AGACNP

I'm currently looking for a NP job (new grad) but I've had interviews at a variety of places. One was a liver transplant inpatient unit, a Urology clinic (seeing outpatients), a Nephrology clinic (seeing outpatients), a GI clinic (seeing outpatients with ability to see inpatients), an ICU inpatient only, and a Cardiac clinic (outpatient and inpatient) and hoping to interview with a cardiothoracic surgeon (possibly doing inpatient, outpatient, and assisting in the OR).

I think a lot of changes are coming to the landscapes of NPs. I see a lot of hospitalist and inpatient positions open to Acute Care NPs only and I definitely think we are welcome in any specialty (excluding women's health most likely). My local ER/Urgent Care only hires FNP because of peds/OBGYN but I would think in some more academic hospitals and cities that have women/children's hospitals would be more receptive to AGACNP.

Here's a little something I came across last night in my search about the history of the various NP roles. It's from a Medscape CME activity from 2007 and thought it was very interesting and relevant to this age-old question regarding outpatient/primary care. As far as specific specialties, not sure if this stretches to those areas. I guess it would be based on employer and/or employee.

"Should an NP who is educationally prepared as an acute care NP work in an adult primary care setting?

The answer is no. The acute care NP program prepares graduates for a specialty focus in acute, episodic, and critical conditions that are primarily managed in a hospital-based setting. The program of study does not contain adequate clinical and didactic content to support the ACNP for a broader role in outpatient primary care diagnosis, treatment, and follow-up. Diagnosis and outpatient management of stable and unstable chronic illness, as well as directing health maintenance of a wide range of conditions, is a required competency for practice in the primary care role.

Additionally, professional licensure and certification will reflect validation that the provider has met criteria for practice in a focused, rather than broad, scope of practice. Finally, the environment of primary care is not congruent with the acute care secondary or tertiary care training focus. A lack of congruence between the practice environment and level of expertise results in a decreased level of safety for the patient and increased risk of liability for the NP."

https://www.medscape.org/viewarticle/506277_7?src=android&ref=share

Yes, an ACNP can work outpatient in a specialty. It isn't limited to inpatient only. It all comes down to Consensus Statement. The only thing you would be prohibited doing is primary care. All else is game.

Very interesting. Thank you for the input, look forward to other personal experiences. Anyone work in outpatient clinics in a specialty like cards or nephrology? Anyone work for a surgeon and do rounds?

Only curious if you do the following and are indeed an AGACNP.

On 1/25/2020 at 12:43 PM, LucidMonkeyCCRN said:

Very interesting. Thank you for the input, look forward to other personal experiences. Anyone work in outpatient clinics in a specialty like cards or nephrology? Anyone work for a surgeon and do rounds?

Only curious if you do the following and are indeed an AGACNP.

I'm Neurocritical Care by background but I have done neurosurgery on the side too, and yes they involved rounding, OR, and clinic. Clinic was twice a week and involved setting new patients for consideration of surgery on non urgent basis and post op checks, etc. ACNPs can definitely thrive in outpatient setting.

A lot of the sub specialists seem to prefer PA or acute care NP for their clinics and inpatient rounding vs fnp

On 1/23/2020 at 5:07 PM, juan de la cruz said:

Out-patient Cardiology, Nephrology, GI, or ID is not primary care. I know that in some instances, these specialists deal with primary care issues but that does not make them primary care practices just because they are out-patient. Primary care is the purview of physicians who practice out-patient Internal Medicine, Pediatrics, or Family Practice. That said, AGACNP's are not out of scope just because they practice in a specialty in an out-patient setting.

@juan de la cruz If one wanted to practice in out-patient cards, based on your comment, is acute care or FNP more appropriate? I am starting an FNP program and am interested in out-patient cards. Thank you for all of your comments on this site, they have helped tremendously.