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For ER: FNP or ACNP (Texas)

NP   (720 Views 14 Comments)
by CodeBlueMedic CodeBlueMedic (Member)

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I've seen a few threads where this was discussed in some detail, but I must say that I am still very confused about the pathway to ER. I've seen some post FNP emergency medicine programs out there, but I haven't found anything for the ACNP that is EM geared. I know I want to work ER, for the foreseeable future, but may want to specialize further on down the road. I understand the life span issues between the two licenses, so that points me towards FNP, but then I hear and read about the consensus model and it makes me feel like I should do ACNP and try to maintain a pedi certification as well. 

Thoughts? Experiences?

Thanks so much

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FullGlass has 1 years experience as a BSN, MSN and works as a Adult and Geriatric Primary Care NP.

147 Likes; 5 Followers; 6,035 Visitors; 567 Posts

The ACNP program covers ER.  I have not heard of an MSN NP program that is only geared towards EM.  The trend is away from FNP for the ER and to ACNP.  Another option is to become a PA.  An FNP program will not include any acute care didactics or clinical rotations.  

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58 minutes ago, FullGlass said:

The ACNP program covers ER.  I have not heard of an MSN NP program that is only geared towards EM.  The trend is away from FNP for the ER and to ACNP.  Another option is to become a PA.  An FNP program will not include any acute care didactics or clinical rotations.  

How are they covering the age limitations of that licensure? The only NPs I have seen in the ER are FNPs

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djmatte has 7 years experience as a ADN, MSN, RN, NP and works as a Family Nurse Practitioner.

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1 hour ago, FullGlass said:

The ACNP program covers ER.  I have not heard of an MSN NP program that is only geared towards EM.  The trend is away from FNP for the ER and to ACNP.  Another option is to become a PA.  An FNP program will not include any acute care didactics or clinical rotations.  

Acute care and emergency medicine are typically vastly different in training and necessity.  An ACNP imo is no more qualified to work in emergency than an fnp and arguably less if they have any form of pediatric population.  There is an ENP certification that anyone who  works in that arena should attain imo. 

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Dodongo has 7 years experience as a APRN, NP.

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I would say ENP program, FNP + AGACNP or ACPNP + AGACNP.

I had a professor that worked ER with adult gerontology acute care and pediatric acute care.  ACNPs are trained to handle obstetric emergencies - at least I was in my program. 

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FullGlass has 1 years experience as a BSN, MSN and works as a Adult and Geriatric Primary Care NP.

147 Likes; 5 Followers; 6,035 Visitors; 567 Posts

1 hour ago, CodeBlueMedic said:

How are they covering the age limitations of that licensure? The only NPs I have seen in the ER are FNPs

The Consensus Model is moving away from FNPs in the ER.  NPs currently have to choose Adult or Peds Acute Care.  

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FullGlass has 1 years experience as a BSN, MSN and works as a Adult and Geriatric Primary Care NP.

147 Likes; 5 Followers; 6,035 Visitors; 567 Posts

57 minutes ago, djmatte said:

Acute care and emergency medicine are typically vastly different in training and necessity.  An ACNP imo is no more qualified to work in emergency than an fnp and arguably less if they have any form of pediatric population.  There is an ENP certification that anyone who  works in that arena should attain imo. 

There is no "ENP MSN" program that I am aware of.  The OP was asking about which programs to apply to.  You're talking about a post-master's certification in EM.  One still has to get the NP MSN first.

 

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Exactly...there’s so much misinformation out there that it’s daunting as a nurse looking for advancement.

I want to do ER, but it’s concerning when ACNPs can’t see kids (required for ERs), but yet, ERs are moving away from hiring FNPs?

There are Post MSN EM programs for FNPs, but I haven’t seen anything similar for ACNPs. 

Getting AGACNP + ACPNP seems insane for an ER position 

 

 

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ThePsychWhisperer works as a Psychiatric-Mental Health Nurse Practitioner.

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1 hour ago, FullGlass said:

There is no "ENP MSN" program that I am aware of.  The OP was asking about which programs to apply to.  You're talking about a post-master's certification in EM.  One still has to get the NP MSN first.

 

There are probably quite a few emergency nurse practitioner programs out there, but two I can name off the top of my head are offered by the University of South Alabama and Vanderbilt University. They are dual role, and combine clinical experiences of the FNP with the AGACNP. Completion of these programs leaves the student dual-board eligible for both family practice and acute care certifications. 

