ACNP vs FNP: My Summarization of the Great Debate

[rauscht]

I, like many others in the forum, have been recently struggling with which NP program to pursue - FNP or ACNP. I've read so many threads and talked with so many people (RNs, NPs, nurse recruiters, professors, deans) and this is the summary that I've compiled.

Does anyone have any thing to add?? Please let me know!

FNP

Pros:

• Care for patients of all ages
  
• Flexible career options (Primary care, ambulatory care, urgent care (?))
  
• Increased need for FNP/PCNP in future of US healthcare
  
• Increased need in underserved populations
  
• Increased opportunity to work abroad
  
• Will learn more about US healthcare system
  
• Increased opportunity to develop meaningful relationships with patients
  
• Often working with healthy patients
  
• Opportunity to open own practice
  

Cons:

• Ineligible to work as NP in hospital setting
  
• Sacrifice in-depth knowledge in one population for more basic knowledge across lifespan
  
• Often working with healthy patients
  
• Mellow work atmosphere
  
• Most likely working 5 days/wk, less $ than ACNP
  

ACNP

Pros:

• In-depth knowledge in adult population
  
• Can work anywhere in hospital (ED, ICU, Floor)
  
• Can follow pt throughout hospital stay (trauma NP)
  
• More fun work atmosphere
  
• Most likely working 3-4 days/wk, more $ than FNP
  

Cons:

• Education limited to adults
  
• Career options limited to hospital setting
  
• Limited ability to develop relationships with patient (?)
  
• Decreased need in underserved populations
  
• Decreased opportunity to work aboard
  

[FiremedicMike, RN, EMT-P]

4 hours ago, traumaRUs said:

This might be possible where you currently live but the Consensus Model is real and has been adopted by many states. FNP education and clinical experience is NOT geared to inpatient care, it is for outpt only.

There are programs (such as the one I plan on attending) will allow you to tailor your FNP clinicals to your desired practice environment, including inpatient care if that's your thing.

[djmatte, ADN, MSN, RN, NP]

10 hours ago, FiremedicMike said:

There are programs (such as the one I plan on attending) will allow you to tailor your FNP clinicals to your desired practice environment, including inpatient care if that's your thing.

Except your exam certification is geared toward primary care across the lifespan. What kind of education are you getting if you aren't getting clinicals geared toward pediatric, adult/geri, and women's health/OB. These are what you are tested on. Why on earth would you elect to do a clinical outside these areas (unless you are adding to that work which I imagine you aren't given the statement).

[FiremedicMike, RN, EMT-P]

7 hours ago, djmatte said:

Except your exam certification is geared toward primary care across the lifespan. What kind of education are you getting if you aren't getting clinicals geared toward pediatric, adult/geri, and women's health/OB. These are what you are tested on. Why on earth would you elect to do a clinical outside these areas (unless you are adding to that work which I imagine you aren't given the statement).

I could be incorrect here, but I believe there are 3 semesters of clinicals. The first 2 are heavily focused on primary care, the third is allowed to be tailored to your needs..

[Jdartis22, BSN, MSN, NP]

Wherher you are an FNP or ACNP the assessment and diagnosis education is the same in both tracks.... physiology doesnt change. The difference is where you do yiur clinicals. Im FNP and doing all my rotatioms inpatient. My MICU has 80 percent FNP's and they rock. Its like anytbing thing else, you orient and learn your speciality. Its like a new grad nurse.... you learn your environment.

[FiremedicMike, RN, EMT-P]

5 minutes ago, Jdartis22 said:

Wherher you are an FNP or ACNP the assessment and diagnosis education is the same in both tracks.... physiology doesnt change. The difference is where you do yiur clinicals. Im FNP and doing all my rotatioms inpatient. My MICU has 80 percent FNP's and they rock. Its like anytbing thing else, you orient and learn your speciality. Its like a new grad nurse.... you learn your environment.

I was told from an ER attending that I respect that his group prefers FNPs because they are able to see the occasional ped patient who walks through the door.

My personal plan is to get dual certified ACNP/FNP. Whether I take ACNP and then FNP post-grad cert or the other way around is yet to be determined (I've elected to plow through my RN starting next summer instead of the direct entry pathway I was originally planning)..

[Jdartis22, BSN, MSN, NP]

I have friends doing ACNP and they use the same Primary care text book we use in my FNP adult health classes... the education that different

[traumaRUs, MSN, APRN]

If you look to the NCSBN site you will find much info on the Consensus Model and LACE which delineate out the roles of FNP and AGACNP and they are different.

