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 (?)
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
Look at that map... NC where i live doesnt have that
Your state also at one time likely forced NPs to be supervised by an MD in every facet of their job. There was also a time when FNP (and maybe crna) was the only advanced certification you could get as a nurse. By suggesting an FNP can work in an acute care capacity is suggesting either ACNP certifications are useless /worthless or they are perfectly equipped to work in primary care (they aren't).
Times are changing. Our accrediting bodies saw fit to specialize np practice rather than generalize it. Most NPs that frequent here who are in the hospital game recognize the performance differences between ACNPs and FNPs. Hospitals and states are also catching on. This isn't simply relegated to individual strengths. It comes down to clinical competencies and where certifying bodies decide their training should focus. You got away with acute care because you were needed in a spot there are too few ACNPs. This will not be the case in the future and is already changing.
My hospital has made it clear that we will not see a change in hiring of APRN. They state that this will always be the decision of the organization. ACNP are limited because they can only see adults patients where FNP can see any age population. Its funny you compare the two cause our FNP critical care practitioners are just as comparable and ACNP's and some are better so to state there are performance differences is not accurate. Just like some ADN nurses can run circles around some BSN nurses...... its all experience that makes the practitioner option
Lol "always" is a pretty finite statement in a world that's always changing. And it's not a shock that a hospital would try to cut corners because they can't find people actually certified in that role. Keep believing those statements and be glad you are already working there. Meanwhile the consensus model is actively happening and is the future that both pushes nurse practitioners to work more independently and allows legal cover should someone question their scope of practice. Don't presume new NPs who aren't you can expect your same luxuries you experience. For most of them, any certification other than FNP will be far bigger opportunity.
Your state also at one time likely forced NPs to be supervised by an MD in every facet of their job. There was also a time when FNP (and maybe crna) was the only advanced certification you could get as a nurse. By suggesting an FNP can work in an acute care capacity is suggesting either ACNP certifications are useless /worthless or they are perfectly equipped to work in primary care (they aren't).
Times are changing. Our accrediting bodies saw fit to specialize np practice rather than generalize it. Most NPs that frequent here who are in the hospital game recognize the performance differences between ACNPs and FNPs. Hospitals and states are also catching on. This isn't simply relegated to individual strengths. It comes down to clinical competencies and where certifying bodies decide their training should focus. You got away with acute care because you were needed in a spot there are too few ACNPs. This will not be the case in the future and is already changing.
Exactly - this is what you have right NOW. I'm in IL and thats what we had too - FNP was the way to go. Now, in IL, you can't get credentialed for an inpt position unless you are AGACNP or CNS.
Unless you have only a few years left to work, you'd be wise to look at legislation in your area. And...the hospitals aren't the ones that will hold the bag - it will be YOU.
2 hours ago, djmatte said:
Lol "always" is a pretty finite statement in a world that's always changing. And it's not a shock that a hospital would try to cut corners because they can't find people actually certified in that role. Keep believing those statements and be glad you are already working there. Meanwhile the consensus model is actively happening and is the future that both pushes nurse practitioners to work more independently and allows legal cover should someone question their scope of practice. Don't presume new NPs who aren't you can expect your same luxuries you experience. For most of them, any certification other than FNP will be far bigger opportunity.
In IL, FNPs were not grandfathered into their positions - nope they had five years to obtain the proper certification or they were out....
Way back when, there was no such thing as a "NNP." One of my colleagues got her FNP and worked in the NICU as an ARNP many moons ago. Now, of course, it's unheard of for an FNP to work in a NICU. Even hospitals that hire PNPs in the NICU are often "making" their employees get their NNP certification after working awhile.
There is nothing ACNP gets in school to make them better working in acute care that an FnP cant do in the same setting.
Ummm... that is just silly to suggest there is no difference in content delivered between these two tracks. My program had multiple lectures on Continuous Renal Replacement Therapy; ECG interpretation, IV vasoactive drips, IV antiarrhythmics and inotropic agents; invasive hemodynamic monitoring including Swan-Ganz catheterization; Extra-corporeal Membrane Oxygenation; Intra-aortic balloon pumps and impellas; mechanical ventilation, ventilation weaning and Roto-prone therapy, etc. These topics are not covered in any FNP program.
All the things you mentioned, i learn being an ICU nurse. How did i learn it, on the job ICU training and hospital training classes. I know more abt all those things now than an new ACNP. Facts. New NP's and new residents ask us for advice and how to do things. We have FNP in our ICU's....if the Acute care option was that much better how is it our FNP are just as good if not better??
All the things you mentioned, i learn being an ICU nurse. How did i learn it, on the job ICU training and hospital training classes. I know more abt all those things now than an new ACNP. Facts. New NP's and new residents ask us for advice and how to do things. We have FNP in our ICU's....if the Acute care option was that much better how is it our FNP are just as good if not better??
It doesn't matter if an RN is "knows more abt all those things than a new ACNP," what matters is the licensure and certification. And like it or not, the Consensus Model and LACE are here to stay at least for the foreseeable future.
No state list on the board everything NP can do and not do. Have u seen a board that list such things
There are actually two or three states that list scope of critical care. The real issue is risk. Our internal insurance was unwilling to cover liability for non-ACNPs working in the ICU.
djmatte, ADN, MSN, RN, NP
1,248 Posts
Your state also at one time likely forced NPs to be supervised by an MD in every facet of their job. There was also a time when FNP (and maybe crna) was the only advanced certification you could get as a nurse. By suggesting an FNP can work in an acute care capacity is suggesting either ACNP certifications are useless /worthless or they are perfectly equipped to work in primary care (they aren't).
Times are changing. Our accrediting bodies saw fit to specialize np practice rather than generalize it. Most NPs that frequent here who are in the hospital game recognize the performance differences between ACNPs and FNPs. Hospitals and states are also catching on. This isn't simply relegated to individual strengths. It comes down to clinical competencies and where certifying bodies decide their training should focus. You got away with acute care because you were needed in a spot there are too few ACNPs. This will not be the case in the future and is already changing.