How do you choose the right specialty?
Even if you’re confident in the setting in which you plan to work, choosing a nurse practitioner specialty is a major gray area. There’s significant overlap between broader NP specialties, which can be confusing for students planning to further their nursing education. If you want to work as a hospitalist nurse practitioner, for example, should you choose the family, acute care, or adult NP specialty? If your dream is to work in the emergency department, is family or acute care the right path towards achieving your dreams?
In most cases, if it seems your career aspirations fall into a nurse practitioner specialty gray area, there is not one ‘right’ answer when it comes to specialty selection. If you’re having difficulty in the nurse practitioner specialty selection process, here’s a little insight into specialties that commonly cause confusion for NPs to-be.
Family Nurse Practitioner
Typically, the family nurse practitioner (FNP) specialty is reserved for nurse practitioners looking to work in the outpatient, primary care setting. Think community health clinics, family practice clinics, and internal medicine practices. FNPs are certified to care for patients of all ages, from newborns to elderly individuals. Family nurse practitioners are essentially Jacks (and Jill’s) of all trades. From managing chronic disease to treating patients with acute illness, and promoting healthy lifestyles, FNPs know a little bit about everything. When patients with complex medical processes present, family nurse practitioners may refer the patient to a healthcare provider more with more specialized knowledge in a specific area.
While FNPs traditionally work in primary care, they are used in a variety of settings. The broad clinical background family nurse practitioners receive, as well as the ability to treat patients of all ages, allows FNPs to work in the hospital setting in places like the emergency department, as part of hospitalist groups, and in specialty inpatient and outpatient practices, as well as long-term care settings. Becoming a family nurse practitioner does not exclude one from working in the inpatient hospital or specialty setting. And, it doesn’t necessarily mean that the nurse practitioner must work with children.
Adult-Gerontology Nurse Practitioner
Adult gerontology nurse practitioners (AGNP) are more limited than their family nurse practitioner counterparts. AGNP certification does not allow these nurse practitioners to treat children. So, in most cases, they cannot work in settings like the emergency department or urgent care clinics. Traditionally, adult-gerontology nurse practitioners work in settings like internal medicine practices, long-term care facilities, and specialty practices. Another popular employment option for adult nurse practitioners is to work doing home visits for Medicare patients, often patients recently released from the hospital. Most AGNPs work in the outpatient setting, although they may work in the inpatient hospital setting as well.
Some nurse practitioners get themselves into trouble by choosing the adult-gerontology education route. If you would like to work in the primary care, urgent care, or emergency setting, restrictions on the age of patients you may treat limit employment options. Keep in mind that just because you can see pediatric patients as an FNP doesn’t mean you must. Family nurse practitioners may work in all of the same areas as AGNPs and more. Think twice before limiting yourself with the AGNP specialty.
Acute Care Nurse Practitioner
Acute care nurse practitioners work primarily in the inpatient hospital setting. ACNPs may work in the ICU, trauma, critical care unit, surgical specialties, internal medicine specialties such as cardiology, and more. Some ACNPs do work in the outpatient specialty setting, or may work partially in the hospital and partially in the clinic as a result of varied job responsibilities. Unless specializing in pediatric acute care, in most cases, ACNPs cannot treat children under the age of 13. This means that acute care nurse practitioners have limited utility in the emergency department, for example, as providers working in this area of the hospital must be able to treat patients of all ages. Many aspiring NPs go astray here as they assume that acute care is the optimal specialty for a career as an emergency NP. If your heart is set on working in the inpatient setting with critically ill patients, then selecting the acute care nurse practitioner specialty is for you.
If you still can’t decide which specialty to choose, ask others around you. Job shadow nurse practitioners employed in the setting where you see yourself working. What specialty would these NP suggest you pursue? Consider other practical factors such as ease of movement within your nurse practitioner career. If you aren’t quite sure where your passion lies, then choosing a broader specialty, like family, might be the best option for you.
The good news is, that it is relatively easy to obtain an additional nurse practitioner specialty degree later in your career should you choose. It’s always best to make the right choice the first time, but don’t put too much pressure on yourself. Nurse practitioner specialties are pretty broad overall, and will afford you a number of options regardless of your selection.
Which nurse practitioner specialty will you choose?
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