Lubbock Texas

An FNP is not a generalist like a PA. You are trained in primary care. Texas follows the consensus model. You can find detailed info regarding this on the NCSBN website. If you are trained in primary care, you are not trained to care for patients in an acute care setting. If you are set on want to work in an acute care setting, you should complete an acute care NP program.

In their latest quarterly newsletter pg. 2 (https://www.bon.texas.gov/pdfs/newsletter_pdfs/2018/July2018.pdf), they clarify that if you work in a specialty setting (like orthopedics), you may round on inpatients to care for the problems that they would have seen you for in the outpatient setting.

I see many FNPs working in a hospital, and in the area I live at in my home state of TN, almost all NPs working in a hospital are FNPs. The news article also states that you can take care of patients outside of what you are trained to do in school and lists and example.

Tennessee is not Texas. Each state sets its own rules that govern nursing practice. Some are more restrictive while others less. As you will find in your career, more states are adopting consensus model goals and will start to limit where specific nurse practitioners can practice. An fnp working in a hospital is a liability as your training is not in acute care. I suggest you get cozy with your primary care focus or consider adding a certification for acute care if hospitals are where you'd rather work.

I see many FNPs working in a hospital, and in the area I live at in my home state of TN, almost all NPs working in a hospital are FNPs. The news article also states that you can take care of patients outside of what you are trained to do in school and lists and example.

Obviously TN has yet to enforce the consensus model, but it will probably will in the future as NP education and scope slowly become more and more standardized across the nation. The reason why NPs get bad reputation is because they take jobs outside of their educational preparation and then need a ton of (very unstandardized) on-the-job training. You are trained in primary care. If you'd like to work in acute care in a Consensus Model state, you'll need to get training in acute care. It does say that you aren't restricted by setting, but by the type of patient care you are providing. You can't get around that. So if you find a position offering primary care type services within the hospital, it would be within your scope.

"Primary care educated APRNs may provide care in the acute care setting for patients with similar patient care needs, diseases, and conditions to those they diagnose and manage in the outpatient setting."

You can't work as an acute care hospitalist because those problems are not the same as you would care for in the outpatient setting. If you get sued, you were practicing out of your scope, and you will be liable. But if you worked in a specialty clinic like orthopedics, and your patient happens to be in the hospital for something else, you can still round on them in the hospital and provide the same care you would have in an outpatient setting.

My state offered ER fast tract (but not the main ER with acute cases) as an example of a job within a hospital that FNPs could practice. The problems seen in fast tract are very similar to what could have been treated in a primary care office (UTIs, lady partsl infections, etc). My state very strictly follows the Consensus Model and has mandated FNPs working in acute care roles to either get acute care training or find another job. New FNPs can't get those jobs at all. I know that's a rough shift if you've always planned on working in acute care. For a long time, we treated FNPs like generalists that could work anywhere like PAs, but that is changing.