Nursing is a broad field with multiple licensure types and roles to choose from. Although work settings, patient populations, and even some responsibilities may overlap, each type of nurse has a distinct role, scope of practice, and pathway to licensure and specialization.
This article focuses on the difference between nurse practitioners (NPs) and registered nurses (RNs).
Learn the similarities and differences between these essential nursing professionals, from education to typical responsibilities to average salary. As we’ll explore below, NPs must pursue more education and will have a wider scope of practice, greater autonomy, and the authority to diagnose patients and prescribe medications, while RNs mainly provide patient care.
What Is an RN?
An RN is a licensed nursing professional who provides patient care in collaboration with physicians and other healthcare professionals. Registered nurses may work in various settings and specialize in different areas.
How to Become an RN
A practicing registered nurse has completed an RN program, passed the National Council Licensure Examination for Registered Nurses (NCLEX-RN), and met other state-specific requirements to obtain an RN license.
The most common types of RN programs are the following:
- Associate Degree in Nursing (ADN): Depending on the specific nursing program, associate degrees may also be called Associate of Applied Science (AAS) or Associate of Science in Nursing (ASN). These programs typically take two to three years to complete.
- Bachelor of Science in Nursing (BSN): BSN programs usually take four years to complete, although there are accelerated programs for individuals who already hold bachelor’s degrees in another field or have already initiated some form of nursing education.
Where Do RNs Work?
Once candidates obtain their licenses, they can search for RN jobs. According to the U.S. Bureau of Labor Statistics (BLS), the following are the most common settings for RNs to work, along with the percentage of registered nurses working in each setting:
- General Medical and Surgical Hospitals: 30.61%
- Specialty (except Psychiatric and Substance Abuse) Hospitals: 22.42%
- Psychiatric and Substance Abuse Hospitals: 17.40%
- Outpatient Care Centers: 15.39%
- Home Health Care Services: 11.21%
- Offices of Physicians: 7.74%
Most RNs work in hospitals. However, not all hospital RN jobs are the same. Within the same hospital, RNs may have jobs in numerous units: the emergency room (ER), the intensive care unit (ICU), telemetry, medical-surgical (med-surg), and many more. Naturally, RNs obtain different knowledge, experience, and skills depending on the hospital unit or other healthcare setting in which they work.
What Do RNs Do?
An RN’s scope of practice may vary based on their work settings. However, the following are typical responsibilities of RNs:
- Assessing patients’ conditions
- Recording patients’ medical histories and symptoms
- Observing patients and recording the observations
- Administering patients’ medicines and other treatments
- Setting up plans for patients’ care or contributing to existing plans
- Consulting and collaborating with physicians and other healthcare professionals
- Operating and monitoring medical equipment
- Assisting with diagnostic tests and analyzing the results
- Educating patients and family members on managing illnesses or injuries
- Providing patients and their families with instructions for at-home care after treatments
What Is the Average RN Salary?
How much does an RN make? Based on data from the BLS, the average hourly wage for RNs in the United States is $45.42, and the average annual wage is $94,480. However, RN pay can vary due to numerous factors, including location, work setting, and specialization. Here are typical variations in RN wages:
- 10th Percentile: $63,720
- 25th Percentile: $75,990
- 50th Percentile: $86,070
- 75th Percentile: $104,670
- 90th Percentile: $132,680
These percentiles reflect the number of RNs that earn up to a certain amount. In other words, 50 percent of RNs earn up to $86,070, and 90 percent earn up to $132,680.
What Is an NP?
Nurse practitioners are advanced practice registered nurses (APRNs). In other words, NPs are RNs who have continued their studies, gaining the advanced clinical knowledge and skills required to diagnose, manage, and prescribe medications and other treatments for patients.
APRN vs. NP
NPs are classified as APRNs, along with certified registered nurse anesthetists (CRNAs), certified nurse-midwives (CNMs), and clinical nurse specialists (CNSs). NPs are the most numerous group of APRNs. According to the U.S. Bureau of Labor Statistics, in 2022, NPs accounted for 266,300 of the 323,900 employed APRNs. Furthermore, nurse practitioner jobs are expected to grow at the fastest rate among APRNs. Specifically, NP employment is projected to increase by 45 percent from 2022 to 2032.
