Acute Care vs Primary Care Adult-Gerontology NP vs Teaching

[ECoastRN]

Hello everyone,

I've asked Nurse Beth about this. She gave me a detailed answer and also suggested that I can inquire here.

I would very much appreciate any insight or comments you could offer me on my dilemma. I am considering whether to pursue an NP degree. I'm an experienced acute care RN; I also got my MSN/Ed degree a few years ago, and have been teaching a clinical one day a week (adjunct faculty in a local community college), besides the hospital job. It's a long story, but I feel the time has come for me to get an NP degree. The program I'm considering is an Acute Care Adult-Gerontology Nurse Practitioner. I've really enjoyed working in acute care and would like to continue doing so. That is the background, now for the questions:

What do you think is the likelihood of my finding a job when I graduate and pass the licensure exam? I will be about 45 by then. Is my age likely to present a problem?

Are there many NP jobs available in acute care? I work in a mid-size community hospital, and what we have are almost exclusively MDs (there are a few PAs working in the ED). I wouldn't want to invest all the time, effort, and money into getting the degree because I like the subject matter, only to find out that I cannot find a job in my new specialty.

I am on the East Coast; would my chances for gainful employment as a new NP in my geographic area be better if I chose the Primary Care Adult-Geriatric NP program, instead? Or do you have any other suggestions? Everyone I know is doing either Critical Care NP or FNP, but neither one is the one I really want...

What I also find a bit concerning are some comments I'd seen on a recent Medscape article--some nurses got an NP degree, couldn't find work as NPs and couldn't get hired as RNs either, b/c they are overqualified...I cannot really afford to find myself in such a position.

(the article is this one, if you're interested: Medscape: Medscape Access)

Another alternative I've considered is getting a full-time teaching position in the community college where I am currently an adjunct, in the next few years. However, I find myself reluctant to fully leave the bedside just yet, nor am I eager to deal with all the admin stuff one must deal with when one is a full-time faculty member.

Many thanks for your time!

[Corey Narry, MSN, RN, NP]

I don't think your age will be a problem at all.

However, success in finding a job (that you'd be happy with) as a Nurse Practitioner really depends on a lot of factors, not just the employment market in your area, which is certainly essential. Your overall portfolio (experience as a nurse, special skills gained at the bedside), your ability to network with potential employers, and your skill in negotiating the kind of roles and responsibilities you'd like to do as an NP with commensurate pay will get you far.

AGACNP can open many doors just as well as the other NP tracks with the limitation that you can not work in purely primary care practices and those where patients younger than age 13 are seen. Many of us work in specialty practices in adult medicine such as Cardiology, Pulmonary and some work in surgical subspecialties.

[ECoastRN]

Thank you very much; I appreciate your input.

[Bumex, DNP, NP]

I obtained the AGPCNP. In my NP job I see both primary and acute care patients, predominately primary care. I also teach lecture and clinical at a local 4 year university. In all honesty I have several friends who went AGACNP route and they have literally the exact same didactic education I did but clinical rotations in PACU and SICU and other environments. What I've learned in my short time as a NP is, much like the jump from nursing school to working as a RN, most of what you learn will be on the job. It seems there is a huge learning curve regardless of the specialty you pick. Granted I am in a state that doesn't really delineate acute vs primary care NP cert.

[WKShadowNP, DNP, APRN]

I agree with Juan regarding the job market in your area and age: it depends, and not relevant, respectively.

As an FNP I am trained for primary care of populations of all ages. However, I am working as a Hospitalist and undergoing a learning curve, mitigated by my critical care experience. Fortunately for me and for now my state does not specifically regulate one discipline in x setting solely.

AGACNP is suited for that environment and with your background this specialty might interest you, or even more specialized like Juan and others here.

Feel free to pm me if you want more detailed information.