Help me understand the different types of NP programs (ACNP vs FNP etc)

Good morning,

I am interested in becoming an NP. I initially thought my future would be in nursing management and leadership but over the past year or two I've had a change of heart and decided that my true path is in hands on practice. I have 15 credits towards an MSN (mostly the generic core curriculum stuff.)

Here's what I've found confusing: None of the colleges clearly describe the scope of practice you can expect upon completing the program. I have seen some called "acute care NP," other called "adult/gerontology acute care NP," others just called "NP." Is there really a difference? Do they all take the same boards at the end? Do they all just end up with the "CRNP" credential and practice in whatever setting they want?

Right now I am the stroke program director at my hospital. I really enjoy Neuro, and would like to expand upon my role and be able to actually provide care to the patients rather than just run the program. I've also always enjoyed the ED. Is there some path that will enable me to be practice in Neuro full time but also leave the door open to work in a setting like an ED/Urgent Care on the side for extra money? I have zero interest in primary care, and can not see myself ever working outside of a hospital.

Thanks for any help you can provide!

Andy

An ACNP program will allow you to have clinical rotations in various specialties such as the ones you mentioned. As such, you could potentially be working in a more specialized area.

FNP programs have specific course that allow the graduate to work as a primary care provider. However, my clinic hired a new grad FNP for the heart failure clinic.

From what you describe you would definitely want to try to obtain an ACNP certification. A year or two back I believe they changed this certification from ACNP to Adult Gerontology ACNP or (AGACNP). The certification will allow you to practice on adults usually age 18 and over. This certification would allow you to work in specialty clinics such as neuro, cardiac, and so on. It is also geared around working within the hospital as a hospitalist on the hospital floors or an intensivist role in the ICU. Most programs have the majority of their clinical rotations in the ICU setting. You would learn skills like central line placement, art line placement, chest tube insertion, and intubation.

You could also use this certification to work in the ED as a neuro specialist or in a trauma setting. This would be highly hospital dependent. The one major catch in the ED is that some hospitals hire ACNP's, some hire FNP's, and some only hire PA's. You should ask around at the hospitals in the areas you are interested in living to see who they are hiring. The ACNP is slight limiting in the ED especially for the smaller hospitals as you would need to be able to see pediatric and OB patients as well. Many hospital's hire FNP's in the ED for this reason, and a majority only have them work in the fast track area seeing essentially urgent care patients. Larger level one trauma hospitals seem to hire more ACNP's working on the trauma or stroke teams.

If your only interest would be to work in the ED the best bet at the moment seems to be getting dual certified as an ACNP and FNP. For you, you seemed most interested in the hospital setting and it seems the ACNP or the AGACNP, as they now call it, would be perfect for you.

Hope this helps a few people. I'm currently in a AGACNP program.

Darrin RN, BSN, CEN, CCEMT-P

I graduated with an Adult-Geriatric Primary Care MSN, and I was concerned that hospitals wouldn't consider me for hospital based (non-intensivist) positions. But I had no trouble being offered hospital-based jobs. Most hospital recruiters are unaware that there even is an Adult-Geriatric Acute Care focus. The AANP (unlike the AANC) has not even started offering Primary Care vs. Acute Care certifications, they just offer an Adult-Geriatric certification.