ANCC and AANP

Specialties NP

Published

So, I have sent off my application for the ANCC exam and I'm awaiting my approval to schedule my exam. However, should I sign up for BOTH certifying bodies and just risk losing $120 for a cancellation fee from AANP? My husband says no, but the worry wart in me says I should.

I have used three different study guides and test questions to prepare. What do you guys think?

That happened to someone I knew last year. It was the Tx Board of Nursing who audited their clinical hours/sites and that person had already passed their exam! We were told to keep a copy or disk of all that information, b/c supposedly the Board of Nursing can ask for it at any time, even if you've been practicing for years.

That was because of this:

"It has also come to the board's attention that pediatric nurse practitioners who were educated and certified as primary care pediatric nurse practitioners have been invited to sit for the acute care pediatric nurse practitioner (ACPNP) examination if they are working in acute care settings. Please remember authorization to practice in a particular advanced practice role and specialty and use of a particular advanced practice title is granted by the board based on educational preparation. Although the PNCB may grant permission for you to sit for the acute care pediatric nurse practitioner examination, you are not eligible to use the ACPNP title or hold yourself out as an ACPNP unless you have been authorized to do so by the Texas Board of Nursing. Additionally, please be aware that you must maintain your national certification as a primary care pediatric nurse practitioner in order to maintain your authorization to practice as a pediatric nurse practitioner in the State of Texas."

There was also a similar problem with the FNP exam. They audited a number of FNPs and found out they had not completed all the age range requirements for FNP. One FNP had done their entire clinicals in an aesthetics practice. The consequence was that Texas BON threatened to revoke the certifying agency for NP certification if they didn't check the clinical hours. In reality this is a consequence of not having a specific NP program certifying authority. The consequences to a program that graduated a student like this should be probation at the very least.

David Carpenter, PA-C

That was because of this:

"It has also come to the board's attention that pediatric nurse practitioners who were educated and certified as primary care pediatric nurse practitioners have been invited to sit for the acute care pediatric nurse practitioner (ACPNP) examination if they are working in acute care settings. Please remember authorization to practice in a particular advanced practice role and specialty and use of a particular advanced practice title is granted by the board based on educational preparation. Although the PNCB may grant permission for you to sit for the acute care pediatric nurse practitioner examination, you are not eligible to use the ACPNP title or hold yourself out as an ACPNP unless you have been authorized to do so by the Texas Board of Nursing. Additionally, please be aware that you must maintain your national certification as a primary care pediatric nurse practitioner in order to maintain your authorization to practice as a pediatric nurse practitioner in the State of Texas."

There was also a similar problem with the FNP exam. They audited a number of FNPs and found out they had not completed all the age range requirements for FNP. One FNP had done their entire clinicals in an aesthetics practice. The consequence was that Texas BON threatened to revoke the certifying agency for NP certification if they didn't check the clinical hours. In reality this is a consequence of not having a specific NP program certifying authority. The consequences to a program that graduated a student like this should be probation at the very least.

David Carpenter, PA-C

I wonder how long it took it to come to the Texas Board of Nursings "attention"? Sounds like someone was asleep at the controls...

Specializes in ER, PM, Oncology, Management.

Looks like the school was "asleep". My graduate program was VERY clear on where we completed clinicals. They bent when they could regarding who you precepted with but the clinical experience requirements regarding never changed. We HAD to precept with a Pediatrician and an OB/GYN for those two rotations. There were no exceptions.

I find it scary that someone would be allowed to graduate from a FNP program without any primary care clinical experience. What's even worse, is was that student prepared?

Looks like the school was "asleep". My graduate program was VERY clear on where we completed clinicals. They bent when they could regarding who you precepted with but the clinical experience requirements regarding never changed. We HAD to precept with a Pediatrician and an OB/GYN for those two rotations. There were no exceptions.

I find it scary that someone would be allowed to graduate from a FNP program without any primary care clinical experience. What's even worse, is was that student prepared?

A FNP admitted to me that she spent the majority of her clinical hours with a neurologist who only saw adults. She never precepted in OB or pedes. Her online program permitted this and they also permitted her to work with physicians who weren't board certified. It seems to me that if a doctor can't even become board certified in his specialty, then he/she probably shouldn't be passing on their knowledge to anyone!

I wonder how long it took it to come to the Texas Board of Nursings "attention"? Sounds like someone was asleep at the controls...

Umm actually Texas BON is one of the few states to issue guidelines on NP scope or investigate certification in any meaningful way. Despite what the Texas BON found most states continue to blindly accept NP certification without trying to find out how widespread the problem is. I know of one NP in our home state that did her entire "FNP" in an ER which does not see peds. However there was no problem with certification. The NCSBON has identified certification as a problem but its up to the individual states to investigate it.

