Considering FNP or PNP, Lots of Questions!!

Sheri FNP-C · Jul 2, 2009

The state you practice in determines the scope of practice for NPs. I don't know if ACPNPs can practice in primary care, but I have a feeling that it could vary state to state. In my state, PNPs are trained in inpatient and outpatient areas and are able to practice in either as long as the patient is a suitable age. Actually, my children's pediatrician sees college kids, but they can only be seen by the MD after a certain age because seeing patients over age 18 or 21 (I forgot which) is out of their scope.

In this economy, I think it is logical to choose an educational path that is likely to open the most doors. Most people agree that FNP is the most broad. Just think, you can't even work in college health with a PNP since students can be over age 18.

I was in a similar situation a few years ago when I was certain I wanted to remain in women's health after completing my MSN. At the last minute I transferred into a FNP program and I am so glad I did. I found that I enjoyed adult and pediatric primary care even more than OB/GYN. My favorite was peds, by far, and I just accepted a great primary care peds position. However, had this not been the case, and I truly only wanted women's health, I had a job offer in that field as well.

Good luck.

ChristineN, BSN, RN · Jul 7, 2009

Anyone else have any feedback?

PICUPNP · Jul 7, 2009

I have been in Peds for 12yrs with the last 9 in the PICU and 4 of those as a PNP. I have never felt as though my carreer has been limited. The PNPs at my institution do everything. I would hazard to say that 70-80% of all procedures are done by the PNPs as well as most of the admits. I don't know of any FNPs in our institution. I would say that the FNP does give you a wider variety of options but if peds is your first love then stick with it. You won't be sorry. There is a great Pediatric Critical Care NP program at the University of Pennsylvania. Good Luck!

Trauma Columnist · Jul 8, 2009

I'm in the opposite boat but can speak to limiting choices. I did the adult health CNS (which is an APN with the same practice act as an NP in IL) and found myself limited because I can't see pts under the age of 16. So this year, I'm back in school to get the peds/family CNS so that I can see everyone.

Christen, ANP · Jul 8, 2009

With your background, I don't think having a FNP rather than a PNP will keep you from having a job taking care of kids! And if you decide you want to take care of adults later on, you're set! But, as PICUPNP said, if peds is your love and you can't imagine yourself taking care of adults, go for it! You can always get a post-master's certificate later on. :)

ivanh3 · Jul 9, 2009

i work in a pediatric icu and we have several fnps and pnps. they work side by side doing the exact same job. i think the fnp experience could help to broaden your perspective. consider the rising number of children/teenagers with full blown adult problems like htn, dm type ii, obesity, etc. plus in today's economy it is always better not to limit yourself. i think any place that would prefer a pnp over an fnp would possibly be swayed by your pediatric background.

dansingrn · Jul 9, 2009

In my institution, we have PNPs as well as a few FNPs, but the preference is definitely PNP. When I was asking myself "FNP or PNP" my only vote for FNP was the "marketability." In the end, I went with my heart and chose PNP and am so glad I did. Even though FNPs technically have the scope of practice, the focus of the program is adult care, not peds. There are some peds clinicals, but with the PNP its ALL peds obviously. The entire program is specifically focused. When I looked at curriculae for both programs, the peds program made me excited; the FNP program did not. Go with your heart, and you won't go wrong. Get the education for what you really want to do, whichever that is, not what you might do for a back-up. Good luck and enjoy your program!

Sheri FNP-C · Jul 9, 2009

I do agree with going with your heart, but marketability is a big factor. I know of several PNPs that have or are going back to get a FNP post masters. I interviewed at a school district for a school NP, they wanted FNP since 99% of the time you would be caring for students, but they wanted someone that could also care for staff as well.

I do think you need to consider the limits of each program (less marketability vs. less pediatric educatation) and choose what will work best for you. At least you can get a post-masters in either should you so choose.

ChristineN, BSN, RN · Jul 12, 2009

In my institution, we have PNPs as well as a few FNPs, but the preference is definitely PNP. When I was asking myself "FNP or PNP" my only vote for FNP was the "marketability." In the end, I went with my heart and chose PNP and am so glad I did. Even though FNPs technically have the scope of practice, the focus of the program is adult care, not peds. There are some peds clinicals, but with the PNP its ALL peds obviously. The entire program is specifically focused. When I looked at curriculae for both programs, the peds program made me excited; the FNP program did not. Go with your heart, and you won't go wrong. Get the education for what you really want to do, whichever that is, not what you might do for a back-up. Good luck and enjoy your program!

Wow, that's alot of what I've felt. I just don't get excited when I think learning about adult disease processes. Whereas when I think about a PNP program, I know I would be much more excited about the curriculum.

Trauma Columnist · Jul 13, 2009

And...if down the road you find a need for adult care, you can always go back for an ACNP or ANP.