As far as the original question, with more and more states favoring physician assistants and acute care nurse practitioners as the mid-levels of choice in emergency settings, if the OP is sure that ER or hospitalist work is all they may ever want to do, the acute care certification is fine. However, if the OP has the extra cash and time lying around for two to three more semesters of grad school, the dual role option would certainly increase versatility, giving the NP the ability to bounce back and forth between acute care and primary care at will.  The main drawbacks to this are of course the extra time and money spent completing courses for both certifications and maintaining said certifications.

If the OP wishes to have the same versatility with a focus in pediatric emergency, s/he would have to complete the FNP with a PM in pediatric acute care, or vice-versa.

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juan de la cruz has 27 years experience as a MSN, RN, NP and works as a Adult Critical Care Nurse Practitioner.

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Well, the Consensus Model is quite cryptic in it's use of words and if I were to summarize the document, it basically sums it up that NP's must practice within the scope of their educational training. It doesn't specifically address settings where NP's work, in fact, it complicated matters with a statement that says:

"Scope of practice of the primary care or acute care CNP is not setting specific but is based on patient care needs"

I mean, really, this statement does not reflect how healthcare institutions work and it's completely out of touch in terms of how Medicine is practiced. It seems to imply, for instance, that an acute care NP would have to reach out to a primary care NP in a hospital in order to have "primary care" needs addressed. It doesn't work like that in real life. Suffice it to say, the ED situation was totally ignored by the Consensus Model.

What made matters worse is that AANP stepped in to muddy the waters even more by coming up with an Emergency NP certification (ENP-C) that is only open to candidates who are FNP's. It seems shortsighted and self-serving. AANP does not offer an ACNP certification (both adult and peds) so they don't seem to care that they left ACNP's out of being eligible for their shiny and new ENP-C certification. It's ridiculous.

I say if your goal is ER, go to PA school.

https://www.aanpcert.org/faq-enp

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4 hours ago, juan de la cruz said:

Well, the Consensus Model is quite cryptic in it's use of words and if I were to summarize the document, it basically sums it up that NP's must practice within the scope of their educational training. It doesn't specifically address settings where NP's work, in fact, it complicated matters with a statement that says:

"Scope of practice of the primary care or acute care CNP is not setting specific but is based on patient care needs"

I mean, really, this statement does not reflect how healthcare institutions work and it's completely out of touch in terms of how Medicine is practiced. It seems to imply, for instance, that an acute care NP would have to reach out to a primary care NP in a hospital in order to have "primary care" needs addressed. It doesn't work like that in real life. Suffice it to say, the ED situation was totally ignored by the Consensus Model.

What made matters worse is that AANP stepped in to muddy the waters even more by coming up with an Emergency NP certification (ENP-C) that is only open to candidates who are FNP's. It seems shortsighted and self-serving. AANP does not offer an ACNP certification (both adult and peds) so they don't seem to care that they left ACNP's out of being eligible for their shiny and new ENP-C certification. It's ridiculous.

I say if your goal is ER, go to PA school.

https://www.aanpcert.org/faq-enp

I could not agree more...It seems like an absolute dumpster fire of layers and layers of bureaucracy that hinder any cohesive structure. As much as I'd like to not have to worry with it and go to PA school instead, it just isn't really feasible for me as a parent to be out of work that long to complete the schooling, which is why I have come the nursing route to begin with. 

As others have mentioned, there were dual certifications programs where you end up with your FNP and AGACNP, but these have transitioned into simply FNP with the ENP-C specialty included and no longer offer the duel certification. To me, it makes zero sense that we corn hole ourselves by having so many different credentialing bodies that all contribute to the confusion. I understand specializing, but it's turned into a convoluted pile of garbage that no body can understand or plan for. 

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djmatte has 7 years experience as a ADN, MSN, RN, NP and works as a Family Nurse Practitioner.

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9 hours ago, FullGlass said:

There is no "ENP MSN" program that I am aware of.  The OP was asking about which programs to apply to.  You're talking about a post-master's certification in EM.  One still has to get the NP MSN first.

 

I never qualified it as an ENP msn. I stated  the person should get that certification as it's specific to the environment. ACNP by itself is not.

Edited by djmatte

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