David Carpenter, PA-C

Umm actually Texas BON is one of the few states to issue guidelines on NP scope or investigate certification in any meaningful way. Despite what the Texas BON found most states continue to blindly accept NP certification without trying to find out how widespread the problem is. I know of one NP in our home state that did her entire "FNP" in an ER which does not see peds. However there was no problem with certification. The NCSBON has identified certification as a problem but its up to the individual states to investigate it.

David Carpenter, PA-C

This will be the downfall of our profession.

Specializes in ACNP-BC, Adult Critical Care, Cardiology.
A FNP admitted to me that she spent the majority of her clinical hours with a neurologist who only saw adults. She never precepted in OB or pedes. Her online program permitted this and they also permitted her to work with physicians who weren't board certified. It seems to me that if a doctor can't even become board certified in his specialty, then he/she probably shouldn't be passing on their knowledge to anyone!

There is a failure in more than one level in this case - first from the accrediting bodies, and second, from the national certification board. Unfortunately, some states do not have the resources to audit the educational preparation of all the NP's in the state and relies solely on the stamp of approval given by nursing program accreditation commissions and national certification boards for NP's. I give credit to the State of Texas for actually being able to crack the whip. Schools will operate the way they want to if allowed to do so unchecked. They will take any student's money, run away with it, and care less.

But I think the mechanism for making sure these schools do not operate is lacking. In theory, accrediting bodies have the responsibility to inspect programs and only accredit those that are in compliance with the standards of NP education. The problem lies in how the designated accrediting bodies, NLNAC and CCNE, inspects our nursing programs. NP programs are reviewed as part of the process of accrediting Master's degree granting institutions. No accreditation program specific for NP training exist. NONPF should insist on an accreditation commission dedicated to NP programs alone.

Second, either ANCC or AANP should have taken responsibility for not allowing the certification of the NP you gave as an example in your post. Although both certification boards only allow NP grads from programs that are accredited by either NLNAC or CCNE, application packets submitted by ALL graduate NP's applying for certification should be reviewed carefully to ensure that clinical rotations comply with the requirements of the specific specialty exam the graduate NP is applying for. Certification exams are not inexpensive. Both boards should have enough financial resources to do this.

It is really unfortunate for us NP's that we hear about this happening. While there has been tremendous growth in our profession over the small amount of time NP's have been in existence, much work still needs to be done. I think we've reached the point where we need to put a quota on the establishment of NP programs. There's just far too many and it seems like standards have gone amiss in some places and we need to nip it in the bud right away.

Specializes in ER, ICU, Surgical, Radiology.

How timely this discussion is occuring now. I graduated from the Univeristy of Illinois in May, with MS, in the FNP track. I mailed my application to ANCC on June 11. I had my transcripts sent directly from the U of I. Didn't hear anything back until the begining of August when I got a letter saying that ANCC had not recieved my transcripts. So I sent them again, this was August 11. I kept waiting, (keep waiting). I had a fellow student that received her letter and has a test date already scheduled. She said that she began calling ANCC two times a day and finally they called her and gave her the confirmation number so she could schedule her test. So I started calling daily.

Wedensday I spoke with the manager of the registars. I was told that she was unable to verify from my transcripts the population focus of the program (across the lifespan primary care). I freaked! I sent her course descriptions and actually contacted the dean of my program. The dean had to fax all the syllabi to ANCC. She told me that ANCC is beinging a more diligent review process.

I am thankful for that, but wonder if it might be better for review to be done between the ANCC and the university in question. This would help new APN graduates in an already stressful time. So here it is nearly 4 months after graduation, no letter, no confirmation number, job waiting for me. The ANCC was really good about cashing my $390.00 check though:banghead:

How timely this discussion is occuring now. I graduated from the Univeristy of Illinois in May, with MS, in the FNP track. I mailed my application to ANCC on June 11. I had my transcripts sent directly from the U of I. Didn't hear anything back until the begining of August when I got a letter saying that ANCC had not recieved my transcripts. So I sent them again, this was August 11. I kept waiting, (keep waiting). I had a fellow student that received her letter and has a test date already scheduled. She said that she began calling ANCC two times a day and finally they called her and gave her the confirmation number so she could schedule her test. So I started calling daily.

Wedensday I spoke with the manager of the registars. I was told that she was unable to verify from my transcripts the population focus of the program (across the lifespan primary care). I freaked! I sent her course descriptions and actually contacted the dean of my program. The dean had to fax all the syllabi to ANCC. She told me that ANCC is beinging a more diligent review process.

I am thankful for that, but wonder if it might be better for review to be done between the ANCC and the university in question. This would help new APN graduates in an already stressful time. So here it is nearly 4 months after graduation, no letter, no confirmation number, job waiting for me. The ANCC was really good about cashing my $390.00 check though:banghead:

Did you actually have to send the ANCC the logs of your patient encounters? The program I was referring to has all the required classes in their FNP program, but the students aren't required to spend clinical time in all the areas covered. So, what good is that?

