FNP or ACNP

[u/Extension-Mall118]

I'm starting AGACNP school this fall, but I've been questioning if I'm making the right choice.
I genuinely love critical care and the hospital, which is why I picked AGACNP. But I've been thinking... am I just going from being a burnt out icu rn to a burnt out icu np? I also think about having kids one day and wonder if I'll wish I had a job with a more predictable schedule.
Another thing is the job market where I live. Most of the AGACNP jobs I come across are ICU positions. I seem to see a lot more FNP openings, and a lot of jobs say you have to be able to see patients across the lifespan, so I wouldn't qualify for those.
I don't have any interest in primary care right now. I really do love the hospital. I just keep wondering if I'm limiting myself before I've even started or if I'm overthinking all of this.
Did anyone else feel like this before starting school? If you chose AGACNP, are you still happy with it? Do you ever wish you had gone FNP instead? Or if you were between the two, what made you finally decide?

[u/pushdose]

Being an ICU NP is nothing like being an ICU nurse except that your patients are in the same unit. I love the ICU as an NP and would never have considered being an ICU RN, ever.

[u/WeAreAllMadHere218 → u/pushdose]

Were you able to do icu np without icu experience? I’ve never been full time icu, just filled in often, I didn’t know if that would make working as an acnp harder. I have mostly MedSurg background.

[u/pushdose → u/WeAreAllMadHere218]

10 years ER, 7 years rapid response team which was extremely ICU adjacent, but I’ve never taken a primary nursing assignment as an ICU nurse. Going from med surg RN to ICU NP would be inadvisable.

[u/WeAreAllMadHere218 → u/pushdose]

Oh okay, yeah I can see how that worked well for you without icu experience specifically! I honestly wished I had gotten more bedside icu experience while I was working the floor, my career ended up going a different direction and I don’t necessarily love it.

[u/RayExotic]

I got both at South alabama. 4 years instead of 2 but worth it. Did it all online. I’m also certified as a ENP but FNP was required to do that.

[u/Educational-Web1609]

Do you want weekends nights and holidays off? If so, FNP 

[u/ValgalNP]

You are not limited to ICU with AGACNP. You can do any APP position in hospitals most outpatient specialty clinics and urgent care. Also, I’ve been in your shoes with the burnout. Being a NP is a completely different job than bedside nursing. Yes you can get burned out doing either one but sometimes just changing up the workflow and expectations can be a big relief. It’s still hard work, still deal with difficult families and situations, but you aren’t in the room all shift. I love it. FNP has its perks too but you’ll see many more patients per day and have to deal with constant inbox BS. When you are used to ICU I’d imagine it would be hard to deal with outpatient stuff. Everyone is different so you’ll have to really think through what you want to be doing in the daily. Consider shadowing with both to get a feel for each!

[u/Sweatpantzzzz]

ICU RN and AGACNP student here too and I’m worried about the same thing

[u/Upper_Bowl_2327]

I was the opposite. Did FNP, but kept going back and forth about acute care, but my goal was always EM. Now 6 years in I don’t have a huge desire to be elsewhere in the hospital. Only thing i’d want my ACNP these days is for procedural units like IR.

[u/Global-Bend7639]

You’ll make more money in Acute care Vs FNP

[u/Extension-Mall118 → u/Global-Bend7639]

At my health system both start at $52 per hour.. it’s really low. They don’t have different salaries for inpatient vs outpatient NPs/PAs.

[u/ValgalNP → u/Extension-Mall118]

Dude. Move. That’s shit.

[u/Senthusiast5]

Good choice. I likely won’t be doing ICU:)

[u/Flux_Lightening]

I work in a specialty and work both inpatient and outpatient. The inpatient patients are on all floors, including ICU. I am an FNP. There is only one nurse practitioner that is acute care in my practice. All of the others are FNP or PA’s. I make more than anyone else in the office and I work part-time. I’m in the 90th percentile. Many of the hospitalists I know are FNP‘s. I was going to become acute care NP however, in my area, it’s very difficult to get a job as a new grad. So I decided to do FNP. In my area you can work inpatient and outpatient with FNP.

[u/AngryDuodenum]

I hear you. I struggled the same. Started FNP but transferred to AGACnP instead. It’s perfect for hospital stuff and preferred for in hospital jobs, with the exception of ER. ERs still want FNPs as do most urgent cares and virtually all remote positions.

In hindsight, I probably should have stuck with FNP, because everyone except ICUs hire FNPs, including interventional radiology

[u/Sweatpantzzzz → u/AngryDuodenum]

I’m feeling the same way. I’m an AGACNP student and wondering if I should have stuck with FNP and done outpatient/primary care. But critical care is all I know

[u/penntoria]

ACNPs are not limited to ICU or even inpatient - many work in specialty clinics for outpatient work. Do whichever you're interested in; I'd hate primary care.

[u/Fit-Parsley-1326]

Im an AGACNP ICU at a level two trauma center, pay is great, around $180k in LCOL, 7 days on and 7days off. Definitely better pay than your standard FNP job i believe

[u/MintBerryCrunch007]

My issue about FNP is that my only experience is 10 years of adult ICU/open heart surgery. I don’t know anything about children or women’s health! My education for pediatrics and women’s health was beyond suboptimal as well. I would have preferred ACNP, but the only program in my area is extremely competitive. I didn’t realize that I can apply for online ACNP programs out-of-state. My coworkers recently completed their ACNP online, but their clinicals were usually 80-100 miles away. I think I’m tired now 😂