FNP in hospital

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Specializes in Cardiac, Pulmonary, Anesthesia.

Does anyone know of or have a list of states that allow/don't allow an FNP to practice in the acute setting? I'm under the impression that some states will not allow an FNP to work as a hospitalist or in critical care even if you have experience and training to do such.

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Does anyone know of or have a list of states that allow/don't allow an FNP to practice in the acute setting? I'm under the impression that some states will not allow an FNP to work as a hospitalist or in critical care even if you have experience and training to do such.

Maryland (ACNP for any monitored bed) and Texas are the only ones that I know of for sure. A lot of times the state BON is non-committal but hospital bylaws or malpractice rules will prevent NPs trained in primary care advanced practice nursing from working in an inpatient environment. There have been several large settlements in the last few years in the Southeast over this.

David Carpenter, PA-C

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I have Acute Care NP friends who are working in hospitals so I'm guessing texas allows it. I would NOT want to be FNP trained and then work in a hospital...the education is completely NOT geared towards that type of environment.

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Specializes in Cardiac, Pulmonary, Anesthesia.

Thanks for the replies.

Coreo, I know hospital by laws may be a barrier, but it's easier to narrow down places to look by starting with the states. Also I have high level inpatient experience so I'm unconcerned about lawsuits. See the following:

Carachel, I'm anesthesia trained (will be completing that soon) and the FNP will be to supplement my primary care knowledge. I won't have much trouble adapting to inpatient care. I did all the didatics for ACNP before my CRNA program and going back for that just seems redundant. Plus I may want to work in the ED part time so FNP better suits my needs, but in case I do want to work the ICU part time I want to make sure the majority of states don't prohibit it.

Anybody else know of places that do or do not allow FNPs in acute care

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As it has been explained to me-of course before you would start practice you would get a legal opinion or something on this-as long as you can back up your particular specialty area with the proper work experience/certifications/education/seminars, you are ok. This is with the understanding too that you have adequate support in this specialty area in case you need it (an on-call MD if you are hospitalist, etc). Wherever you work, you need to make sure you have the resources in place for when the wheels fall off the bus. Otherwise, you invite the lawsuit...

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Specializes in FNP.

We have FNPs working in an ED here, and there is no physician on site at all. One is available to call in emergency, but he's 20 minutes out. My hospital will not credential NPs at all, even to visit their own patients. So my point is, the state law may permit it, but the culture of the system may not. Good luck!

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Specializes in Cardiac, Pulmonary, Anesthesia.

I appreciate all your replies, but my questions is what states allow/dont allow fnp doing inpatient. I have the rest figured out.

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I appreciate all your replies, but my questions is what states allow/dont allow fnp doing inpatient. I have the rest figured out.

There are only two for sure. There are another 5-6 BONs that are looking at this issue right now. The issue is that even if you make a decision now, it could change dramatically in the next 2-3 years.

David Carpenter, PA-C

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Specializes in Anesthesia, Pain, Emergency Medicine.

Abe,

I am a CRNA/FNP and I can tell you we rock in the intensivist/hospitalist roles. Critical care medicine is our forte, which you will see once you get out. At least if you practice in a NON team environment.

I most enjoy moonlighting in the ER. I find that I am in demand for that role, once again due to the CRNA/FNP.

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