ACNP info

JDCitizen · Jul 19, 2008

Hi, I am a RN and currently work in a neuro trauma ICU. I have wanted to do the FNP degree for awhile and I recently ran on to the ACNP degree. I'm considering going to SLU and doing the ACNP degree with the FNP certificate so that I could work in both practice areas. I've talked to a few people and have heard positives and negatives. I've heard hospitals don't really know what to do with ACNP's and they aren't going to turn over MD responsibilities to a ACNP. But other ppl have told me that ACNP/PA's write orders, do bedside procedures, go to surgery etc. I'm from Missouri and could relocate if necessary but don't really want to HAVE to. I would like to practice as independently as possible. I understand I have to collaborate with MD's and work sometimes closely with them but I don't want to set myself up for wanting a certain form of practice and then not being able to do it.
1. Can anyone out there explain the complete scope of ACNP's.
2. If anyone has gone to SLU can you tell me how class/clinicals are. I'm considering them because I have a previous BS degree in something other than nursing.
3. What are the average compensation packages. Is it hourly, salary, percentage of billings etc.
4. What states are the best to be an ACNP in, for scope of practice etc.
Any other information that you could provide I would really appreciate!

Hope you don't mind if I add some more questions:

1) Clinicals what were they like?

2) What units were your clinicals accomplished in?

3) Preceptors Who / how were they setup with you...

4) Afterwards: Where are you working and what are you doing?

Thanks in advance!

DaisyRN, ACNP · Jul 20, 2008

1. can anyone out there explain the complete scope of acnp's.

honestly, no. scope of practice issues are never a "brief" response... i bought a book on this very subject from aacn. put simply, an acnp is trained to care for acute and chronic complex illness, both inpatient and outpatient in adults. generally speaking, the acnp is trained for an inpatient role. with the acnp program, you do focus on icu-type treatment of patients, but also some not so serious treatment. in my program, we also did a semester of outpatient internal medicine. basically, my program divided each semester by body systems... for example, spring: cardiovascular and endocrine. summer: neurological and respiratory. we focused on each system, in depth. sure we talk about say, diabetes... and we discuss the outpatient mgmt of diabetes, but we go one step further and discuss how to diagnoses/treat diabetic emergencies as well, but we didn't talk a lot about less complex illnesses/conditions like the fnp focuses on. the acnp program just delves deeper into disease management and exacerbations or complications of such.

2. if anyone has gone to slu can you tell me how class/clinicals are. i'm considering them because i have a previous bs degree in something other than nursing.

can't help ya there...

3. what are the average compensation packages. is it hourly, salary, percentage of billings etc.

my base salary is $75k, but after my 6 month "orientation phase," i will be eligible for productivity bonuses every quarter which can be anything from $5000+, depending on what i have billed for the previous quarter.

4. what states are the best to be an acnp in, for scope of practice etc.

i don't know... but texas is great. texas is good for any type of np. we do not have independent practice, but the collaboration/supervision requirement is not very limiting. you still have a lot of independence in decision making, so long as an md is available to you by phone should you need him or her.

5. clinicals what were they like?

first semester: outpatient adult internal medicine, summer: general inpatient (hospitalist role), fall 1 and 2: your choice. for fall 1, i did an inpatient texas dept of criminal justice icu rotation (very sick folks!), for fall 2, i did a cardiology rotation (with most of my hours acquired in the hospital setting, as per required by my program).

6. what units were your clinicals accomplished in?

see above.

7. preceptors who / how were they setup with you...

i set my own up each semester with preceptors i wanted to be with. some facilities do not accommodate these wishes. you have to establish an agreement with the facility and your school, which wasn't a big deal. it was just a piece of paper and something showing how much of an insurance policy the school has for you.

8. afterwards: where are you working and what are you doing?

i am working with a cardiology group doing inpatient and outpatient care. monday-thursday, i am in the hospital from 7:30-10:00 supervising stress tests, then go to the clinic until about 2 or 3 and depending on how many folks my supervising doc has in the hospital, i may either be done at that time or go back to the hospital to help with rounds. on fridays, i do the stress testing and then i help whoever is on call with consults/rounds. on days that my doc is on call, i will often help him with consults that day.

hope this helped...

