Hospitalist --- FNP or AGACNP?

[WestCoastSunRN, MSN, CNS]

Is FNP cert sufficient for most generalist hospitalist roles? I know that high acuity critical care needs ACNP. But it looks like FNP cert is OK and even preferred for a lot of the hospitalist jobs I see.

Also for NP roles that require both primary and acute care certs, or peds/adults ... which strategy is best for obtaining these? I am going to start working on my DNP/FNP in May. Some of the jobs I'm interested in would require both peds/adult and maybe acute care as well.

Does anyone have experience with this? If so, did you get the primary cert first, or the acute care cert? My local school(s) do not offer dual cert programs, so I will have to do a post-grad cert.

[traumaRUs, MSN, APRN]

Look to the consensus model for your guidance. What do your hospitals in your area hire as hospitalists?

In my area, in-pt positions are being transitioned to ACNPs regardless of acuity: if its inpt, its ACNP. The reason is that FNPs only (should) be doing clinicals in the outpt environment.

I'm actually dually certified as an Adult and PEds CNS and because my clinicals were mostly inpt I have no issues working in the hospital. The FNPs are all going back to school or looking for a new job

[WestCoastSunRN, MSN, CNS]

In my area I'm not seeing a ton of ACNP jobs the way I see FNP jobs. So that has me worried. That said, I have a top-ranked teaching hospital university in my backyard that has an AMAZING acute care NP program.

Also, I'm interested in how things are in other areas of the U.S., because my long term plans include moving back East at some point. Truthfully, I am pretty secluded in my little burn world and a bit out of touch with who's staffing how at different places. I know the ACNPs work in the ICUs.

Is it typical that specialties such as cardiovascular, neuro, pulmonary, etc would choose ACNP's for their clinic staffing? I need to know what my other job options could be outside of the hospital or inside/outside in the likely case of clinic/rounding times.

And I'm not an adrenaline junkie anymore ... not looking to place lines and intubate every chance I get and work night shift into my 50s (not saying I won't do those things -- but I'm going to need a physically kinder/gentler nursing career soon). But I do love acute care....

[Bumex, DNP, NP]

My question is why do we still not have more combined FNP/ACNP and AGPCNP/ACNP programs?

[traumaRUs, MSN, APRN]

Good point MSUFAN.

As to ACNPs in clinics - at least in our nephrology practice nope. We hire FNPs or CNSs or PAs

[WestCoastSunRN, MSN, CNS]

Yes, great point about needing dual cert programs like FNP/ACNP. And TraumaRUs, see that surprises me about a little about your nephrology clinic. I think some specialties like cards would like acute care over primary care ... but maybe that's because of all the inpatient procedural stuff that abounds in cards.

Well one thing I discovered is that, of the local schools around here, no one offers a post-grad cert in FNP or Peds. But they do offer post-grad in acute care. Seeing as how I think it's a highly probable I will need both to do some of the jobs I'd like to do, I may need to go ahead and pull the FNP trigger first. Maybe a distance option wouldn't be horrible for a post-grad cert, though, so I should look into those, too, and see how many FNP or peds post-grad cert programs are out there.

[Bumex, DNP, NP]

There are a handful of fnp/acnp programs but we need more of them as well as some AGPCNP combo with acnp. My job combines both inpatient and outpatient, much like many of my friends jobs. If these jobs are so common, we need more than the handful that are currently available.

[WKShadowNP, DNP, APRN]

I am grateful that my employer prefers family nurse practitioners. However I would love to have the additional knowledge that the acute Care Program would have provided. When I have another year of practice under my belt I am considering enrolling in the University of Pennsylvania or is it Penn State program for acute care practitioner.

[JellyDonut]

It all depends on where you live and practice. Anyone who tells you it should only be this or that cannot speak for all areas. Check with your BON and hospitals in your area. However, the dual FNP/ACNP should cover all bases for anywhere you plan to practice. When I graduated I thought I wanted to only work as a hospitalist, but the facilities in my area wanted two years experience. I fell into a speciality and am so glad I did. Hospitalist work mad crazy hours where I am where my specialty is m-f no holidays or weekends..

[Dodongo, APRN, NP]

It all depends on region and more specifically hospital system. The major hospital systems in my region are making a conscious effort to hire ACNPs for solely inpatient positions. However, FNPs can obviously get privileges to see their patients when they are admitted and I don't think it's a hard and fast rule to begin with anyway. Just do your homework before diving in.

If you want to work inpatient get the ACNP. One of my instructors knew he only wanted inpatient/ER. So he did ACNP and APNP and now he works ER no issues. You don't have to be FNP because you're scared of not finding work. I don't understand that mindset. Pursue what you're interested in. If you settle out of fear of the unknown you'll be disappointed. But always try and minimize the unknown first. Haha.

[BostonFNP, APRN]

Is FNP cert sufficient for most generalist hospitalist roles?

Your board certification doesn't dictate where you can work: your state practice act, your own ethics, and your employers policy does. The real question is do you feel you have the experience and training to fill that role both professionally and ethically.

If you are going to dual cert the logical progression in FNP then ACNP.

[nomadcrna, DNP, CRNA, NP]

FNPs admit and manage patients all over rural america. If you remember, there is a Emergency Nurse Practitioner board certification through both ANCC and AANP (AAENP). FNPs are the only ones allowed to take the AANP version.

Many rural ERs are staffed solo by FNPs who admit and manage as well. Much depends on your state laws, of course. Thankfully, hopefully, we are moving away from set roles. I think it's ridiculous that a ACNP is not allowed to do peds or some states want to keep FNPs in the clinic.

This type of thinking only hurts the profession.