Help me decide-FNP vs AGPCNP?

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

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Hello, I would love some advice about furthering my education. I hold a BSN and have been an RN for 12 years, mostly in med surgical at several different hospitals and in progressive. I have been in direct patient care the entire time, I have no interest whatsoever in nurse management and have turned down any offers of charge nurse or nurse manager.

I love working with patients and advocating for them as well as looking at their entire plan of care and how well we as a hospital team are implementing that. I have been researching NP programs. I am a little overwhelmed at the options. I prefer to work with adults only, I want the AGPCNP degree but I'm scared I may sell myself short so to speak by limiting my options vs having an FNP. However, I really don't want to complete an FNP, there's so much clinical rotation in areas that I very much dislike (pediatrics and OB for example). It takes longer and is more expensive and requires more different types of preceptors I must locate. My other concern was getting ANY kind of NP degree from an online university. That's really all I can manage financially and logistically as I will be working and have 2 young kids. But there seems to be a stigma against online only degrees in some circles, I have heard them referred to as "degree mills" that do not adequately prepare their students for patient care compared to their counterpart brick and mortar schools.

And lastly, I have recently discovered Clinical Nurse Leader Masters in Nursing as a much more affordable and manageable online masters from a local brick and mortar nursing college with a great reputation. I like the sound of the job description but I must say I'm not used to seeing any CNL MS nurses in the hospital. That leads me to wonder if CNL nurses are a less common, more specific role that again will limit the amount of job options I have after graduation. I don't want to start a degree I feel trapped in or one that leaves me with a masters degree I can't really use. I would love your thoughts and input on any of these many questions I have posed!

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Specializes in Tele, ICU, Staff Development.

It's great that you're considering furthering your education to advance your career, and it's exciting, too!

Each option you've mentioned—Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), Family Nurse Practitioner (FNP), and Clinical Nurse Leader (CNL)—has its own merits, and the right choice depends on your personal and professional goals.

Let's break down some key points to consider for each option.

AGPCNP vs. FNP

  • Clinical Focus. AGPCNP specializes in adult gerontology, aligning with your preference for working with adults only. While FNP offers a broader scope, it includes pediatrics and OB/GYN, which may not align with your interests.
  • Clinical rotations. If you are sure about working with adults, the AGPCNP program may be more efficient, as you can avoid rotations in areas you dislike.

NP vs Clinical Nurse Leader (CNL)

  • The main difference between nurse practitioners and CNLs is that CNLs are not providers. In my experience, smaller hospitals are less likely to hire a CNL, although having a master's degree qualifies you for many roles (for example, a hospital-based educator).

  • Role Specificity. CNLs are less widespread than NPs, and their role is more specific. Being a CNL qualifies you to focus on care coordination, quality improvement, and patient advocacy at the unit or department level.
  • Local relevance. Research how CNLs are utilized in your local healthcare setting. Some regions may have a higher demand for CNLs, while the role might be less common in others.
  • Career flexibility. While CNLs may not be as prevalent, the skills gained in a CNL program can be valuable in various healthcare settings. It could also serve as a stepping stone to higher leadership roles.

Stigma of Online Degrees

Some view online nurse practitioner programs as inferior to traditional, on-campus programs.

Stigma may come from concerns that graduates of online programs are less prepared for clinical practice than their traditionally educated counterparts.

Concerns include the quality of education received, the extent of hands-on experience, and the level of student-faculty interaction. Hands-on learning is essential, and a lack of clinical time can increase the learning curve when you graduate.

Since online works for you and your family, be aware of the clinical concern when you choose a program.

There is a decreasing stigma against online degrees, especially for programs with a good reputation. It is essential to ensure that your online NP Program is accredited. Furthermore, checking reviews or talking to alumni to determine the program's quality might be helpful.

Once you start working in the field and gain experience, your resume becomes more important than the school you attended.

NP vs Clinical Nurse Leader (CNL)

The main difference between an NP and a CNL is that CNLs are not providers. In my experience, smaller hospitals are less likely to hire a CNL, although having a master's degree qualifies you for many roles (for example, hospital=based educator).

  • Role Specificity. CNLs are less widespread than NPs, and their role is more specific. Being a CNL qualifies you to focus on care coordination, quality improvement, and patient advocacy at the unit or department level.
  • Local relevance. Research how CNLs are utilized in your local healthcare setting. Some regions may have a higher demand for CNLs, while the role might be less common in others.
  • Career flexibility. While CNLs may not be as prevalent, the skills gained in a CNL program can be valuable in various healthcare settings. It could also serve as a stepping stone to higher leadership roles.

Online vs. On-Campus

  • Flexibility. Online programs offer flexibility and self-paced learning, allowing you to continue working and managing family responsibilities.
  • Ensure the online program is accredited and has a good reputation.
  • Preceptorship. Regardless of the program type, securing suitable clinical preceptors is crucial. Confirm that the online program finds preceptors for you. It is a terrible struggle to have to find your preceptors. 

Before deciding, consider contacting professionals who have pursued each of these paths and seeking their insights.

Additionally, consult with faculty or advisors at the institutions you're considering to understand each program's structure, support services, and post-graduation opportunities better. Finally, reflect on your long-term career goals to choose a path that aligns with your interests and aspirations.

Also check out the Nurse Practitioner forum here online.

Best wishes in your decision,

Nurse Beth

 

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