FNP working in acute care

  1. I am a newly licensed/board-certified FNP. Can I practice in an acute care setting (i.e. hospital)? My application for privileges at the hospital was approved. Are there any FNPs that have practiced in a hospital setting?
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    Joined: Jul '18; Posts: 1

    11 Comments

  3. by   djmatte
    While you technically can provided the hospital and the state bon had no restrictions on it, it is increasingly frowned upon. As an FNP, your training and even your boards don't certify you to work in acute care and in the end should a lawsuit present, you'd be hard pressed to show where in your training it did prepare you to be an acute care provider. As the consensus model expands, you will find more opposition to your work arrangements and in some cases may find it harder to keep your job. If memory serves, Ohio just okayed an ultimatum barring primary care NPs from working in hospitals. This trend will continue and I'd hate to be forced to get a post posters or lose my job and then have no primary care experience to fall back on.
  4. by   xxbeach
    To add on to op's question, can you be primarily employed at a primary care clinic and have rounding privileges 1-2 days a week at a hospital as a FNP?
  5. by   Dodongo
    Did your program have any specific classes in your didactic training in inpatient/acute care medicine? Did you have any clinical rotations in an inpatient environment?
  6. by   babyNP.
    It depends on the state in which you are practicing and whether or not the credentialing board of the particular hospital will accept your training. There are people who do this, but it's dependent on those variables.

    Whether you should or not is less cut and dry. Personally I think you should practice in the area in which you are trained. There are programs helping to address the fact that FNPs are trained in primary care and want to work in acute care- there are several post-masters programs to get these folks up to speed, be it by personal desire vs a state board/hospital board telling them they are required.

    tbh- schools should really be telling their students this.
  7. by   Rocknurse
    I'm in an acute program in the NorthEast and my professor has really been driving home to us that we should practice in our area of training. My school will not place FNP students in an in-patient clinical area and only acute students can be placed in hospital environments. Having said that I do know a few FNPs that practice in hospitals, some in critical care, but it becoming increasingly less common.
  8. by   JellyDonut
    Depends on where you live. Where I practice the NP hospitalist and most of the NPs rounding IP are ANP or FNP. I have met maybe 3 acute care NPs in the past five years. Sure, we were told about the consensus model in the state I completed my FNP, but it has not seemed to gain the traction we were told. Even if my state adopted it everyone would be grandfathered in as there is no way they could replace all of us with ACNPs. If you work in a state with the model - stay in your lane, but if you have the opportunity to work acute and don't mind a learning curve - then make it happen. You can always bridge later if you need to.
  9. by   traumaRUs
    What they did at the big hospital system where I live, they gave the FNP's 5 years to get their ACNP or out the door.

    Here is some info about FNPs practicing in the in-pt environment:

    Statement for Employers on Primary & Acute Care CNPs (2013)

    FNP vs ACNP + Core Differences - 218 NurseJournal.org218 NurseJournal.org
  10. by   djmatte
    Quote from JellyDonut
    Depends on where you live. Where I practice the NP hospitalist and most of the NPs rounding IP are ANP or FNP. I have met maybe 3 acute care NPs in the past five years. Sure, we were told about the consensus model in the state I completed my FNP, but it has not seemed to gain the traction we were told. Even if my state adopted it everyone would be grandfathered in as there is no way they could replace all of us with ACNPs. If you work in a state with the model - stay in your lane, but if you have the opportunity to work acute and don't mind a learning curve - then make it happen. You can always bridge later if you need to.
    Be careful what you presume about grandfathering. Because Ohio is going to that model on a hard line and isn't grandfathering anyone.
  11. by   BostonFNP
    Quote from xxbeach
    To add on to op's question, can you be primarily employed at a primary care clinic and have rounding privileges 1-2 days a week at a hospital as a FNP?
    I did it for years.
  12. by   BostonFNP
    Quote from npmm
    I am a newly licensed/board-certified FNP. Can I practice in an acute care setting (i.e. hospital)? My application for privileges at the hospital was approved. Are there any FNPs that have practiced in a hospital setting?
    You need to be able to confidently answer, and demonstrate if need be, that the acute care you are providing falls withing the scope of your education and training. If it does and your state BOD give it the OK and the hospital credentials you then good luck. If it doesn't, regardless of what the hospital approves or the state BON allows, you are putting yourself and your license at risk (as well as patients).
  13. by   lbonn_MICUNP
    I am FNP prepared and currently working in a Medical ICU. I contracted with my job to begin a post-masters for my AGACNP within 2 years of starting. I am currently enrolled and happy to have the dual certification but I do know one ANP who was asked to leave our service (and did leave) a few months ago because she was not willing to go back.

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