APRN vs PA: What's the Difference?

A smiling APRN shows a patient a document on a tablet.

Advanced practice registered nurses (APRNs) and physician assistants (PAs) are two of the most popular choices for careers in health care. They provide an opportunity to deliver care to a variety of patients and have a positive outlook in terms of job growth and security.

However, making the APRN vs. PA comparison uncovers key differences in job duties, scope of practice, educational and certification requirements, and salary. APRNs are registered nurses (RNs) who have a Master of Science in Nursing and specialize in a certain area of care. PAs have a Master of Science in Physician Assistant Studies and are not nurses. They’re usually generalists rather than specialists, and they work closely with teams of physicians. While both APRNs and PAs provide care to patients, they have different roles and areas of focus.

For current and aspiring health care professionals deciding on a path, understanding the two can help clarify which role best fits their career ambitions.

APRN vs. PA: Job Role and Responsibilities

A comparison of APRN vs. PA responsibilities helps clarify their different roles in the health care system.

PA: Job Role and Responsibilities

A PA is a licensed clinician who works under the direct supervision of a team of surgeons or physicians. They work in state, local, and private hospitals; community health centers; nursing homes; retail and workplace clinics; and correctional institutions.

A physician assistant’s daily responsibilities can include:

  • Performing clinical research
  • Making rounds
  • Taking medical histories
  • Conducting physical examinations
  • Diagnosing and treating illnesses
  • Ordering and interpreting tests
  • Prescribing medications
  • Educating patients on preventive care
  • Developing treatment plans
  • Performing non-surgical procedures
  • Assisting doctors during surgery

PAs are committed to team practice and often work with a certain group of physicians or health care providers. Most states require PAs to have a formal agreement with at least one specific physician to practice.

APRN: Job Role and Responsibilities

APRNs are licensed nurses with at least a master’s degree. They can specialize in a particular area of medicine or with a specific patient base. There are four different types of APRN:

  • Certified nurse practitioner (CNP)
  • Clinical nurse specialist (CNS)
  • Certified registered nurse anesthetist (CRNA)
  • Certified nurse-midwife (CNM)

Scope of practice is determined by the individual’s state practice and licensure laws. In full practice authority states, APRNs can evaluate, diagnose, and treat patients, including prescribing medications. In reduced or restricted practice states, APRNs have some elements of practice ability restricted or may be required to be supervised by a physician.

Certified Nurse Practitioner

A CNP is a registered nurse with advanced education and training in a specific area of medicine or with a specific patient population. Nurse practitioner areas of specialization include:

  • Adult-gerontology
  • Pediatric
  • Neonatal
  • Psychiatric mental health
  • Family
  • Women’s health

Specific CNP specialties require additional certifications. For example, family nurse practitioners must earn Family Nurse Practitioner Certification (FNP-BC™) from the American Nurses Credentialing Center to practice legally.

Although a CNP’s specialty largely dictates their role and responsibilities, their duties may include:

  • Educating patients on preventive health and wellness plans
  • Taking medical histories
  • Examining and diagnosing patients
  • Ordering and interpreting diagnostic tests
  • Treating acute and chronic conditions
  • Prescribing medications
  • Providing ongoing guidance about medications and health habits

Clinical Nurse Specialist

A CNS’ specialty is typically determined by:

  • Health care setting (emergency room, critical care)
  • Specific disease (cancer, COVID-19, heart conditions)
  • Subspecialty of medicine (dermatology, oncology, psychiatry)
  • Type of care (rehabilitation, acute, chronic)
  • Type of medical issue (pain, stress, mental health)

Widely considered nurse leaders in the health care community, clinical nurse specialists are trained in physical assessment, pharmacology, and physiology. In addition to diagnosing, treating, and managing patients’ overall wellness plans, they also support other nurses and drive important changes in hospitals and health care facilities.

CNSs must not only have a Master of Science in Nursing but also be certified in their area of specialization. The most popular certifications include adult/gerontology care, pediatrics, and neonatal care.

Certified Registered Nurse Anesthetist

CRNAs specialize in administering anesthesia to patients who are undergoing surgery or other procedures. They work in a wide variety of settings, including emergency rooms, operating rooms, intensive care units, outpatient surgical clinics, and cardiac care units.

A CRNA’s specific duties include:

  • Educating patients about what to expect before, during, and after anesthesia has been administered
  • Identifying potential risks to patients
  • Administering precise doses of anesthesia and assessing patients’ responses
  • Monitoring patients while they’re under anesthesia, as well as during their recovery

In addition to holding an MSN degree, CRNAs must be certified by the National Board of Certification and Recertification for Nurse Anesthetists before working with patients.

