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Discussion

ACNP Question

Hello,

I am at The University of Southern Indiana. I am currently in the FNP track but my desire is to be an ACNP. I have 5 years of ER experience but do not have any ICU or ventilator experience. I have not put in a intubation tube or chest tube etc. Would I be totally overwhelmed in the ACNP world? I find myself bored with the FNP track as I have always been in the ER. I am worried that I would be expected to already be at the level of knowledge of an ICU nurse who has the vent/and other CC knowledge of lines and tubes.

Thank you so much for any input!

Cindy

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    Umm the ER or ICU nurses in my hospital don't intubate or put in chest tubes. That is a very rare skill for an RN

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    Umm the ER or ICU nurses in my hospital don't intubate or put in chest tubes. That is a very rare skill for an RN

    I agree. Sounds out of scope for RN's for most states.

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    I am an ACNP student and we have a mixture of both ER and ICU students in our class. We have SIM lab where we are taught A-lines, CVLs, chest tubes, suturing etc., and an Airway lab and rotation for intubations. If we're lucky depending on our rotation some get to practice putting in lines, etc. I find that some subject matters are easier for ER nurses and others are easier for ICU nurses. If you are in a good program they will teach you what you need to know so you can be proficient in either area you decide to work in. Follow your gut. I knew I didn't want to be an FNP and am glad I took the Acute care route.

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    i agree, if you know you want to do icu, do acnp. otherwise do fnp. I have to admit patients into the icu quite often but i cannot put in lines, cvl, intubate, etc. er doc has to come up to do that or pt has to wait till the morning when PULM/CCU rounds. unless its very very emergent.

    as an fnp we don't get the training to do icu. my supervising physician took her time to train me to do icu stuff like drips, vent settings, etc, and i remembered some from my rotations in icu as an rn. but lines and stuff, i cannot do.

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    • Author

    Thank you for all your thoughts! I believe I would like to continue in the ER as a nurse practitioner or work as a hospitalist. We have a residency program here that is highly competitive that is a hospitalist for NPs. They used to take FNPs but now are requesting ACNPs. I do not want to work in ICU or do ICU things. I really do not like the ICU. I love the ER and anything heart related.

    Do you believe if I did the FNP track that I could be in the ER or a hospitalist??

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    This is why I am against the main theme of this board that EVERYONE should become an FNP. Anyone on here who asks whether they should go FNP or ACNP is told to do FNP for better "flexibility", then ends up upset that they didn't learn acute skills needed to work inpatient. If you're desire is to do inpatient work, please become an ACNP!

    To OP: Maybe you can do a post masters cert in ACNP if that is your desire?

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    Thank you for all your thoughts! I believe I would like to continue in the ER as a nurse practitioner or work as a hospitalist. We have a residency program here that is highly competitive that is a hospitalist for NPs. They used to take FNPs but now are requesting ACNPs. I do not want to work in ICU or do ICU things. I really do not like the ICU. I love the ER and anything heart related. Do you believe if I did the FNP track that I could be in the ER or a hospitalist??

    I believe there is at least one program that is designed for those who want to work in an ER, I don't recall which school has that program, but a search of the board would probably lead you to it.

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    • Author

    Thanks zmansc. I am not able to relocate. I wish I could go to a ER NP program. :)

    BTW, I went to ungrad at UNM. I see you are from NM.

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    Thank you for all your thoughts! I believe I would like to continue in the ER as a nurse practitioner or work as a hospitalist. We have a residency program here that is highly competitive that is a hospitalist for NPs. They used to take FNPs but now are requesting ACNPs. I do not want to work in ICU or do ICU things. I really do not like the ICU. I love the ER and anything heart related.

    Do you believe if I did the FNP track that I could be in the ER or a hospitalist??

    The fact that you said the local residency program for NP's in Hospitalist Medicine now require ACNP makes me suspect an underlying BON restriction to FNP working in a Hospitalist-type of role in your state. The other explanation could be institutional policy. You should clarify this and find out which is the case to better plan your strategy.

    In my opinion, ACNP's are poised better for assuming Hospitalist-type roles because that's exactly the kind of training you get in such a program. However, the field is split into adult and peds so there is a restrictional boundaries that must be maintained. It also does not mean FNP's could not be trained on the job for the role barring any BON or institutional restriction preventing that from happening.

    Your experience as an RN is in ER. I think you have an edge as far as securing ER jobs as an NP in the future because of your experience. However, bear in mind that unless you go to big urban centers, the majority of ED's would want an NP to see patients of all ages. This is why many recommend FNP if you plan on working in the ED as an NP. True, you don't learn acute care skills (intubations, lines, chest tubes) but some NP's in ED's work in lower acuity areas in the ED so those skillsets are not necessarily helpful.

    BTW, I'm an Adult ACNP working in Adult Critical Care for what it's worth.

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