How to Become an Acute Care Nurse Practitioner

Acute care nurse practitioners (ACNPs) are advanced practice registered nurses who treat critically ill or injured patients in acute care settings. They primarily focus on the adult population (young, middle, and older adults, ages 13 and older) with complex diseases. However, acute care NPs can specialize in treating pediatric or geriatric populations.

Also called critical care nurse practitioners (CCNPs), these nursing professionals receive specialized training to provide essential urgent care that significantly impacts their patients' lives. To enter this elite career field, you'll need specialized training and an advanced nursing degree from an accredited program. 

ACNPs provide care for everything from disease prevention to acute care management. Often, practitioners continue to follow patients from the hospital to the outpatient setting.

Specific duties you may do as an acute care NP include the following:

>>Related: Nurse Practitioner: MSN vs. DNP

Acute care NP programs typically take 2-3 years, depending on the curriculum and whether they are full-time or part-time. Students can complete a program in two years if they follow the full-time progression plan and obtain clinical placements without delay. 

However, most students attend critical care NP programs part-time to facilitate a balanced work-study schedule. In these cases, it can take three or more years to become an acute care nurse practitioner. However, most schools allow up to five years for students to graduate from APRN programs.

>> Show Me Online Nurse Practitioner Programs

Acute care NPs are among the highest-paid NP specialties. Zip Recruiter reports the average ACNP salary as $1117,423 annually, with an earning potential of up to $153K. This is comparable to the median annual income of all NPs, which is $129,480, according to the Bureau of Labor Statistics (BLS). 

Your actual critical care nurse practitioner salary will depend on several factors, including your location, experience level, and industry. You should also consider the total compensation package before accepting a job offer. Lower-salaried positions may be preferable if accompanied by plenty of paid time off, health and dental insurance, retirement benefits, and more.

Highest Paying States for Acute Care Nurse Practitioners

You can optimize your ACNP salary by working in states that pay well. The following states have the highest reported salaries for acute care nurse practitioners:

State	Annual Salary	Hourly Wage
New Jersey	$129,046	$62.04
Wisconsin	$126,102	$60.63
Alaska	$123,384	$59.32
Massachusetts	$123,289	$59.27
Washington	$123,078	$59.17

Source: ZipRecruiter, Accessed 9 July 2024

Highest Paying Cities for Acute Care Nurse Practitioners

The following cities report the highest ACNP salaries nationwide:

City	Annual Salary	Hourly Wage
Santa Cruz, CA	$147,011	$70.68
Sunnyvale, CA	$144,541	$69.49
Livermore, CA	$144,464	$69.45
Arlington, VA	$143,737	$69.10
Clay, CA	$141,948	$68.24

Source: ZipRecruiter, Accessed 9 July 2024

How to Become an Acute Care Nurse Practitioner

Step 1. Earn a BSN

You typically need a Bachelor of Science in Nursing (BSN) degree to be eligible for an ACNP program. If you aren't already a nurse, the best course is to pursue a traditional 4-year BSN degree.

If you're a registered nurse (RN) with an Associate Degree in Nursing (ADN), you can bridge the gap with an RN-BSN program. There are two ways to attend an RN-BSN bridge:

• Traditional RN-BSN programs are ideal for nurses with an ADN or RN diploma program who need to further their education.
  
  
• Online RN-BSN programs are great for busy professionals. They allow students to work when their schedule permits and can be completed at their own pace.

As an ADN nurse, you won't have to retake the NCLEX when you complete your RN-BSN bridge. However, non-nurses have the additional step of sitting for the national examination and applying for state licensure.

Step 2. Complete an Acute Care Nurse Practitioner Program

You can select from several ACNP programs depending on your educational background. For example, BSN-RNs can enroll in a 2-year Master of Science in Nursing (MSN) or a 4-year Doctor of Science in Nursing (DNP) program. Whether you pursue an MSN or DNP depends on your career goals and preferred program length. 

However, some aspiring ACNPs may already have an advanced nursing degree. In that case, you can pursue an acute care NP post-graduate certificate. These programs can take as little as one year but require at least an MSN or NP certification from another field. 

Aside from clinical requirements, you can attend most of these programs online or in person, depending on your university.

>> Show Me Online Nurse Practitioner Programs

Step 3. Pass the Certification Exam

The American Association of Critical-Care Nurses offers board certification to acute care nurse practitioners. AACN Certification Corporation exams are accredited by the National Commission for Certifying Agencies.

Step 4. Apply for an APRN License

After passing the certification exam, you must apply for an APRN license from your state's board of nursing. Like RNs, you can hold multiple state board licenses. However, you cannot apply for these licenses until you have passed the initial boards. 

Remember, each state has different certification and recertification requirements. Check with your state's board of nursing to properly understand and apply for licensure.

According to our ranking algorithm, these are the top 5 ACNP programs for 2025. To see the full list and more details on each program, you can read the Top Acute Care Nurse Practitioner Programs. 

1. Duke University
2. Vanderbilt University
3. George Washington University
4. Walden University*
5. University of Maryland

There are two entry-level advanced practice board certifications in acute care available for NPs: pediatric acute care and adult-gerontology acute care.

