Nurse Practitioner Programs: The Difference Between NPs and FNPs

Nurse Practitioner Programs: The Difference Between NPs and FNPs

We hear the terms NP and FNP all the time in nursing. Is there a difference between a nurse practitioner (NP) and a family nurse practitioner (FNP)? The answer is both yes and no.

A nurse practitioner is a catch-all name for any advanced practice nurse who completed advanced nursing studies in a master’s or doctoral program, sat for a state board exam and earned an NP license to practice in a chosen state.

What do NPs do?

Nurse practitioners are educated, trained and licensed to diagnose and treat chronic and acute illnesses and injuries. They see a wide variety of patients from every age group with various conditions, depending on their specialty. They can prescribe medications and order and interpret lab tests and X-rays.

According the American Association of Nurse Practitioners (AANP), NPs have prescriptive authority in all 50 states and the District of Columbia, including the ability to prescribe controlled substances.

In some states, NPs have a full practice authority, which means they are authorized to practice independently. In other states with more restricted scope of practice laws, NPs can only practice under the supervision of a physician.

An NP can specialize in several areas of care, one of which is a family nurse practitioner (FNP). However, there are several other specialties NPs can pursue.

In states that offer full-practice authority and autonomy, NPs of various specialties often have their own private practices.

Disciplines for NPs

Among the different types of NP specializations that exist are the following:

Family nurse practitioner

FNPs provide care for patients and families across the lifespan. You’ll find them working in medical offices, urgent care centers, various types of medical clinics and even in hospitals. FNPs provide comprehensive care for acute and chronic conditions such as, but not limited to, asthma, infections, hypertension and injuries.

Adult gerontology acute care nurse practitioner (AGANP)

AGANPs care for adults and geriatric patients in acute care. You’ll likely be required to have recent acute and critical care experience as an RN before application.

Two options for study are available. One is training as an intensivist caring for critical care patients, and the other is training as a hospitalist, caring for patients in units other than the ICU.

Adult gerontology primary care nurse practitioner (AGPNP)

This group delivers primary care to adults and gerontology patients in primary care environments, such as medical offices, outpatient centers, long-term care and skilled nursing facilities.

Pediatric nurse practitioner (PNP)

PNPs can choose the following two areas of practice:

• PNP-AC: This is a pediatric nurse practitioner in acute care, which cares for children and adolescents up to 21 with acute, critical and chronic illnesses and injuries. PNPs work in hospitals treating pediatric patients with a wide variety of serious conditions, some of which are life-threatening.
• PNP-PC: These clinicians deliver primary care to pediatric patients also up to age 21. PNP-PCs work in outpatient environments such as various types of clinics, schools and medical offices. They treat acute and chronic illnesses, injuries and provide health education.

Neonatal nurse practitioner (NNP)

NNPs care for neonates, which are babies up to one month of age. NNPs provide comprehensive care to pre-term and full-term infants that might have life-threatening conditions.

Most schools require two years of recent neonatal intensive care experience before submitting an application to NNP school. As an NNP, you’ll be involved with high-risk births that might require you to perform neonatal resuscitations.

Women’s healthcare nurse practitioner (WHCNP and WHNP)

WHCNP/WHNPs provide care to women from adolescence through adulthood. Some examples of the work they do is well woman care, managing menopausal concerns, diagnosing and treating sexually transmitted diseases and performing Pap tests and breast exams.

Psychiatric-mental healthcare nurse (PMHNP)

PMHNPs provide care to patients with psychiatric conditions and mental health concerns across the lifespan. They work in inpatient facilities for hospitalized psychiatric patients as well as outpatient clinics.

Some PMHNPs focus on caring for specific populations such as children, adolescents or adults, while others focus on addictive disorders or family dynamic issues. They also can provide counseling to their patients and families.

Average salaries for NPs

While it takes a minimum of a master’s degree — which costs time and money to achieve — the salaries of NPs are robust. According to the latest stats from the U.S. Bureau of Labor Statistics, as of May 2019, the average salaries for NPs in the U.S. ranged from $81,400 to $152,160. The median annual salary for NPs was $109,820.

