FNP or WHNP?

jer_sd · Jul 28, 2007

FNP gives you much more flexability in potential employment. A fnp can do anything a WHNP can do but a WHNP is trained as a specialist FNP is a generalist. I have done both, both are good programs it just depends on what you want to do as a NP.

nicole83 · Aug 18, 2007

I kind of have the same situation as Kirish34. So because the FNP is so general does that mean as a FNP you could work in an OBGYN office doing womens health if you wanted to? I've tried to look at the scope of practice documents but couldn't find it clearly explained anywhere... The broadness of the FNP role will allow you to do that without placing you at risk of practicing too outside of your actual certification area?

core0 · Aug 19, 2007

I kind of have the same situation as Kirish34. So because the FNP is so general does that mean as a FNP you could work in an OBGYN office doing womens health if you wanted to? I've tried to look at the scope of practice documents but couldn't find it clearly explained anywhere... The broadness of the FNP role will allow you to do that without placing you at risk of practicing too outside of your actual certification area?

Siri could probably better explain the differences between the scope of FNP and WHNP. There is a difference in content related to OB/GYN specialty content.

Here is a good article on NP scope of practice:

http://www.medscape.com/viewarticle/506277

Here is the FAQ for Texas which is often referred to in BON scope issues and in particular explains the scope issues between WHNP and FNP (bottom of the page):

http://www.bne.state.tx.us/practice/apn-scopeofpractice.html

It will really depend on what your state board allows. Most of the NP practice acts have a provision where you must practice within the scope of your specialty. Operationally how this is enforced varies widely from state to state. Texas is probably the most restrictive holding that if you do not have specific training in the area as an NP you are outside your scope. TN for example is viewed as more permissive. The current draft compact rules for the BON fall more along the lines of the Texas rule than TN in my opinion. The danger is that if you find yourself in a fringe situation and the enforcement changes you may find yourself out of a job.

David Carpenter, PA-C

NHavenRN · Aug 25, 2007

As core0 mentioned I'm sure it does depend on your state...but I can speak to the fact that most of the preceptors for my WHNP program were actually FNPs, so I think it must be more common for NPs working in OB/GYN to be FNPs than WHNPs. That being said, the students in my school's FNP program felt like they didn't get nearly enough WH clinical experience, so if you know you want to do only WH after graduating then you might feel more prepared with a WHNP program.

I was also concerned with the limitations of a WHNP-only program, which is why I chose a program that educates its WHNPs as ANPs as well...I may be a bit less marketable than an FNP, but ultimately didn't have any trouble finding a first job as an ANP and WHNP. Good luck with whatever path you choose!

chellepnp2007 · Aug 29, 2007

I would just like to say that an FNP can pretty much do anything a WHNP can do. I live in TExas, and I know a lady who has her Whnp for 2 years, works in the largest OB?GYN office in our area, and still is not working as a WHNP, she is still staff RN. So she is going back for FNP. The university I graduated from, University of Texas Medical branch at Galveston discontinued thier WHNP program this year as a result of their former grads having difficulty finding employment. I am a PNP, but I can tell you FNP makes your job choices much more broad and as a rule, FNP's at least in my area get much higher starting salaries than other types of Np's. I also have a friend who really wanted to do WHNP, but did FNP instead who is now working at a universtiy women and childrens clinc doing exactly what she wanted to in the first place: treating pregnant women and thier babies. Long story short, I advise FNP, especially if you do not plan to work in a large metropolitan area.

danceluver · Mar 17, 2012

@chellepnp2007: Your friend who did FNP and is working for a university women's and childrens clinic doing pregnancy care and treating their babies, how did she get this job? What was her background in nursing? This is something I ideally want to do, and I am wondering what she did in order to facilitate this perfect job!

