How do you figure out what specialty to pick?

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Specializes in Med/Surg.

I am a RN who is considering applying to a MSN program to start Fall 2014. However, I cannot figure out what specialty I want to do.

I love trauma/critical care and always considered acute care NP. However, I don't want to work nights/evenings/weekends/holidays for the rest of my life and it can be difficult to find a Mon-Fri daytime job as a ACNP.

So I thought about doing FNP since that's outpatient. But it limits me to family medicine. No real option for specialty offices. But it does let me do adults and kids.

I always wondered what type of NP specialty offices want (such as a cardiologist) but then I found myself getting frustrated that so often these patients are partially to blame for their health issues and ignore the education you give them.

So then I thought I'd be interested in working with kids. But PNP (either acute or primary) is very limiting and I know several that have a hard time finding jobs. So then I was back to FNP since you are a lot more marketable but will a pediatric office hire a FNP?

I have an interest in women's health and thought about doing the dual nurse midwife / women's health NP in my town. However, I'm not sure I'd like looking at THAT part of a women day in and day out and it would make me sad that I wouldn't have anything to do with the baby once it is born.

But I don't want to do neonatal NP - too sad and not enough baby snuggling. Post partum bores me to death.

I have worked in psych and have no interest in it.

So how does one figure out what specialty to pick?

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Specializes in Pediatric Pulmonology and Allergy.

FNP will give you the most flexibility, and you can find work in a specialty, especially if you have some RN or clinical experience in that area.

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Specializes in Pediatrics, High-Risk L&D, Antepartum, L.

I think you just have more soul searching to do.

I'm in a Ped NP program. I want to work with kids. I want to limit myself. I don't want to have adults as patients. So while limiting to kids I'm also ensuring I work with kids. I'm much more likely to get a job in a pediatric office as a PNP than an FNP. So I want to limit myself.

CNM...generally schools want OB experience ahead of time.

WHNP....not just lady partss but a lot of them and you won't be at deliveries.

So I would start with this...adults or kids? It is okay to limit yourself if your want a specific population.

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Specializes in Med/Surg.

The school in my city combines WHNP and CNM - you're both when you graduate and pass the certification exam.

Do most specialty practices (like a cardiologist) prefer FNP, ANP, or ACNP?

I would probably like working at a pediatrician the most, but I know so many PNP graduates around here that cannot find jobs and that scares me...

I work with adults now and I don't dislike it. Some of them are wonderful and have amazing stories to tell. But then others are downright mean. Lots are partially responsible for their illness and most don't actually listen to, care about, or follow through with the education you provide them.

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Specializes in Critical Care, Peds.

I'm in the same boat trying to make a decision. I worked critical care for 2.5 yrs & loved the patient care, but hated the nights, holidays, weekends. With kids still at home, I felt like I missed out on a lot of their events during that time. I have since switched to a clinic setting & love love love the hours, but miss the acuity of the hospital. I've thought about military nursing as a way to help pay for NP school & am currently looking into that option. I think probably FNP is what I will choose, but would like an oncology option. Due to the rural area where I live, I'm limited in both jobs & school unless I want to add an hour or two commute to my day :( I don't think I want an online school - I'm much better hands on. I loved nursing school, (weird, I know) and am looking forward to enrolling, just can't quite make a final decision! Acute care or FNP or PNP??? I am concerned that FNP is too broad & I won't learn enough to be confident in my skills? Anyone find that to be a concern?

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Specializes in Behavioral health.

If I may offer a suggestion. Start with your ideal workplace(s). Then approach several of those places and request an information interview. This should give you the feedback to make a decision. It will either confirm your assumptions or take you in totally different direction you never thought of.

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Specializes in L&D.

It's hard to make a decision. I am very interested in doing the CNM. Google Family Nurse Midwife. This is a dual program that combines FNP and CNM. Seems like a great idea to me :)

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Some states are considering changing their Nurse Practice Acts to prohibit primary care NPs from working in specialty care clinics/centers, and some employers are anticipating this and only hiring certain NPs for certain settings. Primary Care and specialty care are different settings, have different training and may require different types of CE.

I echo the above thoughts of shadowing or doing informational interviews to determine precisely what sort of professional life you want. Then select the right program for that specialty/track.

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Specializes in Med/Surg.

