FNP vs. ACNP + Core Differences

Nurse practitioners (NPs) are responsible for assessing, diagnosing, treating, and managing acute and chronic health conditions. The differences among NP positions depend on their patient populations t and the health conditions they treat.

For NP candidates considering various career choices, it’s important to understand the potential differences and how they can affect your work life. Explore the key similarities and differences when comparing acute care NPs vs. FNPs, including education, national certification, salary, and scope of practice.

FNPs and ACNPs are advanced practice registered nurses (APRNs) with graduate-level education and clinical training. They have to complete a master of science in nursing (MSN) or a doctor of nursing practice (DNP) degree. An APRN must also pass a national certification examination.

The degree of autonomy required to diagnose and manage acute and chronic conditions depends on the state regulations and scope of practice. FNPs and ACNPs emphasize patient-centered care, focusing on health promotion, disease prevention, and education.

There are also specific differences to consider when comparing NPs vs. FNPs. Family nurse practitioners care for patients across the lifespan, typically working in primary care settings such as family practice, community centers, and clinics. They stress preventive care and comprehensive healthcare services.

By comparison, ACNPs specialize in caring for adults, often in acute care settings such as hospitals and intensive care units. These professionals manage complex and critical conditions that require urgent or intensive treatment. The ACNP’s scope of practice usually emphasizes advanced diagnostics, as well as complex monitoring and treatments.

All nurse practitioners can diagnose, treat, and manage acute and chronic health conditions. In some states, they work autonomously, while others require a collaborative agreement with a physician. Yet, NP responsibilities vary depending on whether they work in primary care or acute care and whether they treat children, adults, or patients across the lifespan.

Family nurse practitioners deliver primary healthcare to individuals across the lifespan, emphasizing family-centered preventive care. Their expertise lies in working with many patients to manage health conditions at various stages of life.

Responsibilities include:

AG-ACNPs provide advanced care to adult and elderly patients facing acute, critical, and chronic conditions. They often work in high-intensity environments such as hospitals, intensive care units, and emergency rooms. These NPs must have advanced knowledge of physiological changes that occur in the elderly.

Responsibilities include:

The role differs significantly from PNPs, who treat only pediatric patients, and FNPs, who provide

primary care for individuals from infancy through their senior years.

PNP-ACs care for babies, children, adolescents, and young adults up to age 21 dealing with complex or critical health conditions. These practitioners can work in many different settings, including hospitals, emergency departments, ICUs, and subspecialty clinics. NPs need advanced knowledge of child healthcare.

Responsibilities include

While PNP-ACs focus on younger populations, they perform many of the same duties as AG-ACNPs and FNPs, as these specialties share target populations or healthcare needs.

While all NPs must earn an advanced degree to practice, the nursing field offers multiple educational routes for these nurses. For instance, the simplest route to qualify for a master’s in nursing (MSN) requires students to earn a bachelor of science in nursing (BSN) and get experience with their target population.

Students interested in quickly launching their careers may earn associate degrees in nursing (ADNs) and apply for RN-to-BSN or RN-to-NP bridge programs.

FNP candidates must complete an MSN or DNP specializing in family practice. These programs typically require 2-4 years of study after a BSN program.

During the graduate program, an FNP candidate must gain extensive clinical experience from infancy through senior years. After graduating from an accredited program, the FNP must take and pass the national certification examination offered by the American Nurses Credentialing Center (ANCC).

For eligibility, the nurse must hold an active and unencumbered RN license, graduate from an accredited program, hold 500 faculty-supervised clinical hours, and complete graduate-level courses in advanced physiology/pathophysiology, health assessment, and pharmacology.

FNPs must renew their credentials every five years and up to one year before the expiration date. Renewal requirements include an active APRN license and between 75 and 100 contact hours, including 25 pharmacology contact hours. These requirements ensure that FNPs are prepared to manage various health issues in diverse patient populations, caring for individuals of all ages.

There are education and certification requirements to become an AG-ACNP. Each candidate must complete an MSN or DNP specializing in adult-gerontology acute care. The programs usually take 2-4 years of full-time enrollment. They usually combine advanced nursing theory with intensive clinical training in acute and emergency care settings, focusing on adult and elderly populations.

After graduation, candidates must pass the national certification examination offered by the American Nurses Credentialing Center (ANCC). To qualify, each aspiring AG-ACNP must have graduated from an accredited program, have at least 500 faculty-supervised acute care clinical hours, and hold an active and unencumbered RN license.

The national certification must be renewed every five years. Candidates must have active RN licensure and meet other criteria, such as clinical practice hours, academic credits, evidence-based practice, or quality improvement projects.

PNP-AC candidates must complete an MSN or DNP with a concentration in pediatric acute care. It takes two years to complete an MSN and four to complete a DNP for full-time students. The curriculum includes advanced pediatric nursing theory and rigorous clinical training in acute care pediatric settings, such as pediatric intensive care units.

Once the candidate has graduated, they must pass a national certification examination. The Pediatric Nursing Certification Board offers a certification examination for PNP-AC graduates.

After certification, a CPNP-AC must renew or recertify each year. Eligibility includes maintaining an active, unencumbered RN license and 15 continuing education contact hours.

Prospective NPs in acute and family care can enter a field that is projected to grow significantly from 2022-2032. The U.S. Bureau of Labor Statistics projects a 45% increase in employment for NPs in this period.

Nurse practitioners should note that multiple factors influence earning potential, including location, work setting, experience, and specialty. Earnings vary by chosen specialty. According to May 2024 Payscale data, FNPs earn an annual average salary of $103,830.

Earnings for AG-ACNPs and PNP-ACs are higher, at an average of $111,710 per year. Payscale data from May 2024, though limited, indicates that acute care NPs working with pediatric patients earn an average annual salary of $105,000.

Over 69% of NPs nationwide specialize as FNPs, while less than 1% specialize as PNP-ACs, and only about 3% specialize as AG-ACNPs.

RNs considering career advancement should compare FNP and ACNP roles to determine the right path for their needs. Differences in responsibilities, work settings, populations, and conditions are considerations that should influence their decision.

FNPs work with patients of all ages, providing preventive care and treating acute and chronic illnesses in offices, clinics, and community health centers. By contrast, ACNPs address only the needs of adults and older people who require management of complex and critical conditions. Their work generally occurs in acute care settings such as the hospital, intensive care unit, or emergency room.

FNPs and ACNPs have graduate-level education and must pass a national certification examination. While professionals are qualified to practice autonomously, the scope of practice is determined by state regulations.

Page last reviewed on May 22, 2024