Difference between Adult Acute NP and Adult Primary Care NP

lrchester · Jul 24, 2006

Anyone?? Thoughts???

yellow finch, BSN, RN · Jul 25, 2006

You bring up an interesting question. I'm currently working on a FNP while working in Acute Care and while I would like to spend some time in the ICU before finishing my MSN, I find myself drawn to wanting to work with the hospitalists in the Acute Care setting. But will my FNP degree be enough for that group? So you and I have similiar dilemmas. :)

In your case, I think that the Acute Care degree would benefit you in an office setting as it still deals with adults and in order to treat patients in an acute setting you must understand at least the basics of primary care in order to garner knowledge for tertiary care. It would also make you available to see patients in the hospital if needed that are in your care group. Meanwhile, with the Primary Care degree, you would need additional education (possibly) in order to acheive Acute Care status. Does that make any sense?

Best of luck to you!

lrchester · Jul 25, 2006

Yes it does make sense. Thanks for your input and good luck with your education.

Lori

DaisyRN, ACNP · Aug 3, 2006

Hello to all, I have a question...
I just got accepted into MSN program for "Adult Acute NP." I am of course VERY excited and I have a couple questions.
I currently work in Critical care (for the past 8 years) and my goal is to work in the hospital setting as an NP. I would be happy either caring for the critical care pt and/or those patients admitted to general med/surg.
With the degree I am seeking, I'm wondering if I would be marketable not only to the hospital setting, but to an office setting or a doctors office (if that is what the potential market holds for my future.)
Should I stay with Adult Acute or switch to Adult Primary?? My only concern is that there may not be a position for me just in the hospital setting. I understand the difference in course work and how the two roles differ.
I just wonder if an NP is like an RN in that an RN can go in so many different directions with their careers.
Thanks!

Alright... I am in an Acute Care - Adult program as well. I was told, by a reputable source, that being trained in Acute Care you will be primarily trained to treat patients with acute illnesses either IN the hospital OR in an INTERNAL medicine clinic. You would not, however, be able to work in a FAMILY practice clinic. From what you have described... I think you should stick with acute care.

As for the versatility compared to RNs... no. You will not have the flexibility because of the specialization that you choose as an APN. However, if flexibility is what you are wanting... the FNP may be the route to go. As I mentioned in another posting... some states are pushing for the FNP to be banned from practicing inpatient because it is outside their "primary care" scope of practice. Just some things to think about...

DaisyRN, ACNP · Aug 3, 2006

You bring up an interesting question. I'm currently working on a FNP while working in Acute Care and while I would like to spend some time in the ICU before finishing my MSN, I find myself drawn to wanting to work with the hospitalists in the Acute Care setting. But will my FNP degree be enough for that group? So you and I have similiar dilemmas. :)
In your case, I think that the Acute Care degree would benefit you in an office setting as it still deals with adults and in order to treat patients in an acute setting you must understand at least the basics of primary care in order to garner knowledge for tertiary care. It would also make you available to see patients in the hospital if needed that are in your care group. Meanwhile, with the Primary Care degree, you would need additional education (possibly) in order to acheive Acute Care status. Does that make any sense?
Best of luck to you!

Yes... this is also a great point! The fact that you will be able to follow your patients from your internal medicine office into the hospital. Talk about continuity of care!!

Cynthia_S · Aug 4, 2006

I know it's a bit off topic..but, can you bill for your hospital time like you can bill for your office time? Does anyone ( state ) have admitting privledges for NPs?

NurseCherlove · Sep 28, 2006

I am thinking about enrolling in an Adult Primary Care NP program within the next year. Does anyone know...would I just be limited to the office/clinic setting or would I also be able to make rounds in the hospital on med-surg and/or tele units? Would I have to go back and get the post master's Acute Care certification?

zenman · Sep 28, 2006

As I mentioned in another posting... some states are pushing for the FNP to be banned from practicing inpatient because it is outside their "primary care" scope of practice. Just some things to think about...