It's not so much being unaware of what my future job would be. I have shadowed FNPs in doctor's offices, Minute Clinics, and hospitals. I have shadowed ANPs, ACNPs, and a midwife. My gyno is a WHNP. My best friend's mom is a pediatrician who works with a PNP and I shadowed her for a while. I know what my job will be if I pick any given specialty but that doesn't make it any easier. For now, I love critical care / trauma. Later, I want a Mon-Fri daytime type job. But I don't want to give up what I love and I don't want to go back and do a post-masters.

Ultimately, I think acute care PNP is what I would love the most. But you need a 1 year peds acute care experience so I'd have to leave my job. If I leave my job, I lose my tuition reimbursement. Where I work now, they pay 100% of school with no work requirement (it's a university hospital). If I leave, grad school goes from free to $40,000....

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I would recommend shadowing an Acute Care PNP. Then if you are pretty certain that is what you want, then lay the groundwork for that. There are dozens of facilities in the country with acute peds units. Many of these are also in academic health centers with equally great tuition benefits. For example, I know several RNs at Children's Hospital of Philadelphia (CHOP) who are getting great tuition benefits to study at UPenn. I also know Cleveland Clinic RNs with tuition benefits at Case Western, and Hopkins RNs who are getting there degrees at Hopkins.

If acute PNP is what you really want and you want free tuition, then make a plan and aim for Fall 2015 instead. It is very doable -- but it could mean finding a new job. I have mentioned elsewhere on this Board graduate study is not a race; no one is going to hand you a Starbucks giftcard for a MSN completed faster than your college roommate.

It sounds like you are conducting great research about a future professional pathway for you, but I do not see that you have investigated the acute peds NP yet. Try it, and see if that is what you want. It sounds like you need 1-2 more data points.

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Specializes in Anesthesia, Pain, Emergency Medicine.

OMG, stop with this already. If you are going to give out information, make sure it is accurate. No state that I'm aware of is going to limit FNP from working in specialty clinics and center. They are talking about acute care as in hospitals.

If I want to specialize as an APRN in an area such as oncology, palliative care, or

nephrology, how would I do so after the APRN Consensus Model is implemented?

Areas such as oncology, palliative care, and nephrology are among the many specialty areas

of APRN practice and are not one of the population foci in the APRN Consensus Model. To

be eligible for APRN licensure and certification, the APRN must complete his/her

educational program in a role and population focus (or foci) as defined in the Consensus

Model but can also specialize in a more specific area of practice. Preparation in a specialty

area of practice is optional, but, if included in the educational program, it must build on the

APRN role/population focus competencies. Clinical and didactic coursework must be

comprehensive and sufficient to prepare the graduate to obtain certification for licensure in

and to practice in the APRN role and population focus. Educational programs may

concurrently prepare individuals in a specialty providing they meet all of the other

requirements for APRN educational programs, including preparation in the APRN core, role,

and population core competencies. A specialty area of practice is developed by the

professional organization and is not regulated by boards of nursing. Professional

organizations determine the expected competencies for the specialty and establish 4

LACE: August 19, 2010

certification or assessment requirements. It is not required but recommended that the

APRN practicing in a specialty area of practice seek specialty certification if available

Some states are considering changing their Nurse Practice Acts to prohibit primary care NPs from working in specialty care clinics/centers, and some employers are anticipating this and only hiring certain NPs for certain settings. Primary Care and specialty care are different settings, have different training and may require different types of CE.

I echo the above thoughts of shadowing or doing informational interviews to determine precisely what sort of professional life you want. Then select the right program for that specialty/track.

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Specializes in Med/Surg.

University Hospitals in Cleveland offers up to $3,000/year for tuition reimbursement. Cleveland Clinic offers $7,500/year. CHOP offers $5,250/year. Johns Hopkins offers $15,000/year.

Tuition at my state institution is $995/credit hour. Case Western is $1749/credit hour. Johns Hopkins is $1416/credit hour.

Case Western = 40 credit hours over 2 years

OSU = 57 credit hours over 2 years

Johns Hopkins = 43 credit hours over 2 years

Also worth mentioning is that neither Case Western nor Johns Hopkins offers Acute Care PNP - they only offer primary care.

Case Western (with tuition reimbursement subtracted) = $27,480 per year

Johns Hopkins (with tuition reimbursement subtracted) = $15,444 per year

OSU (with tuition reimbursement subtracted) = $0 per year

So we're still talking about these programs, even with tuition reimbursement, being at least $30k more than staying where I'm at. I just can't do acute care PNP there...

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