Acute Care Nurse Practitioner vs. Family Nurse Practitioner: What’s the Difference?

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A nurse speaking to a child and her mother

As aging and growing populations across the U.S. increase health care needs, qualified professionals are being called upon to help. The great need for more health care professionals, such as highly trained nurse practitioners (NPs), is undeniable. The U.S. Bureau of Labor Statistics (BLS) projects a 31% increase in the employment of nurse practitioners between 2016 and 2026. To put that statistic in perspective, the average anticipated career growth for all jobs is just 7%. As more NP positions become available, it is important to know the differences between NP specializations, which may impact one’s career opportunities and earning potential.

Family nurse practitioner (FNP) and acute care nurse practitioner (ACNP) are two positions within the nurse practitioner (NP) designation. NPs may choose to specialize in one of six categories of patient populations, two of which are family and acute care. FNPs and ACNPs must earn an advanced nursing degree, usually a Master of Science in Nursing (MSN), and pass a certification exam before they can begin practicing as nurse practitioners.

Because ACNPs and FNPs often both possess an MSN, the commonality between the two specializations lies in the foundational science background and experience-based application of skills pertaining to the nursing profession and current best practices. However, despite their similar foundation, the ACNP and FNP roles are quite different. An exploration of each role will help prospective NPs analyze the similarities and differences in the roles of acute care nurse practitioner vs. family nurse practitioner.

Family Nurse Practitioner Programs

When comparing the acute care nurse practitioner vs. family nurse practitioner roles, FNPs are the more common of the two. As one of the most prevalent specializations among NPs, family nurse practitioners contribute a significant amount of skill and service throughout many health care organizations.

Career Opportunities

Duties and Responsibilities. Family NPs always focus on primary care. They concentrate on medical histories of entire families, usually over a long period of time, to provide long-term care and health advice. There is no typical day for FNPs, as they may work with patients of any age and in various health care settings, such as hospitals, private practices, and urgent care clinics. For example, one day, an FNP may see over 20 patients, go through lab results, and form patient care recommendations. Another day, an FNP may be in charge of assessing inbound patients and prioritizing them for care within the facility, all while spending just a few minutes with each patient.

Job and Salary Outlook. As mentioned, the BLS projects a 31% increase in opportunities for NPs (64,200 new jobs). Family NPs constitute roughly 67% of all NPs across the U.S., according to the American Association of Nurse Practitioners (AANP). The combination of BLS and AANP information indicates that around 37,600 new FNP positions may become available before 2026. Current industry trends, reported by the AANP, note that the top practice setting for FNPs is a hospital outpatient clinic, with primary care as the top clinical focus. The average annual salary of a family NP is around $93,200 as of June 2019, according to PayScale.

Specialization-Specific Courses

Primary Care of the Family I & II. During these specialization-specific courses, professionals pursuing an FNP specialty focus on primary care within the family unit. These courses offer FNP students an opportunity to advance their skills in a wide range of specialized fields, from health assessment and women’s health to pathophysiology and pharmacology.

Role and Issues in APN. Advanced practice nursing (APN) — nursing that requires a master’s degree — is complex, as problem-solving at this level often requires knowledge stemming from a combination of education, experience, and analysis of current trends and best practices in the nursing industry. As such, this course is designed to prepare FNPs to act effectively as APNs.

Skills Gained from Specializations

Leadership. FNPs gain strong leadership skills through a family-specialized MSN program. Leadership skills help FNPs manage other nurses, lead patients and their loved ones along a course of care, and deliver educational information to colleagues and the public alike.

Compassion. While working with such a broad range of patients in the family specialty, FNPs must nurture a strong sense of compassion for primary care. Compassion is also important for analyzing issues that arise in APN. It allows FNPs to build lasting relationships with those in their care and their workplace.

Observational Competency. Part of patient care in a primary setting, especially among family units, is the ability to observe. Observational competency allows FNPs to read between the lines in delicate situations and see connections that may improve patient care.

Acute Care Nurse Practitioner Programs

While ACNPs may represent a small percentage of nursing professionals, they play key roles in health care organizations. Please note that Regis College does not offer an ACNP specialization.

Career Opportunities

Duties and Responsibilities. ACNPs navigate patient cases with a high risk of immediate change, such as those with critical illness, physiological instability, dependency on technology, or a vulnerability to complications. ACNPs examine, diagnose, and treat patients who have acute care needs. In addition, they educate patients and loved ones about health options, may prescribe treatment and medication, and retain responsibility for other patient-support activities. For example, ACNPs may work with patients who are immunocompromised or who have unique disease processes. ACNPs have been trained to provide the attention and nursing skill that these patients require.

Job and Salary Outlook. ACNP job growth is part of the BLS’ projected NP job growth of 31%, which equates to 64,200 new jobs. ACNPs are one of the less common NP specialties, constituting 4.8% of all NPs in the U.S., according to the AANP. Combining the BLS’ expected job growth and the AANP ACNP industry percentage indicates that nearly 2,700 new ACNP jobs may open up across the U.S. from 2016 to 2026. The top practice setting for ACNPs is a hospital inpatient unit, and the top clinical focus is cardiology, according to the AANP. Acute care NPs earn an average annual salary of around $99,600 as of June 2019, according to PayScale.

Skills Gained from Specializations

Baseline Acute Care Skills. According to The Nurse Practitioner, ACNP programs generally teach the following baseline acute care skills during management and practicum phases: “12-lead ECG interpretation, chest X-ray interpretation, hemodynamic monitoring, and suturing,” as well as “central venous line insertion, local anesthesia application, and wound debridement.” These skills can be applied across a wide variety of acute care settings.

Critical Thinking. To provide the best possible care for patients, ACNPs need to be able to critically assess any situation. To do so accurately and to the best of their knowledge, ACNPs rely on their acute care diagnosis and management education, as well as the experience-based knowledge gained from their practicum placements.

Choosing the Right MSN Program

An advanced MSN degree prepares students for the entry-level NP focus of their choice, including specialties such as ACNP and FNP. Although ACNP is not currently a specialization within the Regis College curriculum, the online Master of Science in Nursing program can help students prepare for an FNP specialization. The Regis College is designed to help students learn to treat families as a unit, from conducting overall health assessments to providing primary care. Nursing professionals looking for an MSN program with an FNP track may find the perfect fit in Regis College.

Recommended Readings
How Nurse Practitioners Can Close the Gap in Health Care
What Is a Family Nurse Practitioner?

American Association of Nurse Practitioners, NP Fact Sheet
Nurse practitioners: Developing the next generation of health care leaders
Family Nurse Practitioner or Acute Care Nurse Practitioner in the Emergency Department?
PayScale, Average Acute Care Nurse Practitioner (ACNP) Salary
PayScale, Salary for Certification: Family Nurse Practitioner (FNP)
Regis College, Online Master of Science in Nursing
U.S. Bureau of Labor Statistics, Occupational Outlook Handbook: Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners