What's the real difference between a nurse practitioner vs. RN?

When charting your career path in nursing, it's important to understand what education, skills and experience you will need for different roles. Many nursing students ultimately aspire to become nurse practitioners (NPs), but must first become registered nurses (RNs).

Every NP is an RN, but not every RN is an NP. Some may ask if there is a real difference between the two. Several distinctions exist between nurse practitioner and registered nurse, and knowing exactly what separates an RN versus a nurse practitioner will help you plan out what nursing degree(s) to earn and the competencies you’ll need to build.

In general, there are three main areas that nurse practitioners and registered nurses vary in: scope of work, education requirements and practice authority. Let's examine how best to prepare and what nursing degree(s) you will need, like a master of science in nursing (MSN).

Job outlook for RNs and NPs

Despite the difference in careers between a registered nurse versus a nurse practitioner, the two roles are united by one thing: a positive job outlook. The American health care industry is expanding rapidly; so quickly, in fact, that the demand for care is outpacing the supply of medical professionals. That's led to consistent job growth for nurses, as well as financially rewarding careers. According to the U.S. Bureau of Labor Statistics (BLS), registered nurse employment is expected to grow 12% between 2018 and 2028, well above the average across all occupations. RNs earned a median annual salary of $71,730 in 2018, and the highest 10% earned more than $106,530.

Increased interest in the NP career path may also be attributed to the high rate of job growth for the role. The BLS projects nurse practitioner employment to increase 28% between 2018 and 2028, a faster rate than other comparable positions like certified nurse midwife (CNM) and certified registered nurse anesthetist (CRNA). According to BLS figures, NPs earned a median annual salary of $107,030 in 2018, and the highest 10 percent earned more than $182,750. One financial draw to becoming an NP is total compensation beyond base salary. NPs also stand to earn from bonuses and revenue sharing if part of a physician's office or independent practice.

What separates a nurse practitioner from an RN?

There is significant overlap between the roles of registered nurse and nurse practitioner. After all, NPs have to become RNs before they can progress to the stage of advanced practice registered nurse (APRN). That said, becoming an NP requires the same steps as becoming an RN, except more of it: more education, more specialized skill and knowledge, more clinical experience.

Broadly, these differences can be seen in:

• Nursing degrees earned
• Job duties
• Work environments
• Clinical hours completed
• Practice authority
• Type of certification/licensure

Let's take a closer look at how these differences manifest in education requirements, scope of work and nurse autonomy.

Education requirements

The path to becoming either an RN or an NP begins with education. Nurses must be proficient not only in the technical areas of medicine, but also patient safety, compliance and nursing principles. The fundamental difference here is students must earn a graduate degree to become an NP.

RN education requirements

Many assume a bachelor's degree is the only way to become a nurse. While a popular degree, it's not the only one that can start a career as a registered nurse. Here are three additional  degrees:

• Bachelor of science in nursing (BSN)
• Associate degree in nursing (ADN)
• Nursing diploma from an approved program

Each degree has a different timeline to completion, so be sure to choose the right program for your needs and future plans. While a four-year undergraduate program conferring a BSN may offer a more robust education, nurses studying to earn any entry-level degree should expect to cover these basic areas of RN education:

• Human anatomy and physiology
• Microbiology and chemistry
• Behavioral and life sciences
• Fundamentals of nursing theory and practice
• Care delivery
• Basic pharmacology
• Data management

After earning a BSN, ADN or nursing diploma, you’ll need to pass a certification exam. This entails registering with the nursing board in the state you intend to practice in, and then sitting for and passing the National Council Licensure Examination (NCLEX-RN).

NP education requirements

NPs are advanced practice nurses, and a master's degree is required to become an APRN; this is the most important thing to remember. Fortunately, many master's programs will accept students who hold a BSN, ADN, nursing diploma or a bachelor's in a field related to nursing. Some of the core concepts addressed in a master's degree program include:

• Principles of advanced nursing practice
• Evidence-based practice
• Advanced health assessment
• Statistics and research methodology
• Leadership in nursing
• Introduction to population health, nurse/patient advocacy and health care policy

Nurses may want to focus their MSN degree in a specialization of their choice. For instance, Bradley has an MSN track preparing students to become family nurse practitioners (FNP). The most common type of NP specialization, FNPs deliver primary care to diverse patients across their lifetimes, including new parents, growing families with adolescents, new empty-nesters and seniors in retirement.

NPs can also opt to pursue a Doctor of Nursing Practice (DNP) to achieve the highest level of clinical education and competency.

What they share in common

One education-related requirement for both RNs and NPs is continuing education. These are courses professional nurses must complete to satisfy certification demands. They help nurses stay up to date on best practices and new developments in nursing and health care.

