reply! Very informative. Cardiovascular is where I can really see myself thriving - as you said, ACNP is the way to go then. I feel like having my ACNP will really gain the team's trust in a hospital setting since ACNP are focused on how to act on acute situations.

As far as DNP goes, working in NYC, I feel like having that degree under my belt would be a safe bet. There is so much competition in NYC, and they all want, "The 'best educated' nurse." - Which I never really understood because I've met plenty of diploma nurses that were 1,000 times better than some BS Nurses. Having my DNP would allow me to learn "everything" and give me the job security that I would need.

But you are absolutely right, I see plenty of new hires that are RNs and not BSNs.

Also, about the CRNA; I'm curious about it - but I do not think that I would thrive as one. I feel that CRNA provides little hands on with patients. I like to interact and be very hands on with everything, and could not imagine being restricted to the head of the bed with the Anesthesia. (If that is even remotely close to what it is like being a CRNA). I just don't know enough about it.

Thank you again! :-)

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Specializes in Trauma and Acute Care Surgery.

@SopranoKris, BSN, RN

Thank you for the link and your reply! Very informative. Cardiovascular is where I can really see myself thriving - as you said, ACNP is the way to go then. I feel like having my ACNP will really gain the team's trust in a hospital setting since ACNP are focused on how to act on acute situations.

As far as DNP goes, working in NYC, I feel like having that degree under my belt would be a safe bet. There is so much competition in NYC, and the hospitals all want, "The 'best educated' nurse." - Which I never really understood because I've met plenty of diploma nurses that were 1,000 times better than some BS Nurses. Having my DNP would allow me to learn quench my thirst for knowledge and give me the job security that I would need.

But you are absolutely right, I see plenty of new hires that are RNs and not BSNs(I feel like it's just held in front of our faces to intimidate some nurses) lol.

Also, about the CRNA; I'm curious about it - but I do not think that I would thrive as one. I feel that CRNA provides little hands on with patients. I like to interact and be very hands on with everything, and could not imagine being restricted to the head of the bed with the Anesthesia. (If that is even remotely close to what it is like being a CRNA). I just don't know enough about it.

Thank you again! :-)

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Specializes in Hospitalist Medicine.
@SopranoKris, BSN, RN

Thank you for the link and your reply! Very informative. Cardiovascular is where I can really see myself thriving - as you said, ACNP is the way to go then. I feel like having my ACNP will really gain the team's trust in a hospital setting since ACNP are focused on how to act on acute situations.

As far as DNP goes, working in NYC, I feel like having that degree under my belt would be a safe bet. There is so much competition in NYC, and the hospitals all want, "The 'best educated' nurse." - Which I never really understood because I've met plenty of diploma nurses that were 1,000 times better than some BS Nurses. Having my DNP would allow me to learn quench my thirst for knowledge and give me the job security that I would need.

But you are absolutely right, I see plenty of new hires that are RNs and not BSNs(I feel like it's just held in front of our faces to intimidate some nurses) lol.

Also, about the CRNA; I'm curious about it - but I do not think that I would thrive as one. I feel that CRNA provides little hands on with patients. I like to interact and be very hands on with everything, and could not imagine being restricted to the head of the bed with the Anesthesia. (If that is even remotely close to what it is like being a CRNA). I just don't know enough about it.

Thank you again! :-)

Being a CRNA is more involved with patients than simply being at the head of the bed with Anesthesia. You also do emergent intubations during codes, among other things. Research the field to learn more.

As far as DNP, it doesn't give you any more clinical experience than the master's. All you're doing by earning the DNP is a scholarly project. So, if it's important to you to have a terminal degree, feel free to pursue it. However, it is not the end-all be-all they make it out to be when you're in school.

Most hospitals care about your experience as a practitioner. Having a DNP is simply a nice feather in your cap. Up to you to decide if adding an extra year of school to do a research project is going to make you a better practitioner. There's no added job security gained from simply getting a DNP vs. having the master's degree as a practitioner.

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