Acute PNP vs. Primary Care PNP

Hi! Im a BSN-RN with two years of experience in inpatient peds oncology/bmt. I am interested in applying to NP programs for next fall and am torn between acute and primary care routes. I think initially I would love to stay in inpatient onco or onco clinic. However, I could see myself in a few years wanting a change of pace and switching to primary care. Is there flexibility for Acute PNPs to switch to a primary care setting? Would love any advice I've been so stressed out about this!! Thanks

[RN4Shizzle]

I called UF (a school I'm interested in) and the director of the ACPNP program set up a zoom call for me and answered this question. I totally recommend calling the school you're interested in and letting them help you with it. It's super helpful! I was very much in the same boat as you (and still kinda am, sometimes). 

He recommended starting acute care, then when you're burnt out with the hospital, take a certificate program in primary care then switch to primary care. 

I'm kind of in a situation where I just want to pick the path I ultimately want to end up at. I'm done with call. I'm done with the hospital shenanigans. I think I'm going to go primary care and teach which is my ultimate end game. 

[adventure_rn, MSN, NP]

If you're interested in oncology at all, I would absolutely start with acute care peds.

The thing I've come to find in my acute care peds program is that the role is extremely flexible--you can work in all sorts of specialty roles and clinics, many of which have great hours. I would argue that it's actually a lot easier to find a 'cushy' outpatient acute care role than in primary care. In 'true' primary care, you're seeing dozens of patients per day while trying to squeeze a ton of screenings and teaching into a very short period of time. In my acute care rotations in outpatient clinics and consulting services, many of the NPs had lighter patient loads where they could spend a lot of time on each case (for instance, seeing around 8-10 patients per day).

Beyond that, you might come to find (as I did) that primary care is extremely different from acute. Primary care is heavily focused on developmental screenings, minor infections/injuries, immunizations, skin rashes, and figuring out when to refer. I found it kind of tedious and dull compared to learning the complex patho in acute care.

When I first started looking at schools, I was certain that I wanted to do a combined dual-specialty program for AC and PC in order to have the greatest flexibility--after I actually started learning primary care, I was so glad that I didn't.