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 know this has been touched on a bit, but I have a question. I know a lot of people suggest going FNP and then getting their acute care cert afterward - that way they can see all ages.

What about getting a peds cert after getting your ACNP? Is that something that is possible?

I am interested in working in acute care, but not being able to see peds is kind of worrying.

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Specializes in Pediatrics/Emergency Medicine/NICU.

I am in the pediatric realm, but know that the differences out there in pay for CRNA are pretty significant. It is not the environment for me, but definitely in demand right now and will be in the future. Of course, FNP will has and will have many positions available. They are two totally different environments. Anyone considering what specialty to go into should very much consider if they would be happy several hours per day in a more closed environment of an OR, or would enjoy the constantly changing environment of a primary practice or clinic/hospital. Happiness is first to me...money second :)

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I am in the same boat CRNA vs NP. I am an associate degree RN working home care here in the north midwest. 2011 is the 1st full year of RN in home care, and at the end of the year i will have cleared $73,000 before taxes. seems like a lot, but i did on average 8hrs OT every week. I am interested in becoming a mid-level practitioner with being able to intubate, insert chest tubes and central lines; along with being able to work in ER or ICU. I like the idea of the CRNA income, but just sitting in the OR for hours at a time administering drugs for the majority of your job, dosen't appeal to me. In my position now, the most interesting part is the replacement of the airway. I enjoy the adrenalin rush, i have no kids or spouse, nor do I plan on having either. so working a lot, is exciting to me. I still don't know what I want to do when I grow up. haha

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Specializes in Anesthesia, Pain, Emergency Medicine.

You are NOT a mid-level practitioner. :)

Delete that word.

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.....

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Specializes in CTICU.

One of the facilities in my area pays dayshift float pool RNs (Critical Care, Med-Surg, and Telemetry) $40/hr for days and $45/hr for nights. Weekend diff is $4 per hour. No benefits with the float pool positions.

Regular permanent positions for new grads start at between $21 and $22/hr.

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I have looked at NP versus PA salary information and the difference is negligible. I personally believe the disparity is a result of gender bias which still exists to an extent. There are more male PA's and more female NPs. Over time this will continue to change until there is virtually no difference. If anything the NPs will eventually make more as they are moving to a doctoral level of education. May not happen for a decade or more though.

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I am a RN with my BSN, PHN and 5 years experience. I make $80k a year doing 3-12 hour shifts a week. It can be done :) by advancing your degree and/or specialty certifications. I keep thinking about going back to school for either my FNP or CRNA.... I feel like when I research the average salary of NP's it is the same as or close to what I already make. I looked into CRNA and they make a very high salary but the lifestyle seems exhausting! Tough choice....I agree though I don't know if I want to take time away from my family and have that stressful lifestyle, yet I want to continue on, challange myself and continue with my education???

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First, even if a job isn't posted and you want to work say ER express care type jobs, you just contact the company that provides the physician services to the hospital near you. (At least here in Florida, most ER doctors,PA's and NP's are contracted through a company, not hired by the hospital). If you are willing to move after you get some experience, NP's can make $100000 a year with experience under your belt. CRNA is an interesting job, but unlike NP school, you can not work and do it. Most schools make you sign and/or show your letter of resignaton to them that you no longer work. 28months straight through. No breaks. Where with the NP, you can go part time at most schools and take a LOA if needed for a short term. According to my University, now is the time to become a NP more than ever with Obama care. There are avg of 60 primary care physicians in FL per 100,000 people, not enough by far. So, NP's are in high demand here.

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Specializes in RN-BC, CCRN, TCRN, CEN.

Hi all who originally posted. What did you end up doing?

I'm an ED RN of 3 years and really enjoy bedside nursing and critical patients. I've always thought I wanted to be a CRNA but am at least open to the NP option. I love the hands-on, I love the airway management and being completely in charge of the hemodynamics of a pt. I loved the job shadows I did (especially when they let me intubate!) but I'm not sure if OR is where I want to be forever- I went into nursing because of the options for change and not being locked into a specialty. I think surgery might get old after awhile.

Consequently, I do NOT want to be in an office M-F, 9-5, writing for antihypertensives and protonix, and a cardio referral. I see the NPs in the ED in fast track/"urgent care"- I don't want to be suturing and handing out percs for back pain all day. I'd like to learn about more job options for FNP/ACNP. Being on a medicine/critical care team might be interesting, but as others have said, the supervision and having to answer to a doctor in some states/hospitals is not my favorite. Though for liability's sake, it can be a good thing. Besides, most hospitalists end up consulting specialties anyway so they end up managing very few of the pt's medical problems and overall care.

Finally, I am not crazy about peds or OB but I understand I'd have to do both in CRNA school (I'm fine with throwing an epidural in then taking off haha). Another reason I was thinking acute care. But that may limit employment options.

And yes, of course the salary vs investment/loans is huge. It might kill me to not work through CRNA school for 2-3 years, but in the end it would be worth it.

Any advice would be great!

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Specializes in ICU.

I work in ED at 2 different companies. I work fast track and in the main ED depending on my schedule. Yesterday, I diagnosed a stroke, a likely mets to the bone with malignant pleural effusion among the sore throats and fractures. You could get experience, work in Alaska or Montana and run the ED by yourself in a critical access site. Check out Employment Opportunities - Wilderness Medical Staffing

to see the jobs offered.

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Hi all who originally posted. What did you end up doing?

I'm an ED RN of 3 years and really enjoy bedside nursing and critical patients. I've always thought I wanted to be a CRNA but am at least open to the NP option. I love the hands-on, I love the airway management and being completely in charge of the hemodynamics of a pt. I loved the job shadows I did (especially when they let me intubate!) but I'm not sure if OR is where I want to be forever- I went into nursing because of the options for change and not being locked into a specialty. I think surgery might get old after awhile.

Consequently, I do NOT want to be in an office M-F, 9-5, writing for antihypertensives and protonix, and a cardio referral. I see the NPs in the ED in fast track/"urgent care"- I don't want to be suturing and handing out percs for back pain all day. I'd like to learn about more job options for FNP/ACNP. Being on a medicine/critical care team might be interesting, but as others have said, the supervision and having to answer to a doctor in some states/hospitals is not my favorite. Though for liability's sake, it can be a good thing. Besides, most hospitalists end up consulting specialties anyway so they end up managing very few of the pt's medical problems and overall care.

Finally, I am not crazy about peds or OB but I understand I'd have to do both in CRNA school (I'm fine with throwing an epidural in then taking off haha). Another reason I was thinking acute care. But that may limit employment options.

And yes, of course the salary vs investment/loans is huge. It might kill me to not work through CRNA school for 2-3 years, but in the end it would be worth it.

Any advice would be great!

This is the exact same thought process I have been going through when considering my options for grad school in the future. I wish there was an option for all of the coursework that occurs in CRNA school but more of an FNP role. But not necessarily the ACNP role either. I just have no clue how to integrate everything I want to do and still feel like I'm not missing out on anything. Blah.

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