FNP vs ACNP? Please help

[Smccar]

Hi, I am having difficulty deciding wether to start and FNP program or an acute care no program. I have been an RN for 5 years and have worked in acute care; telemetry and ICU. I want to become an NP and I see myself working in a doctor's office or urgent care faculty when I am done. I have never worked with children as an RN and don't have much of an interest to do so as an NP so that detours me from the FNP program. But, I love working with adults but would like a slower paced environment once I graduate. Can I do FNP and not work with children? Can I do ACNP and work outside of a hospital. Any informations will help.

[cmbullins]

It sounds like you have reviewed your career goals which is the first step in determining which program you should do. If you're looking for a role that's primarily outpatient, and deals with pediatrics to elderly, then FNP is probably the correct route. Furthermore, if you're interested in any urgent care or ED, then FNP is also the correct degree. This is primarily because the variety (peds-adults) is better covered in the FNP criculium). just because the FNP covers pediatrics, you don't have to see them when you graduate. You may chose a practice that only requires you to see adults, females, etc depending on the terms of your practice agreement.

With all all that being said, the ACNP, now AGACNP is more favored for inpatient be uses of how the criculium is setup. You spend the majority of your time seeing the inpatient arena and the knowledge that goes with that. Not to say that FNP's don't practice inpatient, but their criculium doesn't provide as rich of an inpatient rotation. Furthermore, the consensus model doesn't really support FNP's practice for inpatient. This is the same for ACNPs outpatient. Typically ACNPs don't work in the outpatient setting unless they are in a specialty clinic. Again, it's all in what the criculium provides.

At the end of the day there are no hard stops for most states saying no which program you gave to do at the moment. FNPs can do inpatient and ACNPs can do outpatient. However some states and institutions have starting aligning themselves with the consensus model and saying that the NP can only practice within the scope of their training, which is probably fair. As this happens many institutions pay for an Np to return and obtain the certification required for their role.

[twozer0, NP]

Adult Geriatric NP is probably more the road you want if you want office work with no kids. To work in Urgent care I would strongly advise FNP as a large percentage of your patient base will be children under 18. Acute Care NP has a special scope of practice and you will rarely see them outside of the inpatient setting. It's also hard to snag a job as an ACNP if you dont have the proper contacts. There just isnt a huge job market for them at its current setting. If you want to do ICU and see kids its not bad to have dual FNP/ACNP certifications.

So if you want my take on it. Adult Gero NP for office works with no kids. FNP for urgent care. ACNP for inpatient ICU/Pulm/Cardiac ETC type work. Again you may find the job market for ACNP is slim. FNP of course is the most marketable.

[carachel2]

Our family practice rarely saw pedi patients and when we did they we almost all > 5-10 years old. Most people use a pediatrician these days. I have FNP colleagues who work IM and never see kids. Good luck with your decision!

[Dranger]

I wouldn't say the ACNP market is slim. In my area, only ACNPs are hired for inpatient work and many are also in specialty outpatient clinics where they round in the hospital as well

[bebbercorn]

In my FNP program, we aren't allowed to do inpatient clinicals. You can do up to 20% of your hours in an urgent care or ED, but that's it.

[sailornurse]

It depends on location. In my area both FNP & ACGNP/ACNP work inpatient as hospitalists, FNPs work ER. I work urgent care & and see kids all ages. I also know if FNPs in Derm & Cardiology so it depends on local market.

[Goldenfox]

Do the FNP degree. You can choose to do or not do any pedi. The acute care degree is more for practitioners who want to work inpatient, or in urgent care. As an FNP you can also work in a hospital or urgent care with appropriate acute care orientation. But some primary care facilities will not hire ACNPs.

[Dranger]

Do the FNP degree. You can choose to do or not do any pedi. The acute care degree is more for practitioners who want to work inpatient, or in urgent care. As an FNP you can also work in a hospital or urgent care with appropriate acute care orientation. But some primary care facilities will not hire ACNPs.

As I said above some ACNPs can work outpatient and some FNPs can go inpatient.

Just depends on the area. If the OPs primary goal is urgent care or office then go FNP or AGNP. But to EXPECT to work inpatient as a FNP is not smart. Like I said the trend in many areas is to go only ACNP or inpatient work per the consensus model.

[twozer0, NP]

I wouldn't say the ACNP market is slim. In my area, only ACNPs are hired for inpatient work and many are also in specialty outpatient clinics where they round in the hospital as well

Do you work in a metropolitan area or more of a suburban/community setting? In my area that is community based, the job market for ACNP is very thin as there isnt a huge need. The only two ACNP's that work at my facility work in pulmonology (because pulm does the ICU). The rest of the NP's that do inpatient are FNP's or AGNP that work with the Hospitalists doing internal medicine.

[Dranger]

Do you work in a metropolitan area or more of a suburban/community setting? In my area that is community based, the job market for ACNP is very thin as there isnt a huge need. The only two ACNP's that work at my facility work in pulmonology (because pulm does the ICU). The rest of the NP's that do inpatient are FNP's or AGNP that work with the Hospitalists doing internal medicine.

In your situation, it seems like they are taking what they can get. There might not be a lot of ACNP applicants. But if the job was open for a hospitalist position and a FNP and ACNP applied, who do you think would get it?

I live in the suburbs on the cusp of a major metro area. So rather urban.

[twozer0, NP]

In your situation, it seems like they are taking what they can get. There might not be a lot of ACNP applicants. But if the job was open for a hospitalist position and a FNP and ACNP applied, who do you think would get it?

I live in the suburbs on the cusp of a major metro area. So rather urban.

My point is that ACNP's seems to be more concentrated near metropolitan and medical university hospitals. If you want my opinion on who would be hired for a hospitalist position, I would still say the FNP. I know you have a lot of people that think FNP is outpatient based and ACNP is inpatient, the reality is FNP's are used readily on the inpatient setting. Most specialist groups will not hire an ACNP for the lack of being able to see a child (which is also why you wont find them in the ER). I work in a community hospital and we do have ACNP's but our parent company does not look for them specifically due to restraints on whom they can see.