Sick of the Certs!!!!! Just let 'em be an NP!

[bsnanat2]

Below is my response to the posts of others in another APN forum where a job was posted requiring ACNP and FNP certs. Some were quick to point out the wrongness of this job post. Is anyone else sick of this?

Threads like this are what make PA's laugh at us and makes me sad to be a APRN. No other profession would ever limit itself like NP's do and then fight one another over these small bits of turf. A primary care PA could easily move into pediatric inpatient and no other PA would make a peep, even though it is understood that the PA in question would have to gain some sort of additional training. NP's are so drunk off the kool-aid of a myriad certifications that it is simply sickening. All of these ridiculous certifications and everyone's insistence on pointing out everyone elses' "lack of qualifications" will indeed be the death of this profession. If an FNP wants to work inpatient, let them. They are surely smart enough to know whether or not their training or the training available to them will qualify them to do the job. That is what a professional is. CRNA's, PA's and PMHNP's typically don't have these issues, and they will survive. The rest of us? I don't know. All these alarms are set off by some imagined court action. Shut up and get out of one another's way. The consensus model, lace and the DNP should have taken care of this issue. Standard NP training and licensure should take into account primary and acute care across the lifespan, that way NP's, like CRNA's and PA's could choose where and with whom they want to work. Instead these idiotic online degree mills keep cropping up and the useless DNP focuses on more research. NP's need to get a grip or prepare to be the last generation of this great profession!

[Corey Narry, MSN, RN, NP]

Personally, I see no reason a ACNP could not do primary care in a clinic if they choose. OJT would be very easy, same applies to the FNP that wants to do hospitalist or intensivist.

I'm adding my 3rd certification (ACNP) and find there is a huge overlap between the two.

Or even some sort of educational pathway without having to do the whole cert.

I think we (NPs) are shooting ourselves in the foot by forcing NPs into narrowly defined roles.

...and the national certification boards are actually riding that middle-ground and not being specific about limitations other than the age-restrictions. Neither ANCC nor AANP have been advocating for limits in practice settings. The Consensus Model has not either. AACN, as have been alluded to by other posters, have been the most vocal about ACNP's only in critical care.

For me, where you work and in what area of the country it is will determine what is best for the individual NP. The setting I work in is comparable to other areas of the country where large academic medical centers with an affiliated nursing school presence exerts heavy influence on limits of NP specialization based on their training.

The literature on ACNP-only intensive care units have been concentrated on a few similar medical centers such as NYP-Columbia, Vanderbilt, Penn, UPMC. Physician counterparts in those settings are multiple boarded in the various specialties they practice in so these places are quite restrictive in allowing privileges without formal training.

These large medical centers do not represent the majority of ICU's in the country where primary care physicians likely still manage patients in the ICU. It stands to reason that NP's regardless of training would be able to do the same with some additional training outside of the formal NP program as each hospital's governing board allows.

Yes, as an ACNP, I've had training in adult primary care that was incorporated in the curriculum. While I did not do an out-patient IM rotation, I spent weeks seeing clinic patients while rotating with Pulmonary Medicine and Cardiology services. Yes, most of what I did fell under primary care. Interestingly, surveys on practice patterns of ACNP's (multiple studies by Kleinpell) indicate that there are ACNP's working in purely out-patient settings so the notion that ANP's and FNP's "steal" jobs from ACNP's work the other way around too.

Personally, after almost 10 years of critical care practice, I would not feel competent venturing into primary care now. I would maybe have considered it as a fresh grad but definitely not now that I've had a specialized practice for so long.

[FuturePsychNP]

@FUTUREPSYCHNP: No, it is that I used the example of physician training as a model for an abbreviated version for NP's. The regulating bodies of our profession have created a huge controversy that confuses even the state board of nursing. If you want to argue about the licensing and residency requirements of physicans, feel free to go to studentdoc.net. They love this

topic.

What are you going on about? I addressed your less than factual response. Read my reply before this to again understand the point of my statements. Clearly, you don't care, however, as I am equally tired of reading your excess.

As for us, the nurse practitioners. Most would agree that we have a system that leaves open a huge issue. I, for one, see patients in a hospital setting and office setting. In Florida, any ACNP, FNP, or ANP can see patients in either setting. I, for one, have no issue with the requirements of supervisory or physician-colleague status, because I like my group, trust them, and work well with them. I would like to see board certification for post-graduate experience, based on attestation, for many of the specialties similar to the physician model. Like many physicians do who hold multiple board certifications, I would do the same. I believe it is important for both clarification, and focus.

I'm inclined to agree here. I'm fine with collaboration and couldn't care less if NPs ever get "independence" in all 50 states or even keep it in the states that have it. However, I believe that NPs should all be trained in a general model (slanted more toward a biomedical modely) so that ALL NPs are trained and licensed to treat patients in a primary care-oriented capacity. I believe they should then be required to specialize in an area such as psych, peds, acute/hospital care, gyneo, etc.

And again.