Primary care PNPs in specialty practice?

[amalay, MSN, RN]

I know that I've been posting quite a lot recently--I hope that this is ok! I just have multiple questions in my mind

I'm just wondering for those of you who are primary care PNP (or perhaps FNPs too), do you have an idea of what specific jobs we can technically apply for? I live in California and whenever I do searches, very few large organizations (UCSF/Oakland Children's, Stanford/LPCH, or even Kaiser/Sutter/Dignity Health) hire for just primary care PNPs. I'm assuming it's because the teaching institutions have residents for their continuity clinics, etc.

I do constantly see positions for specific specialties (NICU/PICU, cardiac cath, hem/onc, neurosurgery, anethesia,etc)

I know for me, NICU/PICU is out of the question because I don't have any acute care experience (as an NP or RN- I did a direct-entry program) but I'm wondering about things like neurosurgery, cardiac, hematology, etc whether I should even bother applying for those positions?

I'd love some input from those of you who are certified as primary care PNPs (or FNPs) that actually work in specialty practice and how you ended up there/got there.

[BCgradnurse, MSN, RN, NP]

As far as I know, there is no certification for a primary care NP. Certification is based on the population you have studied-peds, adult-gero, family. Psych has its own certification. For instance, I am certified as a FNP, meaning I can see patients across the entire lifespan. However, I work in a specialty practice, also seeing patients across the lifespan, but for a specific range of conditions. I did work adult primary care for a few years, but really didn't like it. I like being well versed in a specific range of conditions, and not being all things to everyone.

[amalay, MSN, RN]

Ah, that may be a difference between PNPs and FNPs. There's actually a "primary care" certification for a PNP and then a separate "acute care" PNP certification (although I believe this is newer). I think my main concern is say for someone like me, who is a "primary care" PNP and has only worked in a primary care office-- if I had interest in say pediatric hematology or pediatric neurosurgery but had no actual working experience in those specific fields, would I stand a chance as an applicant?

[Corey Narry, MSN, RN, NP]

I think you have chance in some pediatric subspecialties with your general peds primary care background...think out-patient heme-onc, out pt cystic fibrosis clinics, teen health, peds urology, etc. BTW, UCSF has postings for peds NP's in neurosurgery, cardiology, and peds ICU but the role involves in-patient management including high acuity units where the preference is for PNP-AC.

[amalay, MSN, RN]

I would absolutely love to be able to do something like outpatient pulmonary/asthma clinics; I guess I'll keep my eyes peeled for these should they come up!

[Chris Caulfield RN NP-C]

I was under the understanding that FNP was more outpatient "primary care" and Acute Care (Adult) NP was in-patient (I didn't rotate or do any training outside of primary care (urgent care) for my FNP).

As long as you are working with and training with physician collaborator for your specialty field, go for it.