Primary Care NP vs Family NP, what's the difference?

[ArrowRN, BSN, RN]

I'm looking at going back to school part-time to work on an advance degree.I had an interest in CRNA but I still need to built up years of experience whereas some programs I can get into right away and are less competitive.

So the difference between the Primary NP's and FNP's both of which are called ARNP's is not clear as far as roles and duties performed. Can anyone clarify this for me? For example the ARNPs who may round on med-surg adult floors, ICUs etc in hospitals would they typically be Primary NPs? What is the job outlook for both of these areas and are they interchangable? or can a person be both?

[Corey Narry, MSN, RN, NP]

It's easy to get lost in the semantics and abbreviations in healthcare and the NP field. You mentioned a few terms and letters which should be clarified.

Primary Care, as the Institute of Medicine defines it, is the provision of integrated, accessible health care services by clinicians who are accountable for a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.

Think of it as the role your PCP performs in regards to your healthcare needs. In the NP world, Primary Care NP training involves a number of NP tracks geared towards providing first contact care covering a broad-based curriculum on health maintenance, management of chronic conditions, and care coordination. There are some aspects of acute training in the curriculum as well.

NP tracks that fall into this category are: Family Nurse Practitioner, Adult and Gerontology Primary Care Nurse Practitioner, and Pediatric Primary Care Nurse Practitioner. Sometimes Women's Health Nurse Practitioner is clumped into this category.

In contrast, there are NP tracks that focus more on the Acute Care aspects of healthcare and allow elective training in medical/surgical specialties during the program. While health maintenance is also covered in the courses, the didactics and clinicals are mostly in in-patient (or acute care) settings including critical care. NP tracks that fall into these categories are: Adult and Gerontology Acute Care Nurse Practitioner, Pediatric Acute Care Nurse Practitioner, and Neonatal Nurse Practitioner.

There is a movement in some states to limit only NP's who trained in the Acute Care tracks to provide care to patients with high acuity conditions in in-patient settings but there is no clear national guideline other than the Consensus Model that came up with a vague statement that says something like Acute Care vs Primary Care is not based on setting but on patient needs. I say, know what you state requires and go from there.

The letters ARNP is a state specific protected title. It is used in states like Washington, Florida, and Oklahoma. There are various combinations of letters used in the different states ranging from the simple NP to APRN to RNP to CRNP to CNP, etc. These all mean the same thing but the legal state title is used by practitioners to designate their role to the public.