Adult NP or FNP?? Any Opinions??

nomadcrna, DNP, CRNA, NP · Nov 25, 2011

It was said in this thread, its fair game.

I would think that NPs would support the national NP organizations who have come out and said we should all work to expunge that term.

If we don't stick together and support the goals of our NP organizations, not much will get done.

Nomadcrna - I politely request that you stay on target.
Most of us (myself included) are not offended by being called a midlevel practitioner.
It sure beats physician extender - which sounds just nasty to me. (See - we all have our biases).

coast2coast · Nov 26, 2011

I do not provide mid level care and consider the term midlevel to be derogatory.

Most of us (myself included) are not offended by being called a midlevel practitioner.
It sure beats physician extender - which sounds just nasty to me. (See - we all have our biases).

For what it is worth, nomad, I agree with you 100%. I think a fair share of us would be offended by the midlevel label, trauma. Both 'midlevel' and 'physician extender' undermine the basic concept of being an independent care provider. One day these titles will come back to bite us in our collective orifice.

I am considering switching to the Adult/Gerontology track as I am not really interested in treating children. I also have been hearing some really negative things from friends and on this forum about the FNP track at the school I'm in...a weed-out program, less than half make it through, instructors are unsupportive and you teach yourself, etc. I hear some of the other tracks are much better.
Not sure what to do. Are there any Adult NPs out there that can tell me how they like their practice? Do you feel you made the right choice? Or am I severely limiting myself as far as employment opportunities?

OP, I have been in your shoes and I have a few comments for you:

1. I was also on the fence about treating kids, and I am so glad I stuck with ANP instead of FNP. Peds is really a world unto itself, and I can't imagine trying to learn all the kid-specific stuff on top of trying to master basic adult health. I can't imagine doing either specialty justice with shared clinical time (the programs were equal length at my school). There are always post-master's programs if you want to add a specialty later on.

2. Employment for ANP v. FNP really seems to vary. I think that, overall, it matters less than one might expect. What kind of setting do you want to work in? Retail clinics like FNP's but who in the world graduates and wants to work retail right off the bat? Some private primary care places will still look hard for an FNP over an ANP, but I have been pleasantly surprised at the number who don't. If you want to work inpatient or become a hospitalist the ANP does not seem to be at all limiting. I think this a locational thing - some parts of the country actually use true "family" practitioners who see every member from birth to death, but most of the metro areas Ive been in separate practice by age (peds, adult, specialty gero) and then by medical subspecialty if necessary.

3. BABY BOOMERS! There are so many of them. I didn't become an ANP to become a gerontologist, it's just a consequence of modern practice. Don't be afraid of the gero's! They will guarantee you employment for life :)

And lastly - to everyone re-hashing the ANCC re-naming debacle. Let's not forget the ANCC's (smarter?) cousin, the AANP. If you are super attached to being 'just' an adult or gerontological NP, you still have an option for certification. Not sure why this is considered such a big deal ?

Advanced Practice Columnist / Guide · Nov 26, 2011

And lastly - to everyone re-hashing the ANCC re-naming debacle. Let's not forget the ANCC's (smarter?) cousin, the AANP. If you are super attached to being 'just' an adult or gerontological NP, you still have an option for certification. Not sure why this is considered such a big deal ?

True enough, it looks like AANP haven't announced plans to change their certification program credentials to reflect how the Consensus Model Population Foci is organized. Consequently, AACN has not announced any change to their ACNPC certification as well. I wonder if it's just a matter of time because the Consensus Model is also endorsed by both AANP and AACN. Perhaps, they have something in the works but have not made a formal change since the slated full implementation is 2015. Wish someone from both boards could come and clear it up.

CCRNDiva, BSN, RN · Nov 26, 2011

They are not getting rid of the the acute care tracks. The Consensus Model streamlined the NP specialties by dissolving the Gerontological NP track and incorporating it into the adult tracks as either Adult and Gerontology Primary Care or Adult and Gerontology Acute Care. This change only affects the NP tracks that deal with the adult population. The Family, Peds, and Women's Health tracks are not affected. Psych is affected because the Adult and Peds which used to be separate will be combined as one - Family Psych.
If you are currently enrolled in an Adult Acute Care or Adult Primary Care track, you should check with your program director to see what changes are being planned in order to incorporate the Gerontology content in your program so that you can meet the new certification requirements being launched by ANCC for target implementation year of 2013. I know the school I attended for my ACNP currently imposed an admission moratorium for their ACNP and ANP program while they reorganize the curriculum. Some schools already have a combined Adult and Gerontology curriculum in their ACNP and ANP programs so those programs should be fine with the new changes. My program didn't have a formal Gerontology content but we all know that majority of patients admitted in adult wards of hospitals are above the age of 65.
As far as I'm concerned, I would still recommend doing an Acute Care track if that's where your interest lies. It is a good preparation for in-patient roles. But if given a choice between ANP (primary care) and FNP, I would easily pick FNP, but again, that's just my opinion.

Thanks for the clarification, Juan. I did look over the qualifications for programs under the Consensus Model and I think my school has met the requirements. They state that programs must contain broad based courses covering the lifespan in physiology/pathophysiology, pharmacology and assessment. Our physiology/pathophysiology and pharmacology courses are broad based and cover content across the life span. I will check with my program director to make sure the assessment course does the same.

I definitely want to remain in acute care as primary care does not suit me. I love caring for critically ill patients and I figure that if I can always work in specialty clinic if I want to get out of critical care or tire of shift work later in my career. Thanks again!!

nomadcrna, DNP, CRNA, NP · Nov 26, 2011

CCRNDiva,

There are some programs that teach both acute care and primary care at the same time. Some are called ENP(emergency nurse practitioner) but basically you can take both the ACNP and FNP boards.

Vanderbilt has one. It is a bit longer of course but may be what you are looking for.

CCRNDiva, BSN, RN · Nov 26, 2011

Thanks for the suggestion, Nomad.

reeya · Dec 1, 2011

Gville RN, I sent you a pm.

Gville RN · Dec 1, 2011

Thanks reeya, I was able to read your message, however, I do not yet have the ability to post private messages - need a few more posts on the forum.

Thanks for the info!

Nikchan · Jul 2, 2014

Hi there I am also and RN who is going to enrol in an NP program. I was pretty sure that I wanted to do the ANP route until I came here and read all the posts about how much more marketable the FNP route is. My dilemma is I do want to be more marketable and would not mind working with kids if I go the FNP track, however I love being in the hospital setting but from my research it seems that hospitals rarely hire FNPs. If i could do both that would be great! Any thoughts or Ideas are welcome.