GNP or FNP?

[ANPFNPGNP]

As far as your last question, I trained in a strictly adult specialty (18 and above). I do not work as an NP in the ER. In fact, the ER at our hospital do not hire NP's, only PA's. I work in adult critical care medicine with a cardiothoracic surgery population. Our hospital do not perform cardiothoracic surgery on pediatric patients. That subset of patients are admitted to the nearby children's hospital. I do cross-coverage of the cardiothoracic service and do ER and floor consults with that service but again, there are no kids seen in that service.

First off, why doesn't your hospital hire NP's in the ER? That makes no sense at all. Also, is an ACNP allowed to work in primary care in your state? What I don't understand is, if all these NP's can work wherever they want, then why are there different specialties?

[juan de la cruz, MSN, RN, NP]

first off, why doesn't your hospital hire np's in the er? that makes no sense at all.

this is the preference of the er director and physicians. our er is a level 1 trauma center and the pa's employed there see patients from all levels of acuity from trauma to fast track as well as infants to older adults. the er at our hospital is also a training site for a local pa program. in fact, one of the pa's in the er belongs to the faculty of this program. we can fight the er management and push for np's to work in the er but how can physicians be convinced of the cost effectiveness of np's when fnp's are only trained to see fast track and acnp's are only trained to see adults. even though the state appears to be mixed up when it comes to the different scopes of practice, it does not appear to be a strong argument to change current practice in an er that has employed pa's for many years without a strong case in support of hiring np's.

also, is an acnp allowed to work in primary care in your state? what i don't understand is, if all these np's can work wherever they want, then why are there different specialties?

you tell that to the state bon! i guess what i am trying to say is that i am agreeing with you. however, i am just posting the fact of what goes on in my state. i have made a conscious decision not to sway from my scope of practice based on my acnp training and certification. i work in adult critical care and adult cardiothoracic surgery --- that's acnp territory period!

[johnson0424]

as i went through my FNP program i did FNP b/c i thought i would be more marketable(which you are) but i really have no desire to work w/ kids ever so i kinda wish i would have gone for ANP but then again i could get a job where they dont see kids so it all works out...I would love to go back and get my GNP that is what i eventually want to do is own my own assisted living!!!

[JacangalRN]

How difficult is it to get an ACNP certification after getting FNP? And do they require that you have had ICU experience for entrance into the program?

[juan de la cruz, MSN, RN, NP]

How difficult is it to get an ACNP certification after getting FNP? And do they require that you have had ICU experience for entrance into the program?

I assume it will not be much different than any post-master's NP program available. If one already has the FNP, I assume many programs will allow the student to bypass the pre-clinical courses in pathophysiology, pharmacology, and health assessment. The best thing to do is to go directly to the schools and ask the program directors. Michigan only has 2 ACNP programs, by the way, and both are in Southeast Michigan. Both also offer no on-line component except for some theory courses. Both require in-patient clinical experience as an RN to get in but ICU experience is not indicated as a specific requirement.

[ANPFNPGNP]

as i went through my FNP program i did FNP b/c i thought i would be more marketable(which you are) but i really have no desire to work w/ kids ever so i kinda wish i would have gone for ANP but then again i could get a job where they dont see kids so it all works out...I would love to go back and get my GNP that is what i eventually want to do is own my own assisted living!!!

You don't need a GNP to own an assisted living center, b/c you can do that with your FNP! Although, the GNP "sounds" better if you're going to work exclusively with the elderly.

[juan de la cruz, MSN, RN, NP]

as i went through my FNP program i did FNP b/c i thought i would be more marketable(which you are) but i really have no desire to work w/ kids ever so i kinda wish i would have gone for ANP but then again i could get a job where they dont see kids so it all works out...I would love to go back and get my GNP that is what i eventually want to do is own my own assisted living!!!

ANCC offers an alternative certification as a GNP for FNP's, ANP's, and ACNP's without having to attend a formal post-master's GNP program. You earn eligibility to sit for this exam by showing evidence of clinical practice in the older adult population and completion of CEU's targeted to the care of older adults.

Here's the info: http://www.nursecredentialing.org/cert/PDFs/GeroNP_Alternative-App.pdf