FNP v. ACNP

It seems like ACNPs can work in family practice as well as acute care settings (from some job postings I've seen) whereas a FNP is somewhat limited to a family practice setting (I understand there are some exceptions).

So it would seem the ACNP would me a more marketable specialty than a FNP.

Agree? Disagree? Why?

All the NP specialty tracks have a specific focus. The simplest way to define the differences is to look at the actual titles for each NP role:

There are 3 Acute Care NP tracks. All are focused on training in acute care and crtitical care settings. There is training in chronic disease management but clinicals in out-patient settings are limited or not as extensive as primary care NP tracks.

Adult Acute Care NP - population served are adults only.

Pediatric NP-Acute Care - population served are children only

Neonatal NP - poplulation served are neonates only.

There are 5 Primary Care NP tracks. All are focused on out-patient or primary care management of specific patient types. Clinicals are typically done in out-patient settings only.

Family NP - clinicals are focused on primary care across the lifespan.

Adult NP - clinicals are focused on primary care of adults usually over the age of 13 in some states. There is some acute care training but no critical care component.

Pediatric NP - Primary Care - clinicals are focused on primary care of children.

Women's Health NP - clinicals are focused on the health care needs of women from teen, childbearing, to menopause.

Gerontolgical NP - clinicals are focused on the care of older adults.

None of the NP tracks are interchangeable. One track serves a particular purpose that the other does not offer. FNP offers the broadest flexibility in terms of age of patients seen but does not necessarily address all types of patient acuity and clinical settings. You may see exceptions to this in your own locality but the best thing to do is to check with your BON. Your nurse practice act may be permissive of NP's crossing between specialties or they may be restrictive in enforcing the differences in NP training.

Could an ACPNP still work in a primary pediatric practice?

generally the restrictions are the same as for the ACNP for adults. You could not do general pediatrics, but you could do specialty pediatrics such as pediatric cardiology.

To add to Pinoys excellent post there are other certifications that may or may not be accepted by a given state. The most common is the oncology NP which allows the NP to see oncology patients in the inpatient and outpatient setting.

There are other NP certifications that are generally not accepted such as Emergency NP or transplant NP. The general feeling from the BONs is that these are not valid certifications. What they have in common is they allow certification based on work experience only with no didactic or clinical component. Without these they are unlikely to ever be accepted. Several BONs are discussing not accepting the Geriatric NP since they are now allowing NPs to test without going through an GNP program.

David Carpenter, PA-C

The ACPNP or PNP-AC role is relatively new. It was developed because of a need for Pediatric NP's in high acuity settings not only among hospitalized children but those who are in Pediatric ICU's. There are only a few programs available for PNP-AC at the current time as there is a higher skill set needed for PNP-AC's that can include ability to perform invasive procedures such lumbar taps and invasive lines. The traditional primary care role continues to be under the domain of the PNP-PC. However, as I've mentioned, you will need to check with your specific BON to find out what their take is on this matter.

For further reading, click on this Medscape article: http://www.medscape.com/viewarticle/554327_1