Registered Nurses Contemplating a Career Move: What are the differences between Family Nurse Practitioners (FNPs) and Adult-Gerontology Acute Care Nurse Practitioners (AGACNPs)?

adult gerontology nurse with her patient
adult gerontology nurse with her patient

As the demand for health care providers continues to grow, so does the need for nurse practitioners (NPs). Nurse practitioners are especially crucial to meet the shortage of primary care providers available to treat the aging population. 

There are several specialties for nurse practitioners. According to the 2020 American Association of Nurse Practitioners (AANP) NP Fact Sheet

  • There are more than 325,000 licensed nurse practitioners in the United States.
  • Over 36,000 new NPs completed their academic programs in 2019-2020.
  • Nurse practitioners have prescriptive privileges in all 50 states and Washington DC, although their scope of practice may differ by state. 
  • 69.7% of nurse practitioners are certified in family practice, 7% are certified in adult-gerontology primary care, and 2.9% are certified in adult-gerontology acute care.

As registered nurses gain experience and seek to advance in their careers, many wish to explore advanced practice nursing options. FNPs and AGACNPs both deal with a broader range of patients, but what are the differences between the two? 

While both FNPs and AGACNPs serve as advanced practice nurses, there are some differences for nurses to consider when deciding which career path is best. While many universities offer FNP programs, Rockhurst University is one of the few that offers the more specialized AGACNP program.

Learn more about Rockhurst University's online MSN-AGACNP program

What Does a Family Nurse Practitioner Do?

A family practice provider is often what comes to mind when we think of a traditional health care provider. In the past, a general practitioner would serve an entire town or region—young and old. Many older generations have fond memories of doctors who would make house calls and treat everybody in their household. 

Today, this role is open to both family medicine doctors and FNPs. Although most FNPs no longer make house calls, they do care for patients of all ages across a wide variety of populations.

  • FNPs often deliver babies and then continue to care for them from birth until the end of their lives. FNPs should enjoy working with individuals and families through all stages of life.
  • Depending on their community, FNPs may provide care to the mother prenatally, assist with deliveries, and then continue care for children, adolescents, adults, and older adult patients.
  • In some underserved communities, the FNP may be the only health care provider available.

FNPs typically focus on wellness, as well as chronic disease prevention and management. They can also obtain additional certifications in areas like diabetes education or pain management. FNPs commonly deal with problems like abdominal pain, urinary tract infections, and gastroesophageal reflux disease. As the primary care provider, FNPs may also act as the coordinator of a patient with multiple medical conditions. 

How Are AGACNPs Different From FNPs

How Are AGACNPs Different From FNPs?

Like FNPs, AGACNPs can care for patients at many stages of their lives; however, they do not provide care for the pediatric and early adolescent populations. The AGACNP is trained to meet the unique challenge of supporting adults from late adolescence to the older stages of life. 

As the United States population continues to age, many patients’ health care needs become increasingly complex. Patients entering adulthood have an increased chance of developing one or more chronic health conditions such as diabetes, hypertension, and obesity.

The management of chronic diseases can be challenging for patients, their families, and their providers. This is especially difficult when a patient develops a more acute health issue or a hospital admission. Complications can occur when a patient must take medications for several chronic or acute conditions. Polypharmacy may lead to more complex or unexpected interactions, which could go unrecognized by health care providers.

It is the responsibility of the AGACNP to diagnose and manage complex chronic and acute health conditions that may occur simultaneously in areas such as endocrinology, cardiology, orthopedics, and pulmonology. 

According to the AANP, the top diagnoses treated by AGACNPs are hypertension, heart failure, and diabetes. Proper management of this population requires advanced practice nurses who are trained in critical care concepts. They will need to develop personalized care plans that suit their adult and older patients and their families. 

Currently, fewer nurse practitioners specialize in acute care of the adult and older adult population. As the geriatric population grows, the demand for this specialty will also continue to increase. 

Salary and Employment Outlook for FNPs and AGACNPs

As of 2020, the U.S. Bureau of Labor Statistics lists the following general information about nurse practitioners:

  • There are currently 325,000 licensed nurse practitioners in the U.S. 
  • The median pay is $111,680 per year.
  • There are currently 220,300 jobs. 
  • Between 2020 and 2030, the projected employment growth rate is 52%, or 114,900 additional jobs. 

According to the AANP, full-time AGACNPs have a median total annual income of $113,000 and full-time FNPs have an average income of $115,000. These numbers include base salary, productivity bonuses, incentive payments, and more.

Where Do AGACNPs and FNPs Work?

Some of the most common places nurse practitioners work are: 

  • State, private, and local hospitals.
  • Outpatient clinics and care centers. 
  • Educational care centers.

According to the AANP, the top practice settings for AGACNPs are hospital inpatient units and hospital outpatient clinics. Their primary clinical focus areas are critical care, cardiovascular, and hospitalist. In contrast, the AANP lists the top practice settings for FNPs as hospital outpatient clinics, private group practices, and private physician practices. The main clinical focus for FNPs includes family, primary, and urgent care.

In addition to providing direct patient care, FNPs and AGACNPs can work as case managers for insurance companies, conduct research, and teach at universities. They can also work for nonprofits or government entities. 

Education and Certification Requirements for an AGACNP

Nurse practitioners are advanced practice nurses who hold a master's degree or higher. Preparation includes advanced courses in pathophysiology, pharmacology, assessment, health promotion, diagnosis, and intervention. In addition to classroom education, AGACNPs must have several hundred hours of clinical experience with the adult population in a variety of settings.

Upon completion of their education, AGACNP candidates may obtain one of two entry-level advanced practice certifications from either the American Academy of Nurse Practitioners or the American Nurse Credentialing Center. 

When considering an AGACNP program, students should seek a transformational learning experience that combines personal and professional growth. The ideal program should provide supportive resources and clinical placements to maximize their educational experience. It is also important to find a program with an emphasis on holistic care for patients and their families. 

A Career as an AGACNP May Be of Interest if You Are:

  • A registered nurse with a BSN who is interested in increasing your knowledge and impacting your community. 
  • Motivated to pursue a career that offers competitive pay and job growth.
  • Interested in pursuing a pathway to a rewarding new role, helping adults and older adults and their families deal with the challenges of acute illnesses and conditions.
  • Intrigued by working in a fast-paced, acute care environment.
  • Inspired to pursue learning guided by the Jesuit tradition of service and care for the whole person.

If so, we invite you to learn more about Rockhurst University’s online Master of Science in Nursing–Adult-Gerontology Acute Care Nurse Practitioner program.