Flexibility of FNP sub-specialties

[Adenium]

In the interest of covering all my bases....I'm best prepared given my RN work history to remain in cardiology as I seek my NP, but I'm certainly checking everything out before plunking down my hard-earned dollars for tuition. I'm in my third decade, but I'll certainly be working for many more years and I think it's impossible to be sure what would make me happy for the next 30 years. Sheesh, I didn't start out in the medical field period.

If you train as an FNP you can certainly go into many areas, e.g. derm, endo, heme-onc, primary, allergist, etc. But how many people go into an area and then shift again years later to a different sub-specialty? Is this possible with on-the-job training? Is it looked upon poorly? Not clinically feasible or wise?

How many folks ended up in a different FNP practice area from their background as a working RN?

I guess the same questions apply to an Adult NP degree. What I get is partly dependent on school proximity/finances.....FNP is more marketable but in my situation both more distant and more expensive.

I would love to be one of those people who could say YES! This is my one and ONLY passion and I will never find anything else more interesting. I've ALWAYS KNOWN this was my path. I know a few of these folks, and in my less charitable moments I hate them.

[criticalHP, MSN, RN]

I am in the distance program at University of Cincinnati, and am graduating this Dec as an FNP, but my background has always been adult critical care. I haven't dealt with pediatrics in over 10 years until school. I live in a geographically isolated area, so FNP enables me to go anywhere without limiting the patients I can see by age. Because of my critical care experience I have been approached by my hospitals hospitalist service to round on MS/ICU and cover night admits, and I've been approached by the ED director to work as FNP in the ED.

FNP will best prepare you for primary care, but in my FNP program we study many things you will not see in primary care...acute care for deep burns, hypothermia, septic shock (drugs, drips, SG lines and all). Why? I'm sure there is a variety of sub-specialty NP students in my courses..acute care, womens' health, pediatric. During the practicum we are separated out into primary care, peds, or acute care based environments. I still see womens' health NP or acute care NP students in my episodic illness courses because they need this, too.

So to make a long story short, you can use your past experience to enhance whatever NP specialty you choose. Take a look at the market around you, your likelihood of employment with each specialty, and decide from there. But if you go into something you don't want to do you will not be happy.

There are also post-masters certifications in other areas. Say, Adult NP wants to see peds...take the FNP certicifation courses...Good luck!

[NPinWCH]

My 15 years of RN experience are completely in L&D/Mother-baby, but I'm now an FNP in primary care. I think all experience is helpful. I'm just starting my NP career, so I'm not thinking about moving to a different sub-specialty yet, but I suppose I could if I wanted to in the future.

[traumaRUs, MSN, APRN]

My 14 years as an RN were in ER/ICU. So, as an APN I work in nephrology - go figure.

They were wiling to train me because they liked my level one inner city trauma center experience and my ability to think quickly on my feet.

I have had a part time ER job at various times too during the 5 years I've been an APN but only work nephrology now.

I think you could switch easily with training.

[Adenium]

Thanks for the replies.

I'd like to think you can switch with training, because while for a time I thought "well, I can always get a post-master's certificate" the programs I've seen laid out take 2 years and nearly as many credits as the whole MSN to begin with. Making the right decision the first time would certainly be easier.

[traumaRUs, MSN, APRN]

Uh that I can attest to. Originally thought I wanted to do management so I went into an MSN/MBA program. After a couple of business courses, I said Ugh to that and got the MSN in management and leadership. Did a management position for 6 months and hated every second of it.

So, back to school for an adult CNS - got a job and voila five years later, oops hmmm...need to be able to see kids.

So, back to school yet again for a second post-MSN certificate, this time as a peds CNS.

So, in the end, I have an MSN and two post MSN certificates and tons of loans.

So my best advice is choose a wiser course than I did - lol.

I wish you the best. Let us know how things go.

[Adenium]

Thanks Trauma. I've always appreciated your wisdom on the forums.

[BCgradnurse, MSN, RN, NP]

I've been an FNP in Primary Care for 2 years and was hoping to move into a specialty ( hematology) in the next few years. However, I've found I really like working with the elderly and I'm also interested in palliative care and derm. So I guess I don't know what I want yet!!! However, I think Primary Care is giving me a good background and valuable experience while I figure out what I want to be when I grow up. That all being said, I'm glad I went for my FNP cause it made me more marketable. I only see adults right now, but I could see kids (like if I wanted to moonlight in a retail clinic). I'm not sure I would want to go back for a post-Masters cert. I hope training would be sufficient should I decide to leave primary care.

Best of luck to you!

[Adenium]

I should make my husband read all of these responses. He thinks it's strange that I still don't know what I want to do for sure.....having picked his field in his teens and stayed with it all this time. Stinker.