RN vs. NP: Choosing Between Nursing Career Paths
The need for nurses and other health care professionals has never been greater. With nurses from the baby-boom generation reaching retirement age and other groups of nurses changing careers or leaving the workforce entirely, the health care system is in a precarious situation. The U.S. is currently experiencing a nationwide nursing shortage, and the problem is projected to get worse. According to a study published in the American Journal of Medical Quality, a shortage of more than half a million registered nurses (RNs) is predicted by 2030. This is likely to cause longer wait times for patients and a degradation in care as hospitals struggle to continue operating with insufficient human resources.
What does this mean for the health care field? How can we possibly offset a nursing shortage of that magnitude? These questions are being asked throughout the health care industry. Two solutions are to improve retention efforts with current nurses and to ramp up the education and training of new nurses. Hiring new nurses has become such a priority that some hospitals are offering signing bonuses.
The demand for RNs and nurse practitioners (NPs) is causing many to consider a career in health care, but how do you choose between the two career paths? When making the RN vs. NP comparison, much needs to be considered: each role’s responsibilities and duties, required educational path, and salary and long-term job outlook. The journey to become either an RN or NP is challenging; however, each has a distinct set of advantages. Knowing these advantages and the distinctions between the two will help you along as you weigh your options.
RN job description
In any hospital or health care facility, RNs make up the majority of nursing professionals on staff. When you read about front-line health care workers, this group includes RNs, who are typically the first to deliver and coordinate patient care. Most RNs work in hospital settings, but they also work in private physician offices, outpatient care centers, nursing homes, and government facilities. Some RNs may make house calls to those who are unable to reach a hospital.
The RN job description and day-to-day duties include the following:
- Conducting the initial assessment and documenting the patient’s medical history and symptoms for the hospital’s records
- Observing patients and maintaining detailed records
- Administering treatment and medication to patients
- Operating medical equipment and patient monitoring devices
- Providing patients with information about their condition and treatment plan
- Collaborating with other health care professionals as it relates to patient care
- Assisting with diagnostic tests
- Informing family members about patients’ conditions and teaching them how to manage injuries and illnesses at home
Although most RNs work in hospitals or health care facilities as part of a team of physicians, they can also work in specialized roles or with specific patient groups. For example, an RN interested in working exclusively with older adults may consider becoming a geriatric nurse. Another may choose to work as an addiction nurse, treating patients overcoming substance abuse problems involving drugs, alcohol, or other addictive substances. The specialty or demographic of patients that an RN works with will ultimately determine the job duties and the types of illnesses and injuries treated.
NP job description
When making the RN vs. NP comparison, it’s important to be aware that while all NPs are RNs, not all RNs become NPs. NPs, who are referred to as advanced practice registered nurses (APRNs), have more education than RNs; more clinical experience; and, in most cases, a health care specialty that they practice. Their work environment is similar to that of RNs; they can be found in hospitals, health care facilities, urgent care centers, and outpatient clinics.
NPs provide acute and primary care as well as specialty health care services. The main difference between an NP’s and an RN’s work is that NPs have far more practice authority and are higher up in the health care system’s hierarchy. In some states, NPs can prescribe medication. The presiding NP on staff often manages or directly supervises RNs.
The NP job description and day-to-day duties include the following:
- Managing RNs and delegating tasks
- Collecting and documenting patient information
- Educating patients on maintaining a healthy lifestyle
- Performing patient examinations and ordering applicable diagnostic tests
- Analyzing diagnostic tests and explaining results to patients
- Devising effective treatment plans for both acute and chronic conditions
- Conveying health care information to patients and their families clearly
- Prescribing medication to patients and monitoring the results and/or side effects
NPs generally specialize in one area of medicine or treat a specific patient demographic. The following is a list of NP specialties and subspecialties:
- Acute care nurse practitioner
- Adult-gerontology nurse practitioner
- Cardiac nurse practitioner
- Certified nurse-midwife
- Certified registered nurse anesthetist
- Clinical nurse specialist
- Dermatology nurse practitioner
- Emergency nurse practitioner
- Family nurse practitioner
- Holistic nurse practitioner
- Hospice nurse practitioner
- Neonatal nurse practitioner
- Orthopedic nurse practitioner
- Pediatric nurse practitioner
- Psychiatric nurse practitioner
- Surgical nurse practitioner
- Women’s health nurse practitioner
An NP’s specialty will ultimately determine the day-to-day job duties and work environment. For example, a pediatric nurse practitioner (PNP) works exclusively with children and adolescents, focusing on treating acute injuries and providing preventive care, such as immunizations. A dermatology nurse practitioner works with patients of all ages, but focuses exclusively on skin disorders, such as rashes, eczema, and psoriasis.
The vast number of specialties makes becoming an NP the ideal choice for someone whose interests lie in a specific area of medicine. According to a 2021 report by the American Association of Nurse Practitioners (AANP), 88.9% of NPs are certified in primary care, with 70.2% of all NPs delivering primary care. The most common certifications among primary care NPs include family (69.7%), adult (10.8%), and adult-gerontology primary care (7%).
