Interested in cardiology, any point in getting an FNP?


Hopefully my last post for a while, if I can get an answer to this question:

If one is interested in a specialty area (like cardiology) and serious conditions (like CHF) and has little interest in primary care, does it make sense to go for an FNP (or ANP, GNP, etc...) or should one try the ACNP instead?

Done a lot of thinking about what I've heard and what I like to do, and I've decided I want to work as an NP in specialty area, probably cardiology. Got interested during a rotation in the CCU working with a patient with CHF. Don't want to see kids, don't want to see dozens of patients per day, don't want do deal with illnesses that don't interest me.

So naturally I'm looking at the ACNP. But I know that other NPs work in specialty areas sometimes too, and ACNP programs aren't exactly common. I'd have greater choices (and probably a lesser cost) if I went to one of the many FNP programs in this area.

So what do people here think? I'm flexible about working in a clinic vs a hospital, and I don't care if I work late hours or oncall.


Specializes in Emergency, MCCU, Surgical/ENT, Hep Trans. Has 20 years experience.

I hear you brother...

I chose ANP for those reasons as well. Glad I did. Here's my program:

Note that in the 323 class, I spent a semester with CHF patients mostly, cath lab, Gen Cards, ICD/pacemaker, lipid clinic, it was a FABO time learning all I could about Cardiology. My other two rotations were in Internal Medicine, blended with everything else from capitus to toe fungus...

So, I would suggest that you can do both. But first, look at the market in your area. I see nothing wrong with an A/FNP working in Cardiology, especially someone like you with a solid RN base coming out of a CCU. I would suggest getting the CCRN as a resume filler. That credential speaks volumes to many in healthcare, including physicians, and can only help your cause in Cardiology.

The ACNP is great, but you are smart to examine its limitations. There certainly is nothing wrong with having TWO certifications, I know a few NPs who have both. A/WH/MH who go back for the F/AC to expand their scope.

Best of luck!

Trauma Columnist

traumaRUs, MSN, APRN

153 Articles; 21,231 Posts

Specializes in Nephrology, Cardiology, ER, ICU. Has 31 years experience.

I'm seeing more of us do double certification too.

Specializes in Med surg, cardiac, case management. Has 14 years experience.

A double certification is something I've thought of. And since many of the classes overlap it probably wouldn't be that much extra time.

But the clinicals probably don't overlap, and I believe programs here typically require 600 hours of clinicals.

Which is an awfully long time, especially considering that I'm nearly 40 and only 1 year into being a nurse. Haven't even made it to the CCU yet, still doing med-surg...

Specializes in Emergency, MCCU, Surgical/ENT, Hep Trans. Has 20 years experience.
especially considering that I'm nearly 40

WHAT? Your still a young'en! Get out there and get'er done :specs:

Advanced Practice Columnist / Guide

juan de la cruz, MSN, RN, NP

9 Articles; 4,338 Posts

Specializes in APRN, Adult Critical Care, General Cardiology. Has 31 years experience.

I just would like to offer another angle to answer your question (and BTW, there really are no straight answers because there are so many variables in planning a future NP career). Cardiology is a broad field and encompasses a continuum beginning in primary care management in the clinic setting (BP control for instance) all the way to the fully blown, severely decompensated heart failure patient with a Swan-Ganz catheter and a mechanical circulatory device in the CCU or CTICU. Heart Failure itself is a subspecialty in Cardiology (though not an ACGME board-recognized specialty) and encompasses care of patients with cardiomyopathy living in the home to the other patient recovering from a heart transplant or LVAD implantation in the hospital. NP's can be found in each and every continuum of care in the field of Cardiology.

My experience working in the midwest is that it is probably one the most NP-friendly medical specialties around. I haven't gotten a good feel of how NP's are accepted in Cardiology here in the west coast, but regardless, there is definitely a place for FNP's and ANP's in Cardiology. I've seen jobs for Heart Failure Program coordinators requiring NP qualifications and the role is mostly out-patient follow-up of a group of heart failure patients, educating them about medications, diet, and lifestyle and hopefully keeping them compliant enough to avoid hospitalizations for exacerbations. Many large medical centers sponsor these programs and hire NP's for these kinds of roles. I've also seen NP's do electrophysiology alone and manage a pacemaker clinic for instance. I think that in this field, any NP who has experience working with adults in hospital settings have a place to practice.

However, NP roles involving hi-tech mechanical devices and multiple IV inotropes with patients with advanced heart disease almost always would require a significant time as an RN in a high volume high acuity CCU or CTICU, CCRN certification, and acute care training depending on the age of population you are going to care for (ACNP or ACPNP). With that said, take these with a grain of salt because even with a lot of planning and mulling over a future career as a nurse practitioner, you still can not be absoultely certain that the dream job you've prepared so much for is going to be available when you graduate.

Trauma Columnist

traumaRUs, MSN, APRN

153 Articles; 21,231 Posts

Specializes in Nephrology, Cardiology, ER, ICU. Has 31 years experience.

Juan is absolutely right: you might start off saying "I want to do cardiology" and along the way, you have a wonderful clinical experience and say "ooops, I need to change that."

Yes, when you do two certs, you gotta do two sets of clinicals: I did an adult health CNS in 2006 as a post-MSN and did 576 hours (if I remember right) and then just finished a peds CSN in 2010 and did an additional 512 hours.

And...I'm a whole lot older than you - lol.

Good luck with your decision. You are wise to consider many routes and opinions.

Specializes in Med surg, cardiac, case management. Has 14 years experience.

Definitely many routes to consider. And lots of helpful information here.:up:

Ironically, I may wait on the NP for now. And perhaps might never pursue it.

Right now I dread the thought of going back to school, of working extra shifts to cover tuition, of spending free time studying. Perhaps it's because I'm just a year out of being a full time nursing student.

Perhaps it's because I haven't seen much of nursing yet, except med-surg at a very bad hospital. Maybe I need to try some other specialties. Or perhaps I'll find a niche somewhere and just stay there...

Specializes in Emergency, MCCU, Surgical/ENT, Hep Trans. Has 20 years experience.

Cruzy is so right-on :) in giving this advice,

I can't imagine working with acute cards patients without having some CCU background. I had 5 solid years, transplant center, AMI, arrhythmia, you name it and tried to participate in rounds as much as possible, especially when I decided to return back to grad school.

Cardiology is exploding. There are so many devices and the VP is a great example of how far we have come in a short amount of time. I can remember just a decade ago, LVADs took up half the freak'in room, now they are smaller than your fist and surgically implanted. I can see when we jump into stem cells and even the devices may become obsolete (my hope).

The NPs, be them A/F/ACs who are lucky enough to work in these fields are my heroes. I just don't have the patience for it. I think it takes a special person, very similar to the P/NNPs and MHNPs.

Joe, I think you are wise, take your time and find out what you like. I did, perhaps took a little too long, but hey, no one's of luck :up:


394 Posts

Specializes in Cardiac.

There are many cardiology NP positions like Juan described at U of Michigan.


261 Posts

what about acute care or adult np

allnurses Guide

ghillbert, MSN, NP

3,796 Posts

Specializes in CTICU. Has 27 years experience.

Honestly Joe if you're as conflicted about it as you seem to be from all your posts (you don't seem any closer to a decision than you were months ago, although that perception may be incorrect) - then I think you're wise to hold off. Particularly if you've only been a nurse for a year.. take some time to work out what you want to do before committing to grad school.