Nurses interested in providing acute care to adults aged 18 and over may find that the adult-gerontology acute care nurse practitioner (AGACNP) career path aligns with their professional goals. AGACNPs provide care to adult patients with complex and acute health conditions. This can include both prevention and management of these conditions, as well as working in critical care or trauma departments.

Licensed nurses interested in becoming adult-gerontology acute care nurse practitioners must start by developing the advanced knowledge and skills needed to develop practical, holistic solutions for patients struggling with acute conditions. Completing an advanced education, such as an online Master of Science in Nursing with an AGACNP Concentration or an Online Adult-Gerontology Acute Care Nurse Practitioner Post-Master’s Certificate Program can prepare graduates with the clinical proficiencies needed to provide compassionate, evidence-based patient care.

What Is an Adult-Gerontology Acute Care Nurse Practitioner?

Adult-gerontology acute care nurse practitioners provide advanced nursing care to adult patients, particularly older adults struggling with chronic or episodic health conditions, such as hearing loss, hypertension, osteoarthritis, cardiovascular disease and chronic obstructive pulmonary disease (COPD), among others. Professionals working within this field are certified to provide a spectrum of care to patients with a variety of chronic and acute, high-intensity medical needs.

Where Can an AGACNP Work?

Adult-gerontology acute care nurse practitioners can work in a variety of settings, such as community health care clinics, urgent care clinics, long-term care facilities, emergency rooms, intensive care units and group medical practices. Professionals employed by facilities that keep standard business hours may work 40 hours per week, Monday through Friday. AGACNPs employed by facilities that provide 24-hour care, such as hospitals, may need to work night, weekend, holiday, overtime and on-call shifts.

A Day in the Life of an AGACNP: Roles and Responsibilities

The exact duties of an adult-gerontology acute care nurse practitioner can vary widely depending on their place of employment and the state they practice in. AGACNPs who work in large hospitals or critical care units typically work closely with physicians, critical care nurses and other advanced practice providers throughout the day. They typically have a set of patients assigned to them, conduct patient assessments, review and update charts and then monitor changes in each patient’s condition throughout their shift. An acute care NP may also find themselves answering questions from and directing the work of the RNs on duty. The most common AGACNP roles and responsibilities may include the following:

• Assessing patients’ condition
• Prescribing medication
• Ordering and evaluating diagnostic tests, such as blood and urine tests
• Diagnosing and treating chronic conditions, such as diabetes, high cholesterol and heart disease, among others
• Developing treatment plans designed to improve patients’ health and address acute conditions
• Counseling and educating patients on lifestyle choices and disease prevention
• Collaborating with other medical professionals, such as physicians and other care providers

What’s the AGACNP Scope of Practice?

The AGACNP scope of practice, as well as for nurse practitioners in general, varies by state. For example, some states allow NPs full practice authority, which allows practitioners to operate independently and evaluate and diagnose patients, order and interpret various diagnostic texts, initiate treatment and provide medications and oversee and manage treatment plans. The American Association of Nurse Practitioners reports that 32 states and Washington, D.C. provide NPs with full practice authority.

The AANP also reports 10 states provide NPs with reduced practice authority. In these states, NPs are required to have an ongoing collaborative agreement with a licensed physician to be permitted to provide medical services to patients. 

Lastly, NPs working in the eight states that grant restricted practice authority must be supervised by a licensed physician throughout their career. Professionals working in restricted practice states have at least one practice element, such as the ability to prescribe medication, restricted by state law.

AGACNP Salary and Career Outlook

The U.S. Bureau of Labor Statistics does not have a separate category for adult-gerontology acute nurse practitioners. Instead, APRNs working in this field are classified within the category of nurse anesthetists, nurse midwives and nurse practitioners.

According to BLS data, as of May 2021, the median annual wage for nurse practitioners was $120,680, although workers in the top 10^th percentile reported earnings of more than $200,540. An AGACNP’s salary range can vary based on several factors, such as their experience level, the facility they work for, whether their place of employment is in a rural or metropolitan area and the average cost of living in the state where they practice.

AGACNP Salary by State

Salary ranges for AGACNPs also vary widely from state to state. For example, BLS data from May 2022 notes the mean salary for nurse practitioners in North Carolina was reported at $114,450. During that same reporting period, the annual mean wage for nurse practitioners employed in Iowa was recorded at $128,180.

