Acute Care Nurse Practitioner (NP) – Education, Licensure & Salary
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“Acute care nurse practitioners are not physician extenders, mid-level clinicians, or pseudo-MDs, but rather have an extended educational skillset for advanced clinical assessment and diagnosis of a wide range of medical conditions as well as multidisciplinary coordination of patient care.”
Sharon Bryant, DNP, Director of the Adult-gerontology Acute Care Specialty and Assistant Professor, Vanderbilt School of Nursing
Acute care refers to treating an illness or injury requiring immediate attention. It is typically provided in an emergency setting such as a hospital, urgent care center, or other healthcare facility. In contrast, primary care encompasses preventative treatments and management of chronic illnesses. Acute care nurse practitioners (ACNPs) are an important part of providing quality healthcare, as they possess the specialized knowledge and experience to provide urgent or emergency care to patients in various clinical settings.
ACNPs are skilled in managing complex, serious, or life-threatening illnesses and injuries. They utilize evidence-based practices to provide the best possible outcomes for their patients. They can diagnose various medical conditions, order diagnostic tests and lab work, prescribe medications and treatments, and provide patient education on preventive care.
Becoming an ACNP starts with becoming a registered nurse and subsequently completing a graduate program for acute care nurse practitioners. Depending on the population focus of the program they complete, ACNPs will specialize in either adult-gerontology or pediatrics. Students can complete a master’s of science in nursing, a doctor of nursing practice degree, or a post-graduate certificate.
Nurse practitioners (NPs), including ACNPs, are in very high demand. Between 2022 and 2032, the Bureau of Labor Statistics (BLS 2024) estimates that there will be a 38 percent increase in jobs for NPs. This will be at least 123,600 new open positions. The demand is largely driven by the aging Baby Boomer generation, who are not only retiring from the workforce but also placing an increased demand on the healthcare system.
Keep reading to learn more about becoming an ACNP and providing timely, high-quality care to patients when they need it most.
Meet the Expert: Sharon Bryant, DNP, ACNP-BC
Dr. Sharon Bryant is the director of the adult-gerontology acute care specialty and an assistant professor at Vanderbilt School of Nursing. She is a board-certified acute care nurse practitioner (ACNP) specializing in hospital-based patient care. She holds a clinical practice at Vanderbilt University Medical Center, working in the inpatient spine and trauma departments. Her professional interests include spinal cord injury, acute and chronic pain management, and hospital-based care.
Dr. Bryant holds a doctor of nursing practice (DNP) from Georgia Health Sciences University and a master of science in nursing (MSN) from Vanderbilt University School of Nursing.
NursingColleges.com: What is something you wish the public understood about acute care NPs?
Dr. Bryant: AGACNP providers are advanced practice registered nurses (APRNs) with specialized certification in caring for adult and geriatric patients with complex acute and chronic health conditions. AGACNPs are educated to manage acute situations in various healthcare settings, including hospitals, intensive care units, inpatient rehabilitation (IPR) facilities, long-term acute care (LTAC) facilities, and specialty clinics.
Acute care nurse practitioners are not physician extenders, mid-level clinicians, or pseudo-MDs, but rather have an extended educational skillset for advanced clinical assessment and diagnosis of a wide range of medical conditions as well as multidisciplinary coordination of patient care with additional providers such as physicians, advanced practice providers, therapists, case management and social work. AGACNPs serve as educators for families and patients who recognize barriers to care and provide methods that support patients and caregivers based on their needs.
NursingColleges.com: What advice would you give to aspiring acute care NP students?
Dr. Bryant: Ensure you have a solid foundation in nursing practice. Healthcare experience, regardless of the source, can be very beneficial in laying the groundwork for AGACNP practice. Critical thinking, clinical judgment, and advanced assessment of both patients and situations are all core skills that every AGACNP must identify and develop.
When searching for educational programs, make sure that you know what you are looking for in a program and the program requirements are realistic for you to meet. Ensure the program provides faculty support and allows you to grow as a learner. I tell students to get comfortable feeling uncomfortable as that is their time of growth. Identify potential pitfalls such as cost, distance vs on-campus learning requirements, clinical placement support, and work/life balance. Have a management plan in place to handle those issues.
The time in an AGACNP program looks long on paper, but it is, in fact, very short, so enjoy the journey. Starting healthy habits while in your AGACNP program will support you as you enter your career path.
How to Become an Acute Care Nurse Practitioner (NP)
The first step to becoming an ACNP is to earn an associate’s or bachelor’s degree in nursing from an accredited college or university. A bachelor’s degree program typically takes four years of full-time study, while an associate’s typically takes two. These programs include a combination of classroom lectures and clinical rotations.
Upon completing the program, students should be well-versed in all aspects of nursing practice, including pharmacology, anatomy, physiology, patient assessment, and disease management, and be prepared to become licensed registered nurses (RNs).
After earning their degree in nursing, future ACNPs must obtain licensure as an RN. Graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) This test evaluates candidates’ knowledge about infection control, nutrition, cardiovascular, health care delivery systems, pharmacological therapies for various illnesses and disorders, and more. Upon completing the NCLEX-RN examination, individuals can apply for a license from their state nursing board and seek entry-level work.
The next step to becoming an ACNP is to complete a master’s in nursing (MSN) or doctor or nursing practice (DNP) degree. While an MSN requires one to two years of full-time study, a DNP often takes three years or more. Courses students must complete include advanced pharmacology, acute care physical assessment, pathophysiology, epidemiology, health promotion, advanced physical diagnosis, health care policy and regulation, advanced nursing research methods, ethics of healthcare delivery systems, and leadership development for nurse practitioners.
