JACKMAC

This thread has been going for a while now. Since original postings, the ANCC has changed the way we can sign our names. I now sign ANP-BC. This information can be found on the ANCC website. Also if you are already certified by the AANP you can apply for reciprocity from the ANCC. Why you need this, I do not know but I am sure it may be helpful somewhere. Also, since original posting, I do not know if the AANP has increased the number of times per year you can take the test. I am applying for re-certification next year from the ANCC. (Has it really been almost 5 years?)

I agree with the previous post about the education of the nursing instructors but I don't think we need a DNP. Master's preparation is fine. I think there should be less "fluff" - theory, roles, etc. I had way too much of that stuff taking my time. We need more clinical hours and, like was stated, hands on so that when we graduate we are ready to fly and not need so much supervision. CRNA's have so much clinical that they are well prepared as a new graduate. I am a new grad NP and feel so unprepared. (I haven't found a position yet, which makes it worse.) My cousin graduated from CRNA in August like me and she said she was basically doing everything on her own during her last rotation and it was intense. NP training needs to be more like that. We should probably have more like 1500 hours "hands on". IMHO

Pinoy2.0 are you a nurse or a student? Most FNPs are NOT in the hospital. The previous post is true about some specialties like NICU but don't forget that the NICU is the ONLY place that Neonatal NPs will work. They are not trained for other pediatric populations. PNPs will ONLY work with aged 21 and under ever. I have heard of some a few PNPs being able to go into NICU but that is not what they are trained for. PNPs are trained for primary care peds. Whereas a FNP is certified to care for children, adolecents, adults, and elders. My son's primary care provider is a FNP who worked in a pediatric office until she opened her own practice with another doc. FNPs can work in family practice clinics and most adult specialties and some peds like cardiology, pulmonary, dermatology, GI, urology, and on and on. FNPs cannot deliver babies but CNMs can. It is very similar to medical education. Once you pick an area, doctors can't just change unless they go through another residency program. A FP doc can't decide one day that he/she is going to be a surgeon without the extra training. It is just the way the education has evolved. It is a little confusing but if you are interested in advanced practice, research what you are interested in completely before going through the training. It is a big step and a lot of work but it is worth it.

You could probably work at planned parenthood as long as you are not required to do any pregnancy related visits. I don't think PP does prenatal care but don't quote me. You could work at an STD clinic as long as all of the patients are age 13 and over and we all know that younger ones are sexually active . You cannot work in most health departments unless it is very, very large and separates the care. Actually, I just talked to our local health dept about an open position and even though they see very few children she could not hire me until I have the FNP certification and not just ANP. (I just took the cert exam this week, keep your fingers crossed!) I'll say it again, go for the FNP and you will not have to worry about it.

He also may have meant that a PAs scope of practice is determined by his/her supervising MD whereas a NPs scope is determined by the state board of nursing/medicine (in theory). I see this difference as minimal, if a MD is going to hire you most (not all) are going to want you to be as independent as possible so you are not bothering them all day. There will be some that will want you to consult on every patient but that is not very cost-effective since you can't see as many patients. Be aware that some NPs have "issues" with PAs and I would ask what was meant by that statement. I am interested myself. In my primary care NP program, one of my best preceptors was a PA and I was with MDs, NPs, and a PA. In practice, there just isn't that big of a difference between the two IMO. I think each brings something different to the table because of their various backgrounds.

I would still recommend that you do a Family NP program or a dual ANP/Women's Health so that you will be certified in the areas that you love the most. Are you hesitent to do Family because of the children? That is my suggestion, get the most bang for your buck. As a FNP you can work at Planned Parenthood, OB/GYN and health dept clinics too. I hope this is helpful. Feel free to email me directly.

You may want to get switch to the FNP route if you are very interested in women's health. ANPs scope of practice does not include prenatal care or pregnant women at all. It makes no sense to me as women = adult but I found out this too late into my program (ANP). You could be employed by someone who only does GYN care but not OB as an ANP. Your program may let you "double up" too (ANP/WHNP or FNP/WHNP). It is another semester in most programs but you would be eligilble to take both certifications. My school was looking into doing that but it is too late for me so I am going to complete my FNP online. Good luck and I hope this helps you.

I think that the FNP and PA are equal in scope of practice and mobility. Both have lots of flexibility. In both cases if you find a physician to work with, you can do whatever he/she needs, within your scope. Neither will be performing surgery alone (both can be first assist), delievering babies (only CNMs), but you don't really want them doing that either, IMHO. One difference is that is some states a FNP can open his/her own practice and to my knowledge PA cannot. That is not a goal of most FNPs but I think as NPs get more and more experience more will start opening their own pracitices. If you are already a RN, I would go the FNP route. You won't repeat as much as if you went to PA school. Also there is more flexibilty with NP school than with PA school if you need to work while going to school and go part-time. PA school is full-time no exceptions usually. Please realize my bias since I just finished NP school but there is also a PA school 15 miles down the road and I chose not to go that route. With either one, there is a learning curve when you finish, just like when you finish as a RN. Neither one is completely prepared for the new role. Hope this is helpful.

