NNP vs PNP vs FNP..which one is for me???

santhony44, MSN, RN, NP · Apr 3, 2008

I'm a FNP. I've worked in a pediatric clinic, and have worked in family practice settings seeing quite a bit of pediatrics. If I had to limit my practice to one age group, it would be peds.

However, I prefer basically healthy children. I'm not interested in complex medically needy kids.

I do ER coverage, but again, most of the pediatrics we see is "clinic stuff." In my setting- a very small critical access hospital- I've also done pediatrics admissions.

I wouldn't do pediatric critical care, personally. If I had the interest and motivation and were in the right setting with the right doc to get a lot of extra, intense training, then maybe, but I think that would push the scope of practice a bit. I think neonatal, outside of well newborn, would also be a whole different animal.

BTW, my program was family practice, but my pediatrics instructor was a PNP and my pediatrics preceptors were PNPs and pediatricians; I think that's the best route to go if you do family but want to concentrate in peds.

FL NICU RN · Apr 3, 2008

to santhony--i dont think i would want to be something like PICU in the hospital--but maybe peds med/surg...is that possible for an FNP? or is it out of the SOP? thanks so much that helped a lot!

scribblerpnp · Apr 4, 2008

What is best for you is how much you want to limit yourself age-wise. I am a PNP, this means that BASICALLY (and there are extending circumstances) I am capable of managing it-patient and out patient care of people from the ages of birth to 21 years of age. If a patient is over 21, in most cases, I can no longer be their primary care giver (i.e. write Rx and determine medical diagnosis). I can act as an RN to any age group, however.

NNP's manage the care of premature infants, but they also have an age cut off, though I'm not sure what it is (maybe 2 years?). They usually work in NICU's or premature follow-up clinics.

FNP's manage from birth to death. This probably gives you the most job flexibility, but I have never heard of an FNP working in a NICU setting.

All of the above can manage care in a hospital setting under the supervision of a physician (and this is determined by the BON in which state you practice, some states give more independence to NP's than others).

I chose PNP because I like to work with premies and children but have absolutely no interest in adult care what so ever. Finding a job in the area where I live was difficult. PNP's are not common where I live, and most places are family care and don't want to hire someone who can "only see kids." But eventually I did find a job which was right for me in a primary care office.

If you are a FNP, after so many hours of working you, can sit for the PNP exam (without extra graduate classes) and become certified as a PNP as well, which if you are going to go in to the Peds route, I recommend this. If you are PNP, you cannot sit for the FNP exam without additional graduate classes.

There is a difference in the schooling of an FNP and a PNP. In the grad program I attended, the PNP's took a general pharm course and a peds pharm course. We took a general assessment course and a peds assessment course. We also took a genetics and fetal development as well as a famliy dynamics class.

The program length was the same as that of the FNP's, but the PNP program focused solely on birth to 21, so I think coming fresh out of school, I had a better grasp of peds illnesses and genetic disorders than the new FNP grads. Only because I focused on that for two years, while the FNP's had two years to go over an entire life span (and I am continually awed by FNP students- I don't know how you guys do it!). If you are an FNP who starts working in a peds office, after a little bit of work experience, a PNP and FNP should practice the same. And FNP who works in family pratice may not be (and please don't flame me) as used to certain chronic and genetic illnesses simply because most family physicians will not treat these kids and will send them to pediatricians, and it is hard to learn if you aren't exposed.

scribblerpnp · Apr 4, 2008

I also forgot to mention:

I also managed the care of our patients when they were admitted to the hospital and managed care of newborns in the hospital from the time they were delivered until they were D/C'd home (always under the supervision of a collaborating physician per the state law and hospital policy- an MD had to be available to me if I needed one- either by phone or in person). However, if a child was transferred to NICU or PICU, those teams took care of the child. As a side, if a general pediatrician's pt is placed into NICU or PICU, the general pediatrician no longer is the manager of the care of the child, the NICU or PICU MD's or NP's are. Once the child is discharged or placed back on the regular floor, the care is switched back to the pediatrician and/or NP.

