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GraceOnly GraceOnly (New Member) New Member

FNPagnpFNPFNP....no it's AGNP

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Hello friends! Old experienced nurse of 25 plus years, now new grad AGNP-C about to start first job here. After a long job search and the market being flooded with new grads, I am recently blessed with an opportunity in my dream setting of working with Senior patients. During my graduate education, I came across many opinions on my specialty. A co-worker FNP told me she heard many programs "were doing away with the AGNP" role, and I would be better off pursuing FNP for greater success in finding a job. My previous employer, a hospital, did hire mostly FNPs, without any acute care experience. Most threads are about the FNP role. As our population ages, I was excited for my opportunity. Now that I am hired in my new and true role, I being introduced to future co-workers and the new "FNP" when I am not. Even though I am to work with elderly only at this point, without getting defensive, I still feel like the FNP title is engrained into most mindsets and some even laughed when I corrected them nicely. I was told that's just how they refer to their NPs in general! Have any other AGNP's come across this! Maybe its not such a relevant thing and it won't keep me from doing my job, but not everyone is aware of our scope of practices. Thoughts or insight??

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Hmm...I get this. I'm a CNS and everyone refers to me as their "NP." I used to correct everyone but after 13 years I'm done with that 🙂

I now just say I'm the APN - maybe go to that? We are actually called physician extenders but I can't bring myself to say that with a straight face as it sounds nasty. Would rather be known as mid-level provider or advanced practice provider.

I would definitely want to be known as an APN or APRN versus FNP as you aren't an FNP

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That's odd.  In my hospital system we are all referred to as "NPs", and we are all listed as "CRNPs" in the system - regardless of specialty certification.  

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At one of the hospitals I was credentialed at, we were all APPs - advanced practice providers - this encompassed NPs, CNS, CRNAs, CNMs, and PAs

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11 hours ago, traumaRUs said:

At one of the hospitals I was credentialed at, we were all APPs - advanced practice providers - this encompassed NPs, CNS, CRNAs, CNMs, and PAs

All the NPs, PAs, CRNAs, etc, are referred to as APPs in my system as well.  But, specifically, all NPs, regardless of specialty, are referred to as CRNPs.

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On 2/3/2019 at 2:30 PM, GraceOnly said:

A co-worker FNP told me she heard many programs "were doing away with the AGNP" role, and I would be better off pursuing FNP for greater success in finding a job. 

Maybe they are thinking of the old ANP certification when saying this stuff?

Honestly...I have to say I don't totally understand the thinking behind the consensus model decision to keep the FNP cert when they added in the new population-specific certifications for AG-PCNP, AG-ACNP, the same for peds, etc.  Why keep a primary care certification for all ages?  I can only assume it is useful for rural areas?

It causes confusion in the decision-making process.  Most people are given that advice - get your FNP so you are marketable.  But then that is not the actual INTENT of the consensus model at all.

Anyway.

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35 minutes ago, Polly Peptide said:

Maybe they are thinking of the old ANP certification when saying this stuff?

Honestly...I have to say I don't totally understand the thinking behind the consensus model decision to keep the FNP cert when they added in the new population-specific certifications for AG-PCNP, AG-ACNP, the same for peds, etc.  Why keep a primary care certification for all ages?  I can only assume it is useful for rural areas?

It causes confusion in the decision-making process.  Most people are given that advice - get your FNP so you are marketable.  But then that is not the actual INTENT of the consensus model at all.

Anyway.

The consensus model has nothing to do with advocating for or against specific specialties.  It advocates for ensuring specialties are working within the parameters of their respective training.  Getting primary care trained NPs out of acute/hospital settings to both protect patients and the nurses license. 

Family Nurse Practitioners are trained to provide primary care across the lifespan.  It is needed in a range of areas spanning rural into urban centers with focuses on populations that need improved access to care.  As such, family medicine and the role of general practitioners is still a thing and in places like FM clinics and urgent cares, you need mid level providers who can cover all avenues.  We have a luxury to go into any field we wish within our scope...women's health, pediatrics, adult only, or all of the above.  But our training covers all of those areas quite thoroughly.  

While it can be confusing deciding what you want to do, it really isn't that bad.  Do you prefer adults, pediatrics, a mix, or wish to do something hospital focused?  The confusion is more on those doing the hiring IMO.  They need to have a clear strategy in the type of NP they hire and maximizing the earning potential of that staff member.  If you are a family medicine clinic, you will get more bang for your buck with an FNP or PA.  Hire a peds only or adult only, you run the risk of specific populations not showing up or not maximizing that provider's schedule (more so a problem with peds).

