Hospitalist NP Certification ever be likely?

[Bumashes, MSN, APRN, NP]

Just got done rounding on my pts and charting charting charting, and I got to wondering....

Does anyone think it likely that there will ever be a way to become board certified as a Hospitalist NP? Just like how you can now graduate as an FNP and then work in an ER for a set amount of time and become eligible to take the ER specialty exam?

For those of us who are designated as "primary care" by our degree title (such as my AGNP) but who practice in a more acute care environment, I just think it might be a good option to create something like that so as to better comply with the dang national consensus stuff.

Let me be clear, I am in no way practicing in an ICU or step down environment. Mostly I see inpatient rehabilitation pts, or I help round on the hospitalist consults on the general med-surg floors. And also, I never ever WANT to practice in any environment more acute than this. No ICU, thank you. Because, well, my education certainly never prepared me for it, and also my background as a nurse was only in emergency medicine. So I don't feel qualified and would definitely need an ACNP degree for that, of course. However, I do feel well-qualified and trained to provide the level of care I do now, partially due to my nursing background and partially because the entirety of my NP clinicals was done with a physician who practiced old-school style and saw her pts both as inpatient and outpt. So I got to experience both worlds. I loved it so much, and was such a dork (and had no life) that I actually did about twice as many clinical hours as was required by my program. And while the majority of the "book learning" for my program was geared towards outpt settings, it did include the acute care management of the top hospital admitted diagnoses, such as CHF, COPD, PNA, PE, CVA, Hypertensive Crisis/Urgency, Cellulitis, etc. Not as much as the ACNP program did, I'm sure, but enough to claim basic competence with many of the major admission diagnoses.

So, now I sit, and ponder, how could I make myself more in line with the national consensus junk? Besides going back for an ACNP post-masters, which would be both time consuming, financially consuming, and overkill for my career goals. I mean, its not like I would then gain the ability to work where I'm already working. It would just confirm it. I don't want the intensive care training or skills training that an ACNP has. I just want to be able to continue to practice basic hospitalist medicine and not have someone pointing at me in the future and saying, "Hey weirdo, you're not qualified for this anymore." LOL! Or maybe I just worry too much? Anyway, what do you guys think? Oh, I'm in Mississippi by the way. Our BON is lax as far as practice setting for NPs, but in 10 years, who knows. And what if I were to move to another state with stricter practice setting rules? Then I'd cry I guess, because hospital medicine is my true love. Ok, I'm rambling now. Sorry. Opinions/Advice? Good, Bad, Meh?.....

[Jules A, MSN]

Prolly gots to suck it up and do the post-masters like the rest of us did. :)

Seriously though, how much longer do you plan to work? I think thats a big consideration as well as how worried are you about litigation coming a knocking if there is an adverse outcome?

I totally understand the clinical hours would be overkill but maybe do them in specialties that interest you but you don't get to fool with much in your present role? And while you are at it if serious about worrying about having your heels nipped from the latest nursing trends I'd throw in to consider a DNP with the ACNP.

[Corey Narry, MSN, RN, NP]

Your option is the streamlined, distance accessible, 3-semesters worth, post-Master's AGACNP program offered at Penn that takes into account your current employment setting and will use the hours at your current job as clinicals. I think that's very lenient already and I hear the tuition is not too expensive either. No sense in adding a hospitalist NP certification because that's what AGACNP is. God forbid we add another certification to our already complicated mess of NP letters.

https://www.nursing.upenn.edu/adult-gerontology/adult-gerontology-acute-care-nurse-practitioner/streamlined-post-masters-acute-care-np/

[prelift]

The fact they still do not have one year of basic sciences in the curriculum and then some generalist clinicals and then a "fellowship" year for whichever NP specialty one would like to perform in still beats me.

Probably a money issue since why pay people a fellowship stipend when they will pay you more tuition.

Never seen such a cluster bomb as to what they call advanced practice specialties. Such as they sit there at night and dream up things then make programs for them and people pay for em.

[Bumashes, MSN, APRN, NP]

Probably still got another 20 or so years I will be practicing.

Litigation worries? No more than the average practitioner.

