FNP vs. NP: Comparing FNP with Other NP Specialties
Written By: Caitlin Goodwin MSN, CNM, RN
Family Nurse Practitioners (FNP) are well known across the medical profession for being well-prepared in most areas of advanced practice nursing. FNPs have a broad background of study and are prepared for both primary care and subspecialties. Nurses from different specialties across the board enter school to become an FNP.
However, other nurse practitioners (NP) specialties are a practical option for those with expertise in a specific area of nursing. These specialties include pediatrics, neonatal, women’s health, and gerontology. When selecting an FNP vs NP in other specialties, the decision can be challenging but should be based on your career goals, skills and experience. This article will cover the differences between FNP and NP in other specialties, the requirements to become either type of NP, and the factors to consider when choosing between these careers.
What is an FNP?
An FNP is a registered nurse with a graduate degree and became credentialed and certified to provide advanced care to clients. Like family practice physicians, FNPs offer comprehensive health care across the lifespan, continuing from birth to geriatrics. While both FNPs and family practice doctors achieve a bachelor’s degree, family practice physicians complete a residency and medical school. FNPs attend a graduate program with clinical requirements. The FNP continuously cares for families across all ages, genders, diseases, and body systems.
What is the Difference Between FNP and NP?
An FNP is a specific credential that is either designated FNP-BC or FNP-C, whereas an NP is any type of nurse practitioner in any kind of specialty including family nurse practice. When looking at whether you should become an FNP vs NP in other specialties, there are numerous variables at play. While the FNP has a broad background, many FNPs wind up working in a subspecialty like dermatology, cardiology, women's health, or oncology. The other types of NP specialties
focus more on a specialization, like women’s health, pediatrics or geriatrics, than the wide-ranging education of the FNP. As nurses, many enjoy working and subspecialties and wish to continue on that path as an advanced practice nurse. For example, a nurse who loves his or her career in the pediatric intensive care unit may look into a pediatric acute care NP program.
What are the Other Major Types of Nurse Practitioner Specialties?
Just as there are distinct nursing specializations, there are many types of NP specialties. The specialties focus on the population that nurse practitioners provide health care. These populations range from neonatal NPs to adult-gerontology NP and from acute care to primary care to mental health.
Adult-Gerontology Acute Care Nurse Practitioner (AGACNP):
The adult-gerontology nurse practitioner provides continuous and complete medical care for adults across the lifespan. Adult-gerontology NPs care for patients from adolescence through geriatric, also known as the care of adults over the age of 65 years old. The AGACNP is trained in acute care, meaning short-term treatment.
Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP):
The AGPCNP is similar to the AGACNP but provides primary care instead of acute care. Primary care means they are typically the first contact and medical home for the daily health needs. AGPCNPs deal with a combination of acute and chronic health care issues, such as hypertension and diabetes.
Neonatal Nurse Practitioner (NNP): Neonatal NPs provide specialized care
to newborns across a broad range of health statuses, including prematurity, low birth weight, congenital and genetic disorders, or respiratory problems. They care for high-acuity infants in neonatal intensive care units (NICU) and resuscitate babies on labor and delivery units.
Pediatric Acute Care Nurse Practitioner (PACNP):
Pediatric NPs provide collaborative, comprehensive care to adolescents and children with acute and critical conditions. PACNP provides short-term treatment to patients that focuses on the family, as well. PACNP focuses on urgent conditions and sees patients in urgent cares, emergency departments, and intensive care units.
Pediatric Primary Care Nurse Practitioner (PPCNP):
Pediatric NPs take care of children from birth through adolescence. PPCNP provides well-child care, preventative healthcare, and manages common pediatric illnesses (both acute and chronic). Primary care pediatric providers are typically the first contact and medical home.
Psychiatric Mental Health Nurse Practitioner (PMHNP):
PMHNPs provide a full range of psychiatric medication services, including assessment, diagnosis of mental illness and substance abuse disorders, treating disease with medication and psychotherapeutic management. Some PMHNPs lead psychotherapy groups while others subspecialize in forensic, addiction, or child and adolescent psychiatry.
Women’s Health Nurse Practitioner (WHNP):
WHNPs provide gynecologic and obstetric care. They differ from a Certified Nurse-midwife in that they don’t provide intrapartum (labor and delivery) hospital care and often work in an office setting. These providers offer:
● pap smears
● sexually transmitted infection screening
● annual exams
● prenatal care
● postpartum care
● preventative care
● primary care
● patient education
FNP vs. NP in Other Specialties: Job Duties
All NPs are advanced practice registered nurses who:
● diagnose acute and chronic conditions,
● prevent disease,
● treat conditions,
● prescribe medications,
● order labs and imaging,
● manage overall patient care,
● and provide patient education.
