Primary vs Acute Care PNP?

[amalay, MSN, RN]

Hi,

I'm a fairly new PNP currently about 6-7 months into my first job in an outpatient pediatric practice. I wanted to do a quick poll for my fellow PNPs out there who do more inpatient work - were you formally certified or graduate from an acute care PNP program? My program was a primary care oriented PNP program. I know that in CA, there's no clear distinction between whether you are "primary care" or "acute care", although I'd imagine no NP would ever work outside of their comfort level or scope of practice/knowledge.

I am personally interested in being more involved in inpatient care - but I'm not sure how to go about doing this. Am I required to go back for another 2 year acute care PNP program? Or have others simply "learned on the job"?

Are there such things as residencies or part-time programs for someone like me who IS looking to gain more experience and knowledge? I'm currently contracted in a full time position for at least the next 3 years, so I can't really drop out completely to attend school again full time.

Thank you for any input!

[crossfitNP]

I am a PNP (primary care) and have only worked inpatient since becoming an NP.

Our hospital only requires acute care certification for the ICUs (at least in the children's hospital). Most of the other inpatient NPs are primary care.

I have entertained the idea of going back for acute care certification, as my alma mater has implemented an acute care program recently. However, even as a former PICU nurse who has always worked inpatient, I'm just at the point where it would not be worth it for me to go back for that.

I did, however, go back for FNP certification. The PNP opportunities in my area are limited despite having 3 very large healthcare organizations in my city. I knew that if I wanted more options and a better work/life balance, FNP was the way to go. Don't regret it one bit and will be transitioning to a FNP position in a few weeks.

This is coming from someone who swore up and down I would be a Peds person for life...

[amalay, MSN, RN]

Did you only feel comfortable doing inpatient care as an NP given your previous inpatient RN work? Or did you feel comfortable right off the bat as an np?

[crossfitNP]

I definitely think the only reason I felt comfortable doing inpatient care was because of my RN background, not because of anything I learned in NP school. There was an adjustment period regardless since I was transitioning from a bedside role to a provider role.

However, our attending is a micromanager and wants to be updated on every little thing, so even if I was alone, I never was truly on my own (ie, had no autonomy). I once gave a patient a NS Bolus and he wasn't happy about that. So, I can't even make simple decisions it seems, even though I am capable of doing so.

[Annaiya, NP]

I feel that our certification should match the work that we are doing. It justifies a lot of the arguments being made regarding why we are competent for full practice authority. That's not to say you can't work a job and then learn what you need to know, but that doesn't mean it's the best way to do it. However, I work with a number of PICU NPs who have primary care certification because they started before the acute care certification existed. They are excellent, knowledgable PICU NPs. You can learn any job if you are given the opportunity to learn and support you need. If you can't go back to school, then look for an inpatient position where you feel you can practice safely while learning wht you need to know.