I need advice!

[BSN2FNP1]

I need advice!

So I've been accepted into a FNP program starting Fall 2017. I was under the impression that I would be able to do clinicals in the OR (which is what 3 out of the 6 years of RN experience is in), but after talking to my advisor today my only options for clinicals are those in primary care clinics and that I wouldn't be able to do OR until my residency class and apparently only hours in the clinic would count.

She recommended after hearing that I wanted to continue to work in surgery that I maybe consider doing AG-ACNP instead of family practice. I considered doing a AG-ACNP program first, but after looking at jobs in my area they either do not specify needing acute care or want someone who can take care of peds.. I'm torn. I feel like AG-ACNP limits you (population wise), but the thought of having to do two separate certifications (FNP, AG-ACNP, or PNP) to be able to continue to work in surgery doesn't make sense to me. If I couldn't work in surgery I would be interested in urgent care/ER, but then again you need to be able to take care of peds patients. My thought was if I had my FNP I could take care of any age group that the surgeon would see. I'm in need of some direction. I thought I had it figured out, but apparently I do not.

[Corey Narry, MSN, RN, NP]

That's the reality of NP programs. There's not a single program that prepares you to become "Jack of all trades". There are some compromises and the NP field was not envisioned to exist similar to pre-licensure nursing (BSN) that makes you a generalist nurse after graduation.

AG-ACNP does allow students to have rotations in the surgical specialties including a possible OR rotation. However, I have yet to see a strong OR training in NP programs aside from a few that market its AGACNP program with an RNFA option such as the one at UAB. NP programs are not as sophisticated as medical school if you will. Much of the educational resources offered in programs depend on the availability of preceptors who can match the kind of practice the students are interested in. The likelihood of you being matched to a preceptor that will expose you to OR diminishes even further if you attend online programs that make you find your own preceptor. Your best bet to have a strong surgical rotation is to consider PA programs which do require General Surgery rotations in the curriculum.

Your other question about how AGACNP would fit in with surgical specialties is a good one. Some surgical specialties treat patients of all ages such as Trauma, Orthopedics and sometimes Neurosurgery. Others such as Cardiac Surgery, Transplant, Surgical-Oncology, Urology tend to be more age-specific. This variation alone to me, makes the NP field less marketable in the field of surgery.

[traumaRUs, MSN, APRN]

Moved to student NP forum

[Alicia777, MSN, NP]

Go with the FNP. If you have OR nurse experience already you're ahead of the pack. You don't want to be population-limited and there really is no perfect specialty for NP first assist.