ANP vs. FNP for cardiology?

**RosesrReder, BSN, MSN, RN** · Aug 11, 2005

Hello and welcome to the wonderful family of allnurses.com. Enjoy your stay, and best of luck to you. :) (There is someone with a name just like yours around).

CardioTrans, BSN, RN · Aug 12, 2005

I work with many CRNPs in the hospital with varying subspecialties. All of them are FNP's. Several work for the cardiologists, some for pulmonary, renal, infectious disease and neuro. Come to think of it, I have not seen one with anything other than an FNP.

carachel2 · Aug 12, 2005

I've talked to no less than three NP's who work with local cardiologists and they all say to go the FNP route for more flexibility,etc. One has an adult NP degree, but says she wishes she was FNP so she could possibly be open to other positions.

Fox · Aug 13, 2005

bump

Angie O'Plasty · Aug 13, 2005

Thanks for the advice. The consensus seems to be that FNP is the way to go, which makes sense because it gives you the most options. I also called one of the programs I'm interested in (actually my first choice) and they said I can still take the cardio classes with FNP. So that's probably what I'll do. On a related note, if one does FNP can she then go and work in a children's hospital (say, in pediatric cardiology)? Or do only PNP's do that? I must sound like an idiot with all these questions!

Gennaver, MSN · Aug 14, 2005

Thanks for the advice. The consensus seems to be that FNP is the way to go which makes sense because it gives you the most options. I also called one of the programs I'm interested in (actually my first choice) and they said I can still take the cardio classes with FNP. So that's probably what I'll do. On a related note, if one does FNP can she then go and work in a children's hospital (say, in pediatric cardiology)? Or do only PNP's do that? I must sound like an idiot with all these questions![/quote']
Hello Angie,
Glad to read your post and the answers that followed, (I am an direct entry student myself). You may also be interested to read the thread in the student nurses forum, (under graduate msn/np/doctorate nursing). There are several more of us direct entry master's nursing students, (many are starting this fall and some started classes in May).
Good luck,
Gen

Cardiology EP NP · Aug 17, 2005

Lately, I have heard differently about which direction to go for the cardiac NP. Since the FNP is the most popular program, there are more FNPs out there than any other type of NPs so hospitals and physicians offices don't have much choice when pooling from NPs.

Also, there aren't many Acute Care NP programs out there. Hence you see more FNPs working in hospitals these days. According to an admissions director at a fairly prestigious nursing school, FNPs who work in specialy areas in a hospital setting are actually working out of their scope of practice. FNPs are typically supposed to work in physician offices or clinics treating people from birth through adulthood. FNPs were not trained to do specialty work such as cardiac care. According to this admissions director there are now some lawsuits being followed because of this issue where FNPs are working outside their scope of practice.

If I were to do cardiac care, I wouldn't want just the FNP training because I would think it would be way too general. I just wouldn't feel prepared to care for cardiac patients. In order to be a cardiac NP, I would go to a school that offers an acute care NP program where I can concentrate my clinicals in cardiac care. I would feel more comfortable going the "safe" route and not find myself in dire straits later. And then later on, I can always go back for FNP if I want to.

Anyway that's my 2 cents worth. (I actually work on a cardiac step down unit at a large teaching facility where we have quite a few cardiac NPs. I see the work they do and it just seems like their training should be more specialized and technical.)

Hello Angie,
Glad to read your post and the answers that followed, (I am an direct entry student myself). You may also be interested to read the thread in the student nurses forum, (under graduate msn/np/doctorate nursing). There are several more of us direct entry master's nursing students, (many are starting this fall and some started classes in May).
Good luck,
Gen

