Subspecialty requirements for inpatient

[knit_nurse]

I am an RN in Ohio, applying to school to be an NP. The program which I am applying for is titled "Adult Gerontological Primary Care Nurse Practitioner". The directors of the program are telling me that this program is strictly taught as outpatient care. They do not offer a program that is just Adult NP. I am not sure that I'm ready to do strictly outpatient, and they are telling me I need to have acute care NP to be able to get a job doing inpatient care. I am not interested in working in ICU or ED. I'm hoping to get some insight from NPs who are either working or applying for work (preferably from NPs in Ohio, but any responses welcome)...

1. If you work in an inpatient area, what is your specialty? (Acute, Adult, Family, etc.)

2. Have you had trouble obtaining a position based on the specialty you chose? (Adult NP unable to find a job working inpatient)

3. Are there specific certifications for each different subspecialty or does everyone sit for the same board exam?

Any help is welcome, thanks!

[Sha-Sha RN]

Most programs no longer offer a straight Adult NP program anymore because of the Consensus Model which calls for more specificity. This is why you see adult-gero primary vs acute care. Plus the certification bodies are phasing out the ANP exam at the end of this year. I'm from NY and I did an Adult-gero primary care NP program. I just got a job in a hospital doing 80% inpatient coverage and 20% outpatient. Many of my classmates have obtained jobs with I think a equal mix of some working strictly input and some working output only. I know some hospitals are recruiting specifically for Acute Care certified NPs to work in their facilities, but there are still plenty of hospitals who hire FNPs to work inpatient in their subspecialties. I worked as a RN in the CCU and our NP service was made up of mainly FNPs and ANPs, there were only 2 ACNPs in the group. However, it is the expectation that those NPs go back to school at some point and become certified in acute care.

As far as the exam, the acute care and primary care exams are different and the ANCC is the only body that offers both the acute care exam and the primary care exam; AANP only offers the primary care AGNP exam. Again both still offer the ANP exam but those will be phased out by Dec 2015.

[knit_nurse]

Thank you very much, your information was more helpful than anything I have discovered thus far!

[mcknis]

I am a staff RN, but the NPs who worked in our ED were FNP trained, as well as the inpatient NPs. I have a friend who works as a hospitalist NP who was also FNP trained. There has been discussion to eliminate FNP or primary care trained NPs from the inpatient settings as they are not trained to the level of acute care. However, many employers are simply looking at the background of the NP as they worked as an RN and placing them in positions based upon that experience. Is it fair? It depends, but working as a staff nurse (even in an ICU) is completely different than working as an advanced provider on the inpatient side when your advanced training is only focused on primary care areas. There are many ways to look at the situation, but I do understand the logical thinking relating to this.

[AnnaN5]

I am from Michigan, adult-gero primary care is my certification. I work under the hospitalist umbrella but see patients post discharge, kind of like a post discharge clinic. Our hospital credentials committee is making it harder & harder to get credentialed as an inpatient provider if you do not have acute care certification. It will be interesting to see how this pans out in the future. I personally did both inpatient and outpatient clinical rotations and worked cardiology for 6 years as an RN.