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How to Become an Acute Care Nurse Practitioner

Daniel Bal, MS.Ed
Updated January 10, 2023
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Review the role of an acute nurse practitioner, the steps needed for licensure and certification, and the opportunities available for those who pursue this advanced nursing role.
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Acute care nurse practitioners (ACNPs) care for patients with acute conditions who need immediate attention. There are various paths to becoming an ACNP, all of which include earning a bachelor’s degree in nursing and either a master’s or doctorate.

Commonly employed in emergency rooms, intensive care and trauma units, and operating rooms, ACNPs earn a higher-than-average salary while benefiting from the increased demand for advanced practice registered nurses (APRNs). ACNPs typically also work as hospitalists.

Detailed throughout this guide is an overview of the educational requirements, licensure and certification prerequisites, and career outlook for ACNPs.

What Is an Acute Care Nurse Practitioner?

An ACNP is an advanced practice registered nurse who specializes in the care of patients with acute illnesses or chronic conditions. They are responsible for examining, diagnosing, and treating patients with severe short-term healthcare needs or those with chronic issues that are life-threatening.

Specific responsibilities of an acute care NP career include coordinating patient care, assessing the patient’s health history, ordering tests, performing procedures, and prescribing medication. They perform these tasks in emergency rooms, operating rooms, critical care units, trauma units, intensive care units (ICUs), and transplant units.

Steps to Becoming an Acute Care NP

There are various steps necessary for those interested in becoming an ACNP. While specific criteria may differ depending on the location, the basic requirements remain similar from one place to the next.

Before becoming an ACNP, nurses need to fulfill certain academic and professional requirements. An advanced nursing degree, direct experience as a nurse, and certification are all needed.

Earn an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN) degree.

To become an ACNP, the first step is to earn a BSN from an accredited nursing program, which typically takes four years.

Registered nurses (RNs) with an ADN can enroll in an RN-to-BSN program, which will allow them to earn their BSN in two years rather than four.

Those with a bachelor’s degree in a non-nursing field can enroll in an accelerated BSN program, which will allow them to earn the nursing degree in as little as a year.

Pass the NCLEX exam to receive RN licensure.

After completing a BSN program, graduates must pass the National Council Licensure Exam for Registered Nurses (NCLEX-RN) before applying for a nursing license. ADN-RNs should already have passed the NCLEX-RN.

The exam assesses a nurse’s ability to apply their knowledge to different healthcare scenarios. It consists of four parts: safety and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity.

Gain experience in acute care nursing.

Before being accepted into a master of science in nursing (MSN) or doctoral program, most will require RNs to have at least two years experience in acute nursing in the ICU, emergency department, trauma unit, postanesthesia care unit, or operating room.

To gain this experience, some employers offer cross-training programs for nurses looking to gain experience in acute care before enrolling in a graduate program.

RNs can typically gain acute care experience working in a hospital. Opportunities are also available in private practices and other clinical settings.

Earn an MSN degree in acute care.

After earning a BSN and gaining experience, the next step is the completion of a graduate program.The options for earning an MSN differ depending on the nurses

Get APRN licensure in your state.

While APRN licensure requirements vary from state to state, most ask for an application fee, background check, valid RN license, MSN, and verification of completed clinical hours.

The majority of states also require nurses to pass a national certification exam once completing their MSN.

Consider pursuing certification as an ACNP.

There are several certifications available to ACNPs. Each requires coursework and completion of a national certification exam.

Certification options include:

Acute Care Nurse Practitioner – Adult-Gerontology certification (ACNPC-AG) from the American Association of Critical-Care Nurses (AACN)

Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) certification from the American Nurses Credentialing Center (ANCC)

Certified Pediatric Nurse Practitioner – Acute Care (CPNP-AC) from the Pediatric Nursing Certification Board (PNCB)

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Acute Care Nurse Practitioner Education

Becoming an ACNP requires nurses to earn an advanced education consisting of both an undergraduate (BSN) and graduate degree (MSN or DNP).

The educational process can take six years to complete for students who enroll full time. These six years do not include time necessary to build the experience needed to enroll in an MSN program, which is usually an additional year or two.

MSN Degree

The first educational option for nurses looking to become ACNPs is enrolling in a graduate program where they will earn their MSN.

While the earning potential of an ACNP with an MSN is not as high as one with a doctor of nursing practice (DNP), the master’s program allows nurses to earn their degree with fewer credits. This allows them to complete the program and enter the field faster than their DNP counterparts.

  1. 1

    Admission Requirements

    To enroll in an MSN program, prospective students must hold a BSN with a minimum 3.0 GPA, have an active RN license, and have worked as an RN a year or more.

  2. 2

    Program Curriculum

    Most ACNP students will take advanced classes in physiology and pathophysiology, pharmacology and therapeutics, health assessment, and research methods.

