ACNP vs FNP advice needed.

[Telenurse1990]

Hello, all!

I am currently in a dilemma. I have recently applied for FNP school and am set to interview next week. I have 4 years of ICU and about 9 years total of nursing experience. I wanted to originally go for my ACNP due to my more recent experience in ICU. I love the ICU setting and would love to continue on that path.

I also, however, would like to learn how to work outpatient. I love the idea of being able to do BOTH and not limit myself to one setting. My eventual goal is to do LOCUMS because I loved being a travel RN and I feel that I would love to do LOCUMs as an NP (after a few years of experience) so I figured FNP would be the better route.

I have considered CRNA, but after witnessing the actual job, I would be doing it for the wrong reasons. I have no desire to work in anesthesia.

So, what should I do? I was considering FNP and then a post masters in ACNP, but based on my research there aren't too many programs out there that offer that. Then the discussion of an oversaturated market scares me. I see people who go straight through nursing school into NP school, which annoys me to no end, but what can you do?

Anyways, any and all advice is appreciated!

[NICUmiiki, DNP, NP]

As more and more states move to the consensus model, you'll find that FNP isn't the "work anywhere" option it used to be. My state has fully implemented it and has specifically mentioned that hospital acute care is outside the scope and training of FNPs and on the job training isn't appropriate. So while I don't know the rules of your state, things are moving in that direction. I'd urge you to pursue ACAGNP if you want to remain in the ICU. You'll also find yourself better prepared for it vs. FNP where you'll only learn primary care.

For future planning, if you eventually get tired of the 24 hour nature of hospital/intensive medicine, ACAGNPs can work in specialty clinics.

"Emergency" NP programs tend to be dual FNP/ACAGNP. I know University of South Alabama has a program like this, and I'm sure there are more. This may satisfy your needs the best, and you don't have to work in the ER (unless you want to), because it is basically an FNP program and a ACAGNP program done at the same time. You get both certifications.

[SopranoKris, MSN, RN, NP]

I am currently an ICU nurse and my goal is to eventually become a locum tenens after gaining some experience in the field. I chose to pursue a dual ACNP/FNP program. 1) Some institutions want you to have the FNP to see pts of all ages. 2) To work in the hospital setting, more hospitals are going with ACNPs. 3) Having dual certification will give me the flexibility to work either inpatient or outpatient (I'm thinking I'd only want to do Urgent Care, not family practice). I want to be able to work ER, ICU or other inpatient specialties.

If you only want a single certification, I would still suggest ACNP. We have NPs who work for specialty practices in cardiology, pulmonology, nephrology, etc. They see patients in the office (adults only) and they also round on those patients in the ICU. The NPs in cardiology also assist in surgery and closely follow the post open-heart patients to the unit.