Which NP is "safest"?

NSC Nursing · May 25, 2016

Become a pa

totoRN12 · May 25, 2016

I often don't see PA hired for neonatal specialities in my area.

littlepeopleRNICU · May 26, 2016

I am a NICU nurse. I also am an AG-ACNP student. I do have adult experience though. I love my job as a NICU nurse, but I had the same reservations as you...I don't want to 1)not find a job when I graduate or 2) be trapped to NICU and then get burnt out 5 years after graduating and want a change.

I work with a girl who has completed FNP school and taken boards. She has been turned down for every nursery(even well-baby) she has applied for because they want NNP or PNP. This is in several states. They even told her for nicus that they mostly want NNP and not even PNP.

The training in most PNP programs is not specialized enough for NICU, especially in higher levels of care.

I know it's frustrating because I was literally exactly in your place, but you have to decide if you want to include nursery in your realm of options not. I don't think you'd get into an actual NICU as an FNP, but you could POSSIBLY do well-baby.

gelli.25 · May 26, 2016

If working in the NICU environment is truly what you want, go for your NNP. NNP and FNP are completely different. FNP deals with prevention, health and wellness - more chronic than acute. NNP is definitely acute and more complex (as you already know) than FNP. Think about it...as a FNP or even a PNP, you will get no exposure with acute NICU patients as far as diagnosing and treating, but exposure to well individuals. Why would a employer be comfortable hiring someone with absolutely no exposure as a practitioner to that environment? So, yeah...if you go into FNP or PNP, there's a high possibility you will be turned away if you apply for a specialty like NICU. However, if you don't mind working with well pediatrics, adolescents, adults and geriatrics...go for FNP. Good Luck!

applesxoranges, BSN, RN · May 30, 2016

I would look at the NICUs in your immediate area and see what they hire. In one of the NICUs they hired only neonatal NPs. I have heard of pediatric NPs getting hired into NICUs but I don't know if that is true. I don't think any NICU around here would hire an FNP.

If you want to work in a NICU, neonatal NP or pediatric NP would probably be your safest bet. If you want a wider range of jobs and willing to work the cradle to the grave (but not NICU), then family is probably your best bet. If you want just kids, pediatrics. If you want to really just work in the NICU, the neonatal NP since as a pediatric NP you probably will have a difficult time being hired into a NICU.

The neonatal NPs in my area do more than just work in the NICU. They travel to the outlying hospitals and attend risky births. If something goes wrong, the OB deals with mom and the NP deals with baby. They rotate who is driving that day and who is in the NICU. I don't think all companies utilize their neonatal NPs in this manner though.

Elvish, BSN, DNP, RN, NP · May 30, 2016

The hospital I work at has a level IV NICU that staffs NNPs, PNPs, and they've got a couple FNPs on board who have pedi/neo RN experience.

The NNPs take care of the smallest sickest premies, do transports, and attend the high-risk deliveries. PNPs also staff NICU but work with the feeder-growers and do a lot of discharge planning. One of our FNPs does exclusivlely level I-II newborn nursery but the other does regular newborn plus the feeder-grower stuff of PNPs. We're also really lucky to have neonatologists who aren't afraid to roll up their sleeves and come to deliveries or pick up whatever needs picking up if the NPs are slammed.

It sounds like this may vary by facility or by region. I've worked with mothers and babies inpatient and outpatient for 14 years but am in FNP school because I don't want to do hospital practice anymore. (I like my current job, don't get me wrong, but I don't see myself doing it forever.)

BSN16 · Jun 1, 2016

However, to address the OPs question, I am personally going for my fnp. I believe that after obtaining your NP you can go get critical care or whatever specialty certified

pro-student · Jun 3, 2016

However, to address the OPs question, I am personally going for my fnp. I believe that after obtaining your NP you can go get critical care or whatever specialtycertified

That completely untrue. If you complete an FNP program, you can get certified as an FNP. If you want to get "whatever specialty certified" you'd have to do a post-masters program in "whatever specialty". If you're an FNP, there is no credible critical care setting that will hire you. FNP is great as a primary care provider across the lifespan but that's it.

To the OP, You're right, you'll be out of consideration for NICU positions if you're an FNP. Nurse practitioner specialties are population focuses so you need to train for the population you intend to care for. If you want to work in a NICU you need to prepare yourself properly as an NNP. Most NNP programs require at least 2 years experience in a NICU but vary on whether this needs to be in a level II or III. Until recently this experience was also required to take the certification exam as an NNP.

If you want to work inpatient, you should train in an acute care specialty (AG-ACNP, AC-PNP, or NNP). FNP is not the cover-all specialty just because it covers cradle to grave. Sure some places will hire you but any credible employer is going to want a provider with the appropriate training/certification. I mean, you don't see family physicians treating ICU patients or in specialty practices like cards, ortho, GI.

Choose the specialty you want to practice and you (not to mention your future patients) will be grateful for it.

Trauma Columnist · Jun 3, 2016

And now back to the topic at hand which is: which NP specialty would provide the best job opportunities.....

Many posts deleted as off topic. if you wish to discuss PA versus NP versus ???? please start another topic. Thanks.

sailornurse · Jun 3, 2016

However, to address the OPs question, I am personally going for my fnp. I believe that after obtaining your NP you can go get critical care or whatever specialty certified

Are you currently in an FNP student?

BeachsideRN, ASN · Jun 6, 2016

Maybe this varies by region? I'm still an RN student but I work at the local children's hospital, and they hire FNPs in all units that I've see this far (ER, PI, CVI, pulmonology, etc) however all of these NPs had extensive ped experience prior to becoming FNPs. Also, the major local nursing program has eliminated the NNP program and have added some specialty electives to their FNP program (doctorate level). So maybe that has something to do with it.

Just my $0.02