If you have been thinking about making a career change within the field of nursing, you may be wondering what the best nursing career path for you would be. This is an important question because there is a good deal to consider about advancing your career in nursing. First, you may want to consider moving from a role as a registered nurse to the role of nurse practitioner. Then you will have to think about what kind of education you will need to prepare you for that role and a specialization within it.
There are many nurse practitioner specialties to choose from. For the most part, they are defined by the patient population served and severity of disease or illness. For example, Family Nurse Practitioners (FNPs) care for patients across the lifespan, from newborns to the elderly, and a significant percentage of FNPs are engaged in providing primary care. Other nurse practitioners focus on the adult-gerontological population and either focus on primary care (Adult-Gerontology Primary Care Nurse Practitioner; AGPCNP) or acute care (Adult-Gerontology Acute Care Nurse Practitioner; AGACNP).
In this article, we will look at the roles of family nurse practitioner and adult-gerontology acute care nurse practitioner, point out the similarities and differences between the two roles and give you ideas about how to pursue a degree that can set you on the nursing career path that suits your interests and abilities.
How did the role of family nurse practitioner get its start?
FNPs play a crucial role in health care delivery in the United States. A family nurse practitioner is an advanced practice registered nurse (APRN) whose education and certification are geared toward providing primary care for patients of all ages. The role of family nurse practitioner was developed in the mid-1960s to fill in gaps in locations where there weren’t enough physicians to deliver primary care. In the following years, the number of people in the FNP role has increased dramatically—the American Association of Nurse Practitioners (AANP) says that there are 325,000 nurse practitioners in the nation as of June 2021, with 69.7% of those certified as FNPs.
What do family nurse practitioners do?
Family nurse practitioners deliver care in accordance with established, evidence-based nursing protocols. The majority of FNPs provide primary care services, frequently in a private practice. The AANP offers this list of services that FNPs offer:
- Conducting patient examinations
- Diagnosing and treating conditions
- Ordering and performing diagnostic tests
- Managing a patient’s care
- Prescribing medications and other treatments
- Educating patients and families on healthy lifestyle choices
- Offering counseling
- Referring patients to specialists, as needed, and managing patient transfers
One of the benefits of being a family nurse practitioner is being able to deliver health care to multiple family members when necessary. For instance, if several family members develop an infection, the FNP can treat each member according to their age and condition. The FNP can also help assess, diagnose and be part of the interdisciplinary team that cares for individuals experiencing mental health illnesses.
Where do FNPs work?
FNPs can deliver care in a variety of settings. Most work in outpatient clinics or private practice, but there are many other places where family nurse practitioners can provide care, including:
- Urgent/immediate care clinics
- Long-term care facilities
- Community health center
- School or university clinics
- Rural health centers
- Home health care services
- Hospice centers
- Correctional facilities
- Government centers
- Military service
- Telehealth services
What is the job outlook for FNPs?
People who pursue careers as nurse practitioners will find themselves in one of the careers with the highest demand in the U.S. According to the U.S. Bureau of Labor Statistics (BLS), nurse practitioners, along with other APRNs, have a projected job growth of 45% for the period between 2020–2030, which is much faster than the national average growth rate of 8%. Nurse practitioners alone are projected to have a job growth rate of 52% in the same period—translating to nearly 115,000 additional positions.
The need for FNPs will continue to increase not only because of population pressures but because of a predicted shortfall of anywhere from 17,800 to 48,000 primary care physicians by 2034, according to the Association of American Medical Colleges.
What are the benefits of being an FNP?
There are several benefits of being a family nurse practitioner. One is the ability to treat and manage the care of patients, no matter their age, and the opportunity to maintain a caring relationship with patients over several years. An FNP also masters a wide range of clinical competencies to serve patients with a variety of disorders.
Perhaps one of the most highly valued benefits is the ability to practice independently and deliver patient care based on the NP’s own education, experience and judgment. Rules regarding the scope of practice for nurse practitioners vary depending on the state in which the FNP practices. The AANP and allied organizations advocate for full practice authority in every U.S. state and territory. Currently, some states require nurse practitioners to be supervised by physicians for some aspects of care delivery, such as prescribing certain medications.
The AANP reports that full-time FNPs earn a median salary of $115,000.
What is involved in the educational path to becoming an FNP?
To become a family nurse practitioner, you must be a licensed RN with at least a Bachelor of Science in Nursing (BSN) degree and then enroll in a graduate program of study. That can be one of the following:
- Master of Science in Nursing - Family Nurse Practitioner (MSN-FNP)
- Post-Master's FNP (Second Degree MSN) (for RNs with an MSN in another nurse practitioner specialty)
Through didactic coursework and clinical rotations, a successful graduate will be eligible to take the board-certification exam. Depending on the way your course is structured, you can complete the program in as little as 4 semesters (for a post-master's FNP), or 6 (full-time study) to 8 semesters (studying part-time) plus 600 clinical hours.
What is an AGACNP?
As mentioned above, an NP can select among several nurse practitioner specialties. One is adult-gerontology acute care. This specialty focuses on an adult patient population, ranging from late adolescents to the elderly, with an additional focus on acute or emergent conditions, some of which may be life-threatening.