SteveNNP, MSN, NP · Apr 4, 2008

I am in NNP school, and I will be limited to the primary care of children ages 0-2. That's fine with me. I have no desire to sit in an peds OP office and write scripts for Augmentin and Amoxicillin all day. I have no desire to care for adults/geriatrics, which is why I have completely avoided caring for anyone over 21 almost my entire nursing career. Nothing personal, but adults aren't my thing. I'd much rather catch a 26 weeker in the delivery room and resuscitate/intubate, place umbilical lines, etc, or attend a helicopter transport of a sick neonate from facility to facility. Neonates have a problem set of their own, and I find myself very comfortable and competent in being able to care for these kids. I "may" add my PNP post-Masters certificate later on to expand my practice to PICU eventually, but I'm sure my heart lies with NICU. While I "technically" could practice in NICU as a PNP, I wanted every second of my graduate education to apply to neonates, and not intermixed with a LOT of peds stuff.

santhony44, MSN, RN, NP · Apr 4, 2008

If you are a FNP, after so many hours of working you, can sit for the PNP exam (without extra graduate classes) and become certified as a PNP as well, which if you are going to go in to the Peds route, I recommend this. If you are PNP, you cannot sit for the FNP exam without additional graduate classes.
The program length was the same as that of the FNP's, but the PNP program focused solely on birth to 21, so I think coming fresh out of school, I had a better grasp of peds illnesses and genetic disorders than the new FNP grads. Only because I focused on that for two years, while the FNP's had two years to go over an entire life span (and I am continually awed by FNP students- I don't know how you guys do it!). If you are an FNP who starts working in a peds office, after a little bit of work experience, a PNP and FNP should practice the same. And FNP who works in family pratice may not be (and please don't flame me) as used to certain chronic and genetic illnesses simply because most family physicians will not treat these kids and will send them to pediatricians, and it is hard to learn if you aren't exposed.

I didn't know that it was possible to sit for the PNP exam as a FNP. That's something I might be interested in looking into. Which certifying body would that be?

I won't disagree with you that PNPs know more about the chronic and genetic illnesses that most FNPs do. That's one reason I'm not as interested in working with those. I also think that my education benefited from a lot of exposure to PNPs and pediatricians. I've worked with pediatricians, too, which I think has also been helpful to me. I'm not knocking family practice folks, by any stretch of the imagination; after all, "I are one," but I'd recommend as much pediatrician/PNP precepting as possible for a FNP student. (I also had pediatric med/surg, PICU, and pediatric telephone triage experience as an RN).

To the OP: you may want to look at the nurse practice act in your state, to see if being a FNP would be any barrier to doing peds hospital practice (med/surg or well nursery). If not, then I don't see why you couldn't. I'd get as much peds exposure as possible in school, and go to work with a doc who's interested and willing to teach you. Personally, I prefer the coughs, colds, runny noses, rashes, and earaches in the clinics, but it's a good thing we all like something different!

scribblerpnp · Apr 11, 2008

I didn't know that it was possible to sit for the PNP exam as a FNP. That's something I might be interested in looking into. Which certifying body would that be?
I won't disagree with you that PNPs know more about the chronic and genetic illnesses that most FNPs do. That's one reason I'm not as interested in working with those. I also think that my education benefited from a lot of exposure to PNPs and pediatricians. I've worked with pediatricians, too, which I think has also been helpful to me. I'm not knocking family practice folks, by any stretch of the imagination; after all, "I are one," but I'd recommend as much pediatrician/PNP precepting as possible for a FNP student. (I also had pediatric med/surg, PICU, and pediatric telephone triage experience as an RN).
To the OP: you may want to look at the nurse practice act in your state, to see if being a FNP would be any barrier to doing peds hospital practice (med/surg or well nursery). If not, then I don't see why you couldn't. I'd get as much peds exposure as possible in school, and go to work with a doc who's interested and willing to teach you. Personally, I prefer the coughs, colds, runny noses, rashes, and earaches in the clinics, but it's a good thing we all like something different!

For the PNP certification, I received mine for http://www.pncb.org. I looked on the website, and they didn't have anything about FNP to PNP that I could find, so maybe they won't do the FNP to PNP certification, it may just be for PNP students? But if I remember correctly, I THINK the people who do the FNP certification (ACNP?- Don't know not being an FNP and all) have a PNP one as well. Though when I was in school, they said that the PNCB was the preferred choice for PNPs, and the other test "wasn't looked upon as highly because it was easier to pass." I don't know if that is because they were being snotty academics and discouraged the other one because they would use FNP's or not. Something to check into at least.

I'm sorry I am fuzzy on the details, but I'm going on something I remember from grad school which was over 6 years ago now.