Family NP or Adult acute care NP

allnurses Guide · Feb 23, 2011

If you're going to be an NP for the money you might be disappointed...

Which type to do for that environment sounds like Acute Care, but if you want to work at a children's hospital I am not sure why you would do adult acute care? Why not pediatric acute care? The best type to do is the one that the hospital/area you want to work in employs - check out the children's hospital and find out which type of NP they hire.

KatGoodman · Feb 24, 2011

If I do family NP would I still be able to work with children and adults in the hospital? I'm sorry, I know my questions are probably stupid but I really just started and want to know everything I can.

KatGoodman · Feb 24, 2011

Also, I'm not looking to make huge money or anything because I want to do nursing to help people but I don't want to get my NP just to make the same as I would without it. I do want to work in the ER or ICU but I also want to work with kids. I haven't figured out exactly which setting i'll be in but I don't want to limit myself until then. Do you think Adult acute care NP or Family NP would be better?

allnurses Guide · Mar 7, 2011

there is no current single NP track that will permit you to see children and adults of all ages, plus be trained for acute ER/ICU. For acute care, you choose either adult ACNP, or pediatric AC-PNP. Some places do permit FNPs (who can see kids and adults) to work in the ER/ICU, but it's a regional/institutional thing as to whether it's permitted, because strictly, FNPs are trained and educated for primary care and not acute care.

UVA Grad Nursing · Mar 8, 2011

It you want to work in-patient, I would not recommend Family NP. A Family Nurse Practitioner is a primary care role. Many states are changing their nurse practice acts to reflect this difference in education/role, and are prohibiting primary care NPs from working in acute care, ICU, and in outpatient specialty clinics.

At my institution, there are several NPs with FNP certification who have been working in clinics for a decade or more. They have been told to get ACNP certification within 24 months if they want to keep their jobs. NPs at other Marget institutions in my state have been told the same thing. As a result, I have been contacted by 2 dozen FNPs seeking post-masters ACNP in the past several months.

So if you want to work in acute care, ICU, or a specialty clinic, I would really recommend an ACNP program. You do not want to be told later that you need to go back to school a second time.

shadowflightnurse · Mar 9, 2011

Another option I have not seen anyone mention is being certified in dual specialties. For example, get your FNP then do a post-Master's program for the acute care. I am about to begin a program that is molded for an ED role. At the end of the program I will be eligible to sit for both FNP and adult acute care. It is a little longer than other programs, but to be prepared to sit for both exams...eithout having to go back to school :) makes it worthwhile to me.

I'm sure you will hear otherwise, but this is purely an opinion. Get plenty of GOOD quality clinical experience before going back to school. Many schools are decreasing/dropping their requirement for experience and I (again, my opinion) think this is a mistake.

Good luck in your efforts!!

TJFRN · Mar 10, 2011

Another option I have not seen anyone mention is being certified in dual specialties. For example, get your FNP then do a post-Master's program for the acute care. I am about to begin a program that is molded for an ED role. At the end of the program I will be eligible to sit for both FNP and adult acute care. It is a little longer than other programs, but to be prepared to sit for both exams...eithout having to go back to school :) makes it worthwhile to me.
I'm sure you will hear otherwise, but this is purely an opinion. Get plenty of GOOD quality clinical experience before going back to school. Many schools are decreasing/dropping their requirement for experience and I (again, my opinion) think this is a mistake.
Good luck in your efforts!!

What school are you going to?

shadowflightnurse · Mar 11, 2011

Univ of south alabama. All online with only 1 (I think ) on-campus visit for orientation before starting clinicals.

They have FT & PT tracks available.

nomadcrna, DNP, CRNA, NP · Mar 11, 2011

I've seen this inaccurate information before. The states are NOT moving toward this. A few states are like this but many more allow the NP to function according to their training NOT their title.

For instance, FNPs DO see patients of all ages, from babies to old folks and yes even prenatal care.

FNPs also cover the ERs in many, many rural towns.

FNPs also function in the hospitalist and intensivist roles.

I happen to be covering both ER and inpatient roles as we speak.

I've pasted the following from the consensus model that states are looking at. It will be all 50 states.

Here is the link. http://www.aacn.nche.edu/education/pdf/APRNReport.pdf

So lets get the accurate information before we speak as many believe what they see here on the boards.

This is not meant as a flame towards anyone.

The Certified Nurse Practitioner

For the certified nurse practitioner (CNP), care along the wellness-illness continuum is a dynamic process in which direct primary and acute care is provided across settings. CNPs are members of the health delivery system, practicing autonomously in areas as diverse as family practice, pediatrics, internal medicine, geriatrics, and women's health care. CNPs are prepared to diagnose and treat patients with undifferentiated symptoms as well as those with established diagnoses. Both primary and acute care CNPs provide initial, ongoing, and comprehensive care, includes taking comprehensive histories, providing physical examinations and other health assessment and screening activities, and diagnosing, treating, and managing patients with acute and chronic illnesses and diseases. This includes ordering, performing, supervising, and interpreting laboratory and imaging studies; prescribing medication and durable medical equipment; and making appropriate referrals for patients and families. Clinical CNP care includes health promotion, disease prevention, health education, and counseling as well as the diagnosis and management of acute and chronic diseases. Certified nurse practitioners are prepared to practice as primary care CNPs and acute care CNPs, which have separate national consensus-based competencies and separate certification