Been thinking about it sucking it up, though, actually. Only 4 years into my NP career....so it could be worth the effort. However, it isn't the additional course work that I am opposed to, it is the additional clinical time. I worked fulltime as an ER RN while in school for my original NP degree. Would really like to not do the 7 days a week of work and/or school for another 2 years if I could help it. Plus, not sure if my finances would allow for me to screw up my current job by getting fired since they won't allow for part time status. I see someone else here has recommended a program at Penn that I am going to look into. Would be nice to have experience taken into consideration for clinicals.

As for the DNP....I won't go there, for many reasons. But that's a topic for a whole other discussion. LOL!

Anyway, thanks for the response! All good things to consider.

[Bumashes, MSN, APRN, NP]

Thank you thank you. This is fairly much what I was looking/hoping for (as long as tuition wouldn't kill me, so hopefully it is reasonable as you said). Would be great to get some credit for current/past work experience. My hospitalist physicians gave me a fairly good introductory onboarding process into inpatient medicine when I was hired so as to better assess my preparation for the job, and it was wonderful to revisit what my preceptor in school had taught me before. And I feel they are a good supportive group, great at ongoing education, so I don't feel I would be doing myself a particular disservice by using work experience for clinical hours. I could even manage a few turns in the ICU if they absolutely had to have me go there just enough to show I had been exposed to it. I just don't ever want to work in that environment, so meh. The additional course work would be a welcome refresher, and would also help count toward my yearly CEU requirements, so yay. LOL! Thanks for pointing me in this direction. I am going to email the Penn program folks shortly....

[Bumashes, MSN, APRN, NP]

Prelift, I agree. There is not much to be said about how our degree programs are built sometimes. The only reason I have more than the required Basic Chem, Micro, and A&P 1 & 2 is because a long ways back, I originally went to school thinking I was going to teach college level organic science courses. Alas, life changed. But, it still gave me more than the basic sciences our NP programs seem to require. And while the additional gross anatomy type classes were helpful, the others like the additional chem courses and whatnot...meh. Just not my bag. But I hear what you're sayin'.

And I agree on another point you make, that it is all a money game. Honestly, why not instead of all these NP designations, just have a program like PAs do? Instead of FNP...just NP. AGNP? Nope, just NP. Practice in all settings after a good grounding in each type. If you want to specialize with additional knowledge, then do a fellowship after graduation. But, again, they can more easily get us to jump through hoops and chase certifications and degrees with what little money we get paid.

Back to topic. Thanks for the comment. Having another certification for hospitalist NPs does kind of feed into that big money hole that we dump our dollars into to just create another certification. But I just think there could be a better way other than dumping our dollars into another full NP program just to basically come out and do the same thing I already do, you know. Hopefully the Penn program another poster mentioned will offer something along the lines that I have been searching for.

Thanks for the response again!

[Skippingtowork]

Prelift, I agree. There is not much to be said about how our degree programs are built sometimes. The only reason I have more than the required Basic Chem, Micro, and A&P 1 & 2 is because a long ways back, I originally went to school thinking I was going to teach college level organic science courses. Alas, life changed. But, it still gave me more than the basic sciences our NP programs seem to require. And while the additional gross anatomy type classes were helpful, the others like the additional chem courses and whatnot...meh. Just not my bag. But I hear what you're sayin'.

And I agree on another point you make, that it is all a money game. Honestly, why not instead of all these NP designations, just have a program like PAs do? Instead of FNP...just NP. AGNP? Nope, just NP. Practice in all settings after a good grounding in each type. If you want to specialize with additional knowledge, then do a fellowship after graduation. But, again, they can more easily get us to jump through hoops and chase certifications and degrees with what little money we get paid.

Back to topic. Thanks for the comment. Having another certification for hospitalist NPs does kind of feed into that big money hole that we dump our dollars into to just create another certification. But I just think there could be a better way other than dumping our dollars into another full NP program just to basically come out and do the same thing I already do, you know. Hopefully the Penn program another poster mentioned will offer something along the lines that I have been searching for.

Thanks for the response again!