When looking closer at FNP vs NP in other specialties, the duties of the FNP
translate well to a broad population. FNPs treat a broad range of conditions like diabetes, hypertension, and asthma. FNPs often refer patients to a specialist, depending on the complexity, scope, and severity of the issue. The job duties of other kinds of NPs are to specialize within the healthcare environment, specific population, or area of medicine. For example, neonatal NPs insert umbilical venous catheters (UVCs) and intubate infants. Pediatric primary care NPs screen children for developmental and physical disorders.
FNP vs. NP in Other Specialties: Skills & Personality Traits
Whether pursuing an FNP or NP in any other specialty, there are specific skills and personality traits required to be successful in this career. The following are critical characteristics to be a competent NP:
NPs are known for providing personalized education and caring. They empower patients and families to tackle their health issues with kindness and sensitivity.
NPs must take their role seriously, as they are liable for the patient's health and life
NPs must be sensitive to their patients' needs. They should be willing to go the extra mile and place themselves in the shoes of their patients.
NPs are responsible for coordinating care and establishing a long-term plan.
While perfectionism can be seen as a negative trait, NPs who are detail-oriented are less likely to make a mistake.
● Work hard:
NPs must have a strong work ethic and endure long shifts or difficult employment settings.
● Manage stress:
NPs must deal with conflict and high-stress situations. Those who have the coping skills to deal with tough situations are better prepared.
NPs never know what kind of issue a patient may present with, just like nursing. NPs often must be flexible with their expectations and in some cases, their work hours.
● Decision-making skills:
NPs must have solid decision-making and critical thinking skills to solve complicated problems and diagnose various health conditions.
Nurses know that sick families and patients have questions and concerns. When you’re the provider responsible for the care, the expectations are even higher. NPs must be patient. By remaining diligent in the face of adversity and keeping your composure in trying environments, NPs can excel.
Trust your gut. There are so many times why I haven’t been able to explain why I spent an extra half hour in a client’s room at the detriment of the rest of my patients on my schedule or consulted a back-up doctor. However, at least once in your career, you will feel that something is off. Believe it and assess it accordingly.
● Clear communication:
The difference between a nurse and NP means that you are now giving the orders. NPs must clearly ask for what they need, communicate appropriately with patients and their family, and be able to take charge of a group of medical professionals during an emergency.
● People person:
The best NPs have excellent bedside manner and are attentive to both patients and their families. A little humor goes a long way.
FNP vs. NP in Other Specialties: What Education is Required to Become?
The education to become an FNP or NP in any other specialization is similar and upwards of six years of academic training. Both professions require a bachelor’s degree and a master’s degree in nursing (MSN). However, the specific type of MSN differs based on career aspirations. For those that desire an FNP, they should apply to the FNP track. If you are looking for a different specialty, it is critical to apply to the program that matches your dream career.
However, the primary difference between FNP and NP in other specialties is the clinical aspect and specific coursework. The FNP will obtain practical experience in a variety of practice areas such as women’s health, chronic care, acute care, and various settings. For NPs of various specialties, the clinical will focus on those aspects. For example, a neonatal NP will participate in clinical work on the neonatal intensive care unit and work with neonatal experts.
FNP vs. NP in Other Specialties: How Long Does It Take to Become?
While the FNP or NP in other specialties vary slightly in the program’s length, FNPs are fairly standardized depending on the degree one currently holds and whether you plan to attend full-time or part-time. The programs build on prior nursing education to enable you to be a skilled NP. To become an NP in any specialty, you must have a master’s or doctoral degree.
| Program Type|| Pathway|| Full-Time|| Part-Time|
| MSN|| RN to MSN|| 30 to 36 Months|| 36 to 48 Months|
| BSN to MSN|| 15 to 24 Months|| 24 to 48 Months|
| DNP|| BSN to DNP|| 36 to 48 Months|| 48 to 84 Months|
| MSN to DNP|| 12 to 24 Months|| 24 to 48 Months|
How Much Does It Cost to Become?
The cost difference between FNP and NP in other specialties depend on your current level of education and the type of school that you choose. Private universities cost more than public universities. Those that have an associate’s degree will usually pay more to obtain their bachelor’s degree.
Overall, MSN-FNP programs range from $18,810 to $231,600. Degrees from other NP specialties also range depending on type of school and the length of the program. For example, most NP programs require students to complete 30 to 54 credits (45 on average).
