Nurses play a crucial role in administering care to patients across the globe. In fact, the World Health Organization (WHO) notes that more than half of all health care providers are nurses. When it comes to addressing patient needs, members of the nursing profession are on the front line.
Two of the most common nursing roles are nurse practitioner (NP) and registered nurse (RN). Both roles encompass a broad range of duties and usually involve delivering direct patient care. Important distinctions include a nurse practitioner’s advanced education, such as a Master of Science in Nursing (MSN) degree. This can create a path to leadership positions with greater autonomy and higher pay.
To understand career options in the nursing field, understanding the relationship between the nurse practitioner and RN roles is important.
What Is a Nurse Practitioner?
An important place to begin is with a definition of each role. For starters, what is a nurse practitioner? According to the U.S. Bureau of Labor Statistics (BLS), 220,300 nurse practitioners were employed in 2020 alone, making it a significant role with a huge impact on the health care industry.
Nurse Practitioners at a Glance
Nurse practitioners are a type of advanced practice registered nurse (APRN). In other words, they’re nurses who receive their RN designation and then go on to achieve a more comprehensive level of clinical training, empowering them to expand their scope of practice.
Nurse practitioners can perform many of the same duties as physicians. Compared with RNs, they often take a more holistic approach to care, focusing on treating existing conditions and educating patients about disease prevention.
Nurse Practitioner Duties and Responsibilities
The day-to-day responsibilities of a nurse practitioner can vary according to the practice. Generally speaking, however, the duties that fall to nurse practitioners typically include the following:
- Providing primary care for patients, including basic examinations to diagnose illness and injury
- Educating patients about basic wellness and advising them on how to live healthier lifestyles
- Ordering, performing, and interpreting diagnostic tests, such as blood work, to assist with proper diagnoses
- Developing and implementing patient treatment plans, which may involve prescribing medication or referring to specialists
- Following up with patients to ensure the proper management of chronic or long-term conditions
- Recording patient symptoms and medical histories; developing more robust patient records
- Communicating with patients’ family members about care and disease management
- Collaborating with other nurses and with physicians
Nurse Practitioner Areas of Specialization
An important distinction between the nurse practitioner (NP) and registered nurse (RN) roles is that nurse practitioners receive advanced training within a specific area of care, allowing them to become certified in a specialization. The specialization they choose will define the type of practice they have, the kinds of patients they see, and the duties they must perform each day.
A nurse practitioner can choose from a range of specializations, including women’s health and pediatric care. Three of the most common NP certifications are:
- Family Nurse Practitioner. FNP is by far the most common certification for nurse practitioners; in fact, about 75% of nurse practitioners work as FNPs. These providers serve a primary care role for patients of all ages, diagnosing and treating both acute and chronic health conditions. The role overlaps considerably with that of primary care physicians, and indeed, FNPs typically work in private practice and in other outpatient care facilities.
- Psychiatric Mental Health Nurse Practitioner. PMHNP is another certification to consider. The PMHNP role involves diagnosis, treatment, and case management for patients with mental health disorders. PMHNPs may treat patients of all ages, including those with depression, anxiety, trauma, or substance use disorders. These nurse practitioners can work in private practice, in hospitals, in residential care settings, and elsewhere.
- Adult-Gerontology Acute Care Nurse Practitioner. AGACNPs are providers who work with adult patients, including seniors, and typically focus on acute conditions, that is, illness or injury that comes on suddenly or that requires emergency intervention. These nurse practitioners may work in hospital emergency rooms, in intensive care units, or in private practice.
These are just a few specializations available to nurses who choose the nurse practitioner route.
Nurse Practitioner Work Environment
Nurse practitioners can work in many different environments.
- Many nurse practitioners work in doctors’ offices or in private practice, particularly those who see patients on a primary care basis.
- Some nurse practitioners may get work in long-term care facilities, including nurse practitioners who focus on substance use or geriatric health concerns.
- Nurse practitioners may also work in hospital settings, including in emergency departments and in critical care units.
- Some nurse practitioners find work in community clinics and in other public health facilities.
Nurse Practitioner Scope of Practice
Another important aspect of this profession is the scope of practice.
A state’s nurse licensing board sets the nurse practitioner’s scope of practice. Many states permit nurse practitioners to practice with autonomy, meaning that they can set up a private practice and treat patients without the oversight of a collaborating physician.
Other states require nurse practitioners to set up their practice under the authority and supervision of a medical doctor. The best way to determine the scope of practice within a given state is to contact the nurse licensing board.
Importantly, the nurse licensing board determines a nurse practitioner’s ability to prescribe medications. Currently, nurse practitioners have prescriptive authority in all 50 states, though some states limit their ability to prescribe controlled substances: medications that the government has flagged as especially dangerous or addictive.
What Is an RN?
The BLS noted that the U.S. had 3.1 million RNs in 2020, making these caregivers even more numerous than nurse practitioners. What is an RN, exactly, and what role do RNs play in providing patients with high-quality care?
Registered Nurses at a Glance
RNs are licensed medical providers who administer direct, hands-on patient care. RNs perform numerous duties, collaborating with doctors and with other nurses as well as educating patients and their family members.
RNs work in a range of locations, such as in hospitals, in outpatient care centers, and in nursing homes. They may supervise licensed practical nurses (LPNs), nursing assistants, and home health aides, but generally work under the supervision of physicians or nurse practitioners.
