Nurses moving into advanced practice choose specializations that allow them to work with specific populations or in defined practice areas. Two of those areas are adult-gerontology acute care and primary care. While both roles provide vital healthcare to patients, care levels and work environments vary.
This guide details the differences between these two nurse practitioner (NP) roles, covering work environments, job duties, education, and certifications. Keep reading to learn more about the differences between these two important specializations.
Adult-Gerontology Acute Care NP and Primary Care NP Key Similarities and Differences
What is an Adult-Gerontology Acute Care NP?
An adult-gerontology acute care NP (AGACNP) cares for adult patients with acute, often complex, illnesses and injuries, usually in a hospital environment.
What is a Primary Care NP?
A primary care NP (PCNP) works with patients of all ages, focusing on general healthcare and wellness, as well as management of chronic conditions. They typically provide care in clinics, medical offices, or community health centers.
Duties and Responsibilities
Although there are some similarities between the daily duties of an AGACNP and a PCNP, the work environment, focus, and patient demographic vary by career path. The following sections highlight some of the typical responsibilities for each role.
What Does an Adult-Gerontology Acute Care NP Do?
AGACNPs provide immediate, short-term care for adults (which may be anyone over age 12) and elderly persons who have complex, acute illnesses. This often takes place in emergency departments, intensive care units, and trauma units. AGACNPs may also work in long-term care facilities to provide acute care to residents. These professionals have a unique understanding of the aging process and the effects of age on health and well-being, which informs their clinical practice.
Some of the specific duties of an AGACNP include:
- Examining, diagnosing, and monitoring acutely ill patients
- Developing multi-faceted treatment plans and overseeing their implementation
- Coordinating healthcare services for acutely ill patients in critical care
- Identifying appropriate interventions to improve the well-being of patients with acute illness
- Facilitating transfers between different care environments and levels of care
- Serving as an advocate for patients and families and supporting decision-making
- Conducting research
- Teaching and mentoring other healthcare professionals
What Does a Primary Care NP Do?
A PCNP provides ongoing, comprehensive care to patients across age groups, from pediatric and adolescent care to adults and the elderly. They focus on wellness and disease prevention, as well as managing chronic conditions, such as diabetes, asthma, or high blood pressure.
The scope of practice for a PCNP varies by state, with some states allowing PCNPs to practice autonomously, while others require supervision by a licensed physician. All PCNPs can diagnose patients and develop treatment plans. In some cases, PCNPs hold prescriptive authority. This makes them a crucial part of the healthcare delivery system, as research indicates that NPs provide high-quality, cost-effective care, especially in rural areas where access to primary care providers may otherwise be limited.
Some of the specific, day-to-day duties of a PCNP include:
- Examining and diagnosing patients, including general wellness exams, women's health exams, and acute illness
- Managing acute and chronic conditions
- Ordering, conducting, and interpreting diagnostic tests
- Collaborating with other providers to coordinate patient care
- Advocating for patients
- Providing counseling and teaching to patients on wellness, health maintenance, and disease management
Education and Certification
Becoming AGACNP or a PCNP requires additional education beyond the nursing degree. Both roles require an active registered nurse (RN) license, a bachelor of science in nursing (BSN), and a graduate degree, either an MSN or a DNP. However, there are differences in the curriculum, certification, and exams for each role, which are detailed below.
How to Become an Adult-Gerontology Acute Care NP
The path to becoming an AGACNP starts with earning an RN with a BSN degree. To become certified, nurses need an MSN with a relevant specialization. Since 2014, nurses who wish to become an ACNP must choose to specialize in either pediatric or adult-gerontology acute care and take the related courses and specialized exams.
The curriculum for an AGACNP includes coursework related to different age groups (adolescents, adults, geriatric) acute care, and pharmacology. Nurses also complete at least 500 supervised clinical hours to qualify to take the certification exam. You have three options for the exam:
- Adult-Gerontology Primary Care Nurse Practitioner Board Certification (AGPCNP-BC) from the ANCC
- Adult-Gerontology Primary Care Nurse Practitioner (A-GNP) certification from the AANP
- Acute Care Nurse Practitioner (Adult-Gerontology) (ACNPC-AG) certification from the AACN
How to Become a Primary Care NP
Becoming a PCNP also begins with a BSN and an RN license, followed by an MSN degree. The curriculum includes coursework in pharmacology, health education and promotion, healthcare policy, and advanced physiology, and nurses must complete at least 500 hours of supervised clinical experience to qualify to take the certification exam.
PCNPs are certified by the ANCC and the AANP. Specific options include:
- Family Nurse Practitioner (FNP-BC) certification from AANP.
- Family Nurse Practitioner (FNP) certification from ANCC.
Salary and Career Outlook
NPs in any specialty enjoy a wide range of career opportunities and job security. The BLS projects high demand for NPs between 2020 and 2030, with job opportunities expected to increase by 45% in that time. The median annual salary for an NP — which is influenced by location, work environment, experience, and specialty — is $117,670.
Average Annual Salary
Adult-Gerontology Acute Care NP
Primary Care NP
Adult-Gerontology Acute Care NP Salary and Career Outlook
According to Payscale data from April 2022, adult NPs earn an average salary of $102,280, with experienced NPs earning over $113,000 per year. Increased demand for health services, especially among an aging population, plays a significant role in the ongoing demand for AGACNPs.
Primary Care NP Salary and Career Outlook
Demand for PCNPs is also expected to increase in the coming years, as NPs are increasingly recognized as providers of primary healthcare, and more states expand their scope of practice. NPs currently earn an average annual salary of $100,310, according to Payscale data from April 2022. Experienced NPs, particularly those in leadership roles, earn an average of $112,000 per year.
Adult-Gerontology Acute Care NP vs. Primary Care NP: Which Career is Right For Me?
Both AGACNPs and PCNPs provide vital healthcare services to adult patients. They fill an important role in diagnosing, treating, and preventing disease, especially within underserved and vulnerable populations. With similar requirements for education and certification, and equal earning potential, the decision comes down to your individual goals and the work environment you prefer.
Most AGACNPs work in fast-paced, tertiary care environments, including critical care and intensive care units. They often have unpredictable schedules. Patients of AGACNPs often require more complex care.
PCNPs, on the other hand, typically work in office environments on a regular schedule. They are focused on building long-term relationships with patients, with a priority on overall wellness and disease prevention. PCNPs also work with children and adolescents, which can be a factor in choosing a career path.
Page Last Reviewed April 27, 2022
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