  3. 3

    Time to Complete

    Full-time students who already have a BSN can finish an MSN program in 18-36 months. It will take longer for students who complete the program on a part-time basis, have an ADN, or have a non-nursing bachelor’s degree.

  4. 4

    Skills Learned

    MSN programs prepare ACNPs to provide acute and critical care to patients in different settings. Depending on the state, ACNPs can act as independent practitioners, prescribe medications, and own/operate their own practice.

  5. 5

    Admission Requirements

    DNP programs typically require their applicants to have a BSN, active RN license, and one or more years of clinical nursing experience.

  6. 6

    Program Curriculum

    Courses include advanced study in biostatistics, pathophysiology/physiology, and evidence-based practice. Clinical pharmacology, project planning, management and analysis of data, and healthcare policy are also taken.

  7. 7

    Time to Complete

    The length of a DNP program varies depending on the format; however, they typically take between 3-6 years to complete.

  8. 8

    Skills Learned

    DNP programs prepare ACNPs to practice as independent practitioners, use evidenced-based care, carry out new strategies and policies, and develop healthcare research projects.

Acute Care NP Licensure and Certification

To legally work as an ACNP, nurses will need to maintain their RN license while also gaining their APRN license. Nurses also must get the proper ACNP board certification in the specialty of their choosing after completing their MSN or DNP program.

RN license renewal processes vary by state, yet most require a set amount of contact hours. While some regions do not require contact hours, most require around 24-30 hours.

Certain areas require that some of those hours be spent focusing on specific nursing-related subject matter. The majority of states require RNs to meet these criteria every two years, but the time can range from every year to every four years.

To maintain their APRN license, advanced practice nurses including ACNPs must complete 1,000 practice hours and a certain amount of continuing education hours every five years.

ACNPs must also choose from three specializations in which to become nationally certified. Options includeACNPC-AG from the AACN,AGACNP from the ANCC, andCPNP-AC from the PNCB.

All specialty options require completing a graduate-level program with a focus on the chosen specialization. It also requires passing the national certification exam. These certifications must be renewed every five years, except for the CPNP-AC which must be renewed annually.

Certification renewal includes the following:

  • check-circle

    ACNPC-AG Certification

    Complete 1,000 practice hours and 150 continuing education (CE) points; 1,000 practice hours, 25 pharmacology CE credits hours, and re-take the certification exam; or 150 CE points and re-take the certification exam every five years

  • check-circle

    AGACNP Certification

    Complete 150 CE points every five years

  • check-circle

    CPNP-AC Certification

    Complete 15 contact hours annually; 15 hours of pediatric pharmacology and four PNCB modules every seven years

Working as an Acute Care Nurse Practitioner

ACNPs benefit from a high earning potential with an anticipated job growth rate faster than all other fields. While the U.S. Bureau of Labor Statistics does not track ACNPs specifically, they project that all NP positions will increase by 45% by 2030.

Combined with an average annual salary of $105,450 as of May 2022 as per Payscale, the specialization can be a promising nursing option.

There are various factors that influence the salary of an ACNP such as experience and location. As ACNPs gain more experience, they can expect their salary to increase. Those who have 10-20 years of experience can earn $20,000 more than what most nurses earn in their first year, according to Payscale in May 2022.

An ACNP’s salary is also influenced by their location. States such as California and New Jersey earn an average annual salary of $151,830 and $137,010 respectively, which is higher than the national average of $118,040.

Frequently Asked Questions About Becoming an ACNP

question-mark-circleHow many years does it take to become an acute care nurse practitioner?

The length of time it takes to become an ACNP depends on the person’s educational path. Prospective nurses who follow the traditional path, which includes earning their BSN followed by their MSN, can become an ACNP in 6-8 years. Those pursuing their DNP finish in 8-10 years.

question-mark-circleWhat types of certification are required for acute care practitioners?

ACNPs are required to become certified in one of three specializations to legally practice in any state. Their options include the ACNPC-AG certification, AGACNP certification, or CPNP-AC certification, each of which requires an MSN and the completion of a national certification exam.

question-mark-circleIs it hard to become an acute care nurse practitioner?

With the amount of education needed to become an ACNP, the path can be challenging both academically and financially. However, nursing students have many financial aid options for nurses, including MSN scholarships, that can help with the cost.

Nurses can also take advantage of part-time programs, which allow them to work while enrolled in courses.

question-mark-circleDo acute care nurse practitioners get paid well?

Compared to some of the other major specialties, ACNPs fall right into the middle with an average salary of $105,450. In comparison, according to Payscale in May 2022, women’s health NPs earn $96,590, family NPs earn $98,030, neonatal NPs earn $110,330, and psychiatric-mental health NPs earn $113,110.

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Page last reviewed May 22, 2022

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