While there are many similarities between acute care and primary care nurse practitioners, there are also many important distinctions between the two. Acute conditions refer to those that are sudden and severe in onset, typically requiring short-term treatment, while primary care is usually characterized by long-term relationships with patients. Understanding the similarities and differences between these two positions can help you decide what you want to do in your nursing career and what you want to specialize in. Below, we explore both roles and discuss how they differ in terms of who they treat, where they work, and more.
What is an acute care nurse practitioner?
The American Association of Critical Care Nurses (AACN) defines the scope of an acute care nurse practitioner (ACNP) as covering patients who are physiologically unstable, critically ill, technologically dependent, have chronically complex illnesses, rapidly changing conditions, or who are highly vulnerable to complications. ACNPs are trained, licensed and certified to care for any patients who fall within these parameters, and because the scope is defined by the patient’s needs, they do so in various settings. These nurse practitioners often work as part of hospital teams, A&E wards and respiratory wards, for example, typically providing short-term care for severe and rapid onset conditions.
Acute care nurse practitioners may deal with anything from a broken arm to an asthma attack, and their training equips them to stabilize people who need urgent help. These nurses examine, diagnose and treat people with serious injuries and illnesses, often performing invasive diagnostic or therapeutic procedures. After assessing conditions, they may educate family members and patients about treatment options, prescribe medications and provide advanced nursing care in other ways. They may also collaborate with other specialists to provide immediate care when patients require it, such as if they are struggling to breathe.
What is a primary care nurse practitioner?
The American Association of Colleges of Nursing (AACN), along with the National Organization of Nurse Practitioner Faculties (NONPF), define the duties of a primary care nurse practitioner (PCNP) as covering chronic, comprehensive care and continuous care characterized by long-term relationships with patients. These nurses are educated, certified and licensed to help patients who require this kind of medical attention. While PCNPs are qualified to offer treatment for a vast range of health problems, they also coordinate care with other providers. They work in a variety of settings, including local doctor’s surgeries and hospitals.
Primary care nurse practitioners take the lead when patients do not require aid from an acute care specialist. These healthcare providers may work with people within their communities or at home, forming long-lasting relationships with them. The illnesses and ailments they treat do not always last a long time but can also be chronic. However, they may still provide short-term care for such patients. Primary care nurse practitioners who are independently licensed collaborate with physicians and other medical experts to offer evidence-based treatments. They often diagnose illnesses, devise treatment plans, and monitor their progress.
Acute care vs primary care nurse practitioner
While there is a great deal of overlap between the duties of these medical professionals, the differences are crucial. Here are some of the areas in which they differ:
Education/specialization
While the two professionals have advanced nursing qualifications in the same areas up to a certain level, their paths diverge after they complete their master’s degrees. ACNPs go on to complete courses like an acute care nurse practitioner post master’s certificate online or in person, which gives them the tools they need to specialize in their chosen population group. PCNPs complete different courses that further specialize them for primary care, such as an Adult-Gerontology Nurse Practitioner Program. The choice of post-master’s specialization dictates whether a nurse practitioner becomes an acute or primary care provider.
Work setting
While the two professionals sometimes work in the same settings, they are typically found in different locations that are most appropriate to their forms of care. Here are some typical settings for an acute care provider:
- Intensive care unit
- Emergency room
- Surgery or medical unit
- Skilled nursing facility
- Nursing home
- Outpatient subspecialty practice
- Inpatient subspecialty practice
Here are some of the locations where primary care specialists work:
- Prison hospital
- Fast-track sections of the emergency room
- Family practice clinic
- Skilled nursing facility
- Nursing home
- Public health center
- Underserved and rural health community
- Women’s health center
- Urgent care
- Internal medicine clinic
Patients
The main difference between these two providers is the populations they care for. Acute care nurse practitioners (ACNP) deal with patients who are physiologically unstable, critically ill, technologically dependent, have chronically complex illnesses, rapidly changing conditions, and are highly vulnerable to complications. This covers people who are rushed into hospital with broken bones or heart attacks, for example. They deal with people whose conditions have come on quickly and who need immediate attention, which typically resolves shortly after, but not always. Their treatment may become long-term if they require frequent scans or ongoing medication.
Primary care nurse practitioners (PCNPs) deal with people who have chronic, comprehensive care and continuous care needs, and their relationships with patients are typically long-term. This can include family nurse practitioners, for example, who a patient may regularly visit to receive treatment for something like diabetes. They help people manage and overcome illnesses that do not require immediate, life-saving attention. Their job centers more on health promotion and primary prevention, but they also screen, diagnose and treat chronic conditions, as well as common, less threatening ones. Both types of nurse practitioners are experts in their fields and work collaboratively to help patients.
Job outlook
The job outlook for each of these professionals is overwhelmingly positive, as there is a huge demand for their advanced skills. Besides having access to some of the best-paid positions in the healthcare industry, they are both well-equipped to establish their own practices. The Bureau of Labor Statistics predicts a sharp rise in employment opportunities over the next decade, and nurse practitioner graduates already enjoy employment rates of virtually 100%, meaning they have excellent prospects now and in the future. Their national mean wage is also well over $100,000 at the time of writing, making it a lucrative job opportunity.
Skills
The greatest overlap between these two professionals is the skills they possess and apply in the performance of their duties. Here is a closer look at some of their skills:
- Compassion
Compassion is a vital skill for nurses, and it is one that will help you a great deal throughout your career, as it will make the work more rewarding and drive you to provide the best possible care. Because of the trust patients place in their care providers, it is important to be compassionate towards them in return so they can feel comfortable and well looked after. Compassion can also be greatly comforting to those experiencing pain and suffering.