Angie O'Plasty · Aug 17, 2005

Lately, I have heard differently about which direction to go for the cardiac NP. Since the FNP is the most popular program, there are more FNPs out there than any other type of NPs so hospitals and physicians offices don't have much choice when pooling from NPs.
Also, there aren't many Acute Care NP programs out there. Hence you see more FNPs working in hospitals these days. According to an admissions director at a fairly prestigious nursing school, FNPs who work in specialy areas in a hospital setting are actually working out of their scope of practice. FNPs are typically supposed to work in physician offices or clinics treating people from birth through adulthood. FNPs were not trained to do specialty work such as cardiac care. According to this admissions director there are now some lawsuits being followed because of this issue where FNPs are working outside their scope of practice.
If I were to do cardiac care, I wouldn't want just the FNP training because I would think it would be way too general. I just wouldn't feel prepared to care for cardiac patients. In order to be a cardiac NP, I would go to a school that offers an acute care NP program where I can concentrate my clinicals in cardiac care. I would feel more comfortable going the "safe" route and not find myself in dire straits later. And then later on, I can always go back for FNP if I want to.
Anyway that's my 2 cents worth. (I actually work on a cardiac step down unit at a large teaching facility where we have quite a few cardiac NPs. I see the work they do and it just seems like their training should be more specialized and technical.)

Thanks for the info. That does make sense, and I did have some concerns about FNP being pretty general but thought it could be made up for with the choice of clinicals/electives. I think a lot of the FNP's I heard about were in outpatient cardiology offices rather than the hospital--are they outside their scope of practice there, or is that OK? And are ANP's OK working in the hospital, or is it the same problem as FNP? It seems at least that ANP would be somewhat less general. I've seen at a lot of places that NP's run things like CHF clinics, but I'm not sure what type of NP usually does that, maybe someone could enlighten me. Also out of curiosity, what do the cardiac ACNP's do at your hospital? OK, enough of my questions!!

Cardiology EP NP · Aug 17, 2005

I think FNPs in the outpt setting are ok but don't quote me on that. MY boss said the nurse practitioners on our floor are trained as ANPs.

Cardiac NPs at my hospital do alot. they go on rounds with the surgeons. They do complete assessments, order medications, do some of the follow up care in the bypass clinic. They see pts postoperatively. They are very busy. They also pull chest tubes, etc.

Loyola has an ACNP program with a cardiac track. I'm not sure what other schools would have one.

Hope that helps.

Thanks for the info. That does make sense and I did have some concerns about FNP being pretty general but thought it could be made up for with the choice of clinicals/electives. I think a lot of the FNP's I heard about were in outpatient cardiology offices rather than the hospital--are they outside their scope of practice there, or is that OK? And are ANP's OK working in the hospital, or is it the same problem as FNP? It seems at least that ANP would be somewhat less general. I've seen at a lot of places that NP's run things like CHF clinics, but I'm not sure what type of NP usually does that, maybe someone could enlighten me. Also out of curiosity, what do the cardiac ACNP's do at your hospital? OK, enough of my questions!![/quote']

gauge14iv, MSN, APRN, NP · Aug 17, 2005

You might check with your state regs - In Texas, as of Jan 1 2006 - you MUST be an Adult NP, Family NP, Pedi NP, Neonatal NP, CRNA, Nurse Midwife, Acute Care ped or adult NP, Geriatric NP, Womens Health NP or Psych NP BEFORE you get as specific as Cardiac. For instance someone who ONLY was educated and certified in a cardiac specialty might have getting authorization to practice in some states without going back and getting the broader knowledge base first.

IMHO - you are better off getting as broad an education as you can stand. Specialization in a specific area comes later - much like it does for RN's. FNP's and ANP's would not be outside their scope of practice by working in cardiology, making hospital rounds or prescribing birth control, but they WOULD be outside their scope if they delivered a baby or administered anesthesia just as a WHNP might be if she were to prescribe antibiotics for a toddler with an ear infection. It really all boils down to the state you plan to practice in.

lalaxton · Aug 17, 2005

I agree with the poster above. Scope of practice is dictated by your state Board of Nursing and may differ from state to state. For an academic to state that an FNP is practicing outside their scope if they practice in a hospital may be correct in that states. Where I have worked in the past (SC and LA) there was no such limit to the scope of practice. Usually if the NP can demonstrate competency in a specialty through continuing education or X hours under the surpervision of the specialist or something along those lines, you should be covered. As always though, as NP's are responsible for their own actions (as all nurses are) if you feel you are out of your depth dealing with a patient you must consult, consult, consult!!

I agree that starting with a more general area such as FNP gives you more flexibility. There is no program that I know of that will give you a 'Cardiac NP'. Yes FNP's are more Primary Care oriented and ACNP's are really more inpatient oriented but I know FNP's who work in hospitals and ACNP's who work in offices and both have had to have extra training in a specialty area.

Confusing isn't it?