JDCitizen · Jul 20, 2008

1. can anyone out there explain the complete scope of acnp's.
honestly, no. scope of practice issues are never a "brief" response... i bought a book on this very subject from aacn. put simply, an acnp is trained to care for acute and chronic complex illness, both inpatient and outpatient in adults. generally speaking, the acnp is trained for an inpatient role. with the acnp program, you do focus on icu-type treatment of patients, but also some not so serious treatment. in my program, we also did a semester of outpatient internal medicine. basically, my program divided each semester by body systems... for example, spring: cardiovascular and endocrine. summer: neurological and respiratory. we focused on each system, in depth. sure we talk about say, diabetes... and we discuss the outpatient mgmt of diabetes, but we go one step further and discuss how to diagnoses/treat diabetic emergencies as well, but we didn't talk a lot about less complex illnesses/conditions like the fnp focuses on. the acnp program just delves deeper into disease management and exacerbations or complications of such.
2. if anyone has gone to slu can you tell me how class/clinicals are. i'm considering them because i have a previous bs degree in something other than nursing.
can't help ya there...
3. what are the average compensation packages. is it hourly, salary, percentage of billings etc.
my base salary is $75k, but after my 6 month "orientation phase," i will be eligible for productivity bonuses every quarter which can be anything from $5000+, depending on what i have billed for the previous quarter.
4. what states are the best to be an acnp in, for scope of practice etc.
i don't know... but texas is great. texas is good for any type of np. we do not have independent practice, but the collaboration/supervision requirement is not very limiting. you still have a lot of independence in decision making, so long as an md is available to you by phone should you need him or her.
5. clinicals what were they like?
first semester: outpatient adult internal medicine, summer: general inpatient (hospitalist role), fall 1 and 2: your choice. for fall 1, i did an inpatient texas dept of criminal justice icu rotation (very sick folks!), for fall 2, i did a cardiology rotation (with most of my hours acquired in the hospital setting, as per required by my program).
6. what units were your clinicals accomplished in?
see above.
7. preceptors who / how were they setup with you...
i set my own up each semester with preceptors i wanted to be with. some facilities do not accommodate these wishes. you have to establish an agreement with the facility and your school, which wasn't a big deal. it was just a piece of paper and something showing how much of an insurance policy the school has for you.
8. afterwards: where are you working and what are you doing?
i am working with a cardiology group doing inpatient and outpatient care. monday-thursday, i am in the hospital from 7:30-10:00 supervising stress tests, then go to the clinic until about 2 or 3 and depending on how many folks my supervising doc has in the hospital, i may either be done at that time or go back to the hospital to help with rounds. on fridays, i do the stress testing and then i help whoever is on call with consults/rounds. on days that my doc is on call, i will often help him with consults that day.
hope this helped...

thanks !! :nuke:

ANPFNPGNP · Jul 20, 2008

Hi, I am a RN and currently work in a neuro trauma ICU. I have wanted to do the FNP degree for awhile and I recently ran on to the ACNP degree. I'm considering going to SLU and doing the ACNP degree with the FNP certificate so that I could work in both practice areas. I've talked to a few people and have heard positives and negatives. I've heard hospitals don't really know what to do with ACNP's and they aren't going to turn over MD responsibilities to a ACNP. But other ppl have told me that ACNP/PA's write orders, do bedside procedures, go to surgery etc. I'm from Missouri and could relocate if necessary but don't really want to HAVE to. I would like to practice as independently as possible. I understand I have to collaborate with MD's and work sometimes closely with them but I don't want to set myself up for wanting a certain form of practice and then not being able to do it.
1. Can anyone out there explain the complete scope of ACNP's.
2. If anyone has gone to SLU can you tell me how class/clinicals are. I'm considering them because I have a previous BS degree in something other than nursing.
3. What are the average compensation packages. Is it hourly, salary, percentage of billings etc.
4. What states are the best to be an ACNP in, for scope of practice etc.
Any other information that you could provide I would really appreciate!

As far as pay, there is a job currently available in South Texas for an Acute Care NP a.k.a hospitalist and the pay is 120K per year with no benefits. They have been trying to fill it for a year, so I have a feeling they would pay even more since they're getting desperate. They tried to get a physician to take the job, but couldn't find one who was interested.