How to Become an NP
To become a nurse practitioner, candidates must first become BSN RNs. Therefore, if an ADN RN wishes to become an NP, they must first obtain their BSN. They may do this in approximately one year through an RN-to-BSN bridge program. Once a candidate holds both a BSN and an RN license, they must complete an NP-focused graduate master’s or doctoral nursing program and pass a national NP board certification exam.
When aspiring NPs choose a master’s or doctoral program, they determine the patient population they will work with as nurse practitioners. Here are some areas of NP specialization:
- Adult-Gerontology Acute Care NP (AGACNP): These nurse practitioners provide advanced, acute care to adolescents, adults, and the elderly.
- Adult-Gerontology Primary Care NP (AGPCNP): These NPs provide advanced primary care to adolescents, adults, and the elderly.
- Family NP (FNP): FNPs provide a wide range of healthcare services to patients of all ages.
- Neonatal NP (NNP): NNPs specialize in providing advanced care to premature and ill newborns and usually work in neonatal intensive care units (NICUs).
- Pediatric NP (PNP): PNPs care for newborns, infants, toddlers, adolescents, and young adults. PNPs can also choose to focus on primary or acute care.
- Psychiatric Mental Health NP (PMHNP): PMHNPs specialize in providing advanced care to patients with mental health disorders, often working alongside primary care and specialty providers.
- Women’s Health NP (WHNP): WHNPs specialize in providing comprehensive healthcare to women of all ages.
According to the American Association of Nurse Practitioners, 89.7 percent of NPs are certified in primary care, and 69 percent provide primary care. However, remember that NP employment is expected to grow 45 percent over the following decade—compared to 3 percent for all occupations. Therefore, there is an enormous need for nurse practitioners and an interest in NPs in all areas.
Where Do NPs Work?
Nurse practitioners typically work in the following settings:
- Offices of physicians: 47%
- Hospitals (state, local, and private): 25%
- Outpatient care centers: 9%
- Offices of other health practitioners: 4%
- Educational services (state, local, and private): 3%
What Do NPs Do?
Nurse practitioners are primary and specialty care providers, providing advanced nursing services to patients and their family members. Although nurse practitioner and physician collaboration is essential, NPs have a high level of autonomy. Allowing for the fact that an NP’s scope of practice varies by state, the following are typical nurse practitioner duties:
- Assessing patients
- Determining how to improve or manage a patient’s health
- Discussing ways to incorporate health promotion strategies into a patient’s life
- Working independently, prescribing medications, and ordering laboratory tests (subject to state laws)
- Consulting with physicians and other health professionals when needed
Not all NPs prescribe medications. Check whether nurse practitioners can prescribe meds in your state.
What Is the Average NP Salary?
If you see yourself working as an NP, you’re likely wondering, “How much do nurse practitioners make?”
The average nurse practitioner wage is $61.78 per hour and $128,490 annually. NP income also varies due to many of the same factors impacting RN income. Allowing for these diverse factors, the salary of a certified nurse practitioner (CNP) typically falls within the following wage range:
- 10th Percentile: $94,530
- 25th Percentile: $106,960
- 50th Percentile: $126,260
- 75th Percentile: $140,610
- 90th Percentile: $168,030
These percentiles can be interpreted in the same way as RN wage percentiles. Therefore, 90 percent of NPs earn more than $94,530 annually, and only 10 percent earn less.
What’s the Difference between an RN and an NP?
In summary, the question of “RN or NP” boils down to a difference in education and specialization, which results in a differentiated scope of practice and level of remuneration. NPs are required to have more education, a broader scope of practice, more autonomy, and the authority to diagnose patients and prescribe medications. On the other hand, RNs primarily provide patient care and work under supervision.
Are you still unsure which role to pursue? The good news is that there is no rush to decide between becoming a nurse practitioner vs. a registered nurse. You have to become an RN before you become an NP, so finding a good RN program will be a necessary first step, either way. Once you have experience working as a registered nurse, you can decide whether you would enjoy continuing your studies and having greater autonomy in your nursing practice.
If you haven’t started nursing school yet, here are some of the best RN programs in the US broken down by state so you can find an excellent program near you.
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