Acute care versus Family NP


I am a current ICU nurse and love my bedside work. I am 43 years old and have 4 small children and a husband with a steady job. I know I want to go on to advance practice nursing, and I had thought I wanted to work in an ICU setting or ER setting.

I have an application pending for Allen College Acute Care NP program for this fall. However, apparently the hospitals in this area do NOT use NPs in ICU or the ER.

Then I was talking to a friend who is currently in a family NP program. She recommended going the family NP route. She said you can always work in-patient or ER with the FNP, but you couldn't work outpatient with Acute care. Outpatient seems to be where NP jobs are around here.

so, I need some advice and direction sonIncan make some decisions.

1.) Do I stick with Acute care NP? The impact of doing so would be:

*I would likely have to move to get a job in an inpatient setting

*I could also obtain a FNP certification after graduation. Keep in mind I'm 43 years old...

2.) Do I switch to the FNP program? The impact of doing so would be:

*In this scenario, my application is likely to be delayed because it is the more popular program

*I am guaranteed to work in an outpatient capacity unless

*I could then get an acute care certificate. Keep in mind I'm 43 years old...

I'm torn. Thoughts?

allnurses Guide

BCgradnurse, MSN, RN, NP

1 Article; 1,678 Posts

Specializes in allergy and asthma, urgent care. Has 14 years experience.

First of all, I didn't go back to school til I was 45, so don't worry about your age. We have many more years to work, LOL. You mentioned that you would likely have to move to get an acute care job. Is that something that's feasible for your family? If not, it seems like FNP is the way to go.

Good luck with your decision.


10 Posts

It is feasible - right now we don't own a home and in theory my husband's employer would allow him to work remotely. It would be tricky, but do-able if the pay was worthwhile (over $80k annually)

Specializes in critical care. Has 8 years experience.

Not sure where you live that you couldn't work outpatient. There are quite a few acute care NP's that work in outpatient clinics, mainly specialty (cardiology, pulmonology, neurology) clinics. From the research I have done (I'm in the acute care track, graduating this Dec) - it seems that most hospitals are reluctant to hire FNP's as they are not hospital based. Going with the acute care NP affords you to work in an inpatient and outpatient setting. I chose acute care as I didn't want to do pediatrics or OB :wacky: !!

Good luck to you!


214 Posts

Has 16 years experience.

Maybe you could ask your school if there are any alumnae working close to where you live. Or talk to your local NP organization, if there is one in your area.

That might be the best way to get an idea of what the job market is for Acute Care vs FNPs where you live.

bbcewalters, NP

178 Posts

Specializes in NP, ICU, ED, Pre-op. Has 12 years experience.

If you do a search of all nurses this is debated on multiple threads. FNPs that work in acute care vs outpt and vice versa. This is regionally based and has a lot to do with your State and if they operate under the "consensus statement". There are many work arounds to these guidelines and it really seems to have more to do with what the employer wants. For example in my area (Atlanta, GA), the hospitals post jobs for Acute and Family NPs depending on the service you will be providing. Many ERs like FNPs because they have been trained in Peds, where Acute NPs are focused on Adult life span.

This is not true everywhere so you really have to look at your particular area. I would also suggest looking at and reading the "consensus statement" which tries to address this very issue.....

allnurses Guide


3 Articles; 5,581 Posts

Specializes in Adult Internal Medicine. Has 12 years experience.

Shadow some NPs! You can always post-masters cert later on but you want to make sure your initial degree is in the setting you see yourself working in for the foreseeable future prior to investing in it. If it's ED or primary you are interested in than shadow some NPs in those settings!