Certification vs. Licensure for Nurses: What Are the Differences?

View all blog posts under Articles | View all blog posts under Nursing Resources

Two female nurse practitioners meet in a hospital hallway to discuss patient records.

For prospective nurses just beginning their educational journey, the concept of certification vs. licensure can be confusing. Both contribute to a successful nursing career. However, they serve very different purposes. It’s important to know that an accredited nursing program will prepare nurses for licensure so that they can begin their careers with confidence. Licensed registered nurses (RNs) who choose an advanced practice nursing program can become board certified in a nurse practitioner specialty.

What Is Licensure?

Nurses who graduate from an accredited nursing program must pass the National Council Licensure Examination (NCLEX) to be licensed to practice nursing in their state. The National Council of State Boards of Nursing administers the exam. Once they pass this hurdle, nurses can begin their careers.

State nursing boards license nurses to practice within their jurisdiction. They grant licenses to nurse graduates who’ve successfully passed the NCLEX, as well as to nurses who are already licensed in other states and want to continue practicing in a new jurisdiction.

State nursing boards are also responsible for enforcing nursing regulations. They respond to complaints and can revoke a nurse’s license for various violations.

What Are Certifications and Certificates?

Nursing certifications and certificates fall into two categories: board specialization and continuing education.

Nursing Certifications

After graduating and getting licensed, nurses may choose to specialize in a particular area of practice. Professional organizations such as the American Association of Critical-Care Nurses (AACN), American Association of Nurse Practitioners (AANP), and American Nurses Credentialing Center (ANCC) have established certifications to confirm that a nurse has met the highest standards of a specialized area of practice.

Certification requirements vary by credentialing organization and certification, but generally require nurses to have a certain number of years of experience or practice hours under supervision before being eligible to sit for a credentialing exam.

Specialization has many benefits:

  • Job satisfaction. Nurses who receive certification often have more opportunities and career recognition, leading to increased job satisfaction.
  • Respect from peers and employers. Nurses who are certified in a specialty may earn more recognition from peers and supervisors.
  • Patient satisfaction. Patients are often more satisfied with their care when nurses who specialize in a practice area treat them.
  • Higher compensation. Depending on the specialty, nurses who specialize can earn more than those without a specialist certification.

Examples of certifications include the following:

Critical Care RN

AACN certifies nurses in critical care specializations. These include Critical Care RN (CCRN) Adult and CCRN Pediatric, as well as the CCRN-Knowledge Professional (CCRN-K) designation. Nurses seeking one of these specializations must have an unencumbered RN or advanced practice RN (APRN) license and have verifiable clinical hours.

Nurse Practitioner

The American Academy of Nurse Practitioners Certification Board certifies nurses as Adult-Gerontology Primary Care NP and Family NP. These are the entry-level certifications. It also offers an Emergency NP specialty certification for NPs who specialize in emergency care.

Nurse Anesthetist

The National Board of Certification and Recertification for Nurse Anesthetists is the credentialing body for nurse anesthetists. Nurses who have a certified registered nurse anesthetist (CRNA) certification must recertify every four years.

Psychiatric-Mental Health Nurse Practitioner

ANCC offers several NP certifications, including the Psychiatric-Mental Health Nursing certification. This certification confirms that an NP is board certified and has the clinical knowledge and skills to treat patients with mental health disorders. As with most credentials, nurses must recertify periodically.

Nursing Certificates

The nursing profession is one of continuing education. Even without finding a specialty, nurses must complete continuing education hours each year, based on their state’s licensing board requirements. This training is usually sponsored by their employer. Nurses receive a certificate or proof of completion card that confirms they’ve met their continuing education hours requirement.

While certificates confirm that nurses have taken courses and completed training, these classes generally are not as rigorous as the certification exams.

Licensure and Certification for Advanced Practice Nursing

Once a nurse understands the implications of certification vs. licensure, they may wonder which one they need to advance their nursing career. Advanced practice nurses, such as NPs and Doctor of Nursing Practice (DNP) professionals, are RNs whose careers have taken them into higher-level nursing practice. As NPs, they can prescribe medication and administer tests. NPs who specialize in family practice are in high demand across the country due to a shortage of health care practitioners, including a shortage of physicians. DNPs often go into hospital leadership or teaching.

The steps to becoming an advanced practice nurse (or APRN) are as follows:

  • Bachelor of nursing education. Nurses must first graduate from an accredited nursing program and pass the NCLEX.
  • RN Licensure. After passing the NCLEX, nurses need to gain licensure from a state board.
  • Master of nursing education. To become an NP, nurses need to earn an advanced degree, usually a Master of Science in Nursing (MSN). The MSN takes around three to four years to complete, if they already have a bachelor’s degree in nursing.
  • Advanced Practice Licensure. Once aspiring NPs finish their education, they must be licensed to practice by their state board. Depending upon the state, an NP may have full practice authority, which is about similar to a medical doctor’s autonomy, or restricted practice authority.

Salary Expectations for Nurses

Compensation for nurses varies depending on work setting and level of experience. Advanced practice nurses, such as NPs, earn more than RNs. However, there’s a wide variance between different advanced practice specialties as well.

The median annual wage for RNs was $77,600 in 2021, according to the U.S. Bureau of Labor Statistics (BLS). The BLS projected jobs for RNs would grow by 9% between 2020 and 2030.

The compensation landscape is significantly different for advanced practice nurses, according to the BLS:

  • Nurse anesthetists. This is one of the highest-paid specializations. Nurse anesthetists earned a median annual wage of $195,610 in 2021.
  • Nurse practitioners. The median annual wage for NPs was $120,680 in 2021.
  • Nurse-midwives. Nurse-midwives earned a median annual wage of $112,830 in 2021.

Demand for these occupations was expected to grow by 45% between 2020 and 2030. One financial draw to becoming an NP is total compensation beyond base salary. NPs also stand to earn from bonuses and revenue sharing if they’re part of a physician’s office or an independent practice. In addition, some NPs move on to work as managers or executives in clinics, private practices, or hospitals.

Take Charge of Your Career in Nursing

As you can see, the answer to the question of certification vs. licensure is it’s good to have both. If you’re excited by the opportunities of advanced practice nursing, it’s time to explore your options. Visit the online Master of Science in Nursing program at Bradley University and learn the next steps in building a satisfying career as a family nurse practitioner.


Recommended Readings

How to Become a Psychiatric Mental Health Nurse Practitioner

Nurse Practitioner Specialties: Types of Nurse Practitioner Roles and Responsibilities

When Will a DNP Be Required for Nurse Practitioners?



American Academy of Nurse Practitioners Certification Board, About AANPCB

American Association of Critical-Care Nurses, Get Certified

American Association of Neuroscience Nurses, “Impact of Nursing Certification on Nurses, Healthcare Employers and Patients”

American Association of Nurse Practitioners, Nurse Practitioner (NP) Certification

Board of Certification for Emergency Nursing, Certification vs. Certificate — What’s the Difference?

Houston Chronicle, “What Is the Difference Between the NCLEX-PN and the NCLEX-RN?”

National Board of Certification and Recertification for Nurse Anesthetists, Initial Certification

National Council of State Boards of Nursing, NCLEX & Other Exams

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners

U.S. Bureau of Labor Statistics, Registered Nurses