Why choose FNP (family nurse practitioner)

Columnist · Jul 22, 2014

Hello and welcome to the site.

I moved your thread to the Pre-Nurse Practitioner forum where I think you will get more response. Take a look through other threads here for information about your questions.

puravidaLV · Jul 22, 2014

I think your lost in the obscurity of the words.

family treats the family (across the life span), neonatal (neonates), mental health (psych). take any of these and throw in nurse practitioner is by definition is:

a nurse who is qualified to treat certain medical conditions without the direct supervision of a doctor. (google)

subee, MSN, CRNA · Jul 27, 2014

I don't understand how anyone could be competent in caring for patients from neonates to geriatrics in a program that's 2 years tops, usually shorter - and often online. How do you do your clinicals if no professors from the school are with you? You're paying a bundle for tuition but no one is there representing the school you've chosen. How does the school measure your progress with clinical skills over time? And, on top of that, I've read posts from students that go right though their BS to MSN without any nursing experience. When I lived in a previous state, I had to see the NP instead of MD (too healthy:)) and she went to one of those run-thru-real-fast-expensive programs as a mid-life career change. She didn't do anything I would consider "advanced" but did an excellent job of cleaning out my ears. The rest of it I could do myself except for the rx. renewals.

allnurses Guide · Jul 27, 2014

I just recently learned about the FNP profession, but am still unsure exactly what they do and how it compares to an NP. For anyone out there who is an FNP or has chosen the profession, what made you decide to become an FNP versus the other nursing professions out there?

Family Nurse Practitioner is one of many NP specialities. FNPs are educated to treat any age across the lifespan, other types of NPs focus on a specific age range (neonatal, pediatric, adult-geri) or a specific subset (women's health, mental health, emergency, acute care).

Many people choose FNP over other specialities because it gives a lot of flexibility in practice area and many employers prefer to hire FNPs because of the versatility.

NP is one of many types of Advanced Practice Nurse that practice beyond the scope of other types of nurses.

allnurses Guide · Jul 27, 2014

I don't understand how anyone could be competent in caring for patients from neonates to geriatrics in a program that's 2 years tops, usually shorter - and often online. How do you do your clinicals if no professors from the school are with you? You're paying a bundle for tuition but no one is there representing the school you've chosen. How does the school measure your progress with clinical skills over time? And, on top of that, I've read posts from students that go right though their BS to MSN without any nursing experience. When I lived in a previous state, I had to see the NP instead of MD (too healthy:)) and she went to one of those run-thru-real-fast-expensive programs as a mid-life career change. She didn't do anything I would consider "advanced" but did an excellent job of cleaning out my ears. The rest of it I could do myself except for the rx. renewals.

This is a topic for another thread, but the short answer is that the quality online schools actually do a good job of monitoring student's clinical progress, though they do put additional responsibility on preceptors.

PG2018 · Aug 4, 2014

I don't understand how anyone could be competent in caring for patients from neonates to geriatrics in a program that's 2 years tops, usually shorter - and often online. How do you do your clinicals if no professors from the school are with you? You're paying a bundle for tuition but no one is there representing the school you've chosen. How does the school measure your progress with clinical skills over time? And, on top of that, I've read posts from students that go right though their BS to MSN without any nursing experience. When I lived in a previous state, I had to see the NP instead of MD (too healthy:)) and she went to one of those run-thru-real-fast-expensive programs as a mid-life career change. She didn't do anything I would consider "advanced" but did an excellent job of cleaning out my ears. The rest of it I could do myself except for the rx. renewals.

I don't think online matters so much as does breadth of program. Sadly, most FNPs don't seem to come out of school running and gunning, and two years simply won't allow for that. There's a lot of OJT involved, and it's experience in which one learns. I enjoy and see a need for -ology classes, but the student isn't going to learn and integrate anything until he or she has done something a few times. The rub is that doing that thing a few time likely won't happen in the neighborhood of 700 clinical hours that most FNP (and all NP) clinical programs seem to offer.

This can be extrapolated to all NP programs, but you could translate it into PA programs as well. Despite what I observe and infer, a great majority of NP and PA grads come out of school, get jobs, and generally do well.

