Acute Care DNP?

llg, PhD, RN · Aug 13, 2015

I am a little confused. Why would you even consider specializing in Neonatal if really want Emergency Medicine or Surgery? The Neonatal Nurse Practitioner (NNP) role is very well-established and highly valued. That role was established in the 1970's and most NICU's are quite dependent on them. But the NNP-focused degree is not a role that will get you jobs outside of a NICU.

Assaivivace · Aug 13, 2015

I'm a BSN student right now and torn between all of the specialties I listed. I guess the way I worded my post doesn't make sense. For Acute Care - Adult, I'd be interested in ER or SICU or MICU. For neonatal, obviously NICU.

Would Adult Acute care open me up to more prospects in the adult acute care fields I listed?

llg, PhD, RN · Aug 13, 2015

Oh, I see. Thanks for explaining.

In that case, I would suggest delaying any plans you may have for grad school until after you have actually worked for a while as a nurse. Actually being a nurse is very different from being a nursing student -- and you may find that your ideas about advanced roles change as you get experience actually being a nurse. Make that crucial transition from student to professional and then decide what type of patient population - and what type of practice setting and role -- interests you the most. Then (and only then) will you be in a position to make an informed decision about graduate school.

Good luck to you!

Nursetonp · Aug 14, 2015

Oh, I see. Thanks for explaining.
In that case, I would suggest delaying any plans you may have for grad school until after you have actually worked for a while as a nurse. Actually being a nurse is very different from being a nursing student -- and you may find that your ideas about advanced roles change as you get experience actually being a nurse. Make that crucial transition from student to professional and then decide what type of patient population - and what type of practice setting and role -- interests you the most. Then (and only then) will you be in a position to make an informed decision about graduate school.
Good luck to you!

This is great advice. I have met a few NP grads that went to direct NP entry programs without working as a nurse, and found that they hated the speciality they picked. I think it's one bonus to working as a nurse vs experience as a student. For me personally, I was grateful to have worked in several areas that I truly got to see the "ins and outs" of each. I also got to see what I truly enjoyed vs what I thought I would enjoy or what everyone else was picking.

Good luck!

llg, PhD, RN · Aug 14, 2015

This is great advice. I have met a few NP grads that went to direct NP entry programs without working as a nurse, and found that they hated the speciality they picked. I think it's one bonus to working as a nurse vs experience as a student.

Me, too. I've met several nurses who went to graduate school "too soon" in their careers -- and regretted the time, effort, and money they spent specializing in things they found they didn't enjoy.

Unlike some fields, nursing offers a very wide array of choices for graduate school. While that can be great -- it also means that a choice has to be made as to which path to pursue. Making a bad choice can be expensive and painful. That's why always recommend that a person give a field a try before they make such a big investment in it.

PG2018 · Aug 15, 2015

I always like to chime in on discussions like this.

I entered nursing only to become a nurse practitioner, and I chose psychiatry. At no point in my RN work did I ever work in psychiatry or anything related to mental health. Even sans that obligatory nurse experience, I am -by all metrics- good at what I do. I wanted to be good at this. Some people just know what they want and pursue it.

littlepeopleRNICU · Aug 16, 2015

I agree to get your feet wet in the actual nursing world first, but since I am a NICU nurse who chose to enter an ACNP program, I figure I might give you my story, for what it's worth to you.

I love the NICU as a bedside nurse. However, it makes me too nervous to spend the time and money on a degree that would only ever limit me to taking care of neonates. For me personally, that's not something that I am willing to say I would be okay with for the rest of my nursing career. Yes, you can go back to school and change certs, but I don't wanna go into neonatal feeling certain I probably will wanna do that at some point. I am not doing this with the plan to spend more money changing routes all over again. I can see myself 10 years down the road saying that I want a change.

I have adult experience as well, so choosing acute care is not an area I am totally inexperienced in. ACNPs can see adolescents through the lifespan, and you can add a peds portion to that if you're interested. Keep in mind, that route adds another certifying test, and keeping enough active hours(possibly even a second job?) to be able to maintain licensure in both worlds.

In the end, I chose ACNP because it's more flexible than neonatal. (Unless I added peds) I may only be able to see teens and up, but there is a world of settings and patient groups you can choose from, whereas neonatal is NICU or well baby *only*.

That's just me! I do love NICU as a nurse, and it'll be bittersweet leaving when I graduate. I'm not discouraging you from choosing neonatal if you want to do that, and I have to add, to be fair, that all of the NNPs I work with LOVE their jobs and couldn't imagine doing anything else.

littlepeopleRNICU · Aug 16, 2015

I feel like I should also add, and I think this is the most important thing I can say to you...if you feel you choose neonatal, please spend a year or two at least working as a NICU RN prior to entering a program. Most programs require around 2 years NICU experience anyway, but on the off chance you want to jump the gun and find one that takes a new grad- don't. The NICU is not a world for everyone. A lot of people go into it thinking it's easy taking care of babies and that your patients will all be cute, families will always be nice, and "how sick can a baby be?", etc. I have seen so much new grad burnout and turnover due to people who came in with those attitudes and had a rude slap in the face.

That is true for most specialities though. There's a certain kind of nurse for every area.

Nursetonp · Aug 16, 2015

I agree to get your feet wet in the actual nursing world first, but since I am a NICU nurse who chose to enter an ACNP program, I figure I might give you my story, for what it's worth to you.
I love the NICU as a bedside nurse. However, it makes me too nervous to spend the time and money on a degree that would only ever limit me to taking care of neonates. For me personally, that's not something that I am willing to say I would be okay with for the rest of my nursing career. Yes, you can go back to school and change certs, but I don't wanna go into neonatal feeling certain I probably will wanna do that at some point. I am not doing this with the plan to spend more money changing routes all over again. I can see myself 10 years down the road saying that I want a change.
I have adult experience as well, so choosing acute care is not an area I am totally inexperienced in. ACNPs can see adolescents through the lifespan, and you can add a peds portion to that if you're interested. Keep in mind, that route adds another certifying test, and keeping enough active hours(possibly even a second job?) to be able to maintain licensure in both worlds.
In the end, I chose ACNP because it's more flexible than neonatal. (Unless I added peds) I may only be able to see teens and up, but there is a world of settings and patient groups you can choose from, whereas neonatal is NICU or well baby *only*.
That's just me! I do love NICU as a nurse, and it'll be bittersweet leaving when I graduate. I'm not discouraging you from choosing neonatal if you want to do that, and I have to add, to be fair, that all of the NNPs I work with LOVE their jobs and couldn't imagine doing anything else.

Thanks for sharing your story! As an experienced np, it gave me some new perspectives to think about as I contemplated getting a second cert. Now I think I'm just going to stay where I'm at and your post helped me come to that decision. : )

littlepeopleRNICU · Aug 16, 2015

Thanks for sharing your story! As an experienced np, it gave me some new perspectives to think about as I contemplated getting a second cert. Now I think I'm just going to stay where I'm at and your post helped me come to that decision. : )

You're welcome, but I hope I didn't discourage you if it's what you truly want to do and/or think would be best for your career! Where are you now, and what cert do you have? (If you mind sharing, of course!)