If I want to work in ED as NP

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What are the pro's/cons of going the FNP route versus ACNP?

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Specializes in Nephrology, Cardiology, ER, ICU.

Hi there and welcome....pros/cons?

Pro: able to see all ages Con: May not have acute care education

Pro: only have to attend one program Con: State might not allow you to see acutes

In the end, it might be what is up to standard of your state and the facility you work at. For instance, I am an adult health CNS in a state where there is little difference between CNS and NP. However, I can only see pts >16 years of age. So....I'm back in school to complete a peds CNS so that I can see all ages.

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It depends on your state and the facility. In mine adult ACNPs can see patients down to 13. Also, if you ED is one that has a separate PEDS ED and Adult ED, not most, then seeing kids is not an issue. As for me I am in an ACNP program with plans of adding the additional courses for FNP at the end. This of corse will add time to my program butwill make me more marketable as well. The time added ? Probably a semester and a summer.

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Specializes in mostly PACU.

Yeah like they said, it depends on the state. I know of some FNPs in other states who are working in the ED, however, they are mostly limited to fast track or minor cases. You really don't get much in the way of managing acute situations in FNP programs. At least I didn't.

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Isn't it the same license being granted? I mean similar to RN licensing, it is one license and you then can work in the ED, ICU, med surg under that license? I do understand that a family nurse practitioner would not have the same educational background as an acute care nurse practitioner, so that is not what I am trying to say. I understand it differs from state to state but I was under the impression that a nurse who works in the ED could go to NP school...FNP school and still continue to work in the ED as an NP. The jobs I see listed have just said NP.

Interesting.

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Specializes in CTICU.

No, it's not one license being granted - you take the certification exam in a particular specialty. Depends on the employer, the position, and the state as to how picky they are about specialties when hiring an NP - for example some states do not like hiring FNPs into acute inpatient positions, some don't care. You are supposed to take positions in areas for which you are educationally prepared.

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This is what the board says in the state I would work. "The Board does not grant you authority to practice in a specific specialty. The Board grants you authorization to practice in a specific domain of Advanced Practice Registered Nursing. Those domains include Nurse Practitioner (RN/NP), Nurse Midwife (RN/NM), Nurse Anesthetist (RN/NA), and Psychiatric Mental Health Clinical Nurse Specialist (RN/PC)"

I understand there are specialty exams and obviously one would be more competant to practice in that given specialty but the way they explain the laws really confuses me. It then goes on to say this in regards to credentials:

"The nurse will sign his or her name as it appears on his or her license in all records required by federal and state laws and regulations and accepted standards of nursing practice. Specifically, Nurse Practitioner (RN/NP), Nurse Midwife (RN/NM), Nurse Anesthetist (RN/NA), and Psychiatric Mental Health Clinical Nurse Specialist (RN/PC) are the accepted credentialed initials for legal documentation. The initials awarded by the APRN certifying organization may be used on business cards, stationary; advertisements and other materials not required by federal and state laws and regulations and accepted standards of nursing practice."

No, it's not one license being granted - you take the certification exam in a particular specialty. Depends on the employer, the position, and the state as to how picky they are about specialties when hiring an NP - for example some states do not like hiring FNPs into acute inpatient positions, some don't care. You are supposed to take positions in areas for which you are educationally prepared.
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Specializes in mostly PACU.
This is what the board says in the state I would work. "The Board does not grant you authority to practice in a specific specialty. The Board grants you authorization to practice in a specific domain of Advanced Practice Registered Nursing. Those domains include Nurse Practitioner (RN/NP), Nurse Midwife (RN/NM), Nurse Anesthetist (RN/NA), and Psychiatric Mental Health Clinical Nurse Specialist (RN/PC)"

I understand there are specialty exams and obviously one would be more competant to practice in that given specialty but the way they explain the laws really confuses me. It then goes on to say this in regards to credentials:

"The nurse will sign his or her name as it appears on his or her license in all records required by federal and state laws and regulations and accepted standards of nursing practice. Specifically, Nurse Practitioner (RN/NP), Nurse Midwife (RN/NM), Nurse Anesthetist (RN/NA), and Psychiatric Mental Health Clinical Nurse Specialist (RN/PC) are the accepted credentialed initials for legal documentation. The initials awarded by the APRN certifying organization may be used on business cards, stationary; advertisements and other materials not required by federal and state laws and regulations and accepted standards of nursing practice."

What you just quoted here seems to address how Advanced Practice Nurses have to identify themselves legally. In your state they use the initials RN/NP to identify Nurse Practitioners. Where I am you have to sign CRNP (certified registered nurse practitioner), regardless of what your actual specialty is. My state also has laws regarding where certain specialties are and aren't allowed to practice. As an FNP I am not allowed to practice in the in-patient hospital setting. I am allowed to work in the ER, but in a limited capacity. There should be something in your state practice act that specifically addresses practice.

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Specializes in Nephrology, Cardiology, ER, ICU.

I live in IL and the state BON does not specify who can work where. However, what is used in the ER is a combo: ACNP/FNP, ACNP/PNP, ANP/PNP, etc....so two programs of education and certification.

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Nope, nothing in my state.

What you just quoted here seems to address how Advanced Practice Nurses have to identify themselves legally. In your state they use the initials RN/NP to identify Nurse Practitioners. Where I am you have to sign CRNP (certified registered nurse practitioner), regardless of what your actual specialty is. My state also has laws regarding where certain specialties are and aren't allowed to practice. As an FNP I am not allowed to practice in the in-patient hospital setting. I am allowed to work in the ER, but in a limited capacity. There should be something in your state practice act that specifically addresses practice.
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I'm coming across some of the same decisions right now. I'm enrolled in an NP program but need to decide my specialty. My decision is between Adult Primary Care NP and Adult Acute Care NP. I don't know what state I will end up practicing in, nor what field I really want to get in to. For now I would just like to specialize in whatever is more general and will give me more opportunities in the future when I do make a decision. Any suggestions?

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