ACPNP or FNP

Advanced Practice Columnist / Guide · Jun 16, 2017

Is that a children's hospital you're working at? Then I would ask around and figure out what kind of training the NP's there have. We have a separate children's hospital where I work and many of the NP's are PNP trained but some are FNP's. But then again, the institution is NP friendly and has NP's in the Peds ICU's and Intensive Care Nursery (aka NICU) as well as many other specialty practices. These are exclusively PNP-AC's and NNP's respectively in these high acuity units.

There are specialties in the children's hospital here where there would probably be an advantage for FNP's such as the Adult Congenital Heart Disease service (these are patients with childhood congenital heart disease that have grown up as adults but have physiology not typically seen in adult cardiology patients), the pediatric EP service that sometimes sees adults with a pre-existing pediatric congenital anomaly, and the Pediatric Interventional Cardiology service that sometimes sees adults for stenting in conditions such as pulmonary vein stenosis and coarctation of the aorta. These patients go to the adult ICU (with us adult ICU NP's) but are also followed by the pediatric specialty services.

MarkPICU · Jun 16, 2017

Thanks for your reply Juan

Unfortunately there are no Children's hospitals in my region. Out of the four PICUs in my area only one utilizes ACPNP, and they work the night shift. The PICUs here are 12 to 14 beds. The hospital I am currently at is working on expanding its PICU and two of the other PICUs are currently taking bids for a new intensivist group which may open up some opportunities. As of now I don't think I would want to work in a PICU, only round on consulted patients due to the limited need for them in the PICU at the moment. As well I have two friends currently in ACPNP programs and a third about to start, if any positions were available they would get to them first. For this reason, I was thinking of broadening my scope with the FNP but also try and specialize if its possible with the FNP. I would love to do the ACPNP, just worried I'll have a harder time finding a job.

babyNP., APRN · Jun 17, 2017

You need to look at what your city's market is- take a look at this thread

https://allnurses.com/advanced-practice-nursing/needing-encouragement-i-1107246.html

This poster is a FNP and can't get a job because he/she hasn't specialized...

adventure_rn, MSN, NP · Jun 18, 2017

You need to look at what your city's market is- take a look at this thread
https://allnurses.com/advanced-practice-nursing/needing-encouragement-i-1107246.html
This poster is a FNP and can't get a job because he/she hasn't specialized...

On the flip side, I've seen some posts where a new NP couldn't get jobs because they were too specialized (i.e. acute care NP vs. primary care NP vs. FNP). For instance, in the region where I went to nursing school, many peds offices had shifted towards hiring FNPs over PNPs, since they thought that FNPs had a more thorough education in reproductive health and complex acquired medical conditions that you might see in older teenagers (birth control, Type II diabetes, post-trauma, etc.) I met a few PNPs in that region who wanted pediatric clinic jobs but couldn't get them due to the local FNP preference, and ended up in neonatal well baby nurseries.

It truly depends on the local trends in the region where you plan to work, which can be hard to figure out. If you can think of any providers you work with who might know the answer, I'd ask them. Word of mouth may be the best way to get a sense for the trends in your area. It may be helpful to reach out and see if there are any career advisors at the nursing schools you're applying to who may be able to provide some insight. Current students, nursing instructors, and recent new grads may also be helpful.

LadyIce · Jun 19, 2017

I get calls from recruiters everyday for Peds/NICU positions. I am afraid of pediatrics. If you have a passion for Peds, you could consider becoming an ACP NP or a Neonatal NP. You would be able to help a lot of patients. If you did FNP, you could see peds for primary care. But, acute care is a whole different story. I would check out schools that offer the ACPNP.

Dodongo, APRN, NP · Jun 20, 2017

My program has the option of doing a Pediatric Primary Care/Pediatric Acute Care Dual Program. I would look into this. If you know you want 18 years and below do this and you will be able to practice in any setting where kids can be found.

NO NEED TO DO FNP. One local program requires 75 hours for OB, 150 for infants, children and adolescents, and 225 hours for general "family". Less than 4 weeks for a peds rotation. Do yourself and your patients a favor and go to a program dedicated to your specialty.

Like doing the minimal and embarrassingly low clinical hours required in an FNP program makes you competent in anything. I think if you want to do family medicine go to PA school. If you want to do acute care, neonatal, peds, OB or psych - go to a specialty NP program. FNP programs, are generally, in my opinion, sub par (and that's being nice).

WestCoastSunRN, MSN, CNS · Jun 20, 2017

My program has the option of doing a Pediatric Primary Care/Pediatric Acute Care Dual Program. I would look into this. If you know you want 18 years and below do this and you will be able to practice in any setting where kids can be found.
NO NEED TO DO FNP. One local program requires 75 hours for OB, 150 for infants, children and adolescents, and 225 hours for general "family". Less than 4 weeks for a peds rotation. Do yourself and your patients a favor and go to a program dedicated to your specialty.
Like doing the minimal and embarrassingly low clinical hours required in an FNP program makes you competent in anything. I think if you want to do family medicine go to PA school. If you want to do acute care, neonatal, peds, OB or psych - go to a specialty NP program. FNP programs, are generally, in my opinion, sub par (and that's being nice).

I keep hearing about these low numbers of clinical hours. My local FNP program is 1000 hours of real clinicals with no direct entry option (which still can't compete with a PA program, but I've also been an ICU nurse for 13 years). They do allow you choose your area of interest in the last semester. The competing uni has a similar set up/requirements. So I get that there are sub-par programs. I also think we could beef up the good ones. But I do think there are "good" ones. Even for mere FNP's

That said, Dodongo has a point about the power of specializing. I like the idea of it, but for market reasons and general flexibility I want the FNP. That said, I may very well get post-doc certification later if it looks like I'm going to need it.

Dodongo, APRN, NP · Jun 22, 2017

I'm not saying there aren't some good FNP programs out there - although no NP programs have an appropriate required number of hours and every student should get at least 2000 or so, no matter the program. But FNP attempts to cover peds, OB, adults etc and ends up with just a couple hundred in each , which isn't serving anyone well. The only way an NP program works, IMO, is by specializing. If FNP programs required as much time, both in didactics and clinicals, as PA programs, I would have chosen one.

In summary, I wish NP programs included a surgical rotation.