Quick FNP/PNP Question

Dr. Tammy, FNP/GNP-C · Sep 24, 2008

Couldn't a FNP also treat peds in a family practice or even ER setting?

FNP's do care for infants and children as they are trained to do so, in the primary care setting. ER's are part of acute care and differ from the primary care setting (eg: ER is episodic without assuming the role as the primary care provider where as primary care within a family practice is primary care). Having said that, I know many FNP's, however, that do work in the ER setting. Do some research and google "primary care" and "primary health care" and "primary health care services" for more info. Also, check out the difference between FNP/PNP and ACNP (acute care NP).

A PNP couldn't treat adults though, right?

PNP programs focus on caring for children in the primary care setting.

So it'd seem that there's no real advantage to being a PNP over a FNP.

In my FNP program, 600 hours of clinical and the didactic span the life cycle, where as PNP's specifically concentrate on caring for infants and children. True, FNP's are more marketable, but if you desire to work with infants and children, PNP's would have a leg up in a pediatric primary care envioronment.

Trauma Columnist · Sep 25, 2008

The other way to go about it: do two programs. I'm an adult health CNS who can see both acute and chronic adult patients above the age of 16. However, in order to see kids (in the ER) I'm considering a PNP program too. Haven't quite committed to this route but seriously thinking about it.

emtneel · Sep 26, 2008

I am new grad FNP and I have had no problem getting interviews and job offers for PNP geared jobs.

I did FNP to be more marketable, and I like the variety, but If i am truthful, i really like working with just kids. i'm in a setting now at a Pediatric hospital where sometimes adults come in with congenital problems and it is a benefit to be a FNP because we can see them, and there are only a few of us. The PAs can see them as well.

the PNPs can see up to age 21 i believe.

oh i was able to do extra Peds clinicals in my FNP program as well.

jeepgirl, LPN, NP · Sep 26, 2008

I am new grad FNP and I have had no problem getting interviews and job offers for PNP geared jobs.
I did FNP to be more marketable, and I like the variety, but If i am truthful, i really like working with just kids. i'm in a setting now at a Pediatric hospital where sometimes adults come in with congenital problems and it is a benefit to be a FNP because we can see them, and there are only a few of us. The PAs can see them as well.
the PNPs can see up to age 21 i believe.
oh i was able to do extra Peds clinicals in my FNP program as well.

I know that within my university, the differences between the FNP and the PNP program were MAJOR. the FNP's were lost in the one class we took together that met the FNP's peds requirement. they seemed to be on a different level than the PNP students because most of them had very little pediatrics experience. they always had lots of questions - and even though we were in the same class, the PNP's knew a lot more than the FNP's did when it came to a lot of the basic pedi stuff. However, our FNP's were very sharp and were quick to pick up... I just think that it was a new world for them. Most were very thankful to have the peds focused class because otherwise the peds content was integrated in with the rest of their coursework.

you have to realize (at least, where i was) we had a peds focused classes for EVERYTHING. all those basic classes were peds focused. so, while the FNP's got an overview of everything, we got a specialized look and formalized education in the field of Peds.

I know there are some people who argue that FNP's know just as much about peds as PNP's - while I think an FNP can take care of peds patients, I find that arguement very difficult. I mean, if you had to do as much pediatric specific reading/coursework/clinicals as I did... ON TOP OF what I know the FNP's had to do... it would just be unbearable. The FNP's have a lot of work as it is (as do the PNP's) - and that work is focused on giving them a view of the entire lifespan - if they delved into each area as much as each speciality does, I have to believe that the FNP program would be unrealistic to complete... you know?

I think that FNP's are completely competent to take care of peds patients in a variety of settings. I also think that if you are an FNP who has a TON of experience in the field of peds, that can make a HUGE difference too. Don't get me wrong. But I also really feel that if you want to do peds - then go for the PNP. you're doing yourself a favor!

also... i believe the scope of care is up to 21 years of age and during transition to adult care. which can make a difference.

emtneel · Sep 27, 2008

I know there are some people who argue that FNP's know just as much about peds as PNP's - while I think an FNP can take care of peds patients, I find that arguement very difficult. I mean, if you had to do as much pediatric specific reading/coursework/clinicals as I did... ON TOP OF what I know the FNP's had to do... it would just be unbearable. The FNP's have a lot of work as it is (as do the PNP's) - and that work is focused on giving them a view of the entire lifespan - if they delved into each area as much as each speciality does, I have to believe that the FNP program would be unrealistic to complete... you know?
I think that FNP's are completely competent to take care of peds patients in a variety of settings. I also think that if you are an FNP who has a TON of experience in the field of peds, that can make a HUGE difference too. Don't get me wrong. But I also really feel that if you want to do peds - then go for the PNP. you're doing yourself a favor!

I won't argue with you but I will say this, the school I went to is the #1 PNP school in the US, so yes, it probably has a better Peds focus, it is also #6 for FNP.

Many schools i know allow you to finish a FNP program in 4 Semesters, Fall/spring, Fall/spring.

I did FNP it was 7 semesters, Fall/spring/summer, Fall/spring/summer/fall, I also finished faster than most at my school as I took 13-14 credits/semester (full-time is 6) I did 5-6 in the summer. I worked 32 hours/week and did 20+ clinical hrs/week.