Upon successful completion of a graduate degree or post-master’s certificate, students will be eligible to take the certification examination offered by either the American Association of Nurse Practitioners (AANP), the American Nurses Credentialing Center (ANCC), or Pediatric Nursing Certification Board (PNCB). National certification is required for state licensure. Aspiring ACNPs will choose their certification based on specialty and state licensing requirements.
What Does an Acute Care Nurse Practitioner Do?
ACNPs typically work in various settings, including hospitals, outpatient clinics, long-term care facilities, prisons, and home health agencies. They may also specialize in working with particular populations, such as the elderly or children who need immediate care for an injury, short-term illness, or a severe episode of a chronic illness. Day to duties can include:
- Evaluating and diagnosing acute illnesses and injuries for patients in both inpatient and outpatient settings
- Provide emergency care for patients with acute medical issues
- Prescribing medications to treat acute conditions
- Ordering laboratory tests and interpreting results
- Coordinating patient care with other healthcare professionals, particularly if long-term care is required
- Creating individualized treatment plans for each patient
- Consulting with medical specialists when necessary
- Educating patients about their condition and guiding lifestyle modifications or other treatment options
- Participating in continuing education activities to stay abreast of new developments in healthcare
How Much Do Acute Care Nurse Practitioners Make?
The average salary of all nurse practitioners, including ACNPs, based on data from the Bureau of Labor Statistics (BLS May 2023), is $128,490 annually. The percentiles for wages are:
- 10th percentile: $94,530
- 25th percentile: $106,960
- 50th percentile (median): $126,260
- 75th percentile: $140,610
- 90th percentile: $168,030
Acute Care Nurse Practitioner Licensure and Certification Requirements
ACNP Licensing
To practice as an ACNP, all practitioners must be licensed as nurse practitioners in the state where they will provide care. Licensing laws vary from state to state, so it is imperative that candidates contact their local board to ensure they have the necessary qualifications. In general, the requirements include:
- Hold a current, active, and unencumbered registered nurse license
- Complete an accredited or approved master’s, post-graduate certificate, or doctor of nursing practice nurse practitioner program
- Pass a background check and drug screening
- Earn a national certification (more information below)
- Submit a completed application with application and licensing fees
ACNP Certifications and Eligibility
National certification is required in every state to be licensed as a nurse practitioner and work as an ACNP. ACNP certification is available through the American Nurses Credentialing Center (ANCC), the American Association of Critical Care Nurses (AACN), and the Pediatric Nursing Certification Board (PNCB).
Nurse practitioners can earn the Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP-BC) through the ANCC. The eligibility requirements for this certification are:
- Hold a current, active registered nurse license in the US
- Hold a master’s, post-graduate certificate, or doctor of nursing practice from an adult-gerontology acute care nurse practitioner (AGACNP) program accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN), or the National League for Nursing (NLN) Commission for Nursing Education Accreditation (CNEA); this program must include a minimum of 500 faculty-supervised clinical hours
- Three separate, comprehensive graduate-level courses in advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology
The Adult-Gerontology Acute Care Nurse Practitioner (ACNPC-AG) certification from the AACN eligibility requirements are:
- A current, active, and unencumbered registered nurse or advanced practice registered nurse license
- Completion of a graduate-level advanced practice education program that is accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN)
- Pay the exam fee of $265 for members and $375 for non-members
ACNPs who work in pediatrics can earn the Acute Care Certified Pediatric Nurse Practitioner (CPNP-AC) from the PNCB. To be eligible for this certification, candidates must:
- Have a current, active, unencumbered RN license issued by a US state, US territory, or Canada
- Graduate from an ACEN or CCNE accredited nursing master’s degree, doctoral degree, or post-master’s certificate with a concentration in pediatric acute care as a nurse practitioner or formal dual primary/acute care program or have a minimum of 500 supervised direct care clinical practice hours in acute care pediatric
- Complete three separate comprehensive graduate-level courses in advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology
ACNP Certification Renewal
The AGACNP-BC certification from the ANCC must be renewed every five years. Renewal requirements include:
- Hold a current, active registered nurse license in the US
- Hold a current ANCC board certification
- Complete 75 hours of continuing education
- Complete at least one of the eight Professional Development Categories
- Pay the renewal fee
The AACN requires ACNPC-AGs to renew their license every five years. Certificate holders must pay a renewal fee and meet one of the following renewal options:
- Have 1,000 practice pours and 150 continuing education points
- 1,000 practice hours, 25 pharmacology continuing education points, and pass the ACNPC-AG exam again
- 150 continuing education points and pass the ACNPC-AG exam again
Recertification for CPNP-AC certificate holders from the PNCB is an annual process. To recertify, certificate holders must have a current, active, and unencumbered license and complete 15 contact hours each cycle. Every seven years, certificate holders must also provide proof of 15 hours of pediatric pharmacology and complete four PNCB modules, of which two must be in acute care.
Kimmy Gustafson
WriterThanks to her experience writing in healthcare, Kimmy Gustafson has delivered in-depth articles on timely topics for NursingColleges.com since 2022. Her aim is to assist both students and professionals in navigating the intricate process of selecting a nursing program and understanding the ever-evolving realm of nursing education.
Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.