Acute Care NP

christvs, DNP, RN, NP · Sep 30, 2008

Hi. Acute Care NPs can do a wide range of things. You can work with adults and/or children, depending on your program in school and certification type. I am an adult acute care NP and work in hospital medicine. We basically manage all the medical aspects of our patients' care: I can admit patients, write their admission orders, do histories and physicals, order diagnostic and lab tests, order meds/treatments, and evaluate their care as often as needed. Once I start working the day shift (am on nights right now), I will see 5-10 patients per day, and write daily progress notes on them, adjust their tests/meds as needed depending on how they are doing, and write discharge instructions when they are ready to go home. So that is what I do in hospital medicine as an ACNP. ACNPs can also work in ICUs, the ER, in specialty clinics/services such as GI, oncology, cardiology, neurosurgery, etc...You really can do a lot as an ACNP. Hope that helps.

DaisyRN, ACNP · Oct 1, 2008

i have talked about this before, but i'm also an adult (ages 12 and up) acute care np in cardiology.

my days go like this:

m-f 7:30a-10:30 (give or take) - supervision of stress testing at hospital

m-f 11-whenever (usually 2-5pm) - i see clinic patients (hospital follow ups, chf patients, etc.) and because i'm still in this "orientation window," i'm not seeing a whole lot of patients on my schedule yet. today, i saw 8 which was higher than average for me, but i was seeing another physician's clinic patients because he was tied up at hospital today.

mixed in during the day, but usually isolated to the mornings, i follow our inpatients with my supervising physician. he normally splits up his list patients for me to see and he sees the rest... then we discuss at clinic (sooner if i have questions/problems) and i write orders, discharge planning, interpret testing, etc. the new thing for us is weekend call, where i don't take actually nurse or er calls, but i am in the hospital doing rounds on all the patients left from the previous week so the on-call doctors don't have to do it, usually around 10-12 patients max.

i love my job. i get lots of variety in clinic and hospital... love it. absolutely. positively. under no circumstances would i only want to be family np.

revolution · Oct 1, 2008

Thanks for the insight.

I hear FNPs have a difficult time getting into hospitals. What's the reason behind this? I know plenty of GPs that work in hospitals, admit patients, etc.

In my state, there are only FNP, PNP, and NNP programs.

What if someone were to do an ACNP program after they got their FNP? I would think that having your FNP would shave off a decent amount of time.

DaisyRN, ACNP · Oct 3, 2008

there are sooo many topics about fnps vs acnps in the hospital settings. click on my name and view my posts... you will sort through some, but find ones that are pertinent to this information.

the problem lies in how you are trained. generally speaking, fnps do not have any inpatient training in their apn programs... nursing experience does not count. so, therefore, you must be able back up your chosen position with your formal apn education program because some states are buckling down and saying you are working out of your scope of practice if you can't support your job with your training... and are taking action. i'm not saying that it's this way everywhere... it is dependent on where you live... some states don't even have any acnp programs, as this is fairly new. it's certainly something to consider, though.

as an acnp, i received both inpatient and outpatient training (because my school mandated it in the curriculum)... therefore, my formal apn education can support my current cardiology position.

yes, it is feasible for you to become dual certified... anpfnpgnp is a user on here and can tell you how she went through the sequence. i knew that i did not want to work solely in the outpatient realm, so i went straight for acnp and decided that if i missed working with kids, i would go back for fnp or acnp-pediatric later.

good luck with your decisions!