FNPs in the Hospital?

hopefulwhoop · Mar 2, 2014

It is absolutely possible to work inpatient as an FNP. As a matter of fact, I am an FNP working in neurosurgery in a primarily inpatient position.

Trauma Columnist · Mar 2, 2014

Please look to the Consensus Model. As more and more states implement it (41 at last count) new FNPs might find themselves NOT working in the hospital

APRN Consensus Model

allennp · Mar 2, 2014

Consensus model rather poorly named, for a number of states its a reduction in ability to practice and in my opinion a continued fragmentation of the the NP role that confuses the rest of our medical colleagues and restricts my ability to practice. Since many states do not even have a ACNP program it confuses many systems what implementation means.

PatMac10,RN, RN · Mar 2, 2014

It's my understanding that there are a number of states who have considered only adapting potions or certain features of the consensus model. Though, honestly, I haven't seen this proclaimed by any particular state myself.

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MedictoRN · Mar 3, 2014

It's my understanding that there are a number of states who have considered only adapting potions or certain features of the consensus model. Though, honestly, I haven't seen this proclaimed by any particular state myself. Sent from my iPhone using allnurses.com

Not really a consensus then is it…

PatMac10,RN, RN · Mar 3, 2014

Not really a consensus then is it…

Exactly.

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cougdogrn · Mar 4, 2014

I am a FNP in WA and work as a inpatient hospitalist. :)

SummitRN, BSN, RN · Mar 4, 2014

If the Consensus Model will keep NPs out of positions for which they are qualified, then it is more a CRAPcensus.

PatMac10,RN, RN · Mar 4, 2014

Many of the APNs I know personally don't care for the consensus model very much, for varying reasons.

I know one of the nurses on the CVICU where I work, just passed his FNP boards and is being hired by the hospitalist's group. He'll be the first full-time FNP they've hired as a hospitalist. They already have on PA on board.

He worked for 4 years in the regular ICU and is really great.

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Advanced Practice Columnist / Guide · Mar 4, 2014

OP, you'll get responses as varied as the wide inconsistencies in NP programs.

What drives this:

1. State law - check with your BON as far as NP practice acts that govern this issue. You'll find most states don't care one way or the other but there are very few states with strict rules re: acute care vs primary care roles (Texas and Maryland have been mentioned as examples of this in this forum).

2. Institutional policy - our medical center hires all kinds of NP's in various in-patient roles. For example, Palliative Care, ID, GI, Nephrology, etc is an in-patient role that is not necessarily restricted to primary care or acute care in focus. Neurosurgery here hires FNP's, ANP's, and ACNP's and many of their NP's have out-patient follow up and care coordination kind of practice anyway. The transplant services hire NP's regardless of training as well. However, our ICU group only hires ACNP's as a rule and have not had any problems finding candidates that fit this criteria because we are a training site for the univeristy's ACNP program.

3. Consensus Model - As previously mentioned, should take effect in 2015. The truth is, this really requires buy-in from state legislatures in all the 50 states to happen. Practice acts are changed by legislation not the BON. The BON enforces the state practice act. The Consensus Model actually muddies up the issue further as it says:

"The certified nurse practitioner (CNP) is prepared with the acute care CNP competencies and/or the primary care CNP competencies. At this point in time the acute care and primary care CNP delineation applies only to the pediatric and adult-gerontology CNP population foci. Scope of practice of the primary care or acute care CNP is not setting specific but is based on patient care needs. Programs may prepare individuals across both the primary care and acute care CNP competencies. If programs prepare graduates across both sets of roles, the graduate must be prepared with the consensus-based competencies for both roles and must successfully obtain certification in both the acute and the primary care CNP roles. CNP certification in the acute care or primary care roles must match the educational preparation for CNPs in these roles."

Explain to me what the bolded statement means and I'm sure we'll have multiple contradictory responses.

chillnurse, BSN, RN, NP · Mar 11, 2014

i work as a hospitalist as an fnp. there are several more fnps who take some call during the day at my hospital also. only one is an acnp. all of the rest are FNP. you are most defiantly not restricting yourself to outpatient going the fnp route