ACNP vs FNP: My Summarization of the Great Debate

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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

What are the three states

There's no point in arguing with this joker. I too was an ICU nurse in a 1600 bed academic institution for many years prior to going to school. If you honestly think that you as a bedside nurse know as much as a NP or physician about those topics you're delusional. Unfortunately, you seem like the type of RN that will be a dangerous NP, vastly over judging your capabilities and knowledge.

FNPs are not prepared to practice in an inpatient setting, let alone an ICU. Most FNP programs have 1 OB rotation, 1 peds rotation and 1 family med rotation for a whopping total of less than 800 hours. Yes, that is stellar preparation for inpatient medicine. Even in states that have not yet implemented the consensus model, many facilities are implementing it. I am in PA, and my system is now requiring ACNP for inpatient NPs. I give it 10 years before this is standard across the country.

4 Votes

Re read what i said. I said its experience. New NP dont know much of crap a bout how to manage balloon pumps, CRRT etc. Even new residents... not saying know know more. But my experience with critical care compared to a new ACNP with no ICU experience, i run circles. Dude i encounter new NP and Resident mds yearly and this isnt fabrication. How do u explain the thousands of NP that work critical care and have been for years that are awesome. Please explain this to me

Specializes in Nephrology, Cardiology, ER, ICU.
11 hours ago, Jdartis22 said:

Re read what i said. I said its experience. New NP dont know much of crap a bout how to manage balloon pumps, CRRT etc. Even new residents... not saying know know more. But my experience with critical care compared to a new ACNP with no ICU experience, i run circles. Dude i encounter new NP and Resident mds yearly and this isnt fabrication. How do u explain the thousands of NP that work critical care and have been for years that are awesome. Please explain this to me

I respectfully disagree. I had a solid 14 years of high acuity (ICU and level 1 trauma center ED) experience prior to becoming an APRN. In my job I consult on very sick nephrology pts at several hospitals. I certainly give the ICU RNs credit as they also manage these pts. However, I'm the one (along with a nephrologist) that gives the orders and actually is responsible in the end. Even after 13+ years as an APRN I'm still learning as our extremely experienced MDs.

Care has changed over the years and if you quit learning, you are going to harm pts. I have encountered nurses with your attitude at times and although I I always remain professional I also inform them that their attitude is what's going to harm a pt.

I also ask whether you are an RN, APRN, APRN student or ?? And may I ask as to your experience?

Believe me, you don't know what you don't know....

5 Votes

Hello and thanks for the reply. Im an FNP . Worked crirical care 7 years. Now i work in a Medical ICU as an NP. I began working in MICU at the same time as my best friend who went to Georgetown for ACNP. We have both blossomed the last 3 years and learned tons. Prior to us becoming NP's i worked critical care, she worked on a tele floor. When we began i was way ahead of her in the learning curve. However we have now reveleled out and still learning.

So lets see. This FNP (Me) tonight responded to 2 rapid responses, transferred 2 patients to MICU, intubated one of them, ordered pressors , ran a code blue, initiated a sepsis protocol, put in a central line and an arterial line. Wow! But some say FNP's cant perform at that level because we didnt do acute care!!??‍♂️??‍♂️. Just saying.

Specializes in Nephrology, Cardiology, ER, ICU.

Just saying - your education and clinical experience is NOT geared to acute care. Now, that said, since you've been an FNP for awhile, you may have "acquired" this needed training.

However, that was 7 years ago, not now. Heck when I became an APRN 13 years ago education was different too and yes the FNPs in our practice were credentialed at the hospitals. However, not anymore....progression is what its all about...

2 Votes

This is an NP listing at my hospital. ??????

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4 minutes ago, Jdartis22 said:

This is an NP listing at my hospital. ??????

Screenshot_20190902-170630_Photos.jpg

The point is things are changing. Your hospital will take anyone as they likely don't get enough acnp applicants. That will change and it's smart for new NPs to certify and work in areas they are trained clinically. Some states are already pushing for this. Much like our local hospitals mandate bsn or acquisition of it within a designated period, similar things will and are happening in other states.

1 Votes

Ive done my research and each state has their own model. Here is my state's model. Which doesnt separate the two Roles. Also, we get plenty of ACNP applicants.

Screenshot_20190902-172445_Chrome.jpgScreenshot_20190902-172501_Chrome.jpg
On 8/27/2019 at 7:50 PM, Dodongo said:

There's no point in arguing with this joker. I too was an ICU nurse in a 1600 bed academic institution for many years prior to going to school. If you honestly think that you as a bedside nurse know as much as a NP or physician about those topics you're delusional. Unfortunately, you seem like the type of RN that will be a dangerous NP, vastly over judging your capabilities and knowledge.

FNPs are not prepared to practice in an inpatient setting, let alone an ICU. Most FNP programs have 1 OB rotation, 1 peds rotation and 1 family med rotation for a whopping total of less than 800 hours. Yes, that is stellar preparation for inpatient medicine. Even in states that have not yet implemented the consensus model, many facilities are implementing it. I am in PA, and my system is now requiring ACNP for inpatient NPs. I give it 10 years before this is standard across the country.

Pretty much sums it up. As the saying goes... You can lead a horse to water...

1 Votes

FnP has 1 OB 2 adult rotations 1 peds 1 adult gerontology rotation. I did all my rotations inpatient. Both adult clinical were in medicial ICU and CT ICU, Peds was done on a pediatric ICU, OB i did inpatient . My training was ICU inpatient focused.

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