Undecided: Emergency NP or Acute Care NP?

  1. Hey all,
    Thank you, prematurely for reading this message. Just bear with me... all of these things are going through my head right now and need ya'll to help me sort them out. I am in the midst of finishing my RN-BSN program and want to go on to pursue a MSN-NP. I have searched and searched and searched... still no answer. I have been working in an ER for 2 years (only been a nurse that long), and at this particular ER, the physician group director has told me if I get my NP he would consider hiring me to work for this group (WOOHOO!). That's great. Big group that staffs two emergency rooms. Here's my problem... I know that I love the ER, granted I have only been a nurse a couple years, but I have had experience in a lot of different specialties... all leading me back to the ER. OKAY, so #1 is decided. I know I want to be in the ER.

    #2 - I know that the ER NP program is relatively new (last 5 yrs I believe), and I get all warm and fuzzy on the inside just thinking of the clinical training for this. I love the thought of the ER NP program and feel that it is what I want to do. However, I fear difficulty in finding a job as an ER NP... until I have marketed myself sufficiently in my rural East Texas neighborhoods, anyway. SO, with that in mind, I do not want to have an NP degree just sitting there and not being able to use it. So, that brings me to another question... As an ER NP, would I be able to work, lets say... for a physician that makes rounds in ICU's, IMC's if I could not initially find an ER NP position?? OR should I just get the Acute Care NP degree so I would be covered in both areas? The thing that I do not like about the Acute Care NP degree is that it is only for adults OR kidos, not both. SO, that would limit my ability to treat children in an emergency setting (and I like kids, but not well enough to do just kids).

    Am I wearing you out yet?? :chuckle

    I am more or less voicing my thoughts because I want to make sure that I make the best decision based upon more information, as this is a huge commitment and directs the remainder of my professional life.

    Confirm or dispute: Some employers do not care what your specialty is as long as you have a NP degree? I have been doing some job searches in hopes of enlightenment, which I did not find much, and it just seems that they do not specify what KIND of NP they are hiring. They just say, "graduate from accredited" yadda yadda yadda...

    I guess my biggest concern is if I were to do the Emergency NP program, would there be any flexibility in job opportunities other than the ER if I HAD to resort to that?

    Thanks so much!
  2. Visit DaisyRN, ACNP profile page

    About DaisyRN, ACNP

    Joined: Jun '03; Posts: 383; Likes: 166
    Cardiology ACNP
    Specialty: 5 year(s) of experience in Acute Care - Cardiology


  3. by   zenman
    Quote from DaisyRN
    Am I wearing you out yet?? :chuckle
    Nope; I got a lot of endurance. My research pointed to the FNP as the most marketable. I don't particularly care about children and would rather do the Adult NP, however I also needed an online program and UABs FNP turned out to be the best for me. However, you can add on some electives if you have the time and money. UAB for example has an Advanced Trauma Course. Plus, if you have ER experience on your resume I'll bet that will count for something.
  4. by   DaisyRN, ACNP
    Hey Zenman,
    Thanks for the reply. After I posted my initial message, I went back and looked at the program's website for ENPs again. I found that there is no certification exam for ENPs YET, according to ENA (they plan to develop this in the future), so you actually sit for the FNP exam. The curriculum between the ENP and FNP routes are exactly the same except for 3 courses (Invasive Skills, ENP across the Life Span I and II) , so this kind of leads me to believe that I would actually have a FNP license, but be certified in ENP? How does that work? If you sit for the FNP exam, how do you get credit for actually being an ENP? On my credentials it would say XXX,XXXX, RN, FNP? or XXX, XXXX, RN, ENP? Probably FNP, huh?

    Regardless, I am feeling much better about the ENP route knowing that I will have the FNP to fall back on, if need be. Just to add this note, I found that the school with the ENP program will accept 18 hrs of core curriculum for the MSN online through a collaboration with a local university and then I can transfer in to the ENP program. SO... that means that I do not have to move or drive 2 hours one way for classes as much as if I had to do the program from start to finish at the one campus. Also, once I get to the ENP courses, I know I'll have to drive 2 hours periodically throughout the remaining semesters, but hopefully not very often. I am actually feeling more relieved about this whole thing... that maybe it IS meant to work out.
  5. by   FirefighterACNP

    All great questions. I began my career as a firefighter/paramedic, earned my BSN then my MSN as an ACNP. I worked for a little over two years as a staff RN before tackling the ER NP role. There was not an ER NP program when I graduated. Since then, I have worked in a small community ER, a Level I trauma center and an open heart unit. While in the open heart ICU, I learned how to place lines and chest tubes, something we didn't cover in my ACNP program. I believe the ENP programs do cover this. This along with intubation, are great skills to have in the ER

    If you want to be in the ER then I would do a program that will let you take the ACNP exam and offers a ENP course. I don't think there will be many limitations should you decide to venture into another area. I work with an IM Hospitalist service now and use my ER skills almost everyday. The things I had to learn were how to negotiate the insurance nightmare. Thankfully our case manager has all off that under control.