What’s The Difference Between an FNP vs. ACNP?

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FNP speaking with patient


The nurse practitioner (NP) is an important health care professional in the nursing workforce. As an advanced practice registered nurse (APRN), NPs make advanced health assessments, develop treatment programs, prescribe and manage medications, and coordinate care with other key stakeholders.

In reality, that’s just a glimpse into the diverse job duties NPs are responsible for. Depending on the NP’s specialization, they may work closely with children, seniors, patients with chronic conditions, or occupy a position of leadership and help manage hospital systems or contribute to political policy.

When deciding which career pathway is right for you, it’s worth examining the difference between FNP vs. ACNP roles. Two popular NP certifications, either a career as a family nurse practitioner or one as an acute care nurse practitioner, can be rewarding. Yet it’s important to understand the differences between the roles, as well as what education, skills and certifications are needed to practice. Let’s look at the professional responsibilities of FNPs and ACNPs, as well as the importance of a Master of Science in Nursing (MSN) and what a graduate nursing degree program looks like.

What is an FNP?

A family nurse practitioner is an NP who addresses the health care needs of families across their lifespan, which may mean anything from treating parents to young children, adolescents, young adults or people approaching retirement. As such, they are extensively prepared and educated in providing primary care services. During any given practice day, an FNP may conduct a routine checkup for a toddler, educate a parent about the need for immunizations for school-aged children and prescribe cholesterol medication for a patient.

FNPs are the most populous subgroup of NPs, according to the American Association of Nurse Practitioners (AANP). In 2019, there were 270,000 certified nurse practitioners in America, and more than two-thirds (66.9%) were FNPs. According to PayScale, in 2019, the average annual salary for an FNP was just above $121,000 nationally.

The scope of practice for FNPs can encompass neonatal care, pediatrics, women’s health and gerontology, among other diverse patient populations. The day-to-day FNP practice also includes collaborating and coordinating with other health professionals, or helping run a private practice. To that end, they need to be competent in:

  • Pharmacokinetics, pharmacodynamics and pharmacotherapeutics
  • Principles of FNP and APRN practice
  • Advanced health assessment and nursing theory
  • Informatics and statistical procedures
  • Leadership and organizational management

What Education and Certifications do FNPs Need?

Becoming an FNP commonly starts with earning a Bachelor of Science in Nursing (BSN). With a BSN, students can become registered nurses (RNs), as well as apply to enter a graduate nursing program that confers an MSN. However, there are also options to earning an MSN for those with associate degrees (ADN), nursing diplomas and bachelor’s degrees in non-nursing disciplines. It all depends on the program. For example, Bradley has two tracks to MSN-FNP, one in which RNs can enter with a BSN, or one that allows students to enter with an ADN, nursing diploma or non-nursing bachelor’s.

Earning a Master of Science in Nursing from an accredited institution is important because the degree is required for APRN certification. In completion of their degrees, students gain expertise in advanced nursing theory, patient-centered care and evidence-based practice, as well as accruing necessary clinical hours for certification.

The next step after earning an MSN is national board certification. According to the AANP, nurses can be certified as an FNP through:

  • The American Academy of Nurse Practitioners National Certification Board (AANPCB); or
  • The American Nurses Credentialing Center (ANCC) Certification Program

The final action nurses need to take to actually practice as an FNP is to become licensed by or registered with a state nursing board.

Where do FNPs work?

Hospital outpatient clinics (13.5%) are the most common practice setting for FNPs, according to the AANP, but these professionals are found across many diverse employment settings. Some include hospital systems, research hospitals and community health clinics.

FNPs focused in primary care can also find work in private or independent practice. Depending on the state in which FNPs work, they may be granted full practice authority, or the ability to treat patients and prescribe medications — among other core job duties — without the supervision of a physician.

What is an ACNP?

In contrast with an FNP, an acute care nurse practitioner’s focus is on caring for patients for a short time frame — as opposed to long term chronic conditions — and often when critical conditions are present. ACNPs are educated and skilled in the practice of acute care, which is a level of care in which patients are treated for typically brief but severe episodes of illness, disease, trauma or recovery from surgery. ACNPs made up around 5% of the overall NP population in 2019, according to the AANP. The average annual salary for this type of advanced practice nurse practitioner was just more than $100,000 in 2019, according to PayScale.

As NPs, acute care nurse practitioners are well-versed in the principles of advanced practice, nursing theory and evidence-based practice. But given their patient population — patients presenting severe symptoms or suffering from trauma, wounds or complex, even life-threatening, conditions — ACNPs also have specialized knowledge in diagnostic tests, interviewing techniques and emergency care techniques. Some particular subject areas may include:

  • Cardiology (the top clinical focus for ACNPs, according to the AANP)
  • Trauma care and rehabilitation
  • Intensive care for surgery, infant or cardiac/coronary patients
  • Pulmonology and acute respiratory conditions

What Education and Certifications do ACNPs Need?

As with FNPs, the path to becoming an ACNP starts with earning a bachelor’s degree. The most commonly available program type is BSN-MSN, but there are alternatives available to those who are a registered nurse or hold an ADN or nursing diploma. It’s also possible to transition between the two roles, like in an FNP-to-ACNP program. As such, it’s important for students to research their options and whether the program is offered on-campus or online.

With an MSN, nurses can then sit for ACNP certification exams. It’s also worth noting that professionals with a Doctor of Nursing Practice (DNP) can use their degree for certification as an APRN. While the MSN is the overarching requirement, the DNP is the terminal degree for practice-focused nurses and may soon be the standard practice entry for APRNs. According to the AANP, acute care nurse practitioners can be certified by:

  • The ANCC; or
  • The American Association of Critical-Care Nurses (AACN) Certification Corporation

ACNPs can also specialize in caring for adult patients with acute or critical conditions. This certification is available as the:

  • Adult-Gerontology Acute Care Nurse Practitioner Certification (ANCC); or
  • Acute Care Nurse Practitioner Certification Adult-Gerontology (AACN)

Where do ACNPs Work?

Given their patient population, it makes sense that ACNPs are most commonly found in hospital inpatient units — more than half of ACNPs worked in such settings in 2019, according to the AANP. ACNPs can also find work in urgent care centers, as well as other traditional settings like health systems, community clinics, long-term care facilities and research institutions.

Earn Your MSN from Bradley

A Master of Science in Nursing is absolutely essential to become a nurse practitioner, whether it’s an FNP vs. ACNP or another specialization. If you have ambitions for improving patient care, expanding your clinical expertise and gaining autonomy, consider earning your MSN at Bradley. Prospective students can choose from either a BSN-MSN or RN-MSN program that is offered 100% online and allows students to choose their own site supervisors for clinical hours. Contact an enrollment officer today for more information.


Recommended Reading

Earn an MSN to Work in a Variety of Settings

Practice Independently with an MSN-FNP Degree

Bradley University Online MSN-FNP Program



American Association of Nurse Practitioners – Infographic

AANP – NP Fact Sheet

AANP – NP Certification

Glassdoor – Family Nurse Practitioner Salary

PayScale – Acute Care Nurse Practitioner