This article was updated on March 29, 2024.
If you have been thinking about making a career change in the field of nursing, you may be wondering what the best nursing career path would be. This is an important question because there is a good deal to consider about advancing your nursing career. First, you may want to consider moving from the role of registered nurse (RN) to the role of nurse practitioner (NP). 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 NP specialties to choose from. For the most part, they are defined by the patient population served and the severity of disease or illness. For example, family nurse practitioners (FNPs) care for patients across the life span, from newborns to older adults, and a significant percentage of FNPs are engaged in providing primary care. Other NPs focus on the adult-gerontological population and focus on either primary care (adult-gerontology primary care nurse practitioner [AGPCNP]) or acute care (adult-gerontology acute care nurse practitioner [AGACNP]). Still, other nurses choose to focus on mental health, pursuing the role of psychiatric mental health nurse practitioner (PMHNP).
In this article, we will look at the FNP, AGACNP and PMHNP roles, pointing out the similarities and differences between the roles. This may give you ideas about how to pursue an advanced nursing degree program that can set you on the nursing career path that suits your interests and abilities.
What Is a Family Nurse Practitioner?
FNPs deliver care in accordance with established, evidence-based nursing protocols. The majority of FNPs provide primary care services, frequently in a private practice. The American Association of Nurse Practitioners (AANP) offers this list of services that FNPs provide:
- Conducting patient examinations
- Diagnosing and treating conditions
- Ordering and performing diagnostic tests
- Managing patient care
- Prescribing medications and other treatments
- Educating patients and families on healthy lifestyle choices
- Offering counseling
- Referring patients to specialists and managing patient transfers
One of the benefits of being an FNP 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?
Most FNPs work in outpatient clinics or private practice, but they can also provide telehealth and care in environments such as:
- 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
What Is the Job Outlook for FNPs?
People who pursue careers as NPs will find themselves in one of the most in-demand careers in the United States. According to the U.S. Bureau of Labor Statistics (BLS), NPs, including FNPs, have a projected job growth of 45% for the period of 2022 to 2032, much faster than the national average growth rate for all professions. The need for FNPs will continue to increase because of the aging population, as well as a predicted shortfall of anywhere from 17,800 to 48,000 primary care physicians by 2034, according to the Association of American Medical Colleges (AAMC).
What Are the Benefits of Being an FNP?
There are several benefits of being an FNP. One is the ability to treat and manage the care of patients whatever their age, and another is 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 NPs vary depending on the state where the FNP practices. AANP and allied organizations advocate for full practice authority in every U.S. state and territory. Some states require that NPs be supervised by physicians for some aspects of care delivery, such as prescribing certain medications.
FNPs earned a median annual salary of approximately $103,440 as of February 2024, according to Payscale data.
What Is the Educational Path to Becoming an FNP?
To become an FNP, 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. Advanced nursing degrees include the following:
- Master of Science in Nursing – Family Nurse Practitioner (MSN-FNP)
- Family Nurse Practitioner Post-Master’s Certificate (for RNs with an MSN in another NP specialty)
After didactic coursework and clinical rotations, successful graduates 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 four semesters for a post-master’s FNP, or six (full-time study) to eight semesters (part-time study) for an MSN, plus 750 clinical hours.
What Is an AGACNP?
Another NP specialty is adult-gerontology acute care. This specialty focuses on an adult patient population, ranging from late adolescents to older adults, 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. The two are differentiated not by the setting in which they are performed, but by the educational preparation of the NP, 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 comorbidities 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 NP positions as a whole applies. AANP reports that 8.9% of NPs specialize in adult-gerontology primary care, while 6.1% are certified in adult-gerontology acute care.
That being said, the need for this NP specialty is strong. Demographic projections show a growing number of older adult patients who need care. Baby boomers (those born between 1946 and 1964) have entered their retirement years and are experiencing numerous health problems, including heart disease, hypertension, stroke and cancer. 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.