In-state tuition averages for public schools cost about $400 a credit ($225 to $665) or $18,000 for the whole program. For out of state or private tuition cost, expect to pay $500 to $1500 per credit. The average cost of an NP program at one of these universities is about $45,000.
| Program Type|| Pathway|| Tuition Range|
| MSN|| RN to MSN|| $22,070 - $231,600|
| BSN to MSN|| $18,810 - $185,280|
| DNP|| BSN to DNP|| $26,490 - $254,260|
| MSN to DNP|| $17,660 - $169,510|
FNP vs. NP in Other Specialties: Certification & Licensure Requirements
All NPs, including FNPs, require certification and licensure to practice. The FNPs and NPs in other specialty areas must hold an active and unencumbered registered nurse license. After graduation, they will need to pass their respective certification.
For FNPs, there are two different options for the credentialing exam for licensure. The FNP-BC is credentialed by the American Nurses Credentialing Center (ANCC)
, while the FNP-C is credentialed by the American Academy of Nurse Practitioners
Certification Board (AANPCB).
NPs with other specialties must seek national certification from their respective board. Just like FNP, some are done by the ANCC
, while others are done by the AANPCB
, Pediatric Nursing Certification Board (PNCB
), or the NCC.
| NP Specialty|| Certification Board|
| Adult-gerontology acute care NP (AGACNP)|| ANCC|
| Adult-gerontology primary care NP||1. AGPCNP-BC from ANCC|
2. A-GNP from AANPCB
| Neonatal NP (NNP-BC)|| NCC|
| Pediatric acute care NP (CPNP-AC)|| PNCB|
| Pediatric primary care NP||1. CPNP-PC from PNCB|
2. ANCC from PPCNP-BC
| Psychiatric mental health NP (PMHNP-BC)|| ANCC|
| Women’s health NP (WHNP)|| NCC|
The licensure requirements vary by state. However, after passing one’s certification exam, it is time to apply to the state board for NP licensure. In order to apply, you must have a clean background check and an active registered nurse license.
How Many Nurse Practitioners are Currently Working in This Specialty?
There are a great deal more FNPs than any other NP specialty. FNPs work in a broad scope like primary care and also subspecialties like cardiology or oncology. However, other NP specialties include adult-gerontology primary care, pediatrics primary care, women’s health, and psychiatric mental health NP.
| Certification|| Percent of NPs|
| FNP|| 65.4%|
| Adult|| 12.6%|
| Adult–Gerontology Primary Care|| 7.8%|
| Acute Care|| 5.5%|
| Pediatrics–Primary Care|| 3.7%|
| Adult–Gerontology Acute Care|| 3.4%|
| Women's Health|| 2.8%|
| Psychiatric/Mental Health–Family|| 1.8%|
| Gerontology|| 1.7%|
| Hospice and Palliative Care|| 1.5%|
FNP vs. NP in Other Specialties: Sub-Specialization Options
An FNP vs NP in other specialties have a variety of choices in the NP specialties. For those who are interested in a subspecialty, there are specific programs you should pursue:
| NP Subspecialty|| NP Program|
| Orthopedics NP|| Adult-Gerontology NP|
| Palliative care|| Primary care adult-gerontology NP|
| Emergency medicine|| Acute care pediatric or acute adult-gerontology NP|
| Oncology|| Primary care or acute pediatrics or care adult-gerontology|
| Psychosomatic medicine|| FNP|
| Dermatology|| FNP, primary care adult-gerontology|
| Nephrology|| Primary care adult-gerontology, acute care adult-gerontology|
| Cardiology|| FNP|
| Holistic care|| FNP|
| Surgery|| Acute care adult-gerontology or pediatrics|
| Addiction medicine|| Psychiatric Mental health NP|
Where Do They Practice?
Both FNPs and NPs in other specialties
work in a number of different fields:
● Medical offices
● Acute care hospitals
● Long-term care
● Public health department
● Emergency departments
● Urgent care clinics
● Private practices
● Public or private schools
● Colleges and universities
● Medical spas
● Health information technology departments
For work hours, there is not much difference between an FNP and NP in other specialties. Most NPs that work in medical offices and clinics work a typical day shift that lasts about eight hours and a forty-hour work week. However, many nurse practitioners are on call or in-house at health facilities during weekends, holidays, and nights. In these cases, some NPs work longer shifts that last 12 to 24 hours.
Working in the medical profession puts anyone at risk for job stress. However, all NPs increase their job satisfaction by focusing on a specialty they love, experiencing autonomy, having positive communication with peers and supervisors, an environment with stress, and overall experience. Job stress significantly influences job satisfaction.