The difference between certifications for primary care and acute care is important. As stated in its “Statement on Acute Care and Primary Care Certified Nurse Practitioner Practice,” the National Organization of Nurse Practitioner Faculties (NONPF) clarified that acute care and primary care are differentiated not by the setting in which they are performed, but by the educational preparation of the nurse practitioner, thereby determining that practitioner’s scope of practice—specifically, primary care NPs see patients who are medically stable, while acute care NPs treat patients with emergent conditions.
What is work like for AGACNPs?
AGACNPs work in a variety of settings, including hospitals, outpatient and subspecialty clinics, long-term care facilities and even in homes. Because they manage patients whose health is unstable, AGACNPs manage patients with multiple co-morbidities and medications (and any resulting side effects) and develop personal care plans with this in mind.
In older patients, chronic or acute health issues affecting the cardiovascular, pulmonological and nephrological systems are common and acute care NPs may pursue these or other subspecialties to address these needs.
AGACNPs also work closely with multidisciplinary care teams, especially within hospitals or outpatient clinics, so it is a good role for people who work well in a collaborative environment.
What is the job outlook for AGACNPs?
Although the BLS does not break out data for AGACNPs as a group, the information about the growth in nurse practitioner positions as a whole applies. The AANP reports that 9.9% of nurse practitioners specialize in adult-gerontological care, with 2.9% of all NPs certified in adult-gerontological acute care.
That being said, the need for this nurse practitioner specialty is strong. Demographic projections show a growing number of elderly patients who need care. Currently, members of the baby boomer generation (those born between the years 1946 and 1964) have entered their retirement years and are experiencing numerous health problems, including heart disease, hypertension, stroke, cancer and more. Moreover, the cohort known as the millennials (those born between 1981 and 1996) became the largest U.S. population group in 2019 and they face serious health problems, as well. A study done by the Blue Cross Blue Shield Health Index predicts that millennials will be less healthy when they are older when compared to Gen Xers.
What are the benefits of being an AGACNP?
The role of adult-gerontology acute care nurse practitioner will appeal to those nurses who are drawn to helping patients who are facing serious or critical health concerns. Although some aspects of the role include advanced interventions (such as intubation or central line placement), another part of the role demands that the NP communicate calmly and clearly with patients and their families not only about immediate treatment but about prevention. This role might appeal to people who are prepared to make care decisions in a fast-paced environment, such as an emergency room or critical care unit.
Other AGACNPs will find the pace at a subspecialty clinic to be interesting and challenging. Providing direct care for patients with complex conditions, monitoring their status and preventing complications is fulfilling work.
The AANP reports that full-time AGACNPs earn a median salary of $113,000.
What is involved in the educational path to becoming an AGACNP?
To become an AGACNP, you must be an RN with an active license and hold (at least) a BSN from an accredited college or university. Apply to a graduate program with an AGACNP focus, such as:
- Master of Science in Nursing — AGACNP
- AGACNP Post-Master's Certificate Program (for those who already hold an MSN)
Upon completion of the program, which comprises 49 credit hours (20 credit hours for the post-master's certificate) and 600 clinical hours, you may sit for the board certification exam.
The best of both worlds: Dual certification
Some candidates may wish to expand their scope of practice options by pursuing a Dual Track MSN FNP – AGACNP. An online MSN Dual Track prepares students for certification as both family nurse practitioner and adult-gerontology acute care nurse practitioner within a single program of 62 credit hours and 1,000 clinical hours. Dual certification allows the NP to provide care for patients across the age spectrum and with both primary care and acute care management as needed. This can be an especially valuable skill set for NPs planning to practice in rural areas or other places where having a wider scope of practice would be desirable.
Find the best program for you
An accredited program of study will prepare you through didactic coursework and clinical rotations to achieve competence in several key areas, including:
- Advanced practice nursing foundations
- Evidence-informed quality improvement
- Leadership, systems and policy
The online nursing programs offered by Rockhurst University are designed to provide an academically rigorous program of study, based on a philosophy of transformative learning in the Jesuit traditions of professional and personal growth emphasizing ethics, compassion and care for the whole person.
In the Family Nurse Practitioner course of study, you will learn:
- Evidence-based care through analysis of physiologic and pathological disease states
- Application of pharmaceutical principles
- Performance of comprehensive health assessments using the differential diagnostic process
- Use of therapeutic communication in appropriate scientific, cultural and ethical contexts
In the Adult-Gerontology Acute Care Nurse Practitioner track, you will learn:
- Specialized assessment and advanced procedural skills to provide quality care in multiple settings
- Advanced pharmacologic management, advanced pathophysiology and diagnostic testing interpretation for critically ill and hospitalized patients
- How to employ comprehensive assessment, diagnosis and management of patients with acute, critical or complex chronic health problems, or those with acute exacerbations of their chronic illness
In addition, each online program has one or two on-campus immersions at our state-of-the-art simulation facilities and we offer comprehensive support for clinical placements. Our programs are designed to offer a nursing education with the greatest flexibility and quality metrics for students, including:
- Multiple intakes per year
- Part-time and full-time options in an online format
- Second-degree/certificate options for existing APRNs
- Unique FNP/AGACNP dual-degree track offers two high-demand nursing disciplines in one degree
- First-time certification exam passing rates above the national average (92%)
Our nursing programs at Rockhurst University are ranked as Best Value Schools and Best Regional Universities by U.S. News and World Report and are accredited by the Commission on Collegiate Nursing Education (CCNE).
Learn more about our online nursing programs and see which one is right for you.