It wasn't hospital experience where "real learning" happened for me. It was clinic work. I contracted with four docs to provide services and when they came in I would observe them work, and in a lot of instances they weren't completely sure what that their diagnosis was "it." What they could say, however, is why their diagnosis could be it, and I found they would often treat problems generically with the mindset of "well, if this treatment works then great - if not we'll just try something else."

Even when I worked in an inpatient setting I thought doctors just tested and tested and knew until they arrived at a decision. The reason I relate this is that although I don't feel like two years is really enough to do anything other than meet the minimum requirements to get licensed or certified, yet you're not going to know what you're doing anyway until you've done it enough times. I've seen a lot of med students that had no clue what they were doing, yet they jumped through the hoops and did. The MD/DO learning comes with residency. However, if NPs and PAs had to do a residency to qualify them to work a given position then it would negate the purpose of having midlevels to begin with.

ryguyRN · Aug 5, 2014

PsychGuy I agree that the breadth education in NP programs is lacking but we are trained/taught as students (the expectation) to be novices until we gain more experience after graduation. I do not agree with your statement that residency/fellowships negate the purpose of NPs/PAs (the term "midlevel" is offensive) they grow the novice to be more proficient and confident in practice. If a person desired to become an MD/DO then they should choose that path and not think of becoming an NP/PA as a quick route to becoming a "doctor."

PG2018 · Aug 5, 2014

I'm not so sure you followed me. I'm suggesting that if NPs and PAs pursue, or become expected to pursue, residencies (as a whole) then the purpose of the midlevel (easier access and cheaper) will indeed become negated. Further training and education push back the times required to grow a midlevel and certainly require greater reimbursement.

I wish there was some type of middle ground. I've often wondered if all NP programs, regardless of concentration, could incorporate some type of didactics and clinical exposure to the most common 20-30 complaints a sick or injured person is going to present with. Of course, as with all things, that is far easier to think of than to materialize.

PsychGuy I agree that the breadth education in NP programs is lacking but we are trained/taught as students (the expectation) to be novices until we gain more experience after graduation. I do not agree with your statement that residency/fellowships negate the purpose of NPs/PAs (the term "midlevel" is offensive) they grow the novice to be more proficient and confident in practice. If a person desired to become an MD/DO then they should choose that path and not think of becoming an NP/PA as a quick route to becoming a "doctor."

allnurses Guide · Aug 5, 2014

I've often wondered if all NP programs, regardless of concentration, could incorporate some type of didactics and clinical exposure to the most common 20-30 complaints a sick or injured person is going to present with.

What programs don't prepare their NP students for the most common complaints? I wouldn't think you could pass the boards without a working knowledge of both wellness visits at all ages and the most common PC/AC complaints.

PG2018 · Aug 5, 2014

What programs don't prepare their NP students for the most common complaints? I wouldn't think you could pass the boards without a working knowledge of both wellness visits at all ages and the most common PC/AC complaints.

Mine doesn't for starters, and two or three others that I've looked at in the region did not. These aren't online universities either as they're all University of (insert state) programs. Frankly, the only thing I've had that really addressed this was "advanced pharmacology" which talked both about diagnostics and treatment. Even the "advanced health assessment and diagnostic reasoning" seemed somewhat deficient in the diagnosing (or recognition!) category.

I've already started looking for CE activities post-graduation that will incorporate such things.

allnurses Guide · Aug 5, 2014

Mine doesn't for starters, and two or three others that I've looked at in the region did not. These aren't online universities either as they're all University of (insert state) programs. Frankly, the only thing I've had that really addressed this was "advanced pharmacology" which talked both about diagnostics and treatment. Even the "advanced health assessment and diagnostic reasoning" seemed somewhat deficient in the diagnosing (or recognition!) category.
I've already started looking for CE activities post-graduation that will incorporate such things.

What year are you? Are you saying they don't specifically say it in the curriculum? Or they don't teach it?

If you haven't covered this in school by your last year and your preceptors haven't covered it, ask for you money back and write a letter to the ANCC and AANP.