Certified Nurse-Midwife

CNMs focus exclusively on gynecological and women’s health. Specifically, they provide health care services for women during labor and delivery, as well as the postpartum period. They generally work in hospitals, birthing centers, private practices, health maintenance organizations, and health departments.

CNMs usually work in conjunction with OB-GYN doctors and may perform any of the following job duties:

  • Recording medical histories
  • Performing physical examinations
  • Ordering and interpreting lab tests
  • Managing patient therapy and chronic illnesses
  • Conducting activities that promote patient health and reduce pregnancy risks
  • Providing care to new mothers and their babies

In addition to earning an MSN degree, CNMs must also be certified by the American Midwifery Certification Board (AMCB).

APRN vs. PA: Core Similarities

Among the similarities between APRNs and PAs, both work alongside physicians in some capacity, and both must be licensed for their selected field and specialty.

APRNs and PAs also share some overlap in the health care services they provide to patients. Both diagnose patients, provide treatment plans, and prescribe medications. Both roles also require at least a master’s degree, along with relevant certifications and clinical training.

The salary potential is also similar for APRNs and PAs. According to the U.S. Bureau of Labor Statistics (BLS), nurse anesthetists, nurse midwives, and nurse practitioners made a median annual salary of $117,670 in 2020, while PAs made $115,390.

Regarding job outlook, the BLS projects the number of positions for nurse anesthetists, nurse midwives, and nurse practitioners to increase by 45% between 2020 and 2030. By comparison, it projects PA positions to grow by 31% over the same period.

APRN vs. PA: Core Differences

There are some core differences when making the APRN vs. PA comparison. Most notably, their educational paths vary, though they both require a graduate education.

The main steps to becoming an APRN include:

  1. Earn a Bachelor of Science in Nursing (BSN)
  2. Pass the NCLEX-RN exam
  3. Become licensed as a registered nurse (RN) and gain on-the-job experience
  4. Complete an MSN program
  5. Pass a national certification exam, depending on specialty
  6. Obtain state licensure

The main steps to becoming a PA include:

  1. Complete two years of college coursework in basic and behavioral sciences (similar to premed)
  2. Earn a bachelor’s degree in a relevant field of study, such as biochemistry, cellular biology, or pathophysiology
  3. Gain relevant work experience as a medical assistant, emergency medical technician, or paramedic, for example — most PA programs require three years’ experience
  4. Earn a Master of Science in Physician Assistant Studies and complete 2,000 hours of clinical rotations to graduate
  5. Pass the Physician Assistant National Certifying Exam (PANCE)
  6. Obtain state licensure

One of the big differences when making the APRN vs. PA comparison is that APRNs focus on a specialty, while PAs practice more generally. Additionally, PAs must always be supervised by a physician or surgeon, whereas APRNs have full practice authority in certain states, which grants them a certain level of autonomy.

Begin Your Journey to a Career in Health Care

APRNs and PAs play important roles in the health care industry and have the opportunity to deliver vital health care services to a diverse patient base. The job growth and competitive salaries of the two professions make them promising choices for anyone looking to enter the health care field.

Becoming an APRN may be the ideal career path for individuals who want to specialize in a certain type of medicine or work with a particular patient population. The education requirements and salary for nurse practitioners have made it an extremely popular choice for aspiring health care workers. For those interested in more general practice, becoming a PA may be more attractive.

Whichever path they ultimately choose, aspiring APRNs and PAs need to invest in their education. Hawai‘i Pacific University’s online Master of Science in Nursing (MSN) program can be a critical step in pursuing a career as an APRN, offering students their choice of three specializations: Family Nurse Practitioner, Psychiatric Mental Health Nurse Practitioner, and Adult-Gerontology Acute Care Nurse Practitioner.

Take the first step toward your career goals as an advanced practice registered nurse with Hawai‘i Pacific University today.

Recommended Reading:

Burnout vs. Compassion Fatigue in Nursing

The Importance of a Nurse’s Role in Patient Safety

Trauma Nursing in Vacation Cities


American Academy of Physician Assistants, Become a PA

American Academy of Physician Assistants, What Is a PA?

American Association of Nurse Practitioners, NP Fact Sheet

American Association of Nurse Practitioners, Nurse Practitioner (NP) Certification

American Association of Nurse Practitioners, The Path to Becoming a Nurse Practitioner (NP)

American Association of Nurse Practitioners, State Practice Environment

American Association of Nurse Practitioners, What’s a Nurse Practitioner (NP)?

Avita Health System, What Is a CNP?

Indeed, "17 Nurse Practitioner Specialties for 2021"

Indeed, "PA vs. NP: What Is the Difference?"

MedlinePlus, Certified Nurse-Midwife

National Association of Clinical Nurse Specialists, What Is a CNS?

National Council of State Boards of Nursing, APRNs in the U.S.

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners

U.S. Bureau of Labor Statistics, Physician Assistants