The top paying states for the nurse practitioner category in 2022 were as follows:

• California: $158,130
• New Jersey: $143,250
• Massachusetts: $138,700
• Oregon: $136,250
• Nevada: $136,230

The lowest paying states for the nurse practitioner category in 2022 were as follows:

• Tennessee: $99,330
• Alabama: $106,610
• West Virginia: $106,790
• Arkansas: $107,110
• South Carolina: $109,130

AGACNP Job Outlook

The U.S. Bureau of Labor Statistics notes that overall employment of nurse practitioners, including adult-gerontology acute care nurse practitioners, is projected to grow by 46% between the years 2021 and 2031, which is much faster than the average projected across occupations.

Many of these positions will result from the need to replace NPs who leave the workforce, such as those who retire or choose to stay home to start a family, or those who change career paths. Job growth within this field will also be driven by an increased demand for health care services, especially among the aging baby boomer population.

AGACNPs in Missouri and Kansas

Adult-gerontology acute care nurse practitioners in Kansas have full practice authority, whereas professionals working in Missouri have reduced practice authority. The U.S. Bureau of Labor Statistics reports that as of May 2022, the median annual wage for NPs working in Kansas was recorded at $111,670; the median annual wage for NPs working in Missouri, during that same reporting period, was recorded at $113,180.

How to Become an Adult-Gerontology Acute Care Nurse Practitioner

Students interested in becoming an AGACNP must complete both an undergraduate and graduate nursing degree to pursue jobs within this field. The most common steps associated with becoming an adult-gerontology acute care nurse practitioner include the following:

Earn a Bachelor of Science in Nursing

The first step toward becoming an AGACNP is to complete a Bachelor of Science in Nursing (BSN) degree from an accredited institution. Professionals who already hold an associate degree in nursing (ADN) can opt to enroll in an online RN to BSN degree program, whereas individuals who have not yet earned a college degree can directly enroll in an accredited Bachelor of Science in nursing program.

Prospective nurses who have a bachelor’s degree in another field can also choose to pursue an Accelerated BSN (ABSN). An ABSN gives students the opportunity to complete their undergraduate BSN in under two years, fast-tracking their nursing education.

Admissions Requirements for BSN or ABSN programs

BSN program enrollment requirements vary among different schools, but typical admissions requirements include:

• A completed college application
• Payment of an application fee. Application fees vary by school but in most cases, fees span between $30-$90.
• Minimum GPA requirements. The minimum GPA requirement also varies from school to school.
• Submission of SAT/ACT scores. This may or may not apply depending on the institution an individual is applying to. Some colleges require them, while others do not.
• Submission of prior college transcripts. This only applies to applicants who have prior college experience.
• Professionals applying to an RN to BSN program must also hold an active nursing license.

ABSN program admission can also vary between institutions, and some programs have similar enrollment requirements as a traditional BSN program. Some of the specific requirements for an ABSN include:

• A bachelor’s degree in any field
• Completion of prerequisite courses
• A resume
• Minimum undergraduate GPA requirement

Common BSN Completion Timelines

BSN completion timelines vary based on several factors, including whether an applicant enrolls in an online ABSN, RN to BSN or traditional BSN program. Other factors that influence the time it takes to complete a BSN include the following:

Full-Time Enrollment

• ABSN: Most full-time ABSN students can complete their degree in as little as 16 months.
• RN to BSN: Most full-time RN to BSN students find they can complete their degree in as little as 24 months.
• BSN degree program: Most full-time BSN students complete their studies in approximately four years.

Part-Time Enrollment

• RN to BSN program: Part-time RN to BSN students often find they can complete their degree in approximately 3-4 years.
• BSN program: Part-time BSN students may find it takes up to six years for them to earn their degree.

Pass the NCLEX-RN Exam

After completing their BSN or ABSN degree, aspiring nurses must pass the NCLEX-RN exam to demonstrate they have the knowledge and skills needed to safely care for patients. This examination is offered numerous times throughout the year at testing centers across the United States. The objective of the NCLEX-RN is to evaluate candidates’ capability to deliver competent care.

Roughly six weeks before their graduation, students will receive applications for both state licensure and the NCLEX-RN exam. As of July 2023, the National Council of State Boards of Nursing listed the registration cost for the NCLEX-RN at $200. However, it's important to note that additional fees are often required by the state licensing board of the state where the applicant intends to practice.

The NCLEX-RN exam is a computer-based test with a 6-hour time limit that has a variable number of questions, ranging from a minimum of 75 questions to a maximum of 265. This test is graded in a pass/fail format and test takers receive their results immediately after completing the exam. Candidates who do not receive a passing grade must wait at least 45 days before they retest. The NCSBN permits applicants to retest up to eight times in a 12-month period.

Gain Professional Experience

Nurses interested in advancing to leadership and managerial roles typically need several years of clinical experience before they’ll be eligible to apply to an advanced degree program, such as a Master of Science in Nursing (MSN). Although the professional experience requirement varies among schools, most programs require applicants to have between three and five years of professional nursing experience to be considered for enrollment. This prerequisite helps ensure that candidates have the skills and experience needed to excel in an advanced degree program.

