FNP or AGNP

Hello fellow nurses,

I am currently enrolled in a nurse practitioner program. If I take four classes next semester I am able to graduate Spring 2015 with my AGNP. I plan to graduate, take my AGNP boards and begin work (fingers crossed). Then, I would go back to school Fall 2015 and get a post-masters FNP. The reason for choosing AGNP is that I would be wasting time from May until January waiting to finish the pediatric/maternity courses. The issue I am having is that I have to take two certification exams within 6 months of each other. I do not want to work with children, but I want the FNP to be more marketable.

I am so confused on what to do!

Any ideas??!!!

Thank you!!

Hi. I felt just like you at one point in time. I was primarily interested in adults and had no desire at all to work with children. However, I enjoyed my pediatric rotation so much that I did it twice and hope to land a job in pediatrics. If you don't want to work with children at all...then just do the adult track. However, I will tell you that my friend did the adult track and plans on going back for her FNP because most jobs are marketed towards FNPs. So you may just want to do the FNP track...taking two certification exams within 6 months of each other just seems like a lot of stress to me. Good luck.

(This is assuming that you are not seeking to complete the acute care concentration for AGNP)

IMO, from a cost perspective, completing an AGNP program just to turn around and complete a certificate for FNP does not make good sense. Most programs will make you retake your 3Ps + your FNP clinicals will not give you any credit for what you completed previously with your AGNP clinicals. You are looking at probably spending money on ~30+ credits. Is it worth that to complete one program half a year sooner? This might be one of those situations where faster does not equal better.

On the flip side, if AGNP is where you truly want to be, do you need the FNP? I know multiple ANPs (who were certified before it turned to adult-gero) and they have not had issues finding work. With that being said, they never sought out work in places where they would be exposed to peds- they deliberately went after adult care and specialties.

Good luck in your decision.

Cardiac

I think it depends alot on where you reside and the types of jobs you are interested in. I concur that most job postings for primary care are directed towards FNPs, however, many larger primary care groups in my area are happy when a good AGNP or PNP apply and scoop them up just as fast or faster than if a FNP applies. These same employers would scoop up a good pediatrician as well, even though he/she could not see adult patients.

Now, if you want to work ER, Hospitalist, or do certain specialties than FNP might be better. However, the cardiologists I know who are interested in hiring an NP do not see kids, the pulmonologist I know who is interested in an NP does not see kids, I could continue but I'm guessing you get the drift. On the other hand if ortho is your interest, kids would be a must. I'm sure we all could go on and on about specific specialties/specialists who would/would not prefer specific population limitations.

Many years ago I was selling a very unique home, several realtors came to look at it and told me I would be in for a long wait, and that I needed to reduce the price because it was so unique, very few buyers would want it. Finally, I found a realtor that liked it as much as I did, saw it's potential and wanted to market it as such. I agreed, within a week we had two offers for above the listing price and we all ended up being very happy. My point is, do what you want to do, and sell your strengths not your weaknesses.

I think if I were in your position, I would finish the AGNP, sell myself into an NP job, and see how that went. If I was struggling in that and felt FNP would help, then I would decide to go back for it, but for now, I would just focus on doing my best as a AGNP. Oh, and I wouldn't have any issues with trying to talk people who were advertising for a FNP into hiring me as a AGNP and just limiting my panel to adults. Often, they don't really understand the differences in the various NP roles, or care that much!

I had a similar dilemma when I was in NP school. I graduated from an AGNP program and still have thoughts about obtaining a post masters FNP. The reality is that the FNP is more marketable then the AGNP in the sense that you have a broader scope (ie. pediatrics). However, many jobs that are listed for FNP are appropriate for an AGNP. I see internal med jobs frequently that ask for FNP when AGNP is frankly more suitable in regards to training and specialty. This is not because the hiring team only want an FNP but because that specialty has become synonymous with outpatient NP practice. In this case you should just apply and explain your training to the hiring manager.

I expect that AGNP marketability (like FNP) is regionally variable. Although I know of no AGNP/ANPs that are not employed if they want to be. AGNP very closely fits the internal medicine model and as such there are a ton of positions and specialties that are clinically appropriate. Remember that with the changing demographics over the next 20 years, NPs with geriatric specific training will be in demand in a variety of settings.

I think it depends alot on where you reside and the types of jobs you are interested in. I concur that most job postings for primary care are directed towards FNPs, however, many larger primary care groups in my area are happy when a good AGNP or PNP apply and scoop them up just as fast or faster than if a FNP applies. These same employers would scoop up a good pediatrician as well, even though he/she could not see adult patients.

Now, if you want to work ER, Hospitalist, or do certain specialties than FNP might be better. However, the cardiologists I know who are interested in hiring an NP do not see kids, the pulmonologist I know who is interested in an NP does not see kids, I could continue but I'm guessing you get the drift. On the other hand if ortho is your interest, kids would be a must. I'm sure we all could go on and on about specific specialties/specialists who would/would not prefer specific population limitations.

Many years ago I was selling a very unique home, several realtors came to look at it and told me I would be in for a long wait, and that I needed to reduce the price because it was so unique, very few buyers would want it. Finally, I found a realtor that liked it as much as I did, saw it's potential and wanted to market it as such. I agreed, within a week we had two offers for above the listing price and we all ended up being very happy. My point is, do what you want to do, and sell your strengths not your weaknesses.

I think if I were in your position, I would finish the AGNP, sell myself into an NP job, and see how that went. If I was struggling in that and felt FNP would help, then I would decide to go back for it, but for now, I would just focus on doing my best as a AGNP. Oh, and I wouldn't have any issues with trying to talk people who were advertising for a FNP into hiring me as a AGNP and just limiting my panel to adults. Often, they don't really understand the differences in the various NP roles, or care that much!

Please explain how a FNP would be better suited as a hospitalist rather than a ACNP/AGNP? To me that makes 0 sense

The hospitals that I have been affiliated with clearly separate adult and pediatric populations. The adult population are followed by hospitalists that are traditionally educated as internists (or occasionally family medicine) and the pediatric population by pediatricians. This is consistent with physician training and board certifications for hospital medicine (ABIM, ABPS). I think this would mirror the NP specialties. I guess a rural hospital may want an FNP that would be able to admit and follow all ages but for most hospitals an ACNP or AGNP would be fine.

core0, can you elaborate on why a hospitalist would need to see kids?

I was actually replying to a previous post that listed ER and hospitalist. Our hospitalist group only uses ACNPs. There are a few family medicine programs out there that admit adults and kids to the same family medicine floor (in some relatively large urban or suburban hospitals). ACNP or ANP would have a problem there also just like most ERs which don't have a separate peds ER.

I was specifically targeting the hospitalist part, I understand the problem with working in the ED as a ACNP.

To me the obvious gold standard for adult populations in the hospital would be an ACNP.