NPs working in Specialty Areas

Specialties NP

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I'm hoping to gain some insight on the 'acute care' vs 'primary care' roles for NPs. If an NP works for a specialty pracitce (i.e. cardiology, nephrology, GI, etc.), would that NP need to have an acute care NP or primary care NP background/licensure? Do these providers work in a clinic setting, a hospital setting, or a combination of both? Thanks all!

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Specializes in Nephrology, Cardiology, ER, ICU.

It depends. I worked in nephrology with FNPs, CNSs, and PAs - we all did the same job. Unfortunately, FNPs could no longer be credentialed to see hospitalized pts so that was an issue.

In my current job, I work with an ACNP and an FNP - the FNP was grandfathered in to work at the hospital.

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Specializes in Critical Care and ED.

If you're planning on working inpatient at all, you probably want to be leaning towards acute care.

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Specializes in Internal Medicine.

Depends on your state and job role. I have both my FNP and AGACNP and the overlap between the two is pretty epic. Even board questions had some similarity, and both require knowledge of each specialty. I am licensed in Texas and New Mexico, and the two states couldn't be more different. In New Mexico everyone is just a Certified Nurse Practitioner and you have FNP's working in inpatient psych, AGACNP's seeing kids in the ER, FNP's working as hospitalists, and Primary Peds NP's running PICU's. The demand is so high it's really an anything goes environment.

In Texas, your national certification is listed on your APRN license, and that scope of practice is more clearly defined (although there is still some gray areas). When I just had my FNP, my job was probably 80% clinic based with some inpatient rounding thrown in, and I didn't feel outside my comfort zone (and I was allowed to do some inpatient rounding during my FNP program).

In terms of specialties, it's up to you and the specific job expectations. My wife is an AGACNP that works in nephrology, almost is exclusively doing clinic rounding at various HD clinics. They also have an FNP in the group doing the same exact thing.

The reality is both certs require quite a bit of knowledge from each other, and many jobs require you to balance both some clinic and higher acuity function, especially in specialty practice.

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I just accepted a NP position in cardiology, as a Adult-Gero Primary Care NP, working 50/50. Rounding with the physician in the mornings, staying after to complete paperwork etc, and then having office hours 1-2 times a week as well. I like the flexibility of it. I do not feel I'm going outside of my education, as I will not ever be completely alone to make acute/emergency decisions in the hospital setting.

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