Acute v Primary v FNP _NYC area

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Specializes in Cardiothoracic surgery, critical care, med-surg,.

Hi all,

Nurse looking for some advice here. I've been a nurse little under 2 years (medsurg/medical stepdown) and just transitioned to CT stepdown w some ICU crosstraining (basically, soft CTICU cases). Both at Top 10 US hospitals in NYC.

I've wanted to become a provider since before nursing school but liked the route of nursing and gaining some experience/ exposure. I plan to go part-time starting next Summer/fall so by the end ill have about 5 yrs of nursing experience. Before nursing school, I was an EMT in a major city for 3 years and then 3.5 years as an ER Tech in a trauma center before and during school.

When I went into nursing I was so sure I wanted to be only an ER nurse or ICU nurse, and do critical care for life. I think this time I've spent as a tech/nurse + being in NYC epicenter doing 5 moths of covid only patients, including shock induction into a little bit of ICU during that, has dulled this passion for me (which is sad).  But honestly, I am a little sick of doing nights and holidays and really like the idea of working outpatient one day especially when I have a family. BUT I just don't really want to do family practice/general medicine outpatient. I would MUCH rather work as an outpatient cardiac NP  for example (as this is my current nursing specialty it makes sense and I enjoy this). I am still a little worried about being bored outpatient, but I cannot see myself working in the hospital for the rest of my life, and I think the outpatient provider is much more interesting than outpatient nurse.

I am accepted into NYU's AGACNP program starting this Spring but it's SO EXPENSIVE even with tuition assistance. other programs in NY for primary or FNP such as hunter or stony brook I can attend basically for free if I go part-time. I graduated w 4.0 from nyu nursing undergrad so I am hoping I won't have much issue getting into programs, but I know those less expensive options can be very popular and thus hard to get into. I am currently leaning towards applying to those programs and getting a primary care/FNP. 

short version: If I want to work in an outpatient specialty office/clinic (likely cardiac, but open to others), outpatient surgical center, urgent care, etc - what NP degree should I get- is it OK to do primary care NP or FNP for this? Is it worth it to pay like 60-80k more at a fancy school to be an acute NP? Can I do ANYTHING in hospital as a FNP or primary (like, one of those IR suites or noninvasive cardiac areas) 

THANK YOU WISE NPS ?

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Specializes in Vascular Neurology and Neurocritical Care.

Nope, ACNP it is. New York state is big on consensus model and most hospital NP jobs specify the need for ACNP credentials nowadays. You CAN do outpatient with ACNP, such as specialty clinic in any of several specialties such as CV, neuro, pulm, etc. So if it's hospital you want, just do ACNP. If it's primary care, go FNP.

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Specializes in Critical Care.

Do not pay for a colleges name. Find the cheaper options. 

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Specializes in Cardiothoracic surgery, critical care, med-surg,.
1 hour ago, ArmaniX said:

Do not pay for a colleges name. Find the cheaper options. 

I agree, other problem NYU is one of the only acute NP options in new york besides pace, which costs the same, or columbia, which can only be attending full time DNP. 

4 hours ago, Neuro Guy NP said:

Nope, ACNP it is. New York state is big on consensus model and most hospital NP jobs specify the need for ACNP credentials nowadays. You CAN do outpatient with ACNP, such as specialty clinic in any of several specialties such as CV, neuro, pulm, etc. So if it's hospital you want, just do ACNP. If it's primary care, go FNP.

thank you for reply! would a primary or FNP be able to work in an outpatient specialty clinic or is that really restricted to primary care only 

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

I would say that if your interest lies in Cardiology (in-patient or out-patient), AGACNP would be the best preparation because there is a heavy focus on cardiovascular physiology in the program and there is an opportunity to spend a big amount of your clinicals in the specialty if you request it.  Having said that, you almost have to do your own research because in my state, some of the Cardiology NP's who work out-patient did have primary care NP training.  Another option you can consider is to attend the cheaper school and consider a Cardiology NP fellowship (they are gaining traction, just don't know if NY has one).

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Specializes in Vascular Neurology and Neurocritical Care.
On 10/27/2020 at 11:13 AM, emtrn13 said:

I agree, other problem NYU is one of the only acute NP options in new york besides pace, which costs the same, or columbia, which can only be attending full time DNP. 

thank you for reply! would a primary or FNP be able to work in an outpatient specialty clinic or is that really restricted to primary care only 

ACNP is still more geared to that. But there are FNPs in that setting. 

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Specializes in Vascular Neurology and Neurocritical Care.
On 10/27/2020 at 11:13 AM, emtrn13 said:

I agree, other problem NYU is one of the only acute NP options in new york besides pace, which costs the same, or columbia, which can only be attending full time DNP. 

thank you for reply! would a primary or FNP be able to work in an outpatient specialty clinic or is that really restricted to primary care only 

True but there is Molloy College and Hofstra on Long Island too as alternatives to Columbia, Pace, and NYU. I believe LIU is looking to open an ACNP program soon too

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