FNP or ACNP; Don't know what to do, nobody really to ask for info.

[DexterRN]

So background story on me first. When I graduated from LIU, I manage to get a job right away in nyc (2 months after obtaining license) at a hospital. Spent 1 year on a med-surg floor before transferring to the MICU. I have been in the MICU for almost 2 years now.

All and all I started nursing as a second career so I am not exactly young. I've always wanted to do advance practice and am deciding to apply now for the Fall. Again not young, and my wife and I are thinking of having children not too far into the future; so it might just be harder to start in the future. Ideally, I would like to get more experience but since the part time programs I have looked at will require me to do it in 4 or more years; I figured I will be gaining experience while still pursuing the degree.

The thing is, the hospital I work at do have NPs but they generally work in the outpatient clinic that is part of the hospital or hospice. There are no NPs in any of the ICU nor in the ED. So here in lies my lack of information and problem. I would ideally like to pursue the ACNP program provided by NYU or Columbia; as they are designed specifically to train for inpatient care. However, there are soooo much more FNP programs out there; LIU, Downstate, NYU, Columbia, Adelphi, list goes on.

The thing is I have read on here that FNP do get hired by hospitals but they are trained to be primary care providers and personally I don't mind it but I prefer doing inpatient at the hospital. And with the consensus model; I am assuming it will be harder and much more rare for FNP to be hired in those roles, especially in a big city like NYC. So obviously I want to stay with the ACNP route.

The problem lies in the fact that as research I have been looking into Job opportunities at hospitals and pretty much every hospital I see has tons of listings for PAs but barely if any for NPs. So it seems like if I do ACNP; I might be walking into a brick wall since opportunities seem to be hard to come by. Education is an investment in time and money; and I don't want to go down a route that makes things difficult for me.

The hospital I work at has tons of PAs in the ED and ICU but no NP. All the nurses that I work with are content with their jobs and only one is pursuing a MSN, but she is doing an FNP program and she does plan to do primary care.

So for those NPs out there in NYC, what do you think I should do? ACNP or FNP, keeping in mind I would prefer to do inpatient rather than primary. And is my research like all wrong? Are there job opportunities for me if I become an ACNP?

[Corey Narry, MSN, RN, NP]

Not sure which part of NYC you work at but there are 3 NP's in our group who lived in NYC, worked there, and went to Columbia and NYU for their ACNP programs and worked as ICU NP's at NY-Presbyterian and NYU Langone prior to settling here in California. Memorial Sloan-Kettering has published an article on how they incorporated ACNP's in their ICU. It has been the big academic centers that have become places where you see ACNP's in my observation.

Not gonna get into the FNP vs ACNP debate though.

[nomadcrna, DNP, CRNA, NP]

If you want to do ICU, then you should go the ACNP route. If you want to do inpatient, FNP or ACNP but remember You can't see kids as a ACNP. Check your state laws though.

if you want to do ER then FNP would be better due to the kid thing again. There are many ways to get the ER education you need to practice there. ER is considered a specialty above population and role.

[icubel]

I live in Texas and work at Scott and White which is the largest hospital network in Texas, also is a teaching hospital and from talking to all the nurse practitioners here they all say get your family nurse practitioner because it makes you more marketable because you can always go back and get you acute care. Most all the jobs here are looking for family nurse practitioners. I have a friend who just graduated with her ACNP and she is having a very difficult time trying to find a job due to everyone once a FNP. One of our fNP she works with the neuro surgeon in the hospital and in his clinic and she does surgery with him and places ventrics and all sorts of other stuff but she is going back to get her ACNP. Not sure if this helps or not.