No my clinicals were not all Peds, which personally I think makes the most difference. If most of your clinicals are adults or internal medicine.. then yeah you won't have much Peds experience, but most schools have opp.to arrange what speciality you like to do, more cardiac, more peds etc.. like i said, I did extra hours in Peds. My progam said they would prefer 1/3 of clinicals to be Peds, I prob. did more than that.

I think it really depends on the school you went to.

We had more than just one Peds class. We took all the same classes that the PNPs took, hence why they could graduate faster, they were also required less clinical hours.

the PNPs usually took 3-4credits for a class and we would take 2-3 credits of the same class. which usually meant they did 1-2 days extra of something specialty like special needs or something. The FNPs are encouraged to take the full credits the PNPs do, but are not required.

One prof said this, should FNPs and PNPs be required to know the same information. We all agreed. So is little illogical why we didn't have to take the full credits they did.

But same goes for accelerated BSN programs, I did one and the 4 yrs students complained because we didn't have to take some of the classes that they did...

But we were all required to do the minimum.

Anyways....

emtneel · Sep 27, 2008

Another thing is this. As a FNP I seriously doubt anyone would go back to get a PNP degree.

But as a PNP you may seriously consider going back for FNP....

It also depends on where you live.

In colorado there are so many PNPs so its hard to get a job there, and i know the Children's hospital in Denver probably has mostly PNPs and would hire a PNP over a FNP.

That being said I am a FNP and am working in a Peds hosp right now.

i know i should work with adults but kids are so much more fun!! (and half of them are bigger and heavier nowadays anyways, and getting adult problems....)

I also think for some (not all) Pediatric specialty jobs a PNP would be better, esp. for special needs kids. But say a FNP who was a cardiac RN, would prob. be a great peds cardio NP... its all a learning curve anyways.. That's whats great about our profession.. you can do soooo many different things!!!

jeepgirl, LPN, NP · Sep 27, 2008

i agree with you - when it comes to peds speciality, i see a huge difference.

i actually know more than one FNP who has gone back to get the PNP or who is in the process of doing so. those are usually the ones who work in peds and ONLY want to work in peds.

another reason i did the PNP - i only want to work in peds. and i never, ever want to have to assess a prostate!! :-)

not my thing! i'm just protecting myself!!

emtneel · Sep 27, 2008

another reason i did the PNP - i only want to work in peds. and i never, ever want to have to assess a prostate!! :-)

At my school, EVERYONE had to take assessment class and do prostate exams on a human that got paid to let people do that.... Even this one lady who was doing Psych NP and NEVER touches patients HAD to do it... ridiculous!!!!

bayouchick02 · Sep 27, 2008

.... another reason i did the PNP - i only want to work in peds. and i never, ever want to have to assess a prostate!! :-)
not my thing! i'm just protecting myself!!

That's excatly how I feel!! I currently work nicu, but i am SERIOUSLY looking into the PNP role. I've asked this many times before, but I wonder if not having that peds experience prevent me from being a good PNP?? Also, i have been told by many that FNP would be the safer route b/c it is more marketable, but i have absolutely NO DESIRE to work with adults. I guess i am trying to say that I dont want to have to go thru school studying something i have no interest in when i can focus my enitre graduate school experience on children and babies (something I absoulutely love!!):redbeathe

jeepgirl, LPN, NP · Sep 27, 2008

That's excatly how I feel!! I currently work nicu, but i am SERIOUSLY looking into the PNP role. I've asked this many times before, but I wonder if not having that peds experience prevent me from being a good PNP?? Also, i have been told by many that FNP would be the safer route b/c it is more marketable, but i have absolutely NO DESIRE to work with adults. I guess i am trying to say that I dont want to have to go thru school studying something i have no interest in when i can focus my enitre graduate school experience on children and babies (something I absoulutely love!!):redbeathe

the thing that i heard some people say who wanted only to do peds but got the FNP was that:

they only got offers for FNP jobs (thus had to work in that capacity) or

if they worked in, lets say, a large primary care clinic doing peds (and FP was in the same group), that family practice would send over uncomplicated adult patients and overflow for them to see on busy days which they did not like. they made them see everyone and it stretched them. i don't know that the second senario would happen much at all, but i have heard of it happening.

our market here is TIGHT for PNP's and it is competitive for work. so having the PNP does give you a leg up, but there are a some FNP's in peds around here who are very good at what they do. we have more FNP programs around here than PNP programs so... it just depends. we are in dire need in this area of peds healthcare professionals.

i know that in my PNP program we had more than one NICU nurse turned PNP student and she was AWESOME and did great! we loved her and she had some really neat insight as well... I think that if you wanted to do it, then go for it!!!

pedspnp · Sep 27, 2008

Most of my backgroung has been peds. when I started my masters I went with the FNP why because everyone told me that was the way to go that there was no market in the st louis area for pnp's. well i was pretty miserable and quit one year before graduation. I am now in the last 2 semesters of my pnp program and love every minute of it. my current preceptor who precepts fnp and pnp students feels that fnp students have a harder time with the peds rotation because they just dont like kids but it is required to have the peds hours. I know how they feel i was in the opposite situation, loved kids, adults drove me bonkers. My one friend who is now a FNP hated her peds rotation, but guess what where she works now one day a week she runs the peds clinic and just loves it when she does it. I think it is just a matter of your comfort zone.