ACNP vs FNP

[dgclough]

I've been accepted to ACNP school at SLU and I wanted to get the FNP certificate after graduation because some of my interests are out of the hospital and I think I would have the best of both worlds doing it that way...my question is this, should I go with FNP then ACNP or ACNP then FNP. I've got a couple of reasons...I'm scared that ACNP is harder and I'll have problems...I'll have troubles finding a job (been hearing that ACNP jobs are hard to come by)...FNP jobs are out there but I want more of the intensive/acute care/ER ...What do you think guys....??

[Corey Narry, MSN, RN, NP]

For NP Gilly: Where do you work that a SICU only hires ACNP's...and what do you do?

I work at a hospital in Detroit. The NP's in the SICU work under the Division of Trauma and Surgical Critical Care which is a basically a group of surgical intensivists. Currently, the NP's only work in the Cardiothoracic Surgical ICU which occupies two Pods in the entire SICU. The intensivists and cardiothoracic surgeons know that patients who underwent heart and lung surgery have unique needs in comparison to the typical surgical ICU patient (particularly trauma patients) so that having consistent provider coverage from staff who are knowledgeable in caring for this type of patients will be beneficial.

The NP's provide that consistency as we are there 24/7 and we know how the surgeons want their patients managed. There is a new PGY 2 General Surgery resident who rotates in our service every month and we NP's are actually responsible for getting them acclimated to the unit as well helping them learn how to manage post-op heart and lung surgery patients.

As part of our responsibilities, we were trained and are credentialed to perform invasive procedures such as central line placements including Swan-Ganz, arterial lines, thoracentesis and thoracostomy tube insertions, IABP removal, bronchoscopies, and assistance with emergent bedside chest opening. Throughout the day and night, we are on first-call if nurses are having patient issues ranging from hemodynamic instability, respiratory compromise, arrhythmias, etc.

You ask why we only hire ACNP's. A few of our NP's including myself serve as preceptors for the two ACNP programs in the state. We know what kind of clinical rotations the ACNP's go through and we always give preference to students who rotated with us when we have openings. Someone who is trained as an FNP or ANP would probably be considered if they apply with us but we always have ACNP applicants who have extensive ICU backgrounds and they tend to be picked as the strongest candidate.

[ghillbert, MSN, NP]

Sorry, I should have said ACNPs do "adult" acute care. Not "all" acute care.

I am in SW Pennsylvania. There is definitely a lot of talk about restricting areas such as critical care etc to ACNP rather than FNP etc. I know my department advertised for ACNPs and did not get even one applying, although we had PAs and FNPs applying. The job market around here seems friendly to ACNPs.