If you are interested in becoming a nurse, you’ll be happy to hear that a nursing career comes with steady job security, competitive salaries, and the immense satisfaction of knowing that you’ve made a real impact on your patients’ lives. It’s important to note, though, that there are many different potential career paths and job titles that you might want to pursue, and each carries its own educational and training requirements.

Two nursing careers that are often considered side by side are registered nurses (RNs) and nurse practitioners (NPs). But do you truly understand the difference between these roles? Here’s a breakdown of the day-to-day tasks, education and certification requirements, and salaries.

What do Registered Nurses (RNs) do?

The specific job duties that registered nurses perform on a daily basis will vary substantially depending on where they work, the size of their team, and the population they serve, but one thing that is true no matter what is that no two days are ever really the same.

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A registered nurse’s primary role is to assess patients, identify their critical needs, and implement a medical plan. With this in mind, RNs spend much of their time performing tasks like:

  • Assessing and observing patients
  • Recording patient medical history and symptoms in detail
  • Administering and monitoring prescribed medications, IV, and other treatments for side effects and reactions
  • Creating, implementing, and evaluating patient care plans with the medical team
  • Caring for wounds, such as cleaning and bandage changing
  • Drawing blood, urine samples, and other body fluids for lab work
  • Educating patients and family members on treatment and care plans for injuries, conditions, and illnesses
  • Supervising licensed practical and vocational nurses, nursing assistants, and students

Although many people know of RNs in a hospital or clinical setting, they also commonly work in schools, assisted living facilities, in patient homes, for large corporations, and in the military, among other locations.

Registered nurses work within a variety of patient populations and specializations, such as pediatrics, oncology, family medicine, geriatric, ambulatory care, or rehabilitation. This means that you have a wide range of career options and specialties to pursue.

Ultimately, registered nurses wear many hats and play a vital role within medical institutions. They have to be familiar with both the medical industry and hospital technology, they evaluate and educate patients, and they administer potentially life-changing medications.

What do Nurse Practitioners (NPs) do?

Like registered nurses, nurse practitioners work closely with patients to monitor their health and provide medical care, but their roles may change depending on the location of their position, facility, and specific field.

NPs usually perform the following duties:

  • Recording patient medical histories and symptoms and ensuring accurate medical records to provide diagnoses
  • Collecting information and samples from patients
  • Performing routine and detailed examinations
  • Evaluating medical and test results and observing patients
  • Creating individual treatment plans and performing referrals
  • Prescribing medications and monitoring results
  • Ordering diagnostic tests and operating some medical equipment
  • Supervising nurses and other staff members
  • Collaborating with other healthcare professionals to share knowledge, create treatment plans, and diagnose patients

Some common specialties for nurse practitioners are pediatric care, geriatrics, hospitals, managed care facilities, government agencies, family practice, private care, emergency room care, and university faculty.

To be successful, NPs should be familiar with new developments in medicine and health care, be detail-oriented, especially when it comes to data, and have empathy and compassion in order to build a relationship with their patients.

Differences Between Registered Nurses and Nurse Practitioners

Roles and Responsibilities

Although both registered nurses and nurse practitioners focus on patient observation and care, the largest difference between the two roles is that NPs are permitted to prescribe treatments, order tests, and diagnose patients—duties normally performed by physicians—whereas RNs are not. Registered nurses, on the other hand, usually work under a physician who determines patient care, diagnoses, and follow-up.

This means that the primary difference between registered nurses and nurse practitioners, from a responsibility perspective, is that nurse practitioners have greater autonomy and responsibility due to their advanced education, training, and experience.

“In the state of Massachusetts, a nurse practitioner can practice independently,” says Donna Glynn, PhD, RN, ANP, and associate dean of pre-licensure nursing at Regis College. “So that means they can serve as a primary care provider without oversight of a physician. That includes prescribing medication and ordering of tests. In primary care, NPs manage a panel of patients, set up referrals, coordinate with the specialists, and take full account for the patient.”

Training and Education

The amount of training and education required to become a nurse practitioner is different from that of a registered nurse.

In order to become a registered nurse, you must earn a degree from an accredited program and pass the National Council Licensure Examination (NCLEX). You must then apply for state licensure.

Which degree will fulfill the requirements varies by state; some require only an associate’s degree, while others require a bachelor’s degree in nursing (BSN). Even so, bachelor’s degrees are becoming the more common requirement across the country and among employers, so that is typically the recommended entry point if you wish to become an RN.

Registered nurses need a bachelor’s degree in nursing, to pass the National Council Licensure Examination (NCLEX), and to obtain a state licensure to get started in the medical field.

Nurse practitioners, on the other hand, must have earned a master’s degree in nursing (MSN) or higher. They must also complete more clinical hours. If you wish to work with a particular patient population, you will also need to complete additional certifications and training as necessary.

Salary and Job Outlook

You may be wondering what the average salary options look like for both positions, and if they’re dramatically different, especially because both careers require hard work, college education, clinical training, and certifications.

The good news is that both registered nurses and nurse practitioners enjoy generous salaries and benefits. In 2019, registered nurses earned a median annual salary of $74,000 ($35-36 an hour) per year, and even $93,000+ in the state of Massachusetts.

According to the BLS, nurse practitioners earned an average of $115,800 per year ($55.67 per hour) in 2019 and a median of $125,157 in the state of Massachusetts. NPs tend to earn more than RNs, mostly because their positions require a higher level of education, additional clinical hours and certifications, and often work in private settings.

Of course, salary for either position will depend on geographical location, education level, the setting in which you work, and the medical specialty you pursue.

Transitioning from an RN to an NP

While it is possible to become a nurse practitioner all in one go, most NPs start their career as RNs. They then return to school to earn an advanced degree when they decide they would like to advance in their careers to realize a higher salary, more flexible work schedule, increased responsibilities, etc.

No matter which role you pursue, both RNs and NPs lead rewarding careers and have a real impact on patient lives.

“The benefit of nursing is that there’s always more to learn,” says Glynn. “And when people get to that point where they're seeking the next step in their careers, there are always new opportunities.”

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