Here is a map of the states and how they rank as to implementing the Consensus Model:

https://www.ncsbn.org/5397.htm

Believe me your employer is not the one who has your back. If you practice outside your scope as to your education and certification, you will be standing in front of your state's BON explaining yourself.

[djmatte, ADN, MSN, RN, NP]

4 minutes ago, traumaRUs said:

If you look to the NCSBN site you will find much info on the Consensus Model and LACE which delineate out the roles of FNP and AGACNP and they are different.

Here is a map of the states and how they rank as to implementing the Consensus Model:

https://www.ncsbn.org/5397.htm

Believe me your employer is not the one who has your back. If you practice outside your scope as to your education and certification, you will be standing in front of your state's BON explaining yourself.

Exactly. And this isn't new. There's a reason Ohio is in desperate need for ACNPs. They adopted the concensus model and need hospitalists. Your choice in clinical rotation outside primary care won't help you. FNPs have had the luxury of having large numbers where ACNPs are newer op the scene. But that is changing and I would discourage any fnp who wants to work acute care or in a hospital from going the fnp route. You aren't trained there. Your boards don't cover that area. As time goes you will struggle to continue work in that area.

[djmatte, ADN, MSN, RN, NP]

12 minutes ago, traumaRUs said:

If you look to the NCSBN site you will find much info on the Consensus Model and LACE which delineate out the roles of FNP and AGACNP and they are different.

Here is a map of the states and how they rank as to implementing the Consensus Model:

https://www.ncsbn.org/5397.htm

Believe me your employer is not the one who has your back. If you practice outside your scope as to your education and certification, you will be standing in front of your state's BON explaining yourself.

Exactly. And this isn't new. There's a reason Ohio is in desperate need for ACNPs. They adopted the concensus model and need hospitalists. Your choice in clinical rotation outside primary care won't help you. FNPs have had the luxury of having large numbers where ACNPs are newer op the scene. But that is changing and I would discourage any fnp who wants to work acute care or in a hospital from going the fnp route. You aren't trained there. Your boards don't cover that area. As time goes you will struggle to continue work in that area.

[FiremedicMike, RN, EMT-P]

28 minutes ago, djmatte said:

Exactly. And this isn't new. There's a reason Ohio is in desperate need for ACNPs. They adopted the concensus model and need hospitalists. Your choice in clinical rotation outside primary care won't help you. FNPs have had the luxury of having large numbers where ACNPs are newer op the scene. But that is changing and I would discourage any fnp who wants to work acute care or in a hospital from going the fnp route. You aren't trained there. Your boards don't cover that area. As time goes you will struggle to continue work in that area.

Not trying to argue at all, but for what it's worth I just looked at several inpatient jobs at Ohio State and none of them specified ACNP certification..

[djmatte, ADN, MSN, RN, NP]

1 minute ago, FiremedicMike said:

Not trying to argue at all, but for what it's worth I just looked at several inpatient jobs at Ohio State and none of them specified ACNP certification..

I have my feelers out to a range of job boards in Ohio and Michigan (I live in the area) and the majority of regular emails I get from Ohio are looking for ACNPs for hospitalist roles. That's where the landscape is moving. FNPs are not PAs where we can go wherever the wind blows us. That's the disservice our institutions did when creating all of this. If you haven't started school yet, it's best you get on board now. Because it isn't going to be the current FNPs affected by the concensus model changes or the oversaturation of the market. It's going to be all of the new ones who aren't certified in the next few years.

[Jdartis22, BSN, MSN, NP]

My state has one scope of practice for NP's. Many states have one scope for NP's amd doesnt break down specifics of what you can and can not do. Im FNP and did my last rotation in ICU placing central lines , art lines etc...those are things you dont get in text books or lectures. Its experience. States dont place these things in scope of practice as they are learned skills that any NP can perform. There is nothing ACNP gets in school to make them better working in acute care that an FnP cant do in the same setting

4 hours ago, traumaRUs said:

If you look to the NCSBN site you will find much info on the Consensus Model and LACE which delineate out the roles of FNP and AGACNP and they are different.

Here is a map of the states and how they rank as to implementing the Consensus Model:

https://www.ncsbn.org/5397.htm

Believe me your employer is not the one who has your back. If you practice outside your scope as to your education and certification, you will be standing in front of your state's BON explaining yourself.

Look at that map... NC where i live doesnt have that