Both FNP and other NP specialties have high levels of job satisfaction. If one environment is stressful, there are usually options that may be a better fit. In fact, the U.S. News & World Report rated NPs fourth in the ranking of best jobs for 2018 due to high demand and salary. Thus, regardless of which NP path you take, the overall career satisfaction is worthwhile!
FNP vs. NP in Other Specialties: Job Outlook
The overall job outlook of all advanced practice nurses is projected to increase by more than 50 percent, much faster than the average of all occupations. There will be 24,200 career openings per year for the next ten years in the United States, adding up to about 110,700 more NPs by 2029. When looking specifically at FNP vs NP in other specialties, all areas continue to grow. There are nearly 300,000 NPs
in the United States and more than 30,000 new NPs graduated in 2018-2019.
FNP vs. NP in Other Specialties: Starting Salary
The starting salary of nurse practitioners vary tremendously depending on the specialty. The initial annual range is from $65,460 a year as a Pediatric to nearly $10,000 more as a Neonatal Nurse Practitioner.
| NP Specialization|| Hourly|| Monthly|| Annual|
Neonatal Nurse Practitioner (NNP)
| $35.59|| $6,170|| $74,030|
Psychiatric-Mental Health Nurse Practitioner (PMHNP)
| $34.73|| $6,020|| $72,240|
Adult-Gerontology Acute Care Nurse Practitioner (AGACNP)
| $33.62|| $5,830|| $69,920|
Family Nurse Practitioner (FNP)
| $33.04 || $5,730 || $68,730 |
Women’s Health Nurse Practitioner (WHNP)
| $32.00|| $5,550|| $66,570|
Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)
| $31.53|| $5,470|| $65,590|
Pediatric Acute Care Nurse Practitioner (PACNP)
| $31.50|| $5,460|| $65,510|
Pediatric Primary Care Nurse Practitioner (PPCNP)
| $31.47|| $5,460|| $65,460|
Average Hourly Pay
The average hourly pay for nurse practitioners varies tremendously between FNP and other specializations. Interestingly, neonatal NPs who care for infants make the most each hour ($48.90) while pediatric NPs who see children and babies in the office as a primary care provider make the least at $43.23. FNPs earn in the middle of that at $45.39.
| NP Specialization|| Hourly Pay|
| Neonatal Nurse Practitioner (NNP)|| $48.90|
| Psychiatric-Mental Health Nurse Practitioner (PMHNP)|| $47.71|
| Adult-Gerontology Acute Care Nurse Practitioner (AGACNP)|| $46.18|
| Family Nurse Practitioner (FNP)|| $45.39 |
| Women’s Health Nurse Practitioner (WHNP)|| $43.97|
| Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)|| $43.32|
| Pediatric Acute Care Nurse Practitioner (PACNP)|| $43.27|
| Pediatric Primary Care Nurse Practitioner (PPCNP)|| $43.23|
FNP vs. NP in Other Specialties: Average Annual Salary
The salary of FNP vs NP in other specialties varies significantly more than you may think. However, like hourly salary, NNPs make the most ($101,702), pediatric primary care NPs make the least ($90,000), while FNPs make somewhere in the middle ($94,415).
| NP Specialization|| Average Salary|
| Neonatal Nurse Practitioner (NNP)|| $101,702|
| Psychiatric-Mental Health Nurse Practitioner (PMHNP)|| $99,238|
| Adult-Gerontology Acute Care Nurse Practitioner (AGACNP)|| $96,063|
| Family Nurse Practitioner (FNP)|| $94,415|
| Women’s Health Nurse Practitioner (WHNP)|| $91,454|
| Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)|| $90,102|
| Pediatric Acute Care Nurse Practitioner (PACNP)|| $90,000|
| Pediatric Primary Care Nurse Practitioner (PPCNP)|| $89,924|
The Bottom Line: Is FNP the Right Nurse Practitioner Specialty for You?
When considering the FNP vs NP in other specialties, the main difference is that FNPs are flexible and can treat people of all ages and many different populations. The other NP specialties are more narrow in scope and focus on the specific areas of health care or age groups.
Nursing is a noble profession. Nurses give more than just their hours, they give their heart and their time. Regardless of which route to nurse practitioner that you choose, you will be changing and saving lives. Follow your passion and you can’t go wrong!
Caitlin Goodwin MSN, CNM, RN
Caitlin Goodwin is a Certified Nurse-Midwife who has been a nurse for 12 years, primarily in women’s health. She is passionate about caring for children with developmental disabilities, as her son has Autism Spectrum Disorder. Caitlin loved working as a camp nurse for a summer camp for those with special needs