FNP vs Acute care NP vs CRNA

Nursing Students NP Students

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Hello everybody!

I am sure somewhere, somebody asked the same question...so I apologize...I need to make a decision and start planning for applying for a master degree....but I am having a really hard time making a decision! A little about my self: RN BSN, 8 years experience various critical care areas, high GPA, motivated, but...somewhat older 38yo...want to get away from bedside, need a break from the physical part of bedside primary care. I am really, really interested in NP career, but....CRNA comes with almost double the money....sorry I am not greedy...but have o think about, time, effort, and my kids...future...and so on.

I love critical care because it gives me the opportunity of forming a "relationship" with my patients, and their families. I get along with even the most difficult families, demanding and so on....so I believe I could do that while being an NP. I like to help my patients, through education, to take over their health care issues, to become involved and ask pertinent questions...because most of them , at least the less educated ones, become victims of lack of time a physician can offer during visits, or rounds.

In the same time, I do like the critical care part, the"adrenaline rush" to a point...but I am not an adrenaline junkie :uhoh3:. that is why I am having such a hard time deciding...My questions: what path would allow me to build a relationship with my patient but still give me the trill of critical care situation? Does acute care NP differs a lot from FNP? I do not like OB so midwife is out of question. I have not had any Psych experience...so Behav Med does not interests me, do not know how to approach trouble patients or teens.

Any input is appreciated!

Thanks!

Leanne:nurse:

I'm confused...i thought compensation for NPs was pretty good? And that it was certainly on par with PA's (with regional fluctuation)?

I'm also surprised to hear comments about NPS just being doctor lackeys....everything else I read indicates the exact opposite. Was this comment referring specifically to certain settings, like ICU's or academic in-patient?

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
I'm confused...i thought compensation for NPs was pretty good? And that it was certainly on par with PA's (with regional fluctuation)?

It certainly varies by region. My experience as an NP have only been in hospital settings and even in this sector there are variations. Acute Care NP's are relatively new and as such, many hospitals have not structured the pay scale for NP's as they have done for PA's who have had a presence in hospitals longer than we have. In my last job in another state, the PA's have multiple ranks and pay scales depending on their seniority and specialty (i.e., supervising PA's make more than new hires, surgical PA's make more than medicine PA's). The NP's, on the other hand were just classified as a single category in the pay scale. That made it so that the NP's started low (just like the PA's) but progressed slower in salary advancement. That was changed while I was there and we ended up making even in the end.

I work in a San Francisco hospital now where the pay scales for NP's are higher than PA's. That's because the university that the hospital is affiliated with is VERY familiar with the Acute Care NP role (they have an excellent program in th university) and the salary is based on total years of nursing experience including years spent as a bedside RN. Their pay scales are on the public domain and you can easily find them on the internet knowing that there are only 2 publicly funded acute care hospitals in San Francisco so if you do a search, it should be easy without me posting the name of the institution here.

I'm also surprised to hear comments about NPS just being doctor lackeys....everything else I read indicates the exact opposite. Was this comment referring specifically to certain settings, like ICU's or academic in-patient?

It depends on what you mean by "doctor lackeys". Patients in hospitals especially those in the ICU have complex medical issues that involve mutliple organ systems. Though the care is headed by an attending physician trained in critical care, the ICU team is composed of critical care fellows, NP's, residents doing critical care rotation, bedside RN, critical care CNS, respiratory therapists, dietitian, critical care pharmacist, and social worker. This, to me, is the ideal set-up and nothing less than that would suffice in a large academic medical center where patients are reffered to from the entire region. Each of us have a role and have something to bring to the table. Our combined decisions and actions drive patient care in this setting not to mention the input we receive from consultations we have requested from other disciplines. Sure, I am not practicing alone or treating patients without any physician around but in this setting, that is just a set-up for a bad outcome.

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I have the same question too,I'm sorry guys but I'm so confused right now,I want to take crna mainly because they get paid a lot compared to acnp , that's the reason why I'm so eager to take it but it's so tough to get in the prog,I haven't applied yet but my target is next year....I want to get some tips and advice here re the acnp prog so that I would get some encouragement to take this course instead of crna, are they gonna be in demand here in north California for the next few years ( acnp ) coz one of our np said that there's not a lot of jobs right now in that field,what about the hours? Is there 12 hrs or it's always 8 hrs?can I work in md's office while working in the hospital? And the main ques is... What's the starting salary?I've heard that a bedside nurse makes a lot per hour,this is my main concern ,coz of the economic crisis right now,it already affect the health care,I'm just being practical,why take a masteral if I get paid more being a bedside nurse,does the hospitals here in cali use acnp? I want some advice bacause I'm about to apply this year for next year,until now I'm still undecided,pls help me,thanks

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Specializes in Critical Care.
Where I'm at NPs start at $84,000 a year. Experienced RNs and float pool RNs working nights make more than that without overtime. It's sad given the fact that the NPs work way more than 36 hours a week plus they are on call all night.

