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
  

[Jdartis22, BSN, MSN, NP]

????????????

[traumaRUs, MSN, APRN]

Not true. In many states it sure is in place. Lawyers are waiting for you.

[Dodongo, APRN, NP]

This person doesn't get it. S/he doesn't understand the legalities involved. It's like talking at a brick wall.

[Jdartis22, BSN, MSN, NP]

??????

[Jdartis22, BSN, MSN, NP]

??????

[Neuro Guy NP, DNP, PhD, APRN]

There ARE a few hold over family medicine docs in very rural areas who are still practicing as ED attendings. But now that EM is its own mature board certified specialty, it is recognized that the ER is not a place for FM trained docs. I worked with such an MD once, and while she was good there was still a difference between her and the EM trained physicians and it was apparent.

Something similar is happening in the NP profession with the push towards ENP. Not sure why the FNPs cannot grasp this. As an educator and advisor myself I always make it a point to have students state their goals as an NP and pursue the correct track. ACNP is not limited to inpatient; outpatient specialty is possible, just not primary care so I'm not sure the need to go FNP for the sake of 'doing it all'. FNP is a worthy degree in its own right it just has to be accepted for what it is. Just because something used to be the model doesn't mean it always should be. Just because you could make something work doesn't mean you should continually force it once something more targeted comes along.

[Jdartis22, BSN, MSN, NP]

ED docs are overehelmed and without FNP roles they cannot keep up and this is why they are so valuable in the ED. Each state determines their own model

[Neuro Guy NP, DNP, PhD, APRN]

6 minutes ago, Jdartis22 said:

ED docs are overehelmed and without FNP roles they cannot keep up and this is why they are so valuable in the ED. Each state determines their own model

I don't dispute that at all. I'm just saying we're already seeing evidence of a paradigm shift with the development of the ENP and FNP/ACNP combo. How long it will take to see the culmination of this development is anyone's guess.

[djmatte, ADN, MSN, RN, NP]

But again as previously noted, the ENP role was created to specifically address the shortcomings of a primary care focused FNP in an emergency department. Things will and are changing. It should be discouraged that any new or prospective students have a plan to work on a hospital environment if they are an FNP. If they are currently working there, they should take control of their own license and get the acute care cert. Imo the certifying bodies need to start looking at clinic environments to justify recertification. If you aren't working in that spot for the designated hours and seeing all the populations covered (meaning FNPs need to see some kids, some wh, etc,) then any other location doesn't qualify you for license renewal.

[Jdartis22, BSN, MSN, NP]

????. Good talk

[djmatte, ADN, MSN, RN, NP]

10 minutes ago, Jdartis22 said:

????. Good talk

Reiterating for posterity. Because the next student or prospective fnp that comes here looking for info needs to know the full breath of where their choices bring them and the long term financial/legal implications so they don't make the poor choices others have made.

[FiremedicMike, RN, EMT-P]

Sheesh, I feel like this thread got pretty hateful and aggressive..