Acute Care Nurse Practitioner vs Family Nurse Practitioner

There is often a lot of confusion between the roles of the Acute Care Nurse Practitioner (ACNP) and that of the Family Nurse Practitioner (FNP). The ACNP and the FNP are two specializations within the field of nursing. So what are their similarities and differences?

Training and Qualifications

An ACNP has to be licensed as a registered nurse by passing the NCLEX-RN examination. Next is training on the job. Today, thanks to the commitment to improving the standard of nursing skills, the ACNP has to complete a master’s degree, as well.

On the other hand, an FNP has a specialized degree. Many hold a doctorate degree, in fact, although this is not a legal requirement. Completing a master’s degree is a requirement, however. Furthermore, most states also require certification for FNPs, which can be obtained through the American Academy of Nurse Practitioners (AANP).

Course Work

When registered nurses decide to advance their career by gaining a master’s degree, they will have to choose a specialization, such as FNP or ACNP. Their chosen specialization will influence which courses they will take outside of the core requirement of the master of science in nursing (MSN).

For the ACNP, courses include:

  • Chronic healthcare management
  • Mass casualty care
  • Biostatistics
  • Economics of healthcare

An ACNP will also have to undergo specialized on the job training in areas, such as:

  • Pharmacology
  • Health assessments
  • EKG monitoring
  • Laboratory testing
  • Diseases
  • Aging

For the FNP, courses include:

  • Obstetrics
  • Gynecology
  • Pediatric care
  • Geriatric care
  • Family health management
  • Pharmacology for the elderly and children

An FNP will also need to have specialized on the job training that focuses on family care.

Where They Work

An ACNP will most often work in a hospital’s intensive care unit or emergency room. Alternatively, this professional can find work in care homes, home settings, and hospices.

An FNP usually works hand in hand with a physician. In states where they can work fully independently, they may run their own practices. They can also be found in walk-in centers, urgent care centers, and large pharmacies.

Reporting Lines and Management

An ACNP will usually report to the head nurse or charge nurse. They have a clinical role and therefore also consult with physicians. However, any duties they are assigned come from the head nurse.

An FNP is an independent nurse. Depending on the state they work in, they may need to be directly supervised by a physician.

Both the ACNP and the FNP share offices with physicians, and operate as a team rather than in a supervisor-subordinate relationship.

What They Do

An ACNP also works in a clinical role, but with those who suffer from a critical illness or have another type of emergency medical need. Their patients may suffer from acute or chronic illnesses, but they all have complex needs and require intensive care. It is common for the condition of patients to suddenly deteriorate, which is why resuscitation is an integral part of the role of the ACNP.

An FNP is usually the first point of contact for someone entering the health care system. Their role is not dissimilar to that of the general physician, as they offer primary care. An FNP can usually also refer to other services, order tests, and, in some states, write prescriptions (sometimes only with a physician countersignature). An FNP is responsible for the triage of patients, ensuring people get the right care they need.

When They Work

ACNPs work with critically ill patients, and these patients also require around the clock care. Hence, the working patterns of the ACNP tend to be around shifts, with irregular and unsociable hours. Often, their shift ends in the middle of a procedure, which means they have to work outside of their contracted hours as well.

An FNP is more likely to be contracted for specific working areas. That said, some walk-in centers and most pharmacies and urgent care centers now have evening and weekend opening hours, and this means that an FNP may have to work some shifts as well.

Earning Potential and Outlook

According to, the average salary of an ACNP ranges from $81,778 to $118,686 per year. On the other hand, the average salary of an FNP ranges from $72,948 to $109,321 per year. For both professions, the salary will vary greatly depending on geographical location, years of experience, and exact place of work. Additionally, both positions also attract a range of bonuses and other benefits. FNPs also often enjoy profit sharing. According to the U.S. Bureau of Labor Statistics, the average annual earning for any type of nurse practitioner is $98,190 per year.

Similarities between the Two Jobs

What the above discussion shows is that there are significant differences between the two positions, across every element of their profession. So how come they are so often confused, so much so, in fact, that reports have had to be written about this? That is mainly due to the similarities that also exist between the two jobs, such as the fact that:

  • They both work in direct patient care, speaking with families, and recording medical histories.
  • They both perform physical examinations and work with laboratory tests.
  • They both require the same initial education, which is the Associate Degree in Nursing (ADN) or Bachelor’s Degree in Nursing (BSN), and that they both become registered nurses (RNs) after passing the NCLEX-RN examination.
  • They both deal with patients across the ages, from pediatric to geriatric.
  • They both require the successful completion of a specialized certification exam, which must be maintained through continuous education credits.

However, those are where the similarities end between the two. ACNPs and FNPs have very different focuses with their work. Their exact roles are also very different, most particularly about the reasons for patients needing their care. That said, both are nurses so it is no wonder that there are significant similarities as well.