I like your comment about doing it like PAs do. But additionally, instead of a fellowship, how about your last semester spent where you would like to work? Acute care? Do a few more months in acute care. Then if you want to pursue a fellowship in one of the few hospitals that has it, go ahead. I maintain that all NP graduates, regardless of like or desire, should round in the hospital and be well-rounded.

[Skippingtowork]

Do not worry about the title "hospitalist." A hospitalist is just someone that only sees patients in the hospital. It also has nothing to do with intensive care, as most physicians that work in intensive care are intensivists. Be more concerned with the requirements of the state or future hospital employers. Although you have hospital experience, you may, in the future, be required to have the certification or specialty training. If you have 20+ years to go, do like the others said and get the post-masters certificate. It is worth it. An you can stay away from the intensive care unit if you want.

Good luck to you.

[Cllaws889, BSN]

I would say just get a post masters in acute care setting, it's not that long or expensive. Then if you're really worried after awhile down the road you can always get Fellow of Hospital designation for a resume. Membership – Fellow Criteria | Society of Hospital Medicine

[lselvio]

Just got done rounding on my pts and charting charting charting, and I got to wondering....

Does anyone think it likely that there will ever be a way to become board certified as a Hospitalist NP? Just like how you can now graduate as an FNP and then work in an ER for a set amount of time and become eligible to take the ER specialty exam?

For those of us who are designated as "primary care" by our degree title (such as my AGNP) but who practice in a more acute care environment, I just think it might be a good option to create something like that so as to better comply with the dang national consensus stuff.

Let me be clear, I am in no way practicing in an ICU or step down environment. Mostly I see inpatient rehabilitation pts, or I help round on the hospitalist consults on the general med-surg floors. And also, I never ever WANT to practice in any environment more acute than this. No ICU, thank you. Because, well, my education certainly never prepared me for it, and also my background as a nurse was only in emergency medicine. So I don't feel qualified and would definitely need an ACNP degree for that, of course. However, I do feel well-qualified and trained to provide the level of care I do now, partially due to my nursing background and partially because the entirety of my NP clinicals was done with a physician who practiced old-school style and saw her pts both as inpatient and outpt. So I got to experience both worlds. I loved it so much, and was such a dork (and had no life) that I actually did about twice as many clinical hours as was required by my program. And while the majority of the "book learning" for my program was geared towards outpt settings, it did include the acute care management of the top hospital admitted diagnoses, such as CHF, COPD, PNA, PE, CVA, Hypertensive Crisis/Urgency, Cellulitis, etc. Not as much as the ACNP program did, I'm sure, but enough to claim basic competence with many of the major admission diagnoses.

So, now I sit, and ponder, how could I make myself more in line with the national consensus junk? Besides going back for an ACNP post-masters, which would be both time consuming, financially consuming, and overkill for my career goals. I mean, its not like I would then gain the ability to work where I'm already working. It would just confirm it. I don't want the intensive care training or skills training that an ACNP has. I just want to be able to continue to practice basic hospitalist medicine and not have someone pointing at me in the future and saying, "Hey weirdo, you're not qualified for this anymore." LOL! Or maybe I just worry too much? Anyway, what do you guys think? Oh, I'm in Mississippi by the way. Our BON is lax as far as practice setting for NPs, but in 10 years, who knows. And what if I were to move to another state with stricter practice setting rules? Then I'd cry I guess, because hospital medicine is my true love. Ok, I'm rambling now. Sorry. Opinions/Advice? Good, Bad, Meh?.....

I recently exchanged emails with someone at the organization behind the consensus model. We were discussing certifications, like the one you mentioned regarding the ER. She stated that certifications, according to the model, do not change the patient population allowed by the NP's certification. For example, an FNP in the ER should only be seeing the patients with primary care/walk in clinic issues. A patient having an acute event (MI, CVA, etc) would require an ACNP. I asked about an FNP with an ER certification and she said they are still limited, by the model, to the primary care patients. That certifications do not carry the same educational requirements like the FNP or ACNP or ped NP programs do through a credentialing body with a standardized test for license.

[pnwagnp]

I know this post is from last year but did any of you go back for a post masters? I have been an NP for a year now and looking into hospitalist positions, and most in my area require 1 year experience as a hospitalist and/or ACNP; neither of which i have. I am now looking into post masters degrees.