Hello everyone!! I am an ICU Trauma/MICU/SICU RN BSN. I am 25 years old and currently indecisive about deciding between CRNA vs NP in Pennsylvania. Currently, neither is independent in Pennsylvania but I have heard of NP having full practice in 2017 possibly. I'd probably study family medicine. I'm also interested in CRNA...I see no hope currently for independence in Pennsylvania. I shadowed both and love them! Trying to make a smart decision as well. I'd like to be independent at some point I believe is my issue.
FNP and CRNA are worlds apart in terms of practice - do you like acute care or family practice? I would choose a path and then choose the degree that gives you most of that. It sounds like ACNP would be a good compromise.
I don't agree with "independent" practice necessarily because I work in critical care and know that I will never have the depth of knowledge of one of my intensivist attendings. I am extremely intelligent and excellent at my job, but I just don't have the same breadth of knowledge base they do. I rely on having them available to consult with as needed. If "independent" practice really means we cut out a bunch of BS paperwork and red tape ie. collaborative agreements though, I am all for it. They delay care and made it take 4 months for me to switch jobs recently waiting on state approval for my agreement.
I don't agree with "independent" practice necessarily because I work in critical care and know that I will never have the depth of knowledge of one of my intensivist attendings. I am extremely intelligent and excellent at my job, but I just don't have the same breadth of knowledge base they do. I rely on having them available to consult with as needed. If "independent" practice really means we cut out a bunch of BS paperwork and red tape ie. collaborative agreements though, I am all for it. They delay care and made it take 4 months for me to switch jobs recently waiting on state approval for my agreement.
I agree. The exception is those who are skilled and confident enough to open their own practice but if it were me I'd still employ a physician. Although I worked very hard to obtain independent practice for NPs in my state I also believe that due to our sub par education, especially now that there are such lax school admission criteria and no actual RN experience required I believe in most cases having a physician available for collaboration is prudent. Regardless I also continue to rely on my physician peers for insight and guidance despite thinking that I am a very good NP. The delusions that we don't need physicians is sad and doesn't do anything to foster a good working relationship with our bosses who in most cases are physicians.
I vote for ACNP. I may be biased though. I, like you it seems, couldn't see myself sitting at the head of the bed doing the same thing over and over again for the rest of my career. I need options. I want to diagnose. To prescribe. Also, at least in my region of PA, NPs seem to have much more autonomy (and more importantly, in my opinion, laterality in work specialties). Anesthesiologists are present on induction, emergence, intubation, etc. They decide the anesthetic plan and the CRNA carries it out. I expect NPs to have increasing independent practice, and FNPs to have full independence in primary care within 5 years. Or independence after 3 years of supervised practice or something similar.
And as far as sub-par programs - don't go to one. Choose one that requires experience. My program requires 2 years ICU experience minimum. And there are plenty of MSN programs left. Again, I'm in one. I don't want a DNP either.
ghillbert, MSN, NP
3,796 Posts
FNP and CRNA are worlds apart in terms of practice - do you like acute care or family practice? I would choose a path and then choose the degree that gives you most of that. It sounds like ACNP would be a good compromise.
I don't agree with "independent" practice necessarily because I work in critical care and know that I will never have the depth of knowledge of one of my intensivist attendings. I am extremely intelligent and excellent at my job, but I just don't have the same breadth of knowledge base they do. I rely on having them available to consult with as needed. If "independent" practice really means we cut out a bunch of BS paperwork and red tape ie. collaborative agreements though, I am all for it. They delay care and made it take 4 months for me to switch jobs recently waiting on state approval for my agreement.