I would like to hear what the going rate is for an Acute Care NP. Anyone know the ranges?

ANPFNPGNP · Jul 21, 2008

5. clinicals what were they like?
first semester: outpatient adult internal medicine, summer: general inpatient (hospitalist role), fall 1 and 2: your choice. for fall 1, i did an inpatient texas dept of criminal justice icu rotation (very sick folks!), for fall 2, i did a cardiology rotation (with most of my hours acquired in the hospital setting, as per required by my program).

this is very interesting b/c i had no idea that acnp's ever worked in primary care. in my adult np training i precepted in internal medicine, which is primary care and i had to spend 90 hours in a hospital setting too.

i'm curious about something, are there any fnp's working in your cardiology group? would this be considered "outside their scope of practice," since this obviously isn't considered primary care? i've seen several fnp's working for specialists.

JDCitizen · Jul 21, 2008

This is very interesting b/c I had no idea that ACNP's ever worked in primary care. In my Adult NP training I precepted in Internal Medicine, which IS primary care and I had to spend 90 hours in a hospital setting too.
I'm curious about something, are there any FNP's working in your cardiology group? Would this be considered "outside their scope of practice," since this obviously isn't considered primary care? I've seen several FNP's working for specialists.

Curious question? Who decides what scope of practice is? State, hospital, provider one is working with? I know this could very well vary from state to state that is why I am asking.

dgclough · Jul 22, 2008

:bow:Thanks so much, everyone, for your replies. This helps alot. I had almost decided to do ACNP before getting this reply but this cinches it. I have read up (via all nurses...) about ACNP and SLU and I believe that this program and degree is what I'm looking for!

Thanks again!

dgclough · Jul 22, 2008

DaisyRN, what program did you attend? I really liked the separate body systems per semester idea!

DaisyRN, ACNP · Jul 22, 2008

this is very interesting b/c i had no idea that acnp's ever worked in primary care. in my adult np training i precepted in internal medicine, which is primary care and i had to spend 90 hours in a hospital setting too.
i'm curious about something, are there any fnp's working in your cardiology group? would this be considered "outside their scope of practice," since this obviously isn't considered primary care? i've seen several fnp's working for specialists.

yea, we did 180 something clinical hours in each setting... including the im outpt. i don't know that all acnp programs require the adult im rotation, but i would think so because its a basis for building basic assessment skills. this is something that could be looked at online, i'm sure.

and no, there are no fnps in our group. there is a pa that just started and an anp with our other partners. as for out of their scope, i would think it would be okay as long as they weren't in the hospital... which you and i have talked about in other threads. honestly, i do not think that fnps receive the in depth focus of complicated htn, hf that we treat in the clinic in their programs... but i could be wrong. and no... i am not saying that an fnp cannot treat htn... i just mean our complicated cases that are referred to us from primary care providers, which makes up quite a bit of our referral patient base. also, there is a lot of triaging involved in my position... what i mean is triaging those that are sick and those that are not. i've learned that even in my program, there is much more to learn about seemingly simple problems, i.e. htn/hf, that we did not discuss. so i would find it difficult for an fnp to be in our group... but it would be possible for a driven fnp to learn these things for him/herself.

DaisyRN, ACNP · Jul 22, 2008

daisyrn, what program did you attend? i really liked the separate body systems per semester idea!

i went to the university of texas medical branch in galveston, tx. hook 'em!

DaisyRN, ACNP · Jul 22, 2008

curious question? who decides what scope of practice is? state, hospital, provider one is working with? i know this could very well vary from state to state that is why i am asking.

1. the state board of nursing determines general scope for apns... and will say that you must stay within your scope of practice, per your certification, but i've had a hard time finding any specific scope info on the texas bon site... other organizations also discuss certification scopes, i.e. aacn, ancc

2. the hospital determines what they will allow you to be credentialed to do, regardless of what you are "legally" able to do

3. the provider/supervising md and you discuss which tasks are to be delegated to you in your protocol (what we call it in texas)... while staying within the boundaries of scope of practice and what you are credentialed to do at the hospital.

that help?