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4 hours ago, djmatte said:

The consensus model has nothing to do with advocating for or against specific specialties.  It advocates for ensuring specialties are working within the parameters of their respective training.  Getting primary care trained NPs out of acute/hospital settings to both protect patients and the nurses license. 

Family Nurse Practitioners are trained to provide primary care across the lifespan.  It is needed in a range of areas spanning rural into urban centers with focuses on populations that need improved access to care.  As such, family medicine and the role of general practitioners is still a thing and in places like FM clinics and urgent cares, you need mid level providers who can cover all avenues.  We have a luxury to go into any field we wish within our scope...women's health, pediatrics, adult only, or all of the above.  But our training covers all of those areas quite thoroughly.  

While it can be confusing deciding what you want to do, it really isn't that bad.  Do you prefer adults, pediatrics, a mix, or wish to do something hospital focused?  The confusion is more on those doing the hiring IMO.  They need to have a clear strategy in the type of NP they hire and maximizing the earning potential of that staff member.  If you are a family medicine clinic, you will get more bang for your buck with an FNP or PA.  Hire a peds only or adult only, you run the risk of specific populations not showing up or not maximizing that provider's schedule (more so a problem with peds).

djmatte and everyone else,

Thanks for your reply as well as everyone else here! I have already graduated with the AGNP Primary Care certification, over a year ago. Just starting my first dream job of working with geris, after turning down other offers from primary care clinics. The bang for my buck wasn't my goal in becoming marketable as I was already making more $ than most new grad NPs in my state as an RN of 30 years. This was about finding the right job for my last working years as a healthcare provider, as retirement will come in 15 years or so - I am 50 yrs old. I want to love my job especially as I get older! And yes, the FNP is more marketable reaching all lifespans. That is why it probably took me a year to find the right job with geris! My frustration was just with those hiring me, keep wanting to refer to me as the "new FNP" when introducing me to others. I was hired specifically for my love and certification in geriatrics for a senior wellness program. I will be working with another PA and FNP, and then the physician. Those doing the interview said I was hired for the nursing background #1 and the adult geriatric focus. 

I do not want to make "a mountain out of a molehill" since its all semantics. It will blow over as I start my new  position with this group. They will get to know me in time. I made myself clear day one when finalizing the contract with one person that I am adult geri, not family---did not want to run into credentialing problems. It will become like traumaRUs says above, how we become known as the NP, regardless of the letters following our name! Even some of the NPs at my last job were called "Dr" by the patients and family. Again, back to semantics and how one handles the situation. Just needed to talk about it here, versus going to the new job feeling defensive about such a small thing. 

Thank you all for interacting!

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I will say that many physicians really don't know or understand the differences in np training.  They likely have encountered fnps more commonly in the past and it's just a bad habit.  You are good to let it blow over though.  As noted, you will be called by a range of titles and just correct where you deem appropriate.

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On 2/6/2019 at 10:10 AM, Polly Peptide said:

Maybe they are thinking of the old ANP certification when saying this stuff?

Honestly...I have to say I don't totally understand the thinking behind the consensus model decision to keep the FNP cert when they added in the new population-specific certifications for AG-PCNP, AG-ACNP, the same for peds, etc.  Why keep a primary care certification for all ages?  I can only assume it is useful for rural areas?

It causes confusion in the decision-making process.  Most people are given that advice - get your FNP so you are marketable.  But then that is not the actual INTENT of the consensus model at all.

Anyway.

You are so right. And then don't get me started on why they got rid of all the population-focused CNS certs......grrr..

Signed one unhappy adult and peds CNS

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On 2/6/2019 at 8:27 PM, djmatte said:

I will say that many physicians really don't know or understand the differences in np training.  They likely have encountered fnps more commonly in the past and it's just a bad habit.  You are good to let it blow over though.  As noted, you will be called by a range of titles and just correct where you deem appropriate.

If I remember correctly, only 7% of all NPs are ACNP.  So I wouldn't get my panties in a bunch when/if they refer to me as a FNP.  If I had the time and the energy... I would just kindly and succinctly explain the difference.

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On 2/6/2019 at 12:20 PM, djmatte said:

But our training covers all of those areas quite thoroughly.  

Haha, that's up for debate.

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