"FNPs can do anything"

[Jules A, MSN]

Ummm no they can't.

Another thread got me thinking that this might be a good topic for people to consider before going to school. There are still students, practicing NPs, hiring physicians and school perpetrating the fallacy that FNPs are able to practice in any arena. Not true so before you spend time in an expensive program that might not allow you to be hired in your desired specialty please do your due diligence.

Some of it varies by state depending on your BON as well as local culture hiring practices. Examples include psychiatry. In my area, although as everywhere there is an extreme shortage, you can not practice solely in psych without a psychNP designation. Another example is acute care and emergency medicine. At this time hospitals in my area will not hire FNPs in the inpatient attending role, or in the ED although a few have managed to get in the ED in the Urgent Care section. Generally if you don't have an extensive background, documented orientation or fellowship in a specialty you probably shouldn't be practicing solely in that area, definitely check with your BON to clarify.

Please don't fall prey to employers and schools who have little regard for your license and scope of practice. As they say "its all well and good until somebody loses an eye".

[HouTx, BSN, MSN, EdD]

WONDERFUL advice. I hope that it catches the attention of prospective students. My organization employs a lot of NPs. We are definitely having a hard time finding qualified acute care NPs.

[Jory, MSN, APRN, CNM]

You would not believe the number of FNP's employed in Psych and acute care in my region.

[Jules A, MSN]

You would not believe the number of FNP's employed in Psych and acute care in my region.

I know. If your state board of nursing does not support this someone needs to be notified. If this is the case I wonder how medicare and medicaid would feel about knowing NPs practicing out of their scope are billing for services?

[Jules A, MSN]

This is why I hope to pursue a post-graduate cert. In acute care. . I'll be an fnp in UC, and that's all fine for now, but I want to be better skiled, prepared, and competent for my seting.

And all legal and ethical points aside THIS!! Our patients deserve better especially imo the vulnerable mental health patients who are being misdiagnosed and treated inappropriately in the primary care setting. I see it all the time when they need to be hospitalized on my unit. It certainly isn't NP exclusive but the smugness and delusion that sub-par treatment is better than none disgusts me.

[Jory, MSN, APRN, CNM]

I know. If your state board of nursing does not support this someone needs to be notified. If this is the case I wonder how medicare and medicaid would feel about knowing NPs practicing out of their scope are billing for services?

It's the hospital. They have several of them hired.

[Jules A, MSN]

It's the hospital. They have several of them hired.

Just because they are working for a hospital doesn't mean they are permitted to practice outside their scope. BON trumps the hospital, imo.

[Riburn3, BSN, MSN, APRN, NP]

This statement applies to just about every provider discipline. An OBGYN can't perform brain surgery, nor will you see the brain surgeon roll into the delivery room. My boss (an IM physician) isn't covered for reimbursement to treat children, I am.

While it's true FNP's can't do "anything", their scope and population base that they can serve is the most comprehensive of all the NP disciplines. This is why the discipline is more appealing to people than other APRN disciplines.

Some states like New Mexico go out of their way to advertise the limited restrictions and wide scope of practice FNP's are entitled to when recruiting FNP's. Other states severely restrict practice and role.

I have a friend that is an FNP working as a hospitalist and I cringe thinking about it. Where we live, the Texas BON is both prescriptive and vague about what we can and cannot do, and the role falls into a gray area where it could bite him in the butt.

[jayjaybsnrn, MSN, APRN]

Correctme if I amwrong. I am also new tothis and currently in FNP program. But this is what consensus model is all about right?

[NeldaFNP]

I agree, and what is sad is that I trained at a practice with an Adult NP who is regularly seeing pediatric patients 1/3 to 1/2 of her patients). If one little thing goes wrong she will loose her license as well as face reprucutions. I can't believe she allowed herself to be put in that position.

[Dranger]

I work with an ICU nurse pushing (and succeeding) our physician pulmonology group to get her hired after she finishes her FNP soon. Most physicians aren't educated about the difference in NP specialties and they are going to expect her to round and do procedures. I have no idea what she is thinking. Is there an FNP program that teaches critical care medicine with CVC/arterial line insertion and intubation?

[Jules A, MSN]

I work with an ICU nurse pushing (and succeeding) our physician pulmonology group to get her hired after she finishes her FNP soon. Most physicians aren't educated about the difference in NP specialties and they are going to expect her to round and do procedures. I have no idea what she is thinking. Is there an FNP program that teaches critical care medicine with CVC/arterial line insertion and intubation?

Most physicians and even hospitals don't know if you are practicing out of your scope so I would inquire with your state's board of nursing for clarification.

In my FNP program we didn't learn critical care medicine. The procedures would be something that would be learned in clinical so I guess that depends on where she did clinical and what she was allowed to do. As part of the boarding process hospitals grant privileges to do different procedures and in my experience you just check the boxes of things you are qualified to do and request the ability to perform them. I'm not sure who even approves that list but if I was practicing in a specialty that had a certification offered I wouldn't be comfortable working without it.