How to become an RN
Education is an important factor to consider when making the RN vs. NP comparison. For those of you wondering how to become an RN, the path always begins with getting a degree. However, multiple ways to go about getting one exist, each with a distinct timeline and results.
- Diploma in nursing. A diploma in nursing is the most basic nursing degree. It takes between two and three years to complete and will qualify you to become licensed as an RN and to practice in some entry-level positions. If you’re serious about a career in nursing, pursuing further education is highly recommended.
- Associate of Science in Nursing. An ASN will prepare you for licensing and most entry-level nursing positions. The two-year program combines nursing coursework with hands-on experience.
- Bachelor of Science in Nursing. The BSN program is the highest-level undergraduate degree. It will prepare you for all entry-level nursing roles in addition to some higher-level positions. The BSN program generally takes four years to complete; however, accelerated BSN and RN-BSN programs operate on shorter timelines.
After earning a degree, all nurses must be licensed to practice as RNs; this requires passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN). A direct correlation between degree type and pass rate exists for the NCLEX-RN exam: According to the National Council of State Boards of Nursing (NCSBN), 82.8% of ASN candidates passed, compared with 90.3% of BSN candidates (reported in June 2021).
Once you’ve passed the NCLEX-RN, you can apply for your RN license with your state. Beyond having a degree and passing the NCLEX-RN, some states require a comprehensive background check, academic transcripts, and a certain number of clinical hours. Once you meet your state’s licensing requirements, you can begin practicing as an RN.
How to become an NP
Similar to an RN, becoming an NP starts with education. The main difference is that NPs are required to have at least a Master of Science in Nursing (MSN) degree.
Deciding on the type of master’s program is critical, as it will ultimately determine your career path. Some opt for an MSN degree program with no specialization, making them generalists. Others choose an area of focus. The MSN-FNP degree, for example, focuses on family care, while the MSN-PNP degree focuses on pediatrics. If you’ve been working as an RN for a while, you’ve probably had the opportunity to treat a wide variety of patients experiencing an array of health care challenges. Choose your MSN degree specialization based on what interests you most.
MSN program length and coursework vary by specialty, but you should expect to invest two to three years in graduate coursework. After completing a graduate education, you’ll need to take a national board certification exam specific to your area of focus. Five NP certification boards administer exams:
- American Academy of Nurse Practitioners Certification Board (AANPCB)
- American Nurses Credentialing Center (ANCC) Certification Program
- American Association of Critical-Care Nurses (AACN) Certification Corporation
- Pediatric Nursing Certification Board (PNCB)
- National Certification Corporation (NCC)
After passing the exam for your specialty, you’ll need to apply for NP licensure in your state. Make sure to consult your state’s specific NP requirements, as they vary. Then, you’ll need to meet renewal requirements and continuing education hours to maintain a valid credential.
Different NP credentials are valid for different periods of time. Some are valid for five years, while others need to be renewed annually. It’s critical that you’re aware of your credential’s expiration date and recertification requirements to ensure that your license doesn’t lapse. Eligibility requirements vary by NP specialty; however, one consistent requirement is that you must have an unencumbered license that hasn’t been subjected to formal discipline by the state board of nursing.
RN salary and job outlook
When making the RN vs. NP comparison, salary and job outlook are significant factors. According to the U.S. Bureau of Labor Statistics (BLS), the median annual salary for RNs was $75,330 in 2020. The BLS projects the number of positions to grow by 9% between 2020 and 2030, on pace with overall job growth.
Education can play a role in salary. December 2021 data from the salary site PayScale shows that RN salary ranges vary widely by degree type. Experience, region, and the health care facility can also be factors.
NP salary and job outlook
Due to their advanced education, experience, and larger scope of practice, NPs earn higher salaries than RNs. According to the BLS, nurse anesthetists, nurse-midwives, and NPs made a median annual salary of $117,670 in 2020. Positions are projected to grow by 45% between 2020 and 2030, much faster than RNs and the national average.
However, NPs aren’t paid the same across the board. Different specialties yield different salaries. For example, PayScale reported that FNPs made $98,000 per year, compared with psychiatric nurse practitioners who made approximately $112,000 per year as of December 2021. If you’re equally drawn to two or more NP specialties, salary may influence your decision when choosing an MSN degree.
Embark on the path to a career in health care
Although RNs and NPs both positively impact the health care system and the lives of patients, and both offer considerable job security, making the choice between RN vs. NP comes down to a few factors. The path to becoming an RN is shorter and will enable you to enter the workforce sooner, but the salary range is lower than for NPs. Conversely, the path to becoming an NP is longer, but it can lead to a much larger scope of practice and higher salary. Additionally, becoming an NP will enable you to practice in a specific area of health care.
Whichever career path you decide, rest assured that both RNs and NPs are highly valued in the health care system. Pursuing either role means you’re doing your part in helping the country offset the nursing shortage.
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