CRNA to ACNP or FNP repost

[CVCRNA1]

Cross-posted in CRNA forum

I am an MSN prepared CRNA, practicing 10+ years at a large academic hospital, currently enrolled in a post-masters DNP program. The credentialing process is changing at my hospital, which may prevent me from ICU NP cross over as a CRNA. My DNP program offers an FNP track that could be added to my current plan of study.

My intention would be to split my practice between the OR and ICU.

Does anyone have any experience with this? Should I look outside of my current program for an acute care NP post-master's certificate? (The ICU at my current hospital employees both FNP and ACNP in the same capacity).

[Guest1144461]

ACNP if you want ICU, FNP won't prepare you for that. Maybe your current hospital will, but most won't.

[203bravo, MSN, APRN]

If your intentions are to practice in the ICU I would recommend an acute care track. While some facilities may still use FNPs there is no guarantee that as more states and facilities adopt the consensus model of care finding a job in acute settings will become difficult plus there is no guarantee that those already practicing in acute care will be grandfathered in.

[CVCRNA1]

My intentions are to work in the ICU but I am looking for the most versatile path that will give me the most options for practice.

[renzlao, MSN, APRN]

I’m graduating with an FNP this semester and there is nothing in the FNP training that’ll make me work in the ICU. My director who is a lawyer don’t even sign credentialing papers for FNPs working in the hospital. I think you need acute care.

[Rose_Queen, BSN, MSN, RN]

Duplicate threads merged.

[Guest1144461]

2 hours ago, CVCRNA1 said:

My intentions are to work in the ICU but I am looking for the most versatile path that will give me the most options for practice.

Jack of all trades master of none unfortunately isn't what the FNP is anymore. Most likely those ICU FNPs came in with experience, no metro area I have ever been in has FNPs in the ICU. If you want the ICU go for ACNP. You can still do some specialty clinic work with rounding duties.

[Neuro Guy NP, DNP, PhD, APRN]

Besides, as a CRNA you'll find the ACNP curriculum more interesting to you anyway as compared to FNP. Those attracted to CRNA are more of a acute care 'type' of folk and the FNP curriculum with its focus on primary care and outpatient issues would likely not be of great interest to you. I am willing to bet on that one.

[Tegridy]

Essentially unless you want to work with kids Or women’s health I would do ACNP. Specialists even for their outpatient offices prefer this often. I haven’t done CRNA school but I am assuming you would breeze through the program. Just have to learn ddx

[Corey Narry, MSN, RN, NP]

It's interesting that your state NPA allows you as a CRNA to cross over to the NP role currently. You may be able to get by with the FNP since your hospital's credentialing body seems to have no distinction between the differences in FNP and ACNP training. However, you could potentially jeopardize your future chances of staying in the ICU NP role should that policy change in the future. Credentialing boards are not always up-to-date or aware of limitations in NP training but will make appropriate changes once they realize that there is a threat of liability when an NP's training is not matched to the role they are performing.

[dianearc, BSN, RN]

I am truly interested in hearing your perspective as to why you would like to crossover to NP practice being a CRNA? I have been researching this and debating whether to do the FNP program or go the CRNA route. Is there a reason for the change? I love versatility and even with just a regular advanced practice job search, FNP appears to offer more opportunities in most states, sort of how RNs can work across settings they chose, the FNP offers the advanced version of the versatility that BSN-RN offers, jobwise. However, I doubt that the training for FNPs is suited for acute care settings- they work everywhere; inpatient, outpatient, primary care, plastics, independent practice aesthetics/botox non-invasive clinics, urgent care etc...but they dont work in ICU settings typically. Your previous & current critical care experience might make you an exemption to work in either acute care settings or other settings you chose if you go the FNP route. But ACNP would restrict you to just acute care settings. If you want to be boxed into the acute care adult world then that's the sure route. Then again, states vary, at the hospital I am at in NY, there are FNPs in acute care, they had years of previous critical care experience as nurses. Another thing you may consider is PA programs that will allow to crossover to PA practice in two years given your other grad school classes & experience. But that is just a thought. I would still love to hear why the change

[Uroboros, APRN]

ACNP, FNP here with PhD in works. Other convoluted alphabet soup credentials I won't mention but you get the point. I was actually accepted to CRNA school along with several NP programs many years ago, and made the obvious choice. Don't regret it a bit after 16 years of everything from ER to admin, academia, and nearly everything in between. Both are rewarding, I simply saw more diversity for career growth going the NP route.

Think always in terms of liability, and CRNA's work with high risk and typically well understand this, as I'm certain the OP knows. As an APRN we should always be asking ourselves, whether it's placing a chest tube or removing a splinter, if called to court or before the ever benevolent BON, "does my certification support it?"

It's really that simple. Doesn't matter what the supervising or collaborating (cough cough) physician approves, what the other NPs are doing, or hospital policy even. It's our responsibility, one and only, when answering the call.

My program was classroom and just begun to use some online course work. It's hard enough in court for physicians, who receive the very best healthcare training. I can't imagine defending myself with most of the fully online degrees that are flooding the APRN field now. Seriously, I'm not personally knocking anyone's education or training. In fact I teach some online coursework. It's a point of liability. And on the job training holds little water in court as well, ask any med-mal lawyer.

I went to a top ten school, cost a pretty penny that we just paid off. We had no hospital rounding during the FNP coursework, and my FNP exam had no hospital or acute care question material. Vice versa my ACNP training had no primary care or family medicine rounds, and the exam material was critical care based, more akin to the CCRN.

Point is you can take unnecessary risk that your friends will happily report you for, and the lawyers are always waiting for soft targets. My best advice do both, you'll be covered essentially wherever you go. After all CRNA curriculum is far more challenging. You'll do well regardless. Best wishes.