Why would it be outside your scope of practice? FP docs admit patients all the time and follow them in the hospital...as does my FNP exwife.

rnhunter · Oct 5, 2006

It is because FNPs are trained for primary care. None of their training is related to caring for patients in the acute care setting. When a family practice doctor recieves their training they do recieve training in caring for patients in the inpatient setting. It is similar for ACNPs. Their training is focused on acutely and chronicly illnesses. ACNPs do not recieve any training in primary care. Therefore they should not work in a primary care setting. If an APN practices in an area that they have not recieved education and training they are placing their patients at risk and themselves at risk for lawsuit as they would be practicing outside their scope of practice. An APN is NOT an APN. We do not recieve generic training. Iam working on my ACNP and their is a clear difference in the training and education. Their is also some talk of limiting theCNS practicing as a NP. Again, the training is very different. a CNS focus is population focused (i.e. DM, cardiac, CHF, ect....). The NP focus is on individual.

gauge14iv, MSN, APRN, NP · Oct 7, 2006

But a LOT of FNP's are employed as ACNP's.

A lot of OJT happens in that case, but there is certainly nothing wrong with that.

I am in the process of applying for hospital privs, the FP doc I work with admits his own patients - but he does not manage ICU patients. ICU patients are managed by the surgeon, the specialist or a hospitalist. When a Family practice patient is admitted, it is unusual that they woud not be consulted to anyone else. The FP - whether MD or NP - rarely practices in a vacuum. Specialists are generally consulted for just about anything and everything.

I don't ever plan to manage anything that's over my skill level - I can always defer that to the doc or to the specialist - and so can my FP MD that I work for. But saying no FNP should manage acute patients is not exactly the way to go either.

hrtprncss · Oct 7, 2006

But a LOT of FNP's are employed as ACNP's.
A lot of OJT happens in that case, but there is certainly nothing wrong with that.
I am in the process of applying for hospital privs, the FP doc I work with admits his own patients - but he does not manage ICU patients. ICU patients are managed by the surgeon, the specialist or a hospitalist. When a Family practice patient is admitted, it is unusual that they woud not be consulted to anyone else. The FP - whether MD or NP - rarely practices in a vacuum. Specialists are generally consulted for just about anything and everything.
I don't ever plan to manage anything that's over my skill level - I can always defer that to the doc or to the specialist - and so can my FP MD that I work for. But saying no FNP should manage acute patients is not exactly the way to go either.

I had a question on another thread that's similar to this, and no one has answered yet, so I guess I should pose it here...My question is if you're an FNP or an ANP practicing well care in a clinic and your patient becomes acutely ill. Now I know IM physicians do consult specialists left and right, there's no question about that. Though what I would like to know if anyone would like to answer is, working in a clinic, is it a common practice to have hospital priviliges so that you can follow your patients during their in-hospital stay, or would you need to be a dual cert ACNP for that? Meaning as ANP or FNP's with acutely ill patients that you sent to the hospital from your clinic, would you then be able to round on your patients off clinic hours to see your patients in the hospital and still be this patient's primary HCP, order lab tests/meds/treatments etc? Is that even possible? And I understand the notion of putting consultants on your patients such as pulmonologists/cards/nephro depending upon your patient, but I guess my question is, is it common place to have single certified FNP to follow a patient from a clinic to hospital thru discharge, as the primary HCP, or would you have to give up your patient to have a different attending like an attending physician assigned by let's say the ED to manage the patient while they're in the hospital. I guess it's kind of like the same as an IM/FP physician having a critical care patient and giving up that patient completely to the Intensivist group, and them seeing and rounding their patients everyday with the attending physician in the background while the patient is critically ill, but in the case of ANP/FNP it's from well care to acute care. Would dual ACNP/FNP help to have continuity, or it doesn't matter? Sorry if this sounds confusing, but I'm looking at programs such as ANP and I'm wondering if I would need ACNP to follow your own patients thru their whole stay, which really appeals to me. Thank you very much.