Both RNs and NPs must complete practicums or internships as part of their degrees. Clinical hours with approved supervisors must also be logged for certification reasons.

Scope of practice

Given their advanced level of education and skill, NPs naturally have a greater scope of work than RNs. For example, NPs are educated to diagnose patients or prescribe medications (depending on the state in which they reside), which RNs cannot. Still, registered nurses fulfill many crucial care duties.

RN scope of practice

RNs provide and coordinate care, as well as educate patients and their families. This translates to common on-the-job duties like:

• Recording patient medical history
• Assessing, monitoring and observing patient conditions
• Collaborating with other care professionals
• Administering ordered treatments, medications or diagnostic tests
• Sharing information with patients and families
• Operating medical or surgical equipment
• Interacting with health care technology, like electronic health records (EHRs)

NP scope of practice

NPs have the same general charge to provide and coordinate care, but their graduate education prepares them to take on increased responsibility, including:

• Interpreting diagnostic results such as blood testing and X-rays
• Diagnosing and treating acute and/or chronic conditions (heart disease, diabetes, infections, injuries)
• Developing and implementing patient care plans
• Prescribing and managing medications for multiple patients
• Advising and guiding patients on overall health and wellness
• Counseling patients and their families by directing them toward resources, materials or referrals
• Acting as a leader or mentor to other nurses
• Educating patients on disease prevention and promoting positive, healthy lifestyle choices

Leadership is a crucial element to NP practice. These nurses are often managers, directors, educators or executives, and must demonstrate accountability, strong communication and vision.

What they share in common

The specific job responsibilities of RNs and NPs are shaped by two key influencers: work environment and specialization.

• NPs and RNs both commonly work in hospitals, urgent care clinics and outpatient centers. A surgical RN will have different job duties than a public health nurse, just as an NP in a rural community clinic or long-term care facility will have nuanced job duties.
• Specialization often dictates the type of nursing career a student chooses and its job duties. RNs educated in acute care might find work in an ambulatory surgical center, whereas NPs educated in gerontology can become certified providers of primary care to seniors.

Practice authority

This is the area in which RNs and NPs are perhaps most differentiated: autonomy. This separation can be seen in the scope of practice: Whereas RNs are educated on how to approach a patient provider to order diagnostic tests, NPs can order, interpret and determine a plan of care based on those tests thanks to their advanced degree of clinical education and experience.

RN extent of practice authority

Registered nurses need instructions from an attending physician or other senior care provider to perform their job duties. RN autonomy can vary based on work environment, experience and type of specialization, but a physician's approval is needed for just about every task or job duty.

NP extent of practice authority

There has been a great movement to expand practice authority for NPs. The push has been used as a solution to meet care needs in rural or underserved areas where physicians may not be as accessible.

Full practice authority is the autonomy for an NP to carry out their job duties without the presence or prior instruction of an attending doctor.

Currently, states and territories extending full practice authority include Alaska, Arizona, Colorado, Connecticut, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, Wyoming and the District of Columbia. Guam and the Northern Mariana Islands are also on the list.

The rest fall into two categories:

• States and territories that allow reduced practice: Alabama, Arkansas, Delaware, Illinois, Indiana, Kansas, Kentucky, Louisiana, Mississippi, New Jersey, New York, Ohio, Pennsylvania, Utah, West Virginia, Wisconsin, American Samoa, Puerto Rico and the Virgin Islands. Reduced practice is equivalent to state laws limiting the ability of NPs in at least one element of full practice, such as evaluating patients
• States that allow restricted practice: California, Florida, Georgia, Massachusetts, Michigan, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas and Virginia. Restricted practice is equivalent to the limitations on NPs' practice authority like requiring instructions and approval from another health provider before NPs can deliver care

One thing to keep in mind, however, is some NPs may still be required to enter into collaborative practice agreements with other medical professionals.

Earn your MSN from Bradley

Nurses looking to advance their careers from RN to NP may want to consider earning their graduate degree from Bradley University. Our MSN program is offered 100% online, meaning nurses can complete their master's studies when personal and professional time commitments allow.

Our accredited program is designed with the ultimate goal of preparing you for certification as an FNP and ensuring comprehension of core nursing competencies and principles of advanced practice. This is accomplished through a robust curriculum of coursework and opportunities for logging clinical hours that you can complete at a local site with your own approved supervisor.

Want to learn more about the Bradley online MSN-FNP? Contact an enrollment advisor today.

Recommended reading:

What Careers Offer The Best MSN Nursing Salary?

Earn an MSN-FNP to Work in a Variety of Healthcare Settings

Sources:

Bureau of Labor Statistics

BLS

BLS

BLS

American Association of Nurse Practitioners