Definition & Titling of APRNs:

In the regulatory model presented, there are four roles recognized and eligible to use the licensing title of advance practice registered nurse (APRN) which is a legally protected title. Only advanced graduate roles in which direct patient care is provided are included in this model. The four roles recognized for the designation of APRN are certified nurse midwife (CNM), certified nurse practitioner (CNP), certified registered nurse anesthetist (CRNA), and clinical nurse specialist (CNS). The definition of an APRN includes the requirements that an individual has completed an accredited, graduate-level, broad-based education program with focus on the acquisition of advanced clinical knowledge and skills needed to provide direct patient care. Those who graduated prior to the graduate-level mandate are protected with grandfathering language. Education and ensuing practice have been built upon the foundation competencies of the registered nurse (RN) expanding in depth and capabilities to encompass responsibilities and accountabilities covering health promotion, health maintenance, assessment, diagnosis and management including the use of pharmacologic and non-pharmacologic interventions. In addition, a national certification examination measuring both role and population-focused competencies has been successfully completed (and the credential is maintained through appropriate recertification mechanisms) and a license to practice in one of the designated APRN roles has been obtained. The Consensus Model requires that an APRN be licensed for practice in one of the four titled roles and in at least one of six identified population foci. Education, certification and licensure are to be congruent in terms of role and population foci.

In the Consensus Model, the graduate prepared for the role of certified nurse practitioner (CNP) is seen as a health care provider capable of providing primary or acute care in multiple settings and across the health continuum ranging from wellness to illness states. Practice as either a primary care or acute care CNP is based upon separate national consensus-based competencies and separate certification processes and at this point in time, differentiation between primary or acute care CNP applies only to the population foci of pediatrics and adult-gerontology.

NCC offers two nationally accredited certification examinations addressing the competencies and role of the certified nurse practitioner (CNP) within the population foci of neonatal or women's health. Both of these exams are considered to be "entry into practice" level and appropriate for regulatory purposes.

Individuals will be licensed as independent practitioners for practice at the level of one of the four APRN roles within at least one of the six identified population foci. Education, certification, and licensure of an individual must be congruent in terms of role and population foci. APRNs may specialize but they cannot be licensed solely within a specialty area. In addition, specialties can provide depth in one's practice within the established population foci. Education and assessment strategies for specialty areas will be developed by the nursing profession, i.e., nursing organizations and special interest groups. Education for a specialty can occur concurrently with APRN education required for licensure or through post-graduate education. Competence at the specialty level will not be assessed or regulated by boards of nursing but rather by the professional organizations.

It you want to work in-patient, I would not recommend Family NP. A Family Nurse Practitioner is a primary care role. Many states are changing their nurse practice acts to reflect this difference in education/role, and are prohibiting primary care NPs from working in acute care, ICU, and in outpatient specialty clinics.
At my institution, there are several NPs with FNP certification who have been working in clinics for a decade or more. They have been told to get ACNP certification within 24 months if they want to keep their jobs. NPs at other Marget institutions in my state have been told the same thing. As a result, I have been contacted by 2 dozen FNPs seeking post-masters ACNP in the past several months.
So if you want to work in acute care, ICU, or a specialty clinic, I would really recommend an ACNP program. You do not want to be told later that you need to go back to school a second time.

Advanced Practice Columnist / Guide · Mar 12, 2011

Nomad,

It's great that you can do all the roles you said you do. The nature of rural healthcare is very different from the opposite end of the spectrum in large cities and suburban areas. A number of rural ED physicians probably do manage in-patients, get called upon to do highly invasive bedside procedures on admitted patients in hospital floors, and probably even intubate in the ICU. I can see why you, as the NP in that setting, could have a similar role. Not every nurse practitioner can function in that role, however -- at least, not in the way our nurse practitioner programs are set-up in terms of clinical and didactic content. Even physicians would frown on this jack-of-all trades kind of MD practice I described above outside of the rural settings where this is happening.

Anyway, can you state specifically which sentences support your claim that in the consenus model, NP's are NP's and it doesn't matter what the focus of their training is whether acute or primary care? I have read this document in its entirety and the consenus model states that the six NP tracks (FNP, A-GNP/A-GACNP, PNPAC/PC, WHNP, NNP, PMHNP - GNP has been eliminated and combined with the adult tracks, hence A-GNP/A-GACNP) are not "setting specific" but is based on patient care needs. My understanding of that statement is yes, FNP's can work in hospitalized patient settings but when patient whose acuity calls for a provider trained in acute care, then the FNP is not appropriate. I find it hard to accept how the regulatory boards who authored this document can say that FNP's can do practically everything and yet still leave all the other tracks to exist with no real reason but to continue to add confusion to an already convoluted mambo-jambo of nurse practitioner titles.

TJFRN · Mar 12, 2011

shadowflightnurse... Thank you :)