How to change specialties as an FNP?

FullGlass, BSN, MSN, NP · Feb 17

Start applying for jobs in other specialties. Think about what experience you have as an FNP that is related to other specialties. For example, if you have treated a lot of patients with acute infectious diseases, update your resume to highlight that if applying for infectious disease job. Do some research on what specialties are hiring in your area. Are there specialists that you have sent a lot of referrals to? That would be a good place to start.

I used to work in primary care. At one point, I was looking for a job and posted my resume on a job board. An Ob/Gyn contacted me because I had a sent a lot of referrals her way and she recognized my name. She really wanted to hire me, but I just had no interest in specializing in women's health.

I treated a lot of pain patients in primary care and liked that, so I applied to pain management practices and got job offers.

Finally, you can get a post-Master's (or Doctoral) certificate for a more radical specialty change. I ended up getting my PMHNP and am very happy doing psych.

BeenThereDoneThat74, MSN, RN · Feb 19

Since new grad (NPs) get hired in specialties, I think your chances of finding something within your scope of practice as an FNP is definitely a realistic goal. But it may be in an environment that you weren't considering (like inpatient, or off-hours) to get in a door. In my health system, NPs are very utilized in the above environment, working alongside residents and fellows, often in the same capacity (minus the research and academic responsibilities). They usually are more knowledgeable, are a great resource, and tend to pick up the pieces of the novice medical staff (which may not be something you're looking to do, LOL).

What was your area of expertise as an RN? Also, in your current practice, is there an area that you do find to be more interesting (patients who need to be rereferred to specialists)? That could be a great way to break the ice with a prospective employer in a new specialty.

BeenThereDoneThat74, MSN, RN · Feb 19

FullGlass said:

Finally, you can get a post-Master's (or Doctoral) certificate for a more radical specialty change. I ended up getting my PMHNP and am very happy doing psych.

I am interested in how your transition to PMHNP went in the beginning. Did you have an NP masters already? Did you have mental health experience, or was it experience in the way you mentioned above (since mental health is everywhere!)? This is something I am considering, but my masters is not a clinical/NP one.

FullGlass, BSN, MSN, NP · Feb 21

BeenThereDoneThat74 said:

Since new grad (NPs) get hired in specialties, I think your chances of finding something within your scope of practice as an FNP is definitely a realistic goal. But it may be in an environment that you weren't considering (like inpatient, or off-hours) to get in a door.

FNPs are not educated or trained to work in an acute-care setting. Yes, some hospitals will hire them, but they shouldn't. This is a huge liability risk. NPs should practice within the scope of their education and training. And it doesn't matter if an FNP worked in acute care as an RN, they are still not an Acute Care NP.

FullGlass, BSN, MSN, NP · Feb 21

BeenThereDoneThat74 said:

I am interested in how your transition to PMHNP went in the beginning. Did you have an NP masters already? Did you have mental health experience, or was it experience in the way you mentioned above (since mental health is everywhere!)? This is something I am considering, but my masters is not a clinical/NP one.

Most primary care providers do a fair amount of basic mental health. In fact, primary care providers are the #1 source of mental health care, as they are qualified to treat basic depression, anxiety, insomnia. I became the "go to" provider for mental health in the primary care clinic I worked in. Becoming a PMHNP still has a learning curve, as psych providers care for more complex depression, etc., as well as more complex conditions such as bipolar d/o, schizophrenia, etc. In addtion, they prescribe controlled substances as appropriate, which most primary care providers no longer do - stimulants for ADHD, benzos for severe anxiety/panic, etc. As a new grad PMHNP, I certainly had a lot to learn, but adjusted pretty quickly. I am very happy with this specialty.

BeenThereDoneThat74, MSN, RN · Feb 21

FullGlass said:

FNPs are not educated or trained to work in an acute-care setting. Yes, some hospitals will hire them, but they shouldn't. This is a huge liability risk. NPs should practice within the scope of their education and training. And it doesn't matter if an FNP worked in acute care as an RN, they are still not an Acute Care NP.

I was not aware of this, as I know a number of FNPs who work in acute (and sub-acute) care settings. I am a peds nurse, and many peds nurses I know felt it was worth it to pursue the FNP route to expand their marketability (as well as being able to care for young adult patients with chronic issues who continue to receive their care in pediatric facilities).

GoodNP · Feb 22

Thanks for all of the comments. I think I'm feeling a lack of confidence just applying for a specialty position without a good foundation of experience. When I took my first NP job in primary care, I was promised close mentorship, and that did not happen, so it was a stressful first few years. Not looking to repeat that scenario.