What Are the Benefits of Being an AGACNP?
The role of AGACNP 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 also 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.
According to Payscale data, the median annual salary for acute care nurse practitioners was approximately $111,700 in March 2024.
Read More: Everything You Need to Know About AGACNP
What Is 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 and then apply to an advanced nursing degree program with an AGACNP focus, such as:
- MSN — 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 750 clinical hours, you may sit for the board certification exam.
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 both FNP and AGACNP certification within a single program of 62 credit hours and 1,000 clinical hours. Dual certification allows an 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 a wider scope of practice would be desirable.
What Is a PMHNP?
Another advanced nursing degree to consider is the PMHNP. The role is essential in assessing, diagnosing and treating a range of emotional and mental health problems, including depression, anxiety and trauma. The role may also involve emergency interventions for patients who have exhibited signs of self-harm.
For nurses who are interested in mental health work or who are passionate about holistic care, this pathway may be highly rewarding.
What Is Work Like for PMHNPs?
Nurses who work in this role may find employment in a wide range of facilities, including hospitals, community clinics, rehab facilities and long-term care facilities. PMHNP duties can vary by position, but a typical job description includes the following:
- Assessing both mental and physical health symptoms
- Collecting family mental health histories
- Diagnosing potential mental health or neurological conditions
- Recommending treatment plans, possibly including medication or talk therapy
- Collaborating with other providers
- Connecting patients with therapists, counselors and other providers
- Documenting patient symptoms, treatments and progressions
- Identifying risk factors for self-harm or other dangerous behavior
What Is the Job Outlook for PMHNPs?
BLS data shows a promising job outlook for those with an advanced nursing degree. NPs, including PMHNPs, are projected to see a job growth of 45% between 2022 and 2032, much faster than the average for all professions. Opportunities may be especially plentiful for those working in mental health, both due to a heightened awareness surrounding mental health and an overall lack of qualified providers in this area.
What Are the Benefits of Being a PMHNP?
The benefits of becoming a PMHNP include the opportunity to provide potentially lifesaving interventions for patients who struggle with significant mental and emotional health concerns. The collaborative nature of the field can also be a major benefit, especially for nurses who prefer a more collegial, holistic model of care.
Salary can be another important benefit. The question is, how much do PMHNPs make? According to Payscale data, the median annual salary for the position was approximately $120,000 as of February 2024.
Read More: PMHNP Duties, Challenges & Rewards
What Is the Educational Path to Becoming a PMHNP?
To become a PMHNP, 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. Advanced nursing degrees include the following:
- MSN-PMHNP
- PMHNP Post-Master’s Certificate (for those who already hold an MSN)
Upon completion of your relevant program and 750 clinical hours, you can take the board PMHNP certification exam through a relevant regulatory body.
Find the Advanced Nursing Degree Program That Is Right for You
An accredited program of study will prepare you through didactic coursework and clinical rotations to achieve competence in several key areas, including the following:
- Advanced practice nursing foundations
- Evidence-informed quality improvement
- Leadership, systems and policy
The online advanced nursing degree 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 the Psychiatric Mental Health Nurse Practitioner track, you will learn:
- How cultural, social, political and economic forces affect patients’ mental health and treatment options
- Advanced concepts in neuroscience, pharmacodynamics and pharmacokinetics and how they affect psychopharmacological treatment of mental health symptoms
In addition, each online program has one on-campus immersion at our state-of-the-art simulation facilities, and we offer comprehensive support for clinical placements in your area, enabling you to gain experience in your geographic area with potential employers. Our programs are designed to offer a nursing education with the greatest flexibility and quality metrics for students, including the following:
- 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%)
U.S. News & World Report has ranked Rockhurst University as one of its Best Value Schools and Best Regional Universities, and the university’s nursing programs are accredited by the Commission on Collegiate Nursing Education (CCNE).
Learn more about our online advanced nursing degree programs and see which one is right for you.
