Written By: Lauren Jacobson MS, RN, WHNP-BC
Are you looking at nurse practitioner programs and wondering what specialty you should choose? Are you confused about what types of nurse practitioners there are? Here we will clear up that confusion by discussing the difference between nurse practitioner population foci and nurse practitioner subspecialties. The good news is that while you may be feeling confused or boxed in, you may actually have many more options than you think!
Where Do You Start?
One of the draws to becoming a nurse practitioner is the flexibility in being able to change the focus or direction of your career but knowing where to start can be a challenge. A common question soon-to-be students ask themselves is ‘what do I want to specialize in?’ To answer this question, we must first clarify what types of nurse practitioners there are. Though commonly referred to as specializations nurse practitioner degree programs are actually categorized by the population foci that they are nationally certified in. For the purpose of this article “specialization” and “population foci” or “focus” will be used interchangeably. Generally, there are 6: Adult-gerontology Nurse Practitioner (A-GNP), Pediatric Nurse Practitioner (PNP), Neonatal Nurse Practitioner (NNP),Psychiatric Mental Health Nurse Practitioner (PMHNP),Family Nurse Practitioner, and Women's Health Nurse Practitioner (WHNP). PNPs and A- GNPs can also be acute care certified depending on which certification exam you take after graduating. The population focus is what must be chosen when you enroll in your masters or doctor in nursing practice (DNP) degree. You then must take a national certification exam in your population focus. After you have done this you can further specialize either through post-graduate certification, work experience, or sometimes both. Here we go into the details of each population focus group as well as the different types of nurse practitioners there are within those groups.
Nurse Practitioner Population Foci
1. Adult-Gerontology Nurse Practitioner
The A-GNP certified nurse practitioner has completed coursework and clinical hours to sit for the national certification exam for this population focus. Typically, an A-GNP is trained to work in primary care unless they have taken additional coursework and had clinical hours preparing them to sit for the acute care certification exam. A-GNPs often work in outpatient clinics providing primary care to adults. Other options can include working in specialty offices like dermatology or infectious disease.
2. Adult-Gerontology Acute Care Nurse Practitioner (ACNPC-AG)
To be an ACNPC-AG you have to complete an A-GNP focused graduate degree and meet the criteria to take the acute care certification exam for adult-gerontology nurse practitioners. This involves meeting certain criteria including didactic and clinical hours. As an ACNPC-AG you will be qualified to work in clinical settings where providing care to acutely ill adults is needed. This includes but is not limited to emergency departments, inpatient hospital floors, cardiology departments, and more.
3. Pediatric Nurse Practitioner (PNP)
If you know you want to work with kids PNP is the way to go. As a newly graduated nurse practitioner focused on pediatric care you will be prepared to take the PNP primary care national certification exam. In this role, you can work in outpatient family practices or inpatient units caring for children from birth through young adulthood. You can also work in specialty clinics focusing on certain conditions.
4. Acute Care Pediatric Nurse Practitioner (CPNP-AC)
If you have completed a PNP focused graduate degree that has prepared you to sit for the CPNP-AC certification exam you will be ready to provide lifesaving care to the sickest of children. You may find yourself working with kids with chronic or acute illnesses in specialty clinics, or you may be working in an emergency department. With this specialty, you will never be bored!
5. Family Nurse Practitioner
The FNP specialty is very versatile. If you complete your degree with an FNP focus you will be prepared to care for people across the lifespan. Yes, this means children too! While many FNPs work in family practices you can also gain experience or additional certification to work in specialty areas like gynecology or diabetes. FNPs have a broad scope of practice. If you are not sure what age group you want to work with, this is the population focus for you. As an FNP you can work with patients of any age and get experience in different specialties until you find what you are passionate about.
6. Neonatal Nurse Practitioner (NNP)
Do you love working with babies? Do you work well under pressure? If yes, then the NNP route may be for you. NNPs are highly skilled and specialized in providing care to the most high-risk and vulnerable newborns. As an NNP you will not be limited in working only in neonatal intensive care units (NICUs) but may also be able to work in emergency departments, outpatient clinics, and labor and delivery rooms. NNPs often get called into the labor and delivery room when there is a known high-risk delivery occurring.