I work at an urgent care clinic a couple of days per week and I precept students there. Several of them have asked if they can spend all their clinicals hours with me. I've told them they need to spend time in primary care, pedes and OB b/c they aren't even beginning to get the experiences they need. One of their former students spent all of her clinical time in this setting. She never treated hypertension, diabetes, dyslipidemia, anemia, CHF, etc.

We see very few children at that clinic, since there are several pede urgent care clinics and we rarely treat elderly patients in this setting either. The fact that these students are allowed to get all their training at this site is just flat out wrong. The ANCC and the AANP need to require students to submit a log of their clinical experiences and they will be shocked at the training these students are getting. I definitely didn't have this experience in school, I had to spend a specific number of hours in each specialty.

Regarding your situation, I know several students who haven't gotten their letter to test from the AANP and they graduated in May. I didn't realize the ANCC was so disorganized. I graduated in August 2005 and I had taken and passed the ANP ANCC exam in September - less than 6 weeks from start to finish. The process was even quicker when I took the GNP exam 8 months later, but I wasn't competing with new grads either. I remember having to wait almost THREE MONTHS before I got the letter to test from the AANP for the FNP exam. They sent it the first of August and I had less than 3 weeks to schedule the exam. For what it's worth, I thought the AANP exam was much more straightforward and easier than the ANCC exams, so I can't complain too much.

Did you actually have to send the ANCC the logs of your patient encounters? The program I was referring to has all the required classes in their FNP program, but the students aren't required to spend clinical time in all the areas covered. So, what good is that?

I work at an urgent care clinic a couple of days per week and I precept students there. Several of them have asked if they can spend all their clinicals hours with me. I've told them they need to spend time in primary care, pedes and OB b/c they aren't even beginning to get the experiences they need. One of their former students spent all of her clinical time in this setting. She never treated hypertension, diabetes, dyslipidemia, anemia, CHF, etc.

We see very few children at that clinic, since there are several pede urgent care clinics and we rarely treat elderly patients in this setting either. The fact that these students are allowed to get all their training at this site is just flat out wrong. The ANCC and the AANP need to require students to submit a log of their clinical experiences and they will be shocked at the training these students are getting. I definitely didn't have this experience in school, I had to spend a specific number of hours in each specialty.

Regarding your situation, I know several students who haven't gotten their letter to test from the AANP and they graduated in May. I didn't realize the ANCC was so disorganized. I graduated in August 2005 and I had taken and passed the ANP ANCC exam in September - less than 6 weeks from start to finish. The process was even quicker when I took the GNP exam 8 months later, but I wasn't competing with new grads either. I remember having to wait almost THREE MONTHS before I got the letter to test from the AANP for the FNP exam. They sent it the first of August and I had less than 3 weeks to schedule the exam. For what it's worth, I thought the AANP exam was much more straightforward and easier than the ANCC exams, so I can't complain too much.

Part of the blame has to go to the programs. Specifically those that require the students to find their own preceptors. This allows students to game the system. If programs were required to find programs for the students and ensure that the programs met requirements for certification it would go a long way toward eliminating some of the dodgier programs. Of course that would require an accreditation body that actually understood accrediting NP programs (as was mentioned above).

David Carpenter, PA-C

I fully agree. I went out of my way to find a pediatrician because I needed that. My program required no set hours but "some time" with OB. This was a problem since no NPs and none of the family docs do OB in this area, so I found an OB/gyn who was willing to have me observe (plus do some Leopold maneuvers) for a couple of days.

I have said before that I think training needs to be standardized. I realize that the cert exam at the end is supposed to take care of that, but sitting for a test is not the same as experience. It might help if to start there would be just ONE certifying agency (but what a nightmare to arrange that would be).

The ANCC application has a line on the form from the school asking for total clinical hours. I assume they then took the school's word for it that the hours were distributed. If the training were more along the MD/PA model, at least in the beginning, with rotations through specialties, it would help avoid the haphazard process we wade through now.

I would find it encouraging if the powers that be would work on this rather than pushing for the DNP.

I fully agree. I went out of my way to find a pediatrician because I needed that. My program required no set hours but "some time" with OB. This was a problem since no NPs and none of the family docs do OB in this area, so I found an OB/gyn who was willing to have me observe (plus do some Leopold maneuvers) for a couple of days.

I have said before that I think training needs to be standardized. I realize that the cert exam at the end is supposed to take care of that, but sitting for a test is not the same as experience. It might help if to start there would be just ONE certifying agency (but what a nightmare to arrange that would be).

The ANCC application has a line on the form from the school asking for total clinical hours. I assume they then took the school's word for it that the hours were distributed. If the training were more along the MD/PA model, at least in the beginning, with rotations through specialties, it would help avoid the haphazard process we wade through now.

I would find it encouraging if the powers that be would work on this rather than pushing for the DNP.

I had to spend 125 hrs in OB/GYN, 175 in pedes, 175 in adult and 175 in gero for my FNP certification. There is no way I could have learned everything I needed to know in OB in 2 days!

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