What NP specialty offers the most flexibility?

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Specializes in Public Health Science.

I am applying to a nurse practitioner program and would like some advice on what specialties are like. I was a medical school student that left medical school because I realized that the demands of a doctor and quality of life was not something I wanted to pursue further so I left in my first semester of medical school. However, I love patients and I love caring for people so I would like to work as a nurse practitioner. Which specialties offer the most flexibility? I feel like as a Acute Care Nurse Practitioner (ACNP) you can work in different settings such as inpatient care and outpatient care. I want to be able to do research and be able to work in the clinic.

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Specializes in PMHNP/Adjunct Faculty.

Make sure you pick a track that aligns with your goals to work inpatient and outpatient with your state's scope of practice regarding an NP specialty. Population specific specialties like Adult-Gerontological NP, Psych NP have some of the most flexibility. I would 100% not recommend a FNP program unless you are going back for a certification because online programs are producing FNP grads faster than jobs are available. I can't count the number of people I know who are working an RN job as an NP. FNPs also have a more limited scope of practice to an outpatient setting (although I have seen a handful in hospital). If you are going to pursue FNP I would choose a hybrid program with a lot of in class time. Acute Care NP qualifies you to work in Urgent Care Settings, ER, the floor and if you have experience on the floor this would be a natural progression. 

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Specializes in NICU.

If you want to do out patient and in patient with adults then best to get your ACNP and FNP. With the consensus model being implemented in more and more states, NPs are being restricted to their actual trained scope of practice. ACNP is not trained in primary care and FNP is not trained in acute care. Anyone (including RNs) can do research 

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Are you already a nurse? If not, then becoming a PA would be your most flexible option, and would arguably prepare you better than a direct-entry NP Program since it includes far more advanced practice clinical hours.

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If your looking for life balance and flexibility.  Continue to work as a nurse.   the NP role will be 8-5 most likely.  I disagree with previous poster about the FNP.  I have plenty of opportunities.  Working primary care also affords me the benefit of a consistent day shift and minimal weekends.   I have seen your other post about stress. I just haven't met many providers who don't feel a little stress in their life.  I think I cope well overall, but the reality is there is some stress with prescribing and diagnosing (I worry most about missing a diagnosis)  and NPs are also brought into the conversation about the bottom line.  There is an expectation (reasonably ) that our production levels will be an asset to the organization.

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Specializes in Public Health Science.
On 8/27/2020 at 1:30 PM, dallasmiss said:

Make sure you pick a track that aligns with your goals to work inpatient and outpatient with your state's scope of practice regarding an NP specialty. Population specific specialties like Adult-Gerontological NP, Psych NP have some of the most flexibility. I would 100% not recommend a FNP program unless you are going back for a certification because online programs are producing FNP grads faster than jobs are available. I can't count the number of people I know who are working an RN job as an NP. FNPs also have a more limited scope of practice to an outpatient setting (although I have seen a handful in hospital). If you are going to pursue FNP I would choose a hybrid program with a lot of in class time. Acute Care NP qualifies you to work in Urgent Care Settings, ER, the floor and if you have experience on the floor this would be a natural progression. 

Thank you for the advice. I really appreciate it. 

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Specializes in Public Health Science.
13 hours ago, Rnis said:

If your looking for life balance and flexibility.  Continue to work as a nurse.   the NP role will be 8-5 most likely.  I disagree with previous poster about the FNP.  I have plenty of opportunities.  Working primary care also affords me the benefit of a consistent day shift and minimal weekends.   I have seen your other post about stress. I just haven't met many providers who don't feel a little stress in their life.  I think I cope well overall, but the reality is there is some stress with prescribing and diagnosing (I worry most about missing a diagnosis)  and NPs are also brought into the conversation about the bottom line.  There is an expectation (reasonably ) that our production levels will be an asset to the organization.

Thank you for your feedback. I know that every job will have stress at some points. Specially in healthcare and especially if you care about people, which I do. I just want adequate time to recover from that stress. I want to work no more than 40 hours a week so that I have that downtime to recover and feel optimistic about what I am doing. Having a balanced life prevents burnout and that is what I am seeking. 

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Specializes in ICU, trauma, neuro.

I believe that PMHNP is decent. Granted I end up working every day of the week, mostly because I'm very ADHD and inefficient.  However, I actually only see clients three days per week and am on track to earn at least 200k (no benefits however) despite being a first year graduate (and I work from home).  As an ICU RN with ten years experience I never received a raise beyond the $38.00 per hour (no benefits) that I earned for my three twelve hour night shifts per week.  Granted, I could have worked an additional one, two or even three days of overtime as many of my coworkers did, but every shift was such a "battle for survival" that there was no way I could have done that certainly not on a regular basis.

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Specializes in PMHNP Student.

Hi myoglobin, thanks for your advice. I'm in a PMNNP program and am interested in work from home options. Do you have any advice on how to access these kinds of positions? Are there national companies that do telepsych? Or is it just pounding the pavement in your locale to find them? Thanks much for any thoughts you have to offer. 

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Specializes in ICU, trauma, neuro.

I would start with getting licensed in as many IP's states as possible (and joining the compact for RN's if your state participates).  States like Arizona, Colorado, Washington, and Nevada, New Hampshire, Maine, and New Mexico offer some of the best opportunities. Also, consider California since even though they are not IP the pay is so "off the charts" and the licensing process so arduous that it creates additional "supply side barriers" that will make you very valuable even as a new grad so that you might potentially be offered a job in the 200K range with benefits.  Also join every national organization possible and every educational resource such as The Carlat Report, Dr. David Puder's educational podcast, and the Psychoterapeutic Institute.  Also list yourself on Psychology Today and Good Therapy and investigate some of the programs that you could use for charting, and ordering medications (such as Therapy Notes and MD Toolbox).  Also join as many NP facebook pages as possible for additional networking opportunities.  

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Specializes in Psych/Mental Health.

There are a few national companies that will hire people to do only telepsych (some pay crap). However, I think most of the telepsych jobs are temporary and once the emergency is over they might expect you to relocate.

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Specializes in ICU, trauma, neuro.

Keep in mind that you can provide the service yourself and either bill insurance (or use a company to do it for you) or take cash only.  If you go this route your future will be more in "your" hands and less subject to the whims of others.

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