Acute Care Certified Pediatric Nurse Practitioner (CPNP-AC)

Acute Care Pediatric Nurse Practitioners can specialize in acute pediatric care. This specialty provides care for pediatric patients of adolescent age and younger with complex, chronic, and even critical care. 

CPNP-ACs work with other clinicians and medical providers in various settings, such as hospitals and clinics. Some of the conditions that this specialty provides include young patients with:

• Organ dysfunction or failure
• Traumatic injuries
• Autoimmune illnesses
• Life-threatening illnesses

Due to the nature of the patient population, CPNP-ACs work closely with parents and other family members to provide the highest standard of patient care possible.

Adult-Gerontology Acute Care Nurse Practitioner (CAGNP-AC)

Acute Care Adult-Gerontology Nurse Practitioners care for adults and geriatric patients who are seriously ill or experiencing other acute medical conditions. 

Both specialties provide care in acute care units, intensive care units, and trauma units in hospitals. They also often care for patients before and after surgery.

>> Show Me Online Nurse Practitioner Programs

ACNPs are granted the same rights as all other NPs throughout the country. Specializing doesn’t exclude them from any of the laws for this profession. Because of where acute care NPs work, they often practice independently with full practice authority.

In 25 states, nurse practitioners have “full practice authority,” which means they do not have to work under the supervision of a doctor. Full practice states include Oregon, Maine, Alaska, Hawaii, Washington, and Iowa. Most recently, Utah granted NPs full practice authority. 

According to the American Association of Nurse Practitioners (AANP), full practice authority refers to:

“State practice and licensure laws permit all NPs to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing.”

In states with reduced practice (Ohio, Pennsylvania, and Utah) and restricted practice (Texas, California, and Florida), NPs must have a medical doctor sign certain medical patient care decisions. NPs have prescriptive privileges in all 50 states and can administer controlled substances in 49 states.

CCNPs also provide teaching and supportive counseling and refer patients and families as needed. They focus on health education, health promotion, and disease prevention.

Acute Care NPs can work in a variety of settings. They are most likely to work in:

>> Show Me Online Nurse Practitioner Programs

According to the U.S. Bureau of Labor Statistics (BLS), the career outlook for NPs is excellent, with an expected 38% growth rate from 2022 to 2032.

While the BLS does not differentiate between the different types of NPs, acute care NPs will always be in demand as the baby boomer generation ages. Furthermore, the National Center for Workforce Analysis (NCHWA) reported an estimated 20,000 primary care physician shortfall by 2025. Acute Care NPs will help fill this void. 

In addition to the allure of working independently, more nurses may gravitate toward the career field because of its high satisfaction rate. Nurse practitioners consistently rank as the #1 best job in healthcare, according to the U.S. News & World Report in 2024.

Becoming an acute care nurse practitioner is a professionally and financially rewarding decision. Not only are these nursing specialists part of a growing career field, but they're also one of the highest-paid NPs.

But, the career isn't for everyone. ACNPs have demanding work schedules, and most jobs will require you to work long shifts, nights, holidays, or weekends. Additionally, acute care settings require fast thinking and nurses who work well under pressure. 

However, you may thrive under these conditions. If you like fast-paced work environments that challenge you and want to help patients when they are most vulnerable, becoming an ACNP is an excellent decision.

• What is acute care nursing practice? 

  • Acute care nursing involves RNs and APRNs who are highly skilled and trained to care for very ill patients in acute care or hospital settings. Acute care patients generally have a severe illness, require surgical care, or have another serious medical condition.

• What is the difference between acute care and primary care nurse practitioners? 

  • APRNs are different from primary care nurse practitioners because APRNs see patients when they are sick, admitted to the hospital, or are recovering after a surgical procedure or trauma. Primary care nurse practitioners assess a patient's health and administer preventive care to manage general conditions. Primary care NPs also work in various care settings, such as hospitals, clinics, and private practices.

• What is the highest-paid nurse practitioner? 

  • According to Indeed, the highest-paid nurse practitioner is a psychiatric nurse practitioner.  Indeed reports that this specialty earns an average annual income of $161,136.

• Can an acute care NP intubate? 

  • Yes, an acute care NP can intubate patients and perform other procedures such as lumbar punctures, wound debridements, chest tube insertions, and central venous catheter placements.

• What is the role of an acute care nurse practitioner?

  • Acute Care NPs see patients when they are sick, admitted to the hospital, or after a surgical procedure and/or trauma. This specialty is focused on managing complex diseases in adults.

1. General Nurse Practitioner
2. Family Nurse Practitioner
3. Aesthetic Nurse Practitioner
4. Psychiatric Nurse Practitioner
5. Pediatric Nurse Practitioner
6. Neonatal Nurse Practitioner
7. Women's Health Nurse Practitioner
8. Orthopedic Nurse Practitioner
9. Emergency Nurse Practitioner
10. Adult-Gerontology Nurse Practitioner
11. Oncology Nurse Practitioner

 

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