7. Psychiatric Mental Health Nurse Practitioner (PMHNP)
As a PMHNP you will have your choice of where to work and who to work with. PMHNPs work in outpatient clinics, addiction clinics, inpatient settings, and even from the comfort of their own home! You can work with people of all ages and get experience in different settings to create your dream career!
8. Women’s Health Nurse Practitioner (WHNP)
When choosing the WHNP population focus you will be qualified to work with patients from adolescence through the end of life. While you will be specialized in women’s health issues such as obstetrics and gynecology you will also receive training in primary care. This population focus is more versatile than its name makes it seem! Some WHNPs work in labor and delivery, outpatient clinics, college health, and sometimes even areas like occupational health!
Other Types of Nurse Practitioner Specialties
While the population foci trains you in an age group and in a range of clinical issues pertinent to the population you will work with, you always have the option to sub-specialize through work experience, additional certifications, or both.
9. Emergency Nurse Practitioner (ENP)
Emergency nurse practitioners are sub-specialized to work with trauma, acute and chronic illness, and well…anything you would typically see in the emergency department! Usually, an ENP will have been trained as an FNP or A-GNP but in some obstetric or pediatric emergency departments ENPs can be WHNPs or PNPs as well. To be an ENP you need emergency department experience and/or to complete an ENP fellowship after graduating.
10. Aesthetic Nurse Practitioner
There are so many different types of nurse practitioners that almost anything is possible. If you are looking to take a more unconventional route with your NP career, getting additional training in aesthetic medicine may be for you. With this training you would be able to offer your patients aesthetic care, meaning you could provide services like botox, chemical peeling, and laser therapy. You could work exclusively in a clinic that provides these treatments or choose to add these services onto your practice.
11. Cardiology Nurse Practitioner
A cardiology nurse practitioner is usually an A-GNP or FNP who has received specialized training or has experience working in a cardiology setting. To achieve this sub-specialty you just need experience working in cardiology, or completion of a fellowship program like what Duke University offers. The more experience you have, the more recognition as a cardiology expert you will receive! You will be ready to work either inpatient or outpatient with people who have cardiovascular diseases.
12. Dermatology Certified Nurse Practitioner
Like other sub-specialties, there are multiple routes to becoming a dermatology nurse practitioner. You can either become certified by the Dermatology Nursing Certification Board (DNCB) or work in a dermatology clinic and gain experience. Whatever you choose you will find yourself an expert in the body’s largest organ- the skin! Depending on your population foci you can work with people of all ages and help manage chronic or acute conditions. You may do small surgical procedures or work with oncology. The choice is yours!
13. Oncology Nurse Practitioner
Nurse practitioners working in oncology settings can be of almost any population foci. Unfortunately, cancer impacts people of all ages. As a PNP you can work on an oncology floor in a children’s hospital, and as a WHNP you can work in gynecologic oncology. If you want to become certified in oncology that is also possible through the Advanced Oncology Certified Nurse Practitioner certification. As cancer can have detrimental effects on patient’s mental health, PMHNPs may also be needed on oncology floors in hospitals.
14. Orthopedic Nurse Practitioner
Becoming an orthopedic nurse practitioner will enable you to care for patients with musculoskeletal issues. This may mean you work in trauma, an emergency department, occupational health, or an outpatient orthopedics clinic. Many orthopedic nurse practitioners gain their expertise through on the job training however you can also complete a professional certificate at some institutions like Duke University.
Conclusion
There are an abundance of different types of nurse practitioners and after you earn your graduate degree in the population focus of your choice you can either get certified in a different sub-specialty or just work on gaining experience in that area! This is just a small list of possible areas you can work in. Truly if you can dream it, you can do it!
Lauren Jacobson MS, RN, WHNP-BC
Lauren Jacobson is a registered nurse and women’s health nurse practitioner who is passionate about global health and gender-based violence prevention. She is Editor and an Advisory Board Member for the Global Nursing Caucus and volunteers with Physicians for Human Rights as a medical evaluator for asylum seekers.
