Nurse Practitioner Specialties: Types of Nurse Practitioner Roles and Responsibilities

Four smiling nurse practitioners in front of a hospital.The U.S. is currently dealing with a shortage of qualified health care professionals at all levels of the health care industry; for example, the Association of American Medical Colleges projects a primary care physician shortage between 21,400 and 55,200 by 2033. The U.S. Bureau of Labor Statistics (BLS) also projects 45% job growth for nurse anesthetists, nurse midwives and nurse practitioners between 2019 and 2029. Additionally, a projected physician shortage of between 46,000 and 121,900 is expected by 2032.

Because of these shortages and the potentially crucial fallout caused by understaffing, the role of the qualified nurse practitioner is more essential than ever. Nurse practitioners can provide guidance and leadership to other nurses to help them provide optimal care. They can also provide care to patients in lieu of a primary care physician in states that allow full practice and full prescriptive authority. They can even work with patients to help them develop proactive care strategies that can limit their need for visits, which can also help lower their health care costs.

Nurses can choose from several nurse practitioner specialties that can provide a deeper level of care for specific patient demographics. The following nurse practitioner specialties are available:

  • Family Nurse Practitioner (FNP)
  • Neonatal Nurse Practitioner (NNP)
  • Acute Care Nurse Practitioner (ACNP)
  • Pediatric Nurse Practitioner (PNP)
  • Women’s Health Nurse Practitioner (WHNP)
  • Psychiatric Mental Health Nurse Practitioner (PMHNP)
  • Adult Gerontology Nurse Practitioner (AGNP)

What Is a Family Nurse Practitioner?

Family nurse practitioner (FNP) is a broad practitioner category, designed for advanced practice nurses interested in providing family-centered care to a wide range of patient demographics. These practitioners are equipped to treat individuals throughout the different stages of life — from infancy to adolescence to adulthood to old age. The fundamental duties that an FNP can perform include the following:

  • Performing physical exams
  • Ordering diagnostic tests
  • Developing treatment strategies
  • Maintaining patient records
  • Treating chronic and acute illnesses and conditions

In some states, FNPs can prescribe medications independently. In states that don’t allow nurse practitioners to have full prescriptive authority, FNPs must collaborate with a physician to prescribe medication.

Because of the versatility inherent in the FNP role, those in the position can work in a wide range of clinical environments. These include the following:

  • Independently via their own private practice
  • Primary Care
  • Clinical facility
  • Hospital
  • Community health center
  • Health Department
  • Long Term Care Facility

It should be noted that state laws may influence some of these environments. FNPs may not be able to work independently in states that don’t offer full practice or full prescriptive authority.

Typically, a minimum of a Master of Science in Nursing (MSN) is required to pursue a role as an FNP. Certification and licensing are also required to practice as an FNP in all states, additional requirements may vary from state to state. An effective FNP will have strong critical thinking, communication, analytical and decision-making skills, as well as strong interpersonal competencies to effectively interact with a broad scope of patients.

According to PayScale, the median annual salary for an FNP as of August 2020 was around $94,800. Factors like education level, years of experience, certification and location can affect the salary.

What Is a Neonatal Nurse Practitioner?

Neonatal nurse practitioners (NNPs) specialize in providing care to infants dealing with various health conditions. Their duties may include the following:

  • Providing care for infants with low birth weight
  • Providing care for infants with heart abnormalities
  • Providing care for infants with complications resulting from premature birth
  • Providing care for infants with infections
  • Developing care strategies for infants up to 24 months old
  • Providing education and support to parents of infants needing treatment

Because of the nature of the care they deliver, NNPs tend to work in critical care areas of a hospital, including the following:

  • Emergency rooms
  • Neonatal intensive care units (NICUs)

They may also administer care within four specified levels of a NICU, subdivided based on an infant’s needs. For instance, some NNPs specialize in providing stability to critically ill infants in need of breathing or feeding assistance. Others specialize in providing care to babies born severely premature, in the 22- to 24-week range.

An MSN and certification such as NNP-BCNeonatal Nurse Practitioner – Board Certified (NNP-BC) certification are required to become an NNP. All NNPs must be licensed in their state of practice. In addition to possessing strong analytical, observation, communications and critical thinking skills, NNPs must have a deep knowledge of infant-related health conditions and issues. NNPs must also familiarize themselves with technological advances associated with neonatal care.

PayScale lists the median annual salary of NNPs as of August 2020 as approximately $102,100. In addition to factors like education level, years of experience and job location, the specified level of neonatal care an NNP works in may also affect the salary.

An overview of the primary care shortage in the U.S.

What Is an Acute Care Nurse Practitioner?

Acute care nurse practitioners (ACNPs) specialize in treating patients afflicted with sudden critical care illnesses or injuries. Their duties include the following:

  • Treating direct issues, such as a heart attack or respiratory issues
  • Treating the effects of a secondary trauma, such as a car accident
  • Providing emergency services for patients dealing with acute conditions, such as administering defibrillation or intubation procedures
  • Developing long-term treatment plans of chronic conditions caused by an acute episode

ACNPs are often grouped with adult-gerontology acute care nurse practitioners (AGACNPs), who specialize in acute care for young adults through geriatric patients. In some cases, AGACNPs can also be trained to provide acute care on a pediatric level.