Salaries often depend on the state an NP is practicing in.

The five highest-paying states for NPs are California, with an average mean wage of $138,660, followed by Washington ($126,920), Hawaii ($124,000), New Jersey ($123,810) and Minnesota ($122,850).

Typically, salaries for many occupations are lower in rural areas and higher in urban areas. The same generally holds true for the nursing profession. However, there are some outliers when it comes to NP salaries.

The Vallejo-Fairfield metropolitan area in California pays NPs an annual mean wage of $175,060. The non-metropolitan area of the Eastern Sierra-Mother Lode Region in California pays an annual mean wage of $137,450.

Three NP program formats

When you research options regarding nurse practitioner programs, you’ll notice that in addition to the on-site clinical training NP programs require, the didactic portion of various programs are offered in different educational formats. They include:

Online

With these NP and FNP programs, the curriculum is delivered entirely online. These programs typically will require some prescheduled, on-campus meetings for hands-on skills training and testing. These on-campus meetings will be in addition to clinical rotations when you work in the field under the auspices of a preceptor.

One thing to bear in mind with online programs is to find out if classes are non-synchronized or synchronized.

In non-synchronized classes you can attend the classroom online at any time when it’s convenient for you, as long as you complete ongoing assignments by the deadlines.

In synchronized classes you’ll have to attend your online classroom at specific, designated times.

On-site

Some NP programs still offer their entire curriculum the old-fashion way — completely on-site. This means you’ll need to attend a physical classroom on campus for all your lectures and classes. These are in addition to your clinical rotations.

Hybrid

These NP programs are structured to integrate both online and on-site class formats to deliver your NP education. Just as in the other two formats above, these classes are on top of your external clinical requirements.

Types of NP programs

Depending on your immediate and long-term goals, budget and time allotted to reach the goal of becoming an NP, there are a wide variety of programs to choose from. Here is a sampling of options available at various schools.

• RN to MSN: These programs are for students who already have an RN license and are offered in different specialties, culminating in a master of science in nursing.
• RN to DNP: These programs are offered in various NP specialties for RNs and culminate in a doctor of nursing practice.
• BSN to MSN: These programs are for RNs that already have a bachelor of science in nursing and are offered in different NP specialties. The programs award a master of science in nursing upon completion.
• BSN to DNP: These programs require students to hold a bachelor of science in nursing before application, are offered in various NP specialties and culminate in a doctor of nursing practice.
• Post-master’s certificate: These NP programs are offered in several specialties and require the student to hold an RN license and a master of science degree in nursing.
• MSN to DNP: Students are required to hold a master’s degree in nursing before application. These programs are offered in different NP specialties and culminate in a doctor of nursing practice.

As you conduct online research into various schools and programs by visiting their websites, you’ll want to find out what the specific requirements are to meet before application.

Most schools require a grade-point average of 3.0 on previous course work, one or more letters of reference, a resume and experience working as an RN for a specific amount of time.

The only schools that have an exception to the requirement of having an RN license before application are entry-level NP programs. These are geared for people who have a bachelor’s degree in another discipline. The programs integrate RN licensure into their MSN/NP program curriculum.

Some APRN schools and programs require the Graduate Writing Exam (GWE) while others do not. Further, most schools will require the completion of specific prerequisite courses to be completed before application.

Tuition and fees

It pays to shop around with regards to tuition and fees. Tuition for NP schools can range from approximately $17,000 to $50,000 per year. Some states might charge higher tuition for out-of-state students.

The cost for books can range anywhere from $1,000 to $3,000 per year. Fees vary as well, ranging from roughly $1,000 to $2,000.

Many schools offer grants and scholarships for nursing students. Before taking out a loan or dipping into your savings, make sure to inquire about the availability of grants and scholarships first.

Supply and demand by state

With the current shortage of primary care physicians, the demand for NPs has increased. Several states are projected to have significant shortages of primary care providers by 2025. This translates into more job opportunities for NPs.