I am a recent NP grad and he is actually right depending on your area of concentration. If you chose to be a Family NP, you can work in a wide, wide variety of areas. If you choose a more narrow focus then, yes, you will only be employable in that area such as pediatrics, women's health, neonatal, acute care, and psych. But I have seen FNPs in family practice, internal medicine, dermatology, cardiology, ENT, acute care, ER, pediatrics, endocrinology and on and on. Lots of people are finding that they need to expand their scope of practice and most are going back for the FNP because it is much more marketable. I hope this helps you. I should clarify, no concentration is unlimited in scope.

MT-FNP I have to respond to your post about online programs. Just because things have always been done a certain way doesn't mean that it is the best way. I recently finished my Master's in a traditional program, ranked in the top ten in the US. I did just as you - found childcare ($$$), commuted an hour both ways, paid for parking, sat through three hour classes 3 times per week, put up with disorganization and worked part-time. I feel differently though. I am resentful that I wasted so much time in my car and in the classroom, just to be read to off of Powerpoint slides. I can read slides at home in much less time and take the time to absorb the material when I am at my best, not when the class is scheduled. All of that time spent could have been spent actually reading the assigned reading instead of skimming and for me, spending time with my family. I didn't feel that I gained anything by being in a classroom at 1 in the afternoon needing a nap because my baby kept me up all night. The only exception, I met some wonderful people through the program. I don't know if online program are "inferior" but the fact of the matter is most learning happens in the clinical setting and not in the classroom. Online programs have the same clinical requirements as traditional programs. I feel more comfortable about online programs from established universities not an "online university" like UOP. Duke University has an online FNP program. Do you think Duke University would risk its reputation and not prepare its graduates properly? (I didn't go there BTW $$$). Just some of my opinions. Just like you trying to evolve in the new tech world.

I would be very careful about seeing children if you had no content in school and were not tested on children on your certification exam. That means that an ACNP is not certified to see children as I understand it. That would be practicing out of your scope of practice, a major deal. Before you see any children I would check with your state BON. I think you could get into some serious trouble with your license. ANPs run into the same problem.

Yes it is worth it. Research your area for marketability, FNP is usually the most marketable. Some areas with PA schools use them more. Most NPs do not work in a hospital but more are starting to. But if you do not like sick people, and it sounds like you don't, then find another area health care. When people are sick, basic human needs have to be taken care of. Granted in an office there is less feces but I have been thrown up on, spit up on by children, collected numerous samples of lady partsl discharge, and wiped many tears. Yes, I have helped little old ladies go to the bathroom because they needed me and no one else could help. I am just grateful that I don't have to ask anyone for help but one day I probably will and so will you. I know working in a hospital is tough and it sounds like you need to find another area to work in. But please don't just try to avoid human needs, they will always be there.

Papadoc, It is interesting to hear your perspective from an urban area, a saturated market. It isn't unrealistic at all in rural areas for NPs to start a practice. Where I live is also saturated since we have 2 medical schools, 2 NP schools, and 1 PA school. But I have heard several NPs in the state speak at conferences and they have started their own practices in more rural areas. There are areas of the South that are hurting for health care. There are probably areas of New York City that lack the type of access you have. An NP could open a practice there. I don't know the rules for NY but in my state we still have to have a collaborating physician but after a grace period of time, he or she does not have to be in the building with you. That is how NPs in my state have started their own practices. At this point I have no desire to start my own practice. I am not a risk taker but I would love to be employed by a NP someday.:balloons:

I agree that it is a personal decision but I do have my own opinion. I feel that patient contact is some form is extremely valuable in becoming an NP. Yes, the roles are very different but as a RN, I had experience talking with patients about subjects that are very sensitive such as bowel movements, erections, sexual history, diet habits, drug use, etc. Knowing how to talk to patients is so valuable and I don't know how one gets that type of experience without working first. I like the requirement that NP students have at LEAST one year experience. It sets us apart from PA's whose backgrounds are more variable (I love PAs - we are in this together, no disrespect intended). Whenever people ask me the difference between an NP and PA, I always say that NPs have experience as nurses first (Be ready, you will be asked that question at least 1003 times ). I hope that I will continue to be accurate in saying that because I feel it is important.

I just want to add that being a nurse does NOT mean that you are "a follower" and not "a leader". Leaders come in all shapes and sizes. I know that nurses feel this way but so many people couldn't do the job we do, NP or RN. Don't ever forget that nursing one of the most respected professions in the US. That said, give NP school the whole semester. You have so many options as a FNP. There are a lot of hurdles to jump but it will be worth it in the end. I know, I just crossed the finish line and you will make it. Patho is a difficult subject and no, you will not use everything you learn in that class but you are challenging yourself. Patho was the "weed out" class in my program and probably many others too. Stick it out, you can do it!!