acute/critical NP vs. family practice NP and all the other NPs

Dr. Tammy, FNP/GNP-C · May 15, 2009

Hello all,
I am planning to go back to school for NP program. I am interested in critical/acute NP program. Can anyone tell me what is the difference bn this program and family practice NP?
thanks

Double check with specific programs but usually the ACNP does not include peds or OB/GYN. FNP includes both peds and OB/GYN.

allnurses Guide · May 15, 2009

FNP is primary care, ACNP is for "acutely ill" patients, be they in or out patient.

lifelong · May 17, 2009

Hey there,

I am an ACNP and graduated in November. I work in the ICU and love it. As an ACNP I work primarily in the hospital but can work outside the hospital if the patients I would see are a follow up from an acute episode. For me, I would only work external if part of my time would be spent seeing patients in the hosp as well. I can care for patients 16 yrs of age or older (that might be state practice act specific...not sure), anyone younger is out of my scope. I am not prepared to take care of OB patients but can do a gyn exam if need be but if I wanted to subspecialize then I would need to head back to school and pick up an FNP or ANP. If an OB patient has a hypertensive crisis, I may see them in the ICU, but rest assured, the OB would be heavily consulted. ACNP's focus is in the acute phase of disease processes and now a days that lends itself to a hospital environment. I think it comes down to what you want and like to do. Critical care is in my blood, always has been, thought about CRNA and it was not for me (didn't like the grey walls and stationary workbench). With my delineation of privileges, I intubate, place lines, perform therapeutic bronchs, perform LPs if needed, round on patients, and write orders. I do not float swans but place the introducer. This is what I like to do. So I went with the ACNP route. When I graduated, I thought I would end up with a hospitalist team, but there wasn't an opening. However, I did end up with an Intensivist team and thats where I am.

If I can help your further please let me know.

Tracey

JDCitizen · May 18, 2009

Since I can't speak for all programs / states.

I am an FNP now and have done some research two programs. The two programs I checked into are here in Georgia both at the time a my research were part-time and just at a year for ACNP (if you had a FNP first).

Now the bad news:

MCG folded their program due to state budget cuts.

Emory = Expensive (but you have access to some superb clinical sites).

My regret is I did not look into ACNP / ER training earlier.

ncube · May 20, 2009

@ Lifelong, are u employed by the hospital? Do u or can u work in clinics? Do u go back to an office of some sort to do paper work? Can uset up a practice if u wanted to or would u have to get an Adult NP License for that? I want to be an ACNP but do not want to be in the ICU all the time. thanks!!

lifelong · May 22, 2009

Hi there,

I am employed by the hospital. I have an office I share with my collaborating MD (who has his own practice...anesthesia). In Ohio I think the climate is such that the conservatism wouldn't gain me many referrals...but after I get some more experience I may give it a try. Setting up my own practice is something I would eventually want to do and technically could do legally in my state. I would just have to consider all options. I was approached about doing pre-admission testing for patients. I did one, kind of liked it but not sure right now it’s the best fit. It's a little slower pace, but had an office feel to it. I would probably bridge this before setting up anything on my own to give me a better feel for billings, office setup etc.

I graduated this past November, so I have a ton of learning to go through. So right now the 1:1 time with the Intensivist is my golden to me. I hope this has been helpful.

Tracey

jmeng · May 23, 2009

thanks Tracey,

I like ACNP because love working in big hospitals. I have also noticed ACNP in many icus where i work. It's a big city hospital. Do i need ICU experience to be in the program? I have all experience except ICU. Tele, med, ICU stepdown, surgical stepdown...ER breifly.

Why can't ACNPs work as FNPs in doctor's office? Its the same course the two programs have but a couple of courses difference.

thanks.

lifelong · May 23, 2009

You ask very good questions. I will give you my thoughts, but others may be able to shed more light.

It sounds like you have wonderful well-rounded experience, all which will help you no matter what track you decide to go. I honestly believe since the ACNP is focused primarily in critical care/ICU settings, having ICU experience will only enhance your learning and allow you to have some comfort during your clinical time. Having said that I am certain with your vast experience, you will likely do well either way. Graduate school is hard enough...always trying to keep ahead, if there's any way to keep things easy for you, then do it. For me, I was an ICU nurse; I didn't make any job changes (other than going weekend option) during my program...just to keep sane.

As far as the different tracks...I am no expert, but I always kept the two separated solely on what the titles were. FNP focuses on the lifespan of the person, from cradle to grave. So in my mind the focus is on primary care for the entire life span. I believe the clinicals are also focused on primary care. The ACNP focus is solely on acute phases of specific age groups (neonatal, pediatric and adult). Here the clinicals and focus is on deep penetration on the acute phases of disease management within that age group. Thats how I kept them separted in my mind.

I am not certain I hit the nail on the head, but hope that helps a little.

Tracey