Also, if we plan on working in a metropolitan area, is it better to be specialized then?

anyone else is welcome to chime in too :)

kirish34 · Mar 17, 2012

When I receieved an alert in my e-mail that some had responded to this thread, it was fun for me to look back. I did finish my master's with a WHNP program in 2010 and have been licensed since October 2010 & practicing. I've had two different jobs since, one with a midwifery practice and now a private OBGYN office. If I had to go back and do it all over again, I would have gone for the FNP program do to more opportunity. It was really only by luck that I found my current job. I love women's health, but in my search for NP positions, there were so many more general APN jobs available, at least in my location.

danceluver · Mar 17, 2012

@kirish34: Do you think opportunities in ob/gyn will still be there as a FNP? i don't want to work at planned parenthood, but prefer something like you are doing, private ob/gyn office doing both pregnancy, gyn and adolescent women's health. Any suggestions to increase my favor-ability for this type of setting as an FNP?

nomadcrna, DNP, CRNA, NP · Mar 17, 2012

Texas is a very restrictive state. This is a very poor example. FNPs routinely practice in women's health. The compact is not going to be restrictive, the states will not pass it. In my state we are already talking about rejecting it.

To many FNPs can and do practice in ALL settings. Especially rural areas in regards to ER and inpatient medicine.

danceluver · Mar 17, 2012

Texas, really? That's not good, one of the places i was thinking of perhaps practicing in ...I do not plan on living rurally. So as an fnp in texas i couldn't practice in an ob/gyn office?

nomadcrna, DNP, CRNA, NP · Mar 17, 2012

Look at this article. It ranks the states for practice and has some great discussion.

http://www.eileenogrady.net/upload/Ranking%20of%20states%20AJNP_April_07_%5Bfinal%5D.pdf

I would check with the Texas Board about FNP doing women's health. I'm fairly sure you still can but although licensed in Texas, I refuse to practice there until they obtain independence. I am not as familiar with their rules and regs.

Rank State Legal NP Patients’ NP Patients’ State* Ranking Category

Capacity Access to Access to Score

Services Prescriptions

Maximum points 30 40 30 100

1 ARIZONA 30 40 30 100 Grade A: State is exemplary for

2 WASHINGTON 30 40 28 98 patient choice

3 WYOMING 30 37 30 97

4 DISTRICT OF COLUMBIA 30 35 30 95

5 NEW HAMPSHIRE 30 40 25 95

6 MONTANA 27 37 30 93

7 OREGON 27 36 30 92

8 NEW MEXICO 27 40 25 91

9 CONNECTICUT 24 37 27 88 Grade B: State partially supports

10 RHODE ISLAND 24 37 27 88 patient choice

11 UTAH 19 40 27 87

12 IOWA 24 37 25 86

13 ALASKA 21 37 27 85

14 NEW YORK 21 37 27 85

15 IDAHO 25 35 22 82

16 NEW JERSEY 19 37 25 81

17 KENTUCKY 21 37 22 80

18 WEST VIRGINIA 24 33 21 79 Grade C: State confines patient

19 PENNSYLVANIA 24 31 22 78 choice

20 DELAWARE 16 37 25 77

21 WISCONSIN 24 28 25 77

22 VERMONT 24 28 25 77

23 NORTH DAKOTA 22 30 25 76

24 CALIFORNIA 18 32 25 75

25 MINNESOTA 17 33 25 75

26 TENNESSEE 17 33 25 75

27 KANSAS 21 30 22 73

28 NEVADA 17 29 27 73

29 MAINE 18 33 22 72

30 OHIO 18 33 20 71

31 ARKANSAS 19 25 24 68 Grade D: State restricts patient

32 COLORADO 21 30 18 68 choice

33 INDIANA 13 30 22 65

34 MISSISSIPPI 17 26 22 65

35 TEXAS 18 28 19 65

36 SOUTH DAKOTA 14 27 22 63

37 OKLAHOMA 24 20 19 63

38 LOUISIANA 18 25 19 62

39 NEBRASKA 10 23 27 61

40 VIRGINIA 17 28 15 60

41 SOUTH CAROLINA 14 26 19 59 Grade F: State severely restricts

42 MARYLAND 13 24 20 57 patient choice

43 NORTH CAROLINA 13 25 19 57

44 MICHIGAN 22 24 12 57

45 MASSACHUSETTS 17 24 15 56

46 HAWAII 13 33 9 55

47 ILLINOIS 11 25 19 55

48 GEORGIA 12 26 16 53

49 FLORIDA 13 20 16 49

50 MISSOURI 13 18 5 36

51 ALABAMA 17 13 5 35