NP vs Acute Care NP

Advanced Practice Columnist / Guide · Jul 25, 2008

Just looking at your nursing background (ICU) and your career goals (marketing yourself to cardiologists, CT surgeons, and pulmonologists), it sounds like your best bet for training is the ACNP route because this is the program that will allow you to have focused clinical rotations in the above-mentioned fields you are interested in. FNP training focuses on primary care across all age groups and does not get deep into the specialty areas.

It is true that AACN have recently been certifying NP's. However, this exam is only open to graduates of ACNP programs as the credentials for successful examinees are ACNP-C. There are other certifying boards for NP's. ANCC (an ANA subsidiary) certifies ACNP's, FNP's, and a host of other NP specialties. AANP (a national NP association) offers FNP, ANP, and GNP certification. The bottomline is NP's can only certify in the specific exam that they received their training from.

It is possible, as others have done, for a certified FNP to be employed in the specialty fields you mentioned. However, there are certain risks the NP is taking by doing so. One, their NP training did not provide them with the didactic and clinical exposure to the specialty and there is a risk of liability issue in this case. Two, although some state practice acts for NP's do not define the scope of practice for specific NP specialties, rules may change all of a sudden and they may find themselves being out of scope. Three, NP certification boards require practice hours in the NP specialty for recertification (unless you opt to re-take the test). What this means is that a certified FNP practice hours should be in primary care and the same way goes for an ACNP whose practice hours should be in acute care.

The question now is whether you are comfortable attending an on-line program. Unfortunately, ACNP programs are still not as widespread as FNP or ANP. The other question too is whether there are actual NP positions available for your specialty of interest around your geographical area. I think you have a good chance of getting hired by a physician in those fields if you network well given your 20-year background in ICU.

There is a question posted on Medscape that is not quite similar to yours but does address the realities of being certified as a FNP and having to work in high acuity specialties such as ICU and trauma. If you do not have a Medscape ID, it is easy and free to sign up for one. Once you have done so, you should be able to view the article here: http://www.medscape.com/viewarticle/543621

JDCitizen · Jul 25, 2008

Just looking at your nursing background (ICU) and your career goals (marketing yourself to cardiologists, CT surgeons, and pulmonologists), it sounds like your best bet for training is the ACNP route because this is the program that will allow you to have focused clinical rotations in the above-mentioned fields you are interested in. FNP training focuses on primary care across all age groups and does not get deep into the specialty areas.
It is true that AACN have recently been certifying NP's. However, this exam is only open to graduates of ACNP programs as the credentials for successful examinees are ACNP-C. There are other certifying boards for NP's. ANCC (an ANA subsidiary) certifies ACNP's, FNP's, and a host of other NP specialties. AANP (a national NP association) offers FNP, ANP, and GNP certification. The bottomline is NP's can only certify in the specific exam that they received their training from.
It is possible, as others have done, for a certified FNP to be employed in the specialty fields you mentioned. However, there are certain risks the NP is taking by doing so. One, their NP training did not provide them with the didactic and clinical exposure to the specialty and there is a risk of liability issue in this case. Two, although some state practice acts for NP's do not define the scope of practice for specific NP specialties, rules may change all of a sudden and they may find themselves being out of scope. Three, NP certification boards require practice hours in the NP specialty for recertification (unless you opt to re-take the test). What this means is that a certified FNP practice hours should be in primary care and the same way goes for an ACNP whose practice hours should be in acute care.
The question now is whether you are comfortable attending an on-line program. Unfortunately, ACNP programs are still not as widespread as FNP or ANP. The other question too is whether there are actual NP positions available for your specialty of interest around your geographical area. I think you have a good chance of getting hired by a physician in those fields if you network well given your 20-year background in ICU.
There is a question posted on Medscape that is not quite similar to yours but does address the realities of being certified as a FNP and having to work in high acuity specialties such as ICU and trauma. If you do not have a Medscape ID, it is easy and free to sign up for one. Once you have done so, you should be able to view the article here: http://www.medscape.com/viewarticle/543621

Great post... Change of scope rules could do a large amount of damage.

Again rules vary from state to state and add to that hospital rules vary even more. My protocols were different at the three hospitals I worked at under one group. Not that it was enough to have to second guess what I was doing but one hospital the protocol was 3 pages, one was a little over 5 and the last one was just at 15.... The last one had an oversight committie that was not used to NPs with private practice groups although the hospital used them on about every floor. Since I knew a large chunk of their NPs I was able to compare protocols... Mine was much, much longer.

Strange kind-of but since the nurses in that hospital were so used to working with NPs and PAs I had only minimal problems even from the start.