Registered Nurse Duties and Responsibilities
Most RNs see many patients each day, and their scope of duties and responsibilities can vary. The most common tasks they perform include the following:
- Assessing patients for wounds or injury and triaging them to the appropriate provider as needed
- Interviewing patients about their symptoms, concerns, and family medical histories; compiling up-to-date patient records
- Administering medications and other treatments under the supervision or instruction of a physician or a more senior nurse provider
- Ensuring the comfort of patients, including those who are staying in a hospital or in an extended care facility
- Disseminating basic education about wound care, postsurgical recovery, infection control, and wellness promotion
- Offering counsel and comfort to patients’ family members
- Assisting doctors or nurse practitioners during surgical interventions and other treatments
Registered Nurse Specializations
The field offers many opportunities for RNs to choose the patient populations they work with. For example, RNs who prefer to work in a fast-paced environment and who gravitate toward acute care may seek roles in emergency rooms or in intensive care units. RNs may also pursue opportunities to work in pediatric care facilities, in mental health care facilities, and beyond.
Differences Between RN and Nurse Practitioner Roles
Those considering career options in the nursing profession can benefit from a clear understanding of what differentiates the two trajectories.
Before exploring the differences between RN and nurse practitioner roles, however, noting their shared foundation is important. Specifically, all nurse practitioners begin their careers as RNs, and they must maintain their RN licensure to work as advanced practice nurses. In other words, nurse practitioners are RNs who go on to attain additional education and licensing that generally leads to greater responsibility and independence.
Consider just a few of the primary differences between RN and nurse practitioner career paths.
One of the core differentiators between the two roles is the required education level.
Becoming an RN calls for candidates to complete a formal nursing degree. This degree is usually a four-year Bachelor of Science in Nursing (BSN), though some RNs may have a two-year Associate Degree in Nursing (ADN).
To become licensed as a nurse practitioner, seeking a more comprehensive education is mandatory, gaining additional insight into clinical care. At a minimum, this means that nurse practitioners must have earned a Master of Science in Nursing (MSN). For those who already have a BSN, completion of an MSN may take 18 months to two years.
Some nurse practitioners may go on to seek doctoral-level degrees. Though this isn’t necessary simply to practice as a nurse practitioner, it may open the door to a position as a nurse leader or a nurse educator.
Another important distinction is licensing. Both the RN and nurse practitioner roles require a license, which is administered at the state level by the nursing board. Obtaining a license means completing an examination that covers topics related to patient care, medical ethics, medical laws, and more.
Becoming a nurse practitioner means passing examinations even more rigorous than the exams that RNs complete. Additionally, nurse practitioners must complete continuing education (CE) credit hours regularly to keep their license active; the state nurse licensing board sets the specific CE requirements.
Scope of Responsibilities
The nurse practitioner (NP) vs. registered nurse (RN) roles also vary in their scope of responsibilities.
The RN role is more supportive in nature. While the RN may carry out tests or treatments that the presiding physician or the nurse practitioner dictate, they’re typically not as involved in arriving at a diagnosis or creating a treatment plan.
By contrast, nurse practitioners have a broader, more holistic patient care mandate. They often play a much more direct role in diagnosing patients and determining the best treatment plan. They may carry out their treatment plan themselves or request assistance from an RN.
Level of Autonomy
The two roles differ in another crucial way: their level of autonomy. RNs aren’t licensed to establish their own private practice, to function as primary care providers, or to work independently from physicians.
Nurse practitioners, meanwhile, have a lot more independence. In some states, they can set up their own private practice without the need for a supervising or a collaborating physician.
Salary and Job Outlook
Finally, the two roles have some noteworthy differences in salary and job outlook.
Nurse Practitioner vs. RN Salary and Job Outlook
Anyone considering a career in the nursing profession will naturally want to know about potential salary ranges and the overall level of job opportunity. Certainly, an important link exists between education requirements and salary for nurse practitioners.
Nurse Practitioner vs. RN Salary Expectations
In any profession, salary expectations can vary according to level of education, level of experience, geographic area, and other factors. With that said, BLS data found that both professions had median annual salaries well above the $45,760 median salary for all professions as of May 2021.
BLS data for the nurse practitioner role noted a median annual salary of $120,680; those who earned in the upper 10th percentile earned as much as $200,540.
For the RN role, BLS data showed a median annual salary of $77,600. Those who performed in the upper 10th percentile earned as much as $120,250.
As for geographic areas that offered the highest salary ranges in 2021, the BLS found that certain states stood out. For RNs, for example, the two highest-paying states were California and Hawaii. For nurse practitioners, top earnings were in California and New Jersey.
Job Outlook for Nurse Practitioners and RNs
As for job outlook, both the RN and nurse practitioner roles show ample opportunity and much expected growth.
According to the BLS, the nurse practitioner field is expected to grow by 40% between 2021 and 2031, while the RN field is expected to grow by 6%. Note that 6% is roughly the average rate of growth for all professions.
In other words, both professions should see new jobs added over the next decade, though the nurse practitioner profession is poised to grow at a much faster rate. Several factors are contributing to this trend, but they all boil down to one thing: a growing need for independent, primary care providers.
As America’s population ages, chronic health conditions become more common, and specialized care grows more and more sought after, the need for qualified providers continues to rise. With a looming physician shortage, nurse practitioners can help fill the clinical gap, providing patients with the direct, hands-on care they need.
Take Your RN Experience to the Next Level
The RN and nurse practitioner roles are invaluable, and each plays an essential part in high-quality patient care. Of the two, nurse practitioners have a higher level of training and thus an expanded scope of responsibilities. This gives them opportunities for higher pay and wider career options than RNs.
For RNs looking to take on positions with greater autonomy and independence, nurse practitioner licensure may be worth considering. Hawai‘i Pacific University’s online MSN program supplies the formal background needed to pursue the nurse practitioner route. Gain the breadth of clinical training necessary to enjoy an exciting, satisfying range of nursing career opportunities.
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