FNP vs. Acute Care Job Demand & Responsibilities

[SN2751, BSN, RN]

Hello All,

I am trying to decide between applying to FNP or ACNP programs. It is insanely difficult to find legitimate research on job demand between the two. I hear time and again that the FNP route is over saturated, but I also hear that this field is projected to grow exponentially. For those of you out there who have gone through this - do you think I'll be able to find an FNP job within say six months after completing grad school? Is that a sufficient outlook? I fear going back and never finding a job as an FNP - many people have put this fear in my head.

For that reason I have considered the ACNP track. I feel that these programs are somewhat more sporifice and competitive in comparison to FNP programs. I feel that this may make finding a job as an ACNP easier? Any thoughts on this out there?

I also do not want to choose my career path based solely on demand in the field, but also on responsibilities and work environment. I do believe I would enjoy working at the hospital for a given period of time, but not forever. Does anyone know how easy it is to transition to more of an urgent care/outpatient area of work as an ACNP?

Thank you for your time!

[babyNP., APRN]

A big question here is where do you live and are you willing to move. Location is one of the biggest factors.

[SN2751, BSN, RN]

I live in Charlotte, NC. I will be living near Matthews though, which is close to smaller communities like Waxhaw and Indian Trail. I am not willing to move, but willing to commute to a smaller community if that means finding a job and getting experience.

[Neuro Guy NP, DNP, PhD, APRN]

7 hours ago, SN2751 said:

I live in Charlotte, NC. I will be living near Matthews though, which is close to smaller communities like Waxhaw and Indian Trail. I am not willing to move, but willing to commute to a smaller community if that means finding a job and getting experience.

Look at hospitals and other facilities near you and see if they're advertising for help. If not and you're not willing to move where the jobs are, it probably isn't worth getting the degree at this time. It would be terrible to graduate and not be able to find a job (and pay the loans).

Not trying to be a Debbie Downer, but I advise students to look at the market and consider their life factors before deciding to advance their education. If is not a good feeling to embark on a journey only to realize it will not work out the way you hoped.

Good luck

[ArmaniX, MSN, APRN]

Besides the point brought up by Neuro Guy, I feel you are asking the wrong question.

What do YOU want to be in the future. Do you want to be an FNP and manage primary care issues and management of chronic issues, working 8-10hrs (scheduled) 4-5 times a week, “office hours”.

Do you want to be an AGACNP and manage acute issues, acute on chronic, specialty management (Neuro, ENT, Heart, Vascular, Pulm, GI, Nephro, Endocrine, Palliative, Oncology etc), working varied shifts (3 - 12hrs, 4 -10hrs, rotating shifts, weekends, Monday through Friday).

Decide what your interests are... THEN see if there is a job market in your area. There is absolutely no point in becoming a FNP if you do not desire that sort of patient management or vice versa. You will do yourself and your patients a huge disservice.

[KatieMI, BSN, MSN, RN]

If just about circumstances and personality:

FNP/office positives: set, predictable schedule, frequently no calls/holidays/weekends, same docs, same staff, patients are familiar, clerical support you can organize the way you like it, more opportunities to teach and "get closer", after a while less "supervision" (i.e. no one will point your nose into some very minor omission), problems are usually chronic, always opportunity to push unclear or difficult case onto somebody (i.e. send to ER), doing minor procedures if you feel like it.

Negatives: tons of downright silly phone calls from EVERYONE and at ALL TIMES, especially if you cover SNFs as well, load can be high at times, paperwork can be downright exhaustive, drug seekers, noncompliance, idiotic regulations (SNF/Medicare/Medicsid/state/insurances) paralyzing your work and harming patients, not seeing any real results soon, might need to find your coverage should you get sick or something else happens (equals to catastrophe).

Acute positives: high speed, high load, constant mind-teasing, seeing results quickly (sometimes), decision making at razor's edge, knowledge growing exponentially, IMHO more opportunities to grow, more valuable contacts, more all-level networking, better legal protection (at certain cases), paperwork at least usually better organized, better record keeping (important), usually more money and better benefits, set shift time after which you legally can turn off your phone and beeper.

Negatives: feeling stupid (like 95% of time at the beginning but it gets better), speed of work you need to demonstrate, load, tension, drama, politics, multiple (sometimes quite unfriendly) providers, families, drug seekers, "frequent fliers", violently noncompliant patients, usually call, holidays, weekends, shift work, almost by definition conflict between work and rest/family time, brutal schedules like 7/7 with no PTO at all, etc.

I did two years of 50/50 mix and just signed for 100% hospital job. Really person-dependent, but I will be begging on streets for bread for my kids before I again agree to do office and SNFs.