What are the roles of FNPs in hospitals?

Specialties NP

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Hello Everyone,

New member here--sorry if this is in another thread and I will gladly go there if you direct me. I have shadowed FNPs and spoken with students in the program that I am applying to. I am only familiar with the role of an FNP in outpatient clinics and programs. I am wondering what other avenues FNPs can take that do not involve primary care.

I would like to learn about the prospects of working in a hospital. Are you an FNP that works in a hospital, or do you work with them in your hospital? What is your/their job description and why do you/they prefer it over primary care? Is this a common thing, or is there much additional training and degrees required?

I know there are numerous specialties, I am just wondering if an FNP degree can be limiting in this sense.

Thank you in advanced.

There's still a lot of work to be done. The NP role is young and still evolving. It doesn't help that nursing fields have earned the notorious distinction of being divided in many respects. The one thing nursing prides itself in is our commitment to the patient as a whole human being. That always saves us. I don't know the ultimate solution to all these confusion - maybe the DNP, maybe combined programs, time will tell.

I myself am questioning why AACN is coming up with a new and improved ACNP board exam. AACN and ANCC used to jointly administer the exam way back and the relationship split because of difference in opinions about the role to begin with. It hurts my head thinking about it.

I think there is a divergent opionion on what an ACNP is. The ANCC would like to make the field as broad as possible to foster jobs. The danger here is that by broadening the field without additional training you end up with someone that does not have the knowledge to do the job. The AACN I believe views this as a acute/critical care role only. This is the natural counterpart to the ANP with the ANP handling outpatient roles and the ACNP handling inpatient roles. The problem that I see is that the certifications as visualized by the organizations don't seem to be equivalent. I think the part that really hurts nursing is the infighting. There are already credentialling issues with hospitals. With the coming of NPI we will be seeing more credentialling of NPP's. If this is confusing already for hospital credentialling departments, think about how confusing this is for insurance companies.

David Carpenter, PA-C

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

All these viewpoints are well taken. The ACNP role was born out of a need for in-patient management in a hospital. In my geographical area of the country, in-patient NP positions in specialty medical fields are far more prevalent than out-patient primary care roles. I am basing this on the fact that all 13 graduates in my ACNP class obtained jobs within six months of graduation (yes, it is a small class but this is the norm in the ACNP program at my school).

Of all the ACNP graduates, 5 are currently employed by private practice cardiology groups with both in-patient and clinic roles. One is employed by academic transplant surgery (kidney, liver, and pancreas) with both in-patient and clinic roles, the rest of us are employed in purely in-patient roles in ICU (2 grads), neurosurgery (1 grad), ER (2 grads), hema/onc (1 grad), and purely in-pt cardiology practice (1 grad).

Credentialing boards in hospitals both academic, private, and small community have been welcoming of NP's in this area. I have not heard of any NP being denied credentialing as long as they have NP certification from the state.

All ACNP's at the moment are certified by ANCC. Thus, we are all bound by ANCC's definition of ACNP practice. AACN certification will start this year. However, both the ANCC and AACN exam will be available as 2 different choices for certification of ACNP aspirants. This in not the only NP specialty that has 2 certifying boards. ANP, FNP, and PNP is the same way. I just hate seeing this happen to the ACNP specialty. That's what I meant when I wrote that it hurts my head.

For all NP's interested in ACNP, check your area to see if there are barriers to credentialling and specialty clinic practice. Also find out if there are in-patient jobs in your geographical area before you pursue this route. Finally, check to see if your state will recognize AACN certification. My state only recognizes ANCC's certification at the moment but I'm sure that may change as AACN's new exam rolls out.

I think I've gotten off topic here. We've also beaten this ACNP thing to a pulp. Let's go back to BerkelyMom's original post asking for FNP INPUT on the possibility of hospital roles for FNP's. I hope some FNP's respond.

ok I am educated as a primary care np, whnp and rnfa and just for fun I am wraping up my fnp. I have focused my career in radiology for the last 10 years. At both hospitals I have privlages I can provide care from pre-op to ICU. One hospital requires cosignatures the other does not. My role has not been restricted by my education, at the same time I would not independantly manage a MI, cold leg yes do it in my sleep, diangose MI based on nuclear scan yes manage an inpatient MI that is for the cardiac NP or PA. In addition to your certification you also need to work within your specilty field.Jeremy

Specializes in Accepted...Master's Entry Program, 2008!.
.... However, both the ANCC and AACN exam will be available as 2 different choices for certification of ACNP aspirants. This in not the only NP specialty that has 2 certifying boards. ANP, FNP, and PNP is the same way. I just hate seeing this happen to the ACNP specialty. That's what I meant when I wrote that it hurts my head.

Certifications make my head hurt and make no sense. There should only be one certification.

Could you then certify with BOTH boards, ANCC and AACN, or is there something that prevents you from doing this?

Specializes in ACNP-BC, Adult Critical Care, Cardiology.
Certifications make my head hurt and make no sense. There should only be one certification.

Could you then certify with BOTH boards, ANCC and AACN, or is there something that prevents you from doing this?

Sure you can. I imagine some ACNP grads would prefer the AACN certification because you earn the "ACNPC" title instead of the "APRN,BC" you get with ANCC certification. But yeah, you can certify with both and call yourself "Your Name Here, ACNPC, APRN,BC". Ahh, the alphabet soup of nursing....

Certifications make my head hurt and make no sense. There should only be one certification.

Could you then certify with BOTH boards, ANCC and AACN, or is there something that prevents you from doing this?

Nothing says you can't you just have both. Just have to pay the fees twice.

David Carpenter, PA-C

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