FNP vs. AGACNP: Which Nurse Practitioner Career Should I Pursue?

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The United States is facing an unprecedented nursing shortage. This is due to several factors, including an increased demand for nurses because of an aging baby boomer population and the predicted retirement of 500,000 nurses by 2022, according to the American Nurses Association.

An influx of skilled family nurse practitioners (FNPs) and adult-gerontology acute care nurse practitioners (AGACNPs) will be key to mitigating the impacts of the nursing shortage. The U.S. Bureau of Labor Statistics projects the employment of nurse practitioners to grow by 52% from 2019 to 2029 — ensuring great job security, likely with competitive pay.

Nurses interested in earning an advanced degree, such as an online BSN to DNP, to become an FNP or AGACNP should understand how each role approaches care and other key differences.
An adult-gerontology acute care nurse practitioner takes a patient’s blood pressure in an exam room.

The Family Nurse Practitioner Role

An FNP provides a wide range of family-focused health care services to patients of all ages and demographics, including infants, adolescents, adults, and seniors. FNPs take on a variety of important duties, such as:

  • Maintaining patient records
  • Performing physical exams
  • Ordering and/or performing diagnostic tests
  • Prescribing medications
  • Developing treatment plans
  • Treating illnesses, conditions, and injuries that fall under primary care

Common work environments for FNPs include community health centers, private practice, health care systems, and universities. In any setting, the FNP role offers a unique opportunity for nurses to provide care for patients across multiple stages of life, allowing for a nurse-patient dynamic that promotes interpersonal connection and individualized long-term care plans.

Those who enjoy working with diverse communities with a focus on health promotion and disease prevention over the course of someone’s life are best suited for an FNP role, as it provides the opportunity to empower patients seeking control over their wellness.

The Adult-Gerontology Acute Care Nurse Practitioner Role

An AGACNP is primarily responsible for caring for adult patients with complex chronic health conditions. Some of the key roles of AGACNPs include:

  • Closely monitoring chronic conditions
  • Developing multifaceted treatment plans for adult and gerontology patients
  • Implementing preventive health care plans to ward off future complications

While the main focus of most AGACNPs is working with patients to prevent complications stemming from existing conditions and devising methodologies to improve their health, the role also extends beyond clinical practice into components such as administration, research, and teaching.

AGACNPs generally practice in tertiary care settings that have the highly specialized equipment needed for particular treatments, but they can also find opportunities to work in specialty clinics that are devoted to outpatient care, as well as long-term care facilities, such as nursing homes and assisted living centers.

Those who have a passion for improving health outcomes — often for chronically ill individuals — are a great fit for the AGACNP role, getting the chance to make a measurable impact on the lives of patients who need consistent care.

The Differences Between FNPs and AGACNPs

Both FNPs and AGACNPs are indispensable members of health care facilities and the U.S. health care system as a whole. With each role’s specialization, health systems can ensure that every patient’s unique needs are met — making both positions essential to quality care delivery.

When looking at the practices of FNP vs. AGACNP, however, it’s important to be cognizant of distinguishing factors that set them apart.

Patient Demographics

FNPs see patients of all ages and backgrounds, from children to the elderly. AGACNPs, on the other hand, work exclusively with adult and geriatric patients.

Care and Treatment

FNPs often work in primary care, making them a central point of contact and first line of defense for all potential health issues, questions, or complications. In addition to treating injuries and illness, FNPs have the opportunity to educate about prevention of disease and healthy lifestyle habits.

AGACNPs work in acute care with consistent visits from patients, taking a wellness-based, holistic approach to care. Rather than serving as a primary contact for a broad range of health issues across age groups like FNPs, AGACNPs are typically more specialized, working with adult patients to manage chronic conditions.

Certification Opportunities

FNPs have the opportunity to earn the Family Nurse Practitioner-Board Certified (FNP-BC) credential from the American Nurses Credentialing Center (ANCC), which must be renewed every five years. FNPs can also get additional certifications in areas such as diabetes, pain, and obesity management — though they are not required to do so.

AGACNPs can seek the Adult-Gerontology Acute Care Nurse Practitioner Board Certified (AGACNP-BC) credential from the ANCC, which also must be renewed every five years.

Median Annual Salary

FNPs have a slight edge on AGACNPs in terms of median annual salary — though the difference is slight. According to PayScale, the median annual salary for AGACNPs was approximately $96,000 as of May 2021, while the median annual salary for FNPs was around $97,000 as of June 2021.

Pursue a Critical Role in Quality Care Delivery

The nursing shortage in the United States has led to an increased demand for quality nurses with a passion for improving the lives of their patients. While FNPs and AGACNPs perform different specialized functions in the health care system, both roles are extremely important in ensuring that the unique needs of each patient are met.

An important element of advancing a career as a nurse is finding an educational path that is structured around student needs. Hawai‘i Pacific University’s online BSN to DNP program offers concentrations in both the FNP and AGACNP pathways, providing students with a 100% remote learning environment, small class sizes, and dedicated faculty members who care about student success and well-being.

Explore the degree program today to learn how to earn a terminal degree in just 34 to 44 months, with a focus on preparation to pass nurse practitioner certification exams on the first attempt.

Recommended Readings:

How Family Nurse Practitioners Can Play a Major Role in Addressing The Growing Physician Shortage in the U.S. 

Careers in Advanced Nursing: What Is a Family Nurse Practitioner? 

The Benefits of Advanced Nursing: What Is The Expected MSN Salary Range?


American Academy of Nurse Practitioners Certification Board, Family Nurse Practitioner (FNP)

American Association of Critical-Care Nurses, ACNPC-AG (Adult-Gero.)

American Nurses Credentialing Centre, AGACNP-BC

American Nurses Credentialing Centre, FNP-BC

American Association of Nurse Practitioners, “Are You Considering a Career as a Family Nurse Practitioner?”

American Association of Nurse Practitioners, “Are You Considering a Career as an Adult-Gerontology Acute Care Nurse Practitioner?”

American Nurses Association, The Nursing Workforce

LinkedIn, “The Most In-Demand Jobs Rights Now”

PayScale, Average Adult Gerontology Acute Care Nurse Practitioner Salary

PayScale, Average Family Nurse Practitioner (NP) Salary

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