The nature of ACNP and AGACNP specializations allow them to work in a wide range of clinical environments. These environments include the following:

  • Urgent care clinics
  • Emergency rooms
  • ICU wards
  • Outpatient facilities
  • Long-term care facilities

In addition to the minimum requirement of an MSN, ACNPs must be licensed in their state of practice. Certification requirements are met by receiving Acute Care Nurse Practitioner Certified in Adult-Gerontology (ACNPC-AG) certification, as ACNP-specific certification is usually no longer offered for new nurse practitioners. However, those with existing ACNP certification can still have it renewed. It’s important for ACNPs to have advanced communication, teamwork, critical thinking and decision-making skills and equally crucial that they have a deep understanding of key acute care procedures and systems knowledge, along with strong characteristics like flexibility and perseverance.

According to PayScale, the median annual salary for ACNPs as of August 2020 is roughly $102,400. Factors like education level, years of experience and job location can affect the salary.

What Is a Pediatric Nurse Practitioner?

A pediatric nurse practitioner (PNP) specializes in delivering care to children over the course of childhood development, from birth to young adulthood. They possess a deep knowledge of various issues, chronic conditions and illnesses chiefly associated with children. Their primary responsibilities can include the following:

  • Treating issues primarily associated with children, such as ear pain caused by ear infection
  • Treating childhood illnesses, such as croup or Kawasaki disease
  • Developing treatment plans for children
  • Discussing treatment needs and strategies with patients’ families

PNPs may also work with other pediatric health professionals to develop treatment plans. This can include collaborating with physicians to administer certain treatments or prescriptions in states that don’t allow for full practice or full prescriptive authority. PNPs can also be called upon to discuss treatment needs and strategies with patients’ families.

A PNP can work in a wide range of environments, including the following:

  • Private practice organizations
  • Large health care facilities, like hospitals
  • Children’s hospitals
  • Social service agencies
  • Government or public health agencies

An MSN and certification such as Certified Pediatric Nurse Practitioner – Primary Care (CPNP-PC) certification are needed to practice as a PNP. State licensing is also required, with requirements that vary by state. PNPs need advanced communication, interpersonal and detail-oriented skills, and they must be resourceful and compassionate to properly administer care to their young patients.

According to PayScale, the median annual salary for PNPs as of August 2020 is about $90,100. Factors like education level, years of experience and job location can affect the salary.

Salaries for six popular nurse practitioner specialties.

What Is a Women’s Health Nurse Practitioner?

Women’s health nurse practitioners (WHNPs) use their knowledge and skills to meet the health care needs of women throughout the course of their lives. Their duties can include the following:

  • Providing contraceptive care
  • Administering fertility assessments
  • Providing pregnancy care, including prenatal and postnatal care
  • Providing menopausal care
  • Conducting breast cancer screenings
  • Conducting Pap smears
  • Providing gynecological care, including contraceptive care, fertility assessments and menopausal care
  • Providing pregnancy care, including prenatal and postnatal care

WHNPs can also incorporate a unique social perspective into their level of care and care delivery strategies. Factors involving cultural competency, such as race, social class and religious beliefs, can influence the approach a WHNP takes to delivering care or developing a care strategy.

WHNPs can provide care in common health care settings, such as hospitals. They can also work in several unique environments that are conducive to focusing on women’s health, including the following:

  • OB-GYN clinics
  • Prenatal clinics
  • Family planning centers, such as Planned Parenthood
  • Women’s health clinics
  • Women’s prisons

An MSN, certification and state-specific licensure are required to practice as a WHNP. In addition to having advanced knowledge pertaining to women’s health issues, WHNPs must have advanced communication and decision-making skills, along with characteristics like compassion and advanced cultural awareness.

PayScale lists the median annual salary for WHNPs as of August 2020 at around $91,600. Factors like education level, years of experience and job location can affect the salary.

What Is a Psychiatric Mental Health Nurse Practitioner

Psychiatric mental health nurse practitioners (PMHNPs) work to develop mental health treatment strategies for patients of all ages. Their duties can include the following:

  • Assessing a patient’s mental health
  • Diagnosing a patient’s specific mental health needs
  • Developing patient treatment needs, which can often include psychotherapy
  • Prescribing medication

It should be noted that PMHNPs can only prescribe medication to patients in states that grant full prescriptive authority. In states where full practice or prescriptive authority are prohibited, PMHNPs must work with a physician or a psychiatrist to carry out some of their tasks.

PMHNPs work in a wide variety of work environments, including the following:

  • Hospitals
  • Private practice firms
  • State-run psychiatric facilities
  • S. Department of Veterans Affairs psychiatric facilities
  • Correctional facilities
  • Domestic violence shelters

To become a PMHNP, individuals must obtain at least an MSN and certification, such as the Psychiatric Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC). They must also be licensed in their state of practice. It’s essential for PMHNPs to have advanced analytical, communication and interpersonal skills to be effective. They must also be able to have a well-developed sense of empathy and compassion as well as a deep knowledge of therapeutic techniques and strategies.

According to PayScale, the median annual salary for PMHNPs as of August 2020 is approximately $107,300. Factors like education level, years of experience and job location may affect the salary.

An Important Part of Health Care’s Future

Regardless of the specialty aspiring nurse practitioners ultimately choose, their entry into the field can make a substantial impact in health care. Their knowledge and skills can help mitigate the effects of the nursing and the primary care provider shortages that are looming on the industry’s horizon.

By tightening the gap that could be caused by these shortages, nurse practitioners can help ensure optimal health care is provided to all patient demographics, from infants in need of specialized neonatal care to patients seeking therapeutic help for their mental health. Ultimately, the work of a nurse practitioner can help facilities of all kinds deliver care strategies that improve patient outcomes. The ability to make a difference on a concrete level makes the nurse practitioner role one of the most satisfying professions in the health care industry.