FNP vs ACNP

Advanced Practice Columnist / Guide · Sep 18, 2009

Sure, you may find a FNP who hired into a critical care setting as a NP but I will be blunt to say that this practice defeats the purpose of having a program to train NP's specifically for caring for the acutely and critically ill population. Go where your heart is and don't compromise your interest just so can have the NP title by your name.

ivanh3 · Sep 19, 2009

i really want to get my np in adult critical care....but what i've read and heard lately seems to think that a fnp is more hireable. if i go fnp could i have options to work in icu/critical care? i think fnp might bore me to death. thanks for any input!!

what is your rn background? is it in the icu? that should increase your chances i would think. what will be key is finding an icu that takes new grad nps. after a year or two i don't see how it could matter to anyone. i think nps are done a disservice when the training is so specialized. even if you never see peds (or adults, or icu pts, etc) i think the background helps. mds/pas don't do it that way for the most part. specialize when you seek your job. consider those first years your residency.

ivan

foreverLaur · Sep 19, 2009

What about working in the ED or Trauma? I always assumed ACNP would be the role to work in those departments, but I'm starting to see a lot more FNP or ANP in those settings. Anyone know what would be the best route to work in the ED/Level I Trauma?

Trauma Columnist · Sep 20, 2009

I still stand by the idea that to work in ER/trauma, you need two courses: some type of acute care adult and acute care peds.

I'm an adult health CNS in a state where CNS has the same practice act as NP. I'm in school for peds CNS since my prn job is an an ER.

YellowBoneRN · Sep 21, 2009

I really want to get my NP in adult critical care....but what I've read and heard lately seems to think that a FNP is more hireable. If I go FNP could I have options to work in ICU/critical care? I think FNP might bore me to death. Thanks for any input!!

I chose FNP so that I can see kids and adults. I was worried that I would not be able to get a job in hospital.

YellowBoneRN · Sep 21, 2009

What about working in the ED or Trauma? I always assumed ACNP would be the role to work in those departments, but I'm starting to see a lot more FNP or ANP in those settings. Anyone know what would be the best route to work in the ED/Level I Trauma?

Can CNS write prescriptions in outpatient settings? Just curious? Thanks.

Advanced Practice Columnist / Guide · Sep 23, 2009

Can CNS write prescriptions in outpatient settings? Just curious? Thanks.

The CNS scope of practice including whether prescriptive priviledge is allowed is dependent on the Nurse Practice Act in the individual states. Medicare will directly bill CNS for their services in states where they can practice in a health care provider role that includes diagnosing, treating, and prescribing medications.

Joe NightingMale, MSN, RN · Sep 23, 2009

I really want to get my NP in adult critical care....but what I've read and heard lately seems to think that a FNP is more hireable. If I go FNP could I have options to work in ICU/critical care? I think FNP might bore me to death. Thanks for any input!!

I've considered the same choice. I'd agree with Gilly and say that you should go with what interests you more.

The FNP is considered the most marketable degree, but I think that's among primary care NPs, not all NPs.

I too feared that FNP might be boring, but it depends upon your practice area. I followed a community health FNP and I thought it was pretty boring, but since then I've been told that an FNP can practice in many settings with many different roles. I would find doing only disease prevention and minor acute illness boring, but dealing with more chronic and serious illness I would like better. And you can do both as an FNP.

One more thing to consider: I've heard talk of limiting practice in hospitals to ACNPs. Not sure if it's going to happen, but you might want to consider that too.

RN28MD · Jan 9, 2010

I have to add that it all depends where you live and your area. I have seen ANP and FNP work in hospitals as hospitalist and that is in acute care setting. I also seen them in ER too because lot of ER is primary caring if you will.

Cardiology EP NP · Jan 9, 2010

I agree with some of the other posters in that it would be good to do whatever you are interested in. If you want to take care of patients with chronic illnesses in a more acute setting such as a hospital ICU, then I would say go for the ACNP. If you have ICU background the ACNP is a great way to go. I know of some FNP's who work in cardiology practices and I used to work with an FNP who took care of CV surgery patient post operatively on a cardiac step down floor. I think the only time you would be limited is if you just want to work ICU and never do outpatient. So with the ACNP, it would be hard to get an outpatient job so that's something you may want to consider for the future. It helps if you know what you want to do for the long-term. Hope that helps! Good luck!

mdbida · Dec 7, 2011

I didn't think I should make new thread since my question if very similar to this one. I am trying to decided between a FNP program and an Emergency Nurse Practitioner (FNP/ACNP dual route) program.

I am a PICU nurse. I ultimately want to be doing community health nursing in developing countries. This makes me think that I should just do FNP, but I'm wondering what I will be missing out on if I don't do ACNP. I want all the skills I can possibly have because I will be one of the few healthcare providers in the area I will be in. So what are the main differences in training between the FNP and ACNP programs? As an FNP can't I still learn to do all of the skills - chest tubes, intubation, sutures etc,,,? Most likely, I won't have any of the equipment to do that in some of the places I'll be anyways, but I want to have those skills in case. I basically want to know what my limitations will be in training in the FNP program. Thanks for your help!