I'm seeking advice and insight on FNPs that are practicing in the inpatient setting in a hospitalist group or internal medicine type role. What does the job outlook look like for NPs in this setting and if you currently practice in this role, do you enjoy it? I'm in the middle of my FNP program and exploring my options on what I want to do when I'm finished. I think that I would really enjoy this type of position, but definitely need more information. Also, what type of experience would help in landing a job in this setting. Right now, I'm an OR nurse and I don't see that being an easy transition.
Historically, the acute care NP (ACNP) practiced predominantly in the hospital and theprimary care NP (PCNP) practiced within a community setting. These setting boundaries oftenoverlap, however. It is inappropriate and restrictive to regulate acute and primary care scopeand practice based on settings but instead regulation should be based on educationalpreparation and scope of practice.
So, while some individual facilities may request/require ACNP for in-hospital positions, it is not required by our credentialing organization.
For me this is where the legal/ethical issue arises: the vast majority of FNP/AGNP grads don't have any significant education/training in provider-level intensivist role.
Absolutely. Much more on the education and experience and much less on the credential.
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I agree that is why it is discouraging to me that my current system and others around and saying only ACNP for inpatient. I am AGNP but did half of my hours inpatient so while I do not feel I could perform as an intensivist I do have some education/training on the inpatient side.
On the flip side a friend just completed her FNP and wasn't allowed to do any inpatient hours. I think because of the variability on what different programs allow they find it easier to make the blanket statement no ACNP=no inpatient
I agree that is why it is discouraging to me that my current system and others around and saying only ACNP for inpatient. I am AGNP but did half of my hours inpatient so while I do not feel I could perform as an intensivist I do have some education/training on the inpatient side.
On the flip side a friend just completed her FNP and wasn't allowed to do any inpatient hours. I think because of the variability on what different programs allow they find it easier to make the blanket statement no ACNP=no inpatient
Although I would agree that there are some FNPs who have a critical care background and did hours inpatient as a student who would be able to work competently as a hospitalist I would still suggest getting the ACNP or post masters cert. It doesn't make sense not to have the specialty cert imo and I would imagine there will come a time when it is the BONs are also saying you can't do it not just the facilities. In Maryland for example FNPs are not able to practice solely in psychiatry and can lose their license over it. It has been my experience that some FNPs are of the mind set that "we can do anything" and in many cases that just isn't true.
Thank you all for your input. After reading the comments and doing some research. I believe that you are right. Although my program does offer acute care education, I believe it is still outpatient based. I think my bet bet to get the best of both worlds is to maybe work in the ER, doing outpatient care. I could still be in the intense setting I like, yet work within my scope of practice. Thank you!
If you are in a rural area like me you probably could. I am an fnp and admit and round on icu patients all the time. They did give us training for it though with our internal med physician in the group though. Taught us most of what we need to know in a couple months. Thing is a pulmonologist is usually consulted on these patients too so its not like we are swinging along. Except at night, during which we do pretty much everything including change vent settings and stuff. We can't put in lines though, surgeons come in and do that.
I am far far far from an expert but it seems a lot of people have questions about this. I may create a post to spark some peoples interest in regards to this.
Right - I started an FNP program and was told all clinicals had to be outpt. Well - I already am an outpt APRN so why do more of the same clinicals? Duh - dropped that quickly!
Nurse A: She has 18 months experience in a med-surg unit and earns her ACNP from a paid for profit school
Nurse B: She has 15 years experience in SICU/Traums and ED and earned her FNP thru a local well respected program.
The position open is for an ICU NP position. Both interview well. Who would you hire? (this is a real scenario and I know both individuals) - both applicants are/were RNs at the facility.
Nurse A: She has 18 months experience in a med-surg unit and earns her ACNP from a paid for profit school
Nurse B: She has 15 years experience in SICU/Traums and ED and earned her FNP thru a local well respected program.
The position open is for an ICU NP position. Both interview well. Who would you hire? (this is a real scenario and I know both individuals) - both applicants are/were RNs at the facility.
Who needed extra time to consider this choice? lol
BostonFNP, APRN
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For me this is where the legal/ethical issue arises: the vast majority of FNP/AGNP grads don't have any significant education/training in provider-level intensivist role.
Sent from my iPhone.