Complete an Advanced Education

The next step in becoming an adult-gerontology acute care nurse practitioner is to complete an advanced education. Aspiring AGACNPs can achieve this via the following advanced practice nursing degree pathways:

Complete an Online Master of Science in Nursing with an AGACNP Concentration

The MSN prepares BSN graduates with the managerial, clinical and essential nurse practitioner skills needed to advance in their careers. Although the admissions requirements for MSN programs vary from school to school, common requirements include the following:

• Applicants must hold an active nursing license and have completed a minimum number of years of paid full-time RN experience. The professional experience requirement varies depending on the institution.
• Candidates must have completed a BSN degree from an accredited institution and meet minimum GPA requirements. The minimum GPA requirement varies from school to school.
• Completion of an application and payment of an application fee

The time it takes students to complete an online MSN degree varies based on whether students are enrolled in part-time or full-time coursework. Full-time students often find they can complete their MSN degree within approximately two years, whereas part-time students may take up to four years to complete their studies.

Complete a Post-Master’s Adult-Gerontology Acute Care Graduate Certificate

Master’s degree-prepared nurses who did not pursue an AGACNP concentration can complete a specialized post-master’s certificate. Post-master’s adult-gerontology acute care graduate certificate programs are designed for MSN-holding RNs interested in pursuing certification. Admissions requirements for post-master’s AGACNP certificate programs can also vary from school to school, however, common admissions requirements often include:

• Completion of an application
• Payment of an application fee
• Completion of an MSN degree from an accredited institution in addition to meeting minimum GPA requirements. The minimum GPA requirement varies from program to program.
• Holding an active, unencumbered nursing license and having completed a minimum number of years of paid full-time RN experience. The experience requirement also varies depending on the institution an applicant is applying to.

The amount of time it takes students to complete an online post-master’s AGACNP certificate varies based on whether students are enrolled in part-time or full-time coursework. For example, whereas most full-time students often find they can complete their studies within approximately 1.25 years, part-time students may take up to 2.5 years to complete their coursework.

Pass the Adult-Gerontology Acute Care Nurse Practitioner Certification Exam

Upon completion of an MSN with an AGACNP concentration or an online post-master’s AGACNP certificate, graduates must also pass a board approved and recognized national certification exam. Similar to the NCLEX-RN exam, this computer-based test is offered year-round at testing locations throughout the U.S. This 3.5-hour test consists of 175 questions and is graded in a pass-fail format. Candidates need a score of 350 out of 500 to pass. Those who do not pass their certification exam can apply to retest after 60 days. Additionally, candidates are not permitted to test more than three times in a 12-month period.

As of July 2023, the cost to register for the AGACNP certification exam was listed as $295 for American Nurses Association members and $395 for non-members.

Maintaining AGACNP Licensure

AGACNP licenses must be renewed every five years, and renewal applications can be submitted up to 12 months prior to an applicant’s certification expiration date. To maintain licensure, candidates must complete 75 continuing education hours plus at least one of the following:

• Complete five academic credits or six quarter credits in academic coursework related to a candidate’s area of certification
• Deliver three or more presentations totaling more than 5 hours in their area of certification
• Complete one (1) evidence-based research project, publish one (1) peer-reviewed article or book chapter (or five articles in a non-peer-reviewed newsletter or journal) or complete a research project related to their area of certification.

As of July 2023, the cost to renew an AGACNP license was listed as $275 for American Nurses Association Members, $295 for American Association of Nurse Practitioner Members, and $375 for non-members.

Become an AGACNP to Make a Difference in Patient Lives

The future of health care is reliant on the talent and leadership skills of advanced practice registered nursing professionals. Are you ready to take the next brave step toward elevating your clinical competencies and expanding your scope of practice?

Discover how an online MSN-AGACNP or an online AGACNP Post-Master’s Certificate Program from Rockhurst University can help you toward your goal to become an adult-gerontology acute care nurse practitioner.

Sources:
American Association of Nurse Practitioners, “Are You Considering a Career as an Acute Care Nurse Practitioner?”
American Association of Nurse Practitioners, Scope of Practice for Nurse Practitioners
American Association of Nurse Practitioners, State Practice Environment
American Association of Nurse Practitioners, The Path to Becoming a Nurse Practitioner (NP)
American Nurses Credentialing Center, Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP-BC^®)
American Nurses Credentialing Center, “Certification: General Testing and Renewal Handbook”
Kaplan, What Is the NCLEX-RN?
National Council of State Boards of Nursing, NCSBN Examinations
U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2022
Wordsrated, College Application Fees