BSN to ACNP

Advanced Practice Columnist / Guide · Dec 17, 2014

What skills are ACNPs typically allowed to do in an ED setting?

This will vary by institution and is less affected by state mandates. Be aware that Acute Care NP programs are divided into two tracks: Adult and Peds. You take one or the other or you can take one first and then do a post-master's on the other later. Not having both could be a problem in an ED where NP's must be allowed to see all age groups.

ACNP programs train in high acuity situations (including traumas) as well as invasive monitoring and invasive lines. You will have an understanding of high acuity physiology and will likely be exposed to invasive procedures of all types in your program.

In reality, many NP's in the ED could suture lacerations, splint and cast, perform pelvic exams, and many urgent care procedures. Some probably intubate and place lines.

How autonomous are they in the ED?

Autonomy is determined by 2 things: state scope of practice and institutional credentialing. There are independent practice states and AZ is one of them. The degree to which NP's are independent in a hospital setting (i.e., ED) is dependent on bylaws created by the hospital's Medical Staff Board. I suspect that since state scope of practice allows for independence in AZ, it follows that institutions would credential NP's to be independent providers in AZ. However, this may not be the case everywhere in that state.

Not that it's a huge deciding factor, but is the pay really 85k and below like the averages say?

Sorry, can't answer this question

As a disclosure, I am an Adult ACNP who work in adult critical care in Northern California.

2critical · Dec 18, 2014

This will vary by institution and is less affected by state mandates. Be aware that Acute Care NP programs are divided into two tracks: Adult and Peds. You take one or the other or you can take one first and then do a post-master's on the other later. Not having both could be a problem in an ED where NP's must be allowed to see all age groups.

Awesome info. Thank you! I seriously appreciate it. One final question, the portion where you were discussing peds vs adult ACNP. The program I am applying to is a BSN-DNP in Adult Gerontology ACNP. Does this mean that I will also have to complete a pediatric program as well to be able to work in the ED? Would my options be limited to adult patients on standard floors with only a AGACNP?

Advanced Practice Columnist / Guide · Dec 18, 2014

AGACNP training only covers ages 13 and up (this is per ANCC competencies). It will be out of scope for an AGACNP trained NP to care for patients outside of their designated age group. You'll find that in some cases, FNP training fits ED situations better. However, you should carefully research your options. You will have to interact with current NP's where you work and figure out what the trends and patterns for ED employment are.

allnurses Guide · Dec 27, 2014

Also depends on your state I believe - PA allows ACNPs to see 16yrs and older. So yes, you'd need to then do AC-PNP program if you want to see all ages in the ED.