Nebraska FNP Hospitalist in RURAL setting

[APRN., DNP, RN, APRN, NP]

Hello,

I’ve spent several months looking through different websites, looking in the Nebraska Health and Human Services website for Nurse Practitioner, looking through current practice standards in the state, and I cannot find anything definitive on what I need to “Start” with as an FNP in the rural hospital setting.

My specific question is: Can I start in a rural hospital as an FNP and qualify for an Acute Care N P Fast Track certificate program, or an ENP certificate program, OR, am I dead in the water with my FNP, and have to start from scratch with an entire Acute Care NP program after graduating with my FNP?

I am currently a DNP/FNP enrolled student, with an anticipated graduation date of Spring 2021.

I want to obtain my FNP because I am #1. Already enrolled in an FNP program, #2. Want to be able to care of all age groups.

I have spent almost 25 out of a 28 year career in the acute care setting in ICU, Med/Surg, Telemetry, PACU, Mother Baby, etc….. I don’t want to part with my hospital patients. I want to have my own practice (eventually), but I also want to be able to be a hospitalist.

What do you recommend?

[Corey Narry, MSN, RN, NP]

Personally, I feel that rural health care is an entirely different ball game with its own separate "rules". There are many FNP's working in deeply rural areas doing everything from ED to full range hospital care anywhere in the US. Some well known family practice residencies, in fact, focus on rural medicine and the training encompass primary care to emergency to critical care stabilization (there is one in my backyard that is exactly like that).

Unfortunately, I'm not confident that FNP programs mirror that depth of training. You do have an option to do a post-grad Adult Acute Care NP program and the one that would make most sense is the online University of Pennsylvania streamlined AGACNP. However, you have to actually have experience working as an NP in acute care since the training is geared towards primary care NP's already working in acute care roles.

Note: blue underlined statements are links.

[APRN., DNP, RN, APRN, NP]

Thank you kindly for responding to my question with the suggestions. I thought I would update you on this link: https://cchealth.org/residency/ which refers to primary care for rural medicine, as it is only for Medical School graduates, and is not open for Nurse Practitioners. (Bummer). I did email the only link that was listed on the CoCo county website. This is in my backyard as well, as I am in the bay area (currently).

I was aware of the UOP "fast track" FNP to Acute NP, which led me to my question of how to get the FNP acute care experience in the first place.

If you ever come across anything further, either you or anyone who happens across this message string - please feel free to update potential leads.

Thank you,

.RN

[Corey Narry, MSN, RN, NP]

Yes, I know that the Contra Costa FP residency is only for MD's. I only made a reference to it to illuminate that it seems as though physicians make sure that there is training for their family practitioners in rural medicine but unfortunately, our NP field does not keep up and offer something similar for some of us whose goal is to work in deeply rural areas where the needs of patients are not the same as it would be in suburban and urban settings. Anyway, good luck on your quest.

[APRN., DNP, RN, APRN, NP]

Thank you,

Nebraska is in the process of addressing this issue https://www.unmc.edu/news.cfm?match=20859 however, this program is only open for current UNMC NP students ?

Keeping fingers crossed that something will be available for graduates of FNP programs sometime soon.

.RN

[Corey Narry, MSN, RN, NP]

Sounds like a well-thought out program. I think for us in CA, the closest to getting training in rural medicine for FNP's would be UC Davis...their FNP program allows in-patient electives in emergency medicine, inpatient medicine, and acute care specialties:

https://health.ucdavis.edu/nursing/academics/NP_courses.html

BTW, their NP fellowships accept FNP grads for acute care roles:

https://health.ucdavis.edu/nurse/advancedpractice/ap_fellowship_overview.html

[verene, MSN]

Does your DNP program offer a rural specialty track? The NP program I graduated from had this as an option (open to PMHNP, FNP, & CNM students) where accepted students rotated through rural primary care, urgent care, and critical access hospitals specifically to encourage students and provide preparation for rural practice.

Even if not in a rural specialty track program - self-advocate for more rural clinical placements if this is your interest area if you can. I didn't go into the rural specialty track, but did rotate through a private practice in a more rural location because I let it be known to my program that I was willing to drive to a more rural placement. A lot of my peers wanted to stay really local, but I ended up in a great rotation with an AWESOME preceptor by being open to a rural placement.

[APRN., DNP, RN, APRN, NP]

What an awesome idea verene. I am very willing to travel to a remote outpost if necessary to get the experience. I will approach the guidance professor at my college.

Also, no, there isn’t a specific “rural health” track available.

thank you!

.RN