I am not sure where you work but as an experienced nurse in the charge nurse role I only made $30/hr which ends up being about $56,000 before taxes. Please tell me where float pool and experienced RN's make more than $84,000.

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You know I was thinking the same thing! Where do RN's make $84,000. I just started a year ago and I know that I am not going to be making as much as someone with 20yrs experience, but still without overtime I only make $46,800/yr before taxes. Of course that is without overtime, but still... I don't want to have to work my life away either. I hate when people say that RN's make as much as FNP's or ACNP's with overtime. Yes, with overtime. Time away from your family when you could just be working a normal 40 hours a week with weekends and holidays off and vacation time if you worked in an office. Just saying.

I have had the same dilemma FNP or ACNP??? I currently work in a critical care unit and I don't know if I want to give that up or not... I love my sick patients and their families and I love that type of work, and I would love to be able to put in central lines and chest tubes, etc. BUT I also like the idea that with my FNP I could someday open my own practice....so many things to consider! I have also looked at some salary info and if you go on monster.com some jobs will have the salary posted and $50+/hr isn't too shabby, or $74 if you want to live in Oregon or Washington.

I was considering CRNA, however, can I really see myself in an OR for 8-12 hours a day for the rest of my life?

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Specializes in ICU.

If u r considering opening a practice check into Hrsa.gov. They've got grants to start business. Im looking into and accepted to a FNP so I can maybe start up a practice.

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Thank you so much for the information! I knew that they did loan forgiveness, but I had no idea about the business grants, I was kind of wondering how I would go about funding for a new practice.

Where will you be doing your FNP? I am just starting to look at schools right now.

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Specializes in ICU.

University of southern Indiana at Evansville. Website is Usi.edu

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Specializes in ER.

Said "Californy is the place you ought to be" So they loaded up the truck and moved to Beverly. Hills, that is. Swimmin pools, movie stars. I loved that show when I was a kid.

Anyway, prob talking about Cali, I've been working out here off and on as a travel nurse and dependent upon the job, would average around 85-90k per year with monthly take home of around 6500/month. Would work 1-2 extra days per month and I didn't work at all November and December. Out here it's all about selling yourself and I had no problems going to the highest bidder. I went to Hawaii 3yrs ago for the summer at 35/hr x40hr/wk, the other travelers in the ER were getting 25/hr, you had to be able to play the game and negotiate. Now, things are tighter out here but with PA school, there's no way I could work but if I need some quick cash one 12hr shift at the trauma center up the road through my registry would get me $550 after taxes. Now to the OP's question.

I've got a buddy back home that is CRNA and loves his job, the money is great but he loves what he does more than the money. He once told me he loved it so much he'd almost do it for free, almost... Two other guys (we all 4 worked nights at the same ER) went the FNP route and both love what they do as well. One got hired on at the same ER we all worked and the other is doing primary care. You have to ask yourself where you would be happiest and go from there.

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Specializes in ICU, ER, OR, FNP.

I have to agree with the thoughts of: go to where you’ll be happy. I thought I wanted to be a CRNA for years and was filling all of the squares to do so. One day I just got sick and tired of intubated pt’s and missed walkie talkies with a c/c (or 10). I’ll never see CRNA style money – they rake it in, but I get to see every Dz there is and sometimes actually feel like I made a difference.

Folks already explained ACNP vs FNP, but to reiterate – they are completely unrelated. I feel better prepared to work an ER fast track since I trained on all Dz processes, not just crit care lab values, and all ages – birth to death.

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Specializes in ICU.

Sorry I don't know how to copy and paste of my I phone. CRF250Xpert, I wish I had learned what u did prior to spending 36,000 in student loans, lowering my gpa, But now I'm in a Fnp program starting next spring.

To the OP, look deep within, don't do it just for the money, if people around u r telling u, that they don't see you as having the personality of a crna or that u won't like it. Consider listening to them. I had many nay Sayers at work, the people were my work family, people I spent more time with than my own. They were right. So please look Hard within! You don't want to waste time or money on either path. And good luck in your decision.

Ps. Readers sorry about the texted"u" I'm on my I phone, thumb gets tired.

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Specializes in Tele, Med-Surg, MICU.

In terms of ACNP, don't forget that hospitals are now hiring ACNP's to staff their ICU's (mostly in non-teaching hospitals). The ICU NP makes more $$$ than other hospital based NP's in my area. OP, if you love the ICU you may want to look into the job market for this in your area. Downside of ICU APN is that the job may require weekends, holidays, and midnights for 24/7 coverage.

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