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FNP's in acute care

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by direw0lf direw0lf, BSN (Member) Member Nurse

direw0lf has <1 years experience as a BSN.

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What I'm seeing in the curriculums for FNP programs are that they are geared for primary care, and the clinical sites must be completed at primary care settings. I met an FNP graduate who was in the process of completing a certificate program for acute care and was having her clinical rotation in the trauma unit. So my questions really are:

1. Do FNP programs prepare you enough for acute care settings also, with an extra certificate course for acute care

2. How "easy" is it to get hired in acute care with an FNP?

My goal is to work in both primary and acute care settings.

I've even considered medical school because I felt NP programs can be so limiting, but maybe they aren't? I chose a career in nursing in part because of the flexibility..to not have to stay in one area.

Thank you in advance

Edited by direw0lf

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NICUmiiki has 4 years experience as a BSN, RN and specializes in NICU/PICU Flight Nursing.

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1. The FNP program doesn't prepare you for acute care (you will see some who will tell you that they did all of their clinicals in a hospital setting). The certificate program is the NP specialty portion that focuses on acute care. It qualifies you for certification in a new specialty. You just don't have to repeat a lot of the graduate core courses like research, pharm, patho, etc.  If you are really interested in working acute care, do an acute care program from the start. If two new grads are applying to a hospitalist position, one FNP and one AGACNP, who would you hire?

2. Depends on the state. In my state (which has strictly enforced the role portion of the consensus model), an FNP absolutely cannot care for acute patients regardless of the setting. Not only can you not get hired, but they've forced FNPs that have been working those roles before to go back to school and get certified in acute care or leave the job. In other states, they don't enforce roles so strictly so you'll see FNPs all up in acute care. 

Being an ACNP doesn't mean you can't work outpatient at all. They can also be found in outpatient specialties. This might mean that you have clinic hours and hospital rounding. You could also look at some of the "emergency" dual track programs. Although emergency might not be your goal, they are typically an FNP and AGACNP program rolled into one and would prepare you to provide primary care and acute care.

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Dodongo has 7 years experience as a APRN, NP.

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FNP programs do not prepare you for acute care - at all.  In fact, most programs will not let their students do clinical in the hospital at all.  

A post-master's certificate is not one course.  It is usually multiple courses and clinical rotations that will train you for a second population focus (such as acute care).  Rather than completing a second master's degree and repeating classes, you just take the track specific classes.

In my area it is becoming increasingly difficulty for FNPs to be hired inpatient.  The ER group only hires PAs.  The inpatient APPs are mostly PAs and older FNPs with younger ACNPs.  Other hospital systems in the area actually list "ACNP preferred" or "ACNP required" for their inpatient positions.  

There are more and more states prohibiting FNPs from working in the hospital as they follow the consensus model.  And ACNPs can work in the outpatient setting for specialty practices.  I am a surgical ACNP.  I work in the OR, see patients in every area of the hospital, and I also have clinic days. 

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Pallspice_NP has 3 years experience as a MSN, NP and specializes in Palliative Care.

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Hmmm, the short answer is no. FNP programs are not geared towards inpatient work. However, I am an FNP and work inpatient palliative at a major hospital. It really depends upon the specialty you are seeking and your employment history. I have worked in hospice/palliative care for 6 years now. Critical care or hospitalist-type work is definitely out of the question for FNPs. 

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direw0lf has <1 years experience as a BSN.

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Thank you both so much for the clarifications. Very helpful!

Dodongo - that is what I want to be able to do. I turned away from what I originally thought I wanted while I was still in nursing school (psychiatric NP) and fell in love with pediatrics. With psych NP, there seemed to be no separate programs for acute or primary. Now I'm looking at peds NP programs, and many are geared for primary only. I thought maybe FNP would encompass both acute/primary. 

What do you think of this program? http://nursing.rutgers.edu/academics/dnp/postBacc/FamilyNPEmergency/index.html

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direw0lf has <1 years experience as a BSN.

1,046 Posts; 10,851 Profile Views

4 minutes ago, Pallspice_NP said:

Hmmm, the short answer is no. FNP programs are not geared towards inpatient work. However, I am an FNP and work inpatient palliative at a major hospital. It really depends upon the specialty you are seeking and your employment history. I have worked in hospice/palliative care for 6 years now. Critical care or hospitalist-type work is definitely out of the question for FNPs. 

Thank you!  I do not have the experience, I'm a new nurse. I am very ambitious though...I enjoy bedside nursing very much but i want more. So I'm really trying to take the time to find a program that will prepare me or what I should do. If in the end being a better NP means being a nurse for more years, then that's what I'll do.

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NICUmiiki has 4 years experience as a BSN, RN and specializes in NICU/PICU Flight Nursing.

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There are acute care PNP programs popping up. My university has one and right off the top of my head, I know South Alabama has one. Many do require experience in inpatient pediatrics if not PICU much like neonatal programs. 

PNP comes in two tracts: acute and primary. Many schools have options to let you do a dual program. 

Edited by NICUmiiki

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NICUmiiki has 4 years experience as a BSN, RN and specializes in NICU/PICU Flight Nursing.

1,755 Posts; 25,390 Profile Views

And rereading your earlier post, I'd add one more thing. If you are looking to work with children in the acute setting, an Emergency track wouldn't meet your goals. The FNP would allow you to provide non-acute care to children, but the AGACNP portion is only for adults. You'd need to find a PNP-AC program.

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Dodongo has 7 years experience as a APRN, NP.

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See #5

Screen Shot 2019-02-18 at 20.21.31.png

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direw0lf has <1 years experience as a BSN.

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Thank you. I found a peds dual primary and acute NP program with the University of Alabama at Birmingham and applied a couple days ago. I'm also considering Duke's PA program, because I plan to relocate to Raleigh in the future.. it would be a wait but maybe worth it.  Thanks again to those who helped in this thread!

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