- Integrity
Having integrity is crucial for nurse practitioners, as it helps them develop trusting relationships with patients. Primary caregivers may need to focus more on building relationships of rapport because their relationships are often long-lasting, but it is also important for acute care givers. Having strong moral principles can help patients open to you and divulge potentially embarrassing, traumatic, or otherwise sensitive information, which can help you provide better care.
Integrity is also essential when in a position of authority because with authority comes responsibility, and nurses must take responsibility for their actions. If a nurse or someone they work closely with makes a mistake, for example, it is crucial for them to own up or report it for the good of their patients. This can prevent errors from getting out of control and potentially causing harm.
- Attentiveness
Being attentive to the needs of patients is also vital for nurses of both specialisms. This is largely because patients cannot always communicate their needs and issues, and nurses cannot always rely on what patients tell them, for various reasons. Showing attentiveness means being alert to subtle signs and evidence, which allows them to make effective judgments. A lack of attentiveness can lead to the opposite — poor judgment, bad decisions, and potential harm.
Attentiveness during examinations and diagnoses, for example, is imperative so nurses can take the best possible course of action. Nurses must be attentive so they can combine test results with observations and other gathered information to form conclusions. Because the job can be mentally and physically taxing, it is also essential to maintain attentiveness even when tired or stressed. This quality can also help nurses follow the evidence to provide evidence-based treatment rather than make assumptions, which is essential.
How to become an acute/primary care nurse practitioner
Becoming an acute care nurse practitioner requires several years of study and training, including evidence-based coursework and practical experience working in a healthcare setting. The path to becoming an ACNP and a PCNP is largely the same up until the completion of your master’s degree, as it is first necessary to prepare for college and become a licensed nurse for each role. Both healthcare professionals will learn how to diagnose and treat illnesses and prescribe medications throughout their education and training. Here are some steps you can follow to become an acute or primary care nurse practitioner:
- Study for a nursing bachelor’s degree
Regardless of the area in which you intend to specialize, it is essential to first acquire your bachelor’s degree by enrolling in a Bachelor of Science in Nursing (BSN) course. All aspiring nurses must acquire this degree, and if you hold a different bachelor’s degree, it is essential to enroll in an accelerated BSN program, which can enable you to get your BSN in a shorter time compared to a stand-alone BSN course. Accelerated courses require you to complete some prerequisite science courses. BSN programs offer you the foundational knowledge needed to become an advanced nurse.
Those with associate degrees in nursing who are registered may also be able to enroll in a Registered Nurse to Bachelor of Science in Nursing course (RN to BSN), which can also bring you up to the required standard of training and education. The duration of these courses depends on your current position and how fast you complete the units, but they typically last between one and two years.
- Pass the National Council Licensure Examination NCLEX and gain RN license
Stage two for each aspiring nurse is gaining a registered nurse license by successfully completing the National Council Licensure Examination. Since 1982, this exam has been a standard requirement for nurses in countries such as the USA, Australia and Canada. The exam tests your critical thinking abilities, testing skills and how much you know about nursing. To take the test, contact the nursing regulatory body in your state and gain an Authorization to Test (ATT), as you cannot sit the test or gain a registered nurse license without one.
Upon passing the exam, you are able to apply for a registered nurse license in your state, and you will receive the license in approximately 30 days. Once you receive your license, you can legally begin practicing as a nurse. These licenses are to be renewed every three years, with nurses completing continuing education every two years, as this ensures you are familiar with any changes in the field of nursing or new developments.
- Complete a graduate program
To practice advanced nursing, it is important to have at least a Master of Science in Nursing, and many also go on to acquire doctorate degrees. Master’s degree programs build on the education and training you gained through your bachelor’s degree and give you the option to further specialize in modules relating to primary or acute care. A DNP (Doctor of Nursing) qualification can elevate you to one of the highest educational levels in nursing, giving you access to a range of job opportunities and higher pay grades.
Doctorate degrees are not essential to become a primary or acute care nurse practitioner, but many nurses choose to pursue them for the practical advantages it gains them. Nurses possessing doctorates have a vast range of opportunities available to them, even the option to teach nursing in universities if they wish. Achieving such an advanced level of education equips you to take on leadership roles, increase your job security and dramatically improve your earning potential. Although, if you wish to become a primary or acute care nurse practitioner as soon as possible, you can skip the doctorate stage and enroll in a post-master’s program.
- Complete post-master’s nurse practitioner courses
Upon completing your master’s degree, you are ready to enroll in courses that help you specialize in your desired population and gain the knowledge needed for acute or primary care provider. This knowledge is essential before you can pass your NP certification exam, as these exams are tailored to your chosen population and specialism. There is a vast range of courses to choose from, many of which are available online and can be completed in a relatively short timeframe. Besides specializing in acute and primary care, you can also focus on population specifics like age.
- Pass the national NP certification board exam and gain licensure
To gain full licensure and be a fully qualified practitioner, it is essential to successfully complete a national board examination. These exams relate to your population specialism, which is why it is important to complete specialization post-master’s programs prior to sitting the exam. Continuing education is required periodically to renew this license, and nurses must complete certain activities and meet specific criteria to be eligible for renewals. Check with the relevant certification board and regulatory body to find out which criteria apply to you. It is also worth pursuing certifications regularly to bolster your knowledge of nursing science.