Family NP or Adult acute care NP

UVA Grad Nursing · Mar 27, 2011

ED Nurse:

The certification boards require a minimum of 500 hours (plus the specialty classes) for each certification. So a combined FNP/ACNP program would have over 1000 practica hours and twice the number of specialty classes.

It may make better sense to follow NurseW74's advice and do one for specialty area a MSN, and the second as a Post-Masters. Most schools that offer ACNP preparation also have FNP preparation. There are several students in our post-master's ACNP program who have had FNP certification for over a decade. Because of pending changes in the state's Nurse Practice Act, these FNP-prepared individuals need ACNP certification to continue to work in specialty clinics (oncology, urology, neurology, etc). What worked in the past (a FNP in specialty clinics) will not work in the future.

CuriousRN84 · Jul 29, 2012

Great thread!

FNPdude74 · Jul 30, 2012

Relax for now. Watch the Oylympics. Think sports. No nursing. :) hahaha

ED_Nurse_in_the_Hood · Jul 31, 2012

UVA Grad Nursing, you said that your state is changing its Nurse Practice Act to keep primary care NP's from working in specialty areas. What state is that?

BTW, I ended up enrolling in an Acute/Critical Care NP program, at Johns Hopkins. Halfway done!

shadowflightnurse · Aug 1, 2012

I am going to University of S. Alabama. Just finished 4th semester, about to start clinical portion.

newbie23 · Jul 14, 2013

To shadowflightnurse:

Hi! How was the program at USA?I just applied for Spring 2014 and I am still waiting for results. I hope I'd be able to get accepted. Any advice by any chance? Was it hard to get accepted to the program?

OfficerRNBSN · Jul 15, 2013

Of course you need the education to practice in various areas. That is what I've been saying and what the model proposes. The same way credentialing works in a hospital. I can show training in central lines, chest tubes and minor surgical procedures like i&ds, advanced airway management also. I am able to be credetialed to do these because I can show education in these areas.
The model states that education can occur concurrently or after you graduate. So for instance the FNP who wants to do ER, can obtain education, maybe a short fellowship? It could be a specialized class.
The point is all NP will have the opportunity to add to their abilities without the huge headache it is now.
I would like to see the schools put out something like a generalist practioner who have the opportunity to focus on a particular patient population.
It is very common for the generalist, ie: fp doc, ER doc, FNP to cover the ER and inpatients in rural America. There is nothing wrong with it. It makes for good practitioners.
I'm typing on my iPad which I hate so will add more tomorrow.

I'm proud to say that I worked a rural hospital for a couple of years, and the only doctor for the hospital at night was the one staffing the ER. The ER doc was provided by a contracted staffing service, and you had NO IDEA what kind of training your physician would have. More than not, I had a retired general surgeon and an internist who never worked as an internist. On top of that I can recall another general surgeon who didn't like surgery, another internist, an OB/Gyn which is as much surgical as it is anything, a couple of FPs from local nearby clinics moonlighting, and yes even a psychiatrist a couple of times, lol. I wouldn't have been surprised if an MD oral surgeon or ophthalmologist has been in there.

Anyway, the moral of that story, and it's a story I've heard before, is that in a rural setting where you're it you may be called upon to do a lot of things. As above, internal medicine doesn't train on peds or trauma after med school (unless they get a rotation in EM during residency), and most surgeons don't have a lot of primary care/medical training, i.e. the bread and butter of most ERs (walk ins who are sick). The psychiatrist was actually a military psychiatrist who had done a lot of training in things such as combat casualty care. He was pretty sharp in a code too - more so than some of the others I'm reflecting on.

My $0.02 has never been able to do a lot, but I think all NPs should have generalized knowledge added upon by training in their specialty. Best exemplified by a comparison to PAs, I say we need a training for future NPs more like that, but perhaps not as long although mirroring their curriculum certainly wouldn't hurt us. They're trained as a jack of all trades, and can hop from work setting to work setting. Although I don't feel this is what NPs necessarily need, an additional semester of primary care training so that all NPs can diagnose and treat, where warranted (collaboration agreements, reimbursement, regulations, etc. allow), such conditions as diabetes, hypertension, diarrhea, colds, allergies, etc. Why? Because the underpinnings of NPdom have us providing care where care wouldn't have otherwise been provided, and if a patient sees a psych NP and happens to have, as revealed by a BMP or some other lab, hyperglycemia then I feel like the psych NP ought to be able to treat it at least initially. The same goes for say a peds NP who has a parent come in hacking up boogers just as much as the child.

OfficerRNBSN · Jul 15, 2013

Relax for now. Watch the Oylympics. Think sports. No nursing. :) hahaha

What?! The Olympics are on? LOL.

BeeGeeRN · Sep 6, 2013

Read every word (and all the links!) to this post!! I struggle with my decision between FNP and ACNP. I know I want to work inpatient (and esp in Critical care)... But I know that later i will want to leave hospital setting and be in a family practice. So my thinking was go for my FNP, work inpt with extra training etc... IF I run in to road blocks- get my post masters certs in ACNP. Not ideal but it'll work

I also feel as though (currently) brand new FNP are more marketable-- you can work at a variety of places, get your experience then can move on later (rather than hopefully finding that *perfect* job off the bat!)

Appreciate all the dialogue! I really have had some stressful nights recently when looking to apply for school... This helped me a lot!

thanks! ~b. Sent from my iPhone using allnurses.com

calinicumurse · Sep 6, 2013

Read every word (and all the links!) to this post!! I struggle with my decision between FNP and ACNP. I know I want to work inpatient (and esp in Critical care)... But I know that later i will want to leave hospital setting and be in a family practice. So my thinking was go for my FNP, work inpt with extra training etc... IF I run in to road blocks- get my post masters certs in ACNP. Not ideal but it'll work
I also feel as though (currently) brand new FNP are more marketable-- you can work at a variety of places, get your experience then can move on later (rather than hopefully finding that *perfect* job off the bat!)
Appreciate all the dialogue! I really have had some stressful nights recently when looking to apply for school... This helped me a lot!
thanks! ~b. Sent from my iPhone using allnurses.com

I'm on your boat BeeGee... I know I don't want to work primary care right now; I'd like to be in the hospital, either in critical care or the ED. But as ACNPs don't see children, the ED job is out of the question. So is it more beneficial to get the FNP first in order to get the full age spectrum and gain some experience wherever you can and then get qualified as an ACNP? Or is it better to get the ACNP and go after what you really want??

Tough choice!! Any insight is appreciated!