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Acute Care Nurse Practitioner (ACNP): Job Description, Salary, and How to Become One

An Acute Care Nurse Practitioner (ACNP) is an advanced practice registered nurse (APRN) who specializes in providing immediate and critical care to patients who are severely ill or injured.

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  • Erin Lee
    Erin Lee, BSN, RN
    Specializes in Critical Care, Procedural, Care Coordination, LNC. Has 11 years experience.
Acute Care Nurse Practitioner (ACNP): Job Description, Salary, and How to Become One

Are you interested in becoming an acute care nurse practitioner (ACNP) but struggling to decide if it's right for you? 

We've compiled all the information prospective ACNPs need to know, including duties, responsibilities, salary, and the required steps, so they can decide if this concentration fits them best.

Table of Contents

ACNP Job Description

An ACNP is an advanced practice registered nurse (APRN) who specializes in providing immediate and critical care to patients who are severely ill or injured. They possess graduate-level training and are highly skilled in handling complex medical situations, such as acute illnesses, injuries, and worsening chronic conditions. 

As part of a healthcare team, ACNPs diagnose, treat, prescribe, and manage acute and chronic illnesses in patients. They work closely with doctors, nurses, and other medical professionals to create and execute treatment strategies. ACNPs possess excellent communication, critical thinking, and problem-solving skills to quickly identify and manage medical emergencies in high-pressure and fast-paced environments.

ACNP Responsibilities

The primary responsibilities of an ACNP in the acute care setting include:

  • Manage patient care in acute and critical illnesses
  • Assessments and evaluations
  • Diagnoses
  • Treatment
  • Provide care consistency
  • Interact with patients and family members
  • Plan for patient discharge
  • Educate the patient, family, and healthcare team

Related: 10 Best Master of Science in Nursing (MSN) Programs in 2023

ACNPs can also be trained to perform diagnostic exams and invasive procedures in the patient population they serve, including but not limited to:

  • Arterial or Central line placement
  • Intubation
  • Chest tube insertion
  • Bronchoscopy
  • Electrical Cardioversion of heart rhythms

ACNP Places of Work 

ACNPs can specialize in serving various patient populations, such as Pediatric Acute Care Nurse Practitioners (PACNP) or Adult-Gerontology Acute Care Nurse Practitioners (AGACNP). 

ACNPs mainly operate within hospital settings. Some of the places you can find them include:

  • Critical care units
  • Progressive care units
  • Trauma units, emergency rooms
  • Long-term acute care hospitals

NPs specializing in acute care are not limited to working in hospitals. They also provide their services in urgent care centers and specialty clinics.

Benefits of Becoming an ACNP

ANCPs are essential in providing the best possible care to patients who require immediate medical attention. During a health emergency, the support of an ACNP can be invaluable, and their dedication and efforts can significantly impact a patient's overall health and wellness. 

Furthermore, ACNPs have more autonomy in applying critical thinking skills, the chance to work in a fast-paced and challenging environment, the ability to specialize in serving specific patient populations, and the potential for higher salaries than other nursing roles.

ACNP Salary

The average annual salary for an ACNP is $132,094, with the 25th percentile earning between $95,00-$115,00 and the 75th percentile earning between $175,000-$212,000.

ACNP salary will vary depending on experience, specialty, and location. 

Salary for an ACNP grows with experience:

  • 1-3 years ACNP experience: $107,568
  • 7-9 years ACNP experience: $124,652
  • 15+ years ACNP experience:  $143,422

The salary of an ACNP can differ based on their area of specialization:

  • Adult-Gerontological Acute Care NP average salary: $117,854
  • Pediatric Acute Care NP average salary: $132,180

States paying ACNPs the most:

  • New Jersey $123,700
  • Tennessee $123,653 
  • Hawaii $121,398

States paying ACNPs the least:

  • North Carolina $85,326
  • Florida $83,513
  • Georgia $81,570

These numbers significantly differ from the highs and lows listed above, as the aggregate data regarding state pay is from ZipRecruiter, while the remaining aggregate data above is from Glassdoor. Unfortunately, the Bureau of Labor Statistics (BLS) does not make a distinction between APRN and NP salaries. 

Acute Care Nurse Practitioner Job Outlook

While no specific data is available on the job outlooks for ACNPs, it is predicted that the employment of APRNs, including ACNPs, will grow by 40% between 2021 to 2031, resulting in approximately 112,700 new NP job openings. 

ACNPs are particularly needed in the hospital and acute care settings to provide specialized care for patients with complex medical needs, including those with critical and life-threatening conditions. As the demand for acute care services continues to rise, the need for ACNPs to provide this care will also increase. 

This demand is significant in light of the current strain on the healthcare industry, as emphasized throughout the COVID-19 pandemic. Additionally, as the population ages, there will be an even greater need for healthcare providers with specialized training to manage complex medical conditions associated with aging, further driving demand for ACNPs in acute care settings. 

How to Become an ACNP

There are five simple steps to becoming an ACNP. 

1. Nursing Education and RN Licensure.

Becoming an ACNP starts with completing basic nursing education by obtaining your ADN or BSN RN. After completing an undergraduate program in nursing, you will be eligible to sit for the National Council Licensure Examination for registered nurses, NCLEX-RN. 

2. Get Registered Nursing (RN) Experience

Once you have obtained your RN license, you will need to obtain RN experience before applying to an MSN or DNP-level program for your ACNP. At least two years of current bedside nursing is typically required. Some ACNP programs may require more experience. Most ACNP programs will recommend you gain acute care or critical care nursing experience as a foundation, although this is more of a recommendation than a requirement. 

3. Complete Advanced Nursing Education 

To become an ACNP, there are different pathways you can take depending on your educational background. 

MSN ACNP pathway: The Master of Science in Nursing (MSN) is the typical entry-level degree required for all APRNs, including ACNPs. Various pathways are offered for nurses of varying education levels—BSN to MSN, RN to MSN, or Bridge RN to MSN for students with their RN and a non-nursing-related bachelor's degree. Admission requirements, course load, and program length will differ depending on the chosen pathway. Two to four years is the standard length it will take to complete the MSN ACNP pathway. 

DNP ACNP pathway: Available to BSN RNs and MSN RNs who wish to pursue a Doctor of Nursing Practice with a concentration in ACNP. The program duration can range from three to seven years, depending on prior education and whether you opt for full-time or part-time studies.  

Related: 10 Best DNP Programs in 2023

Post-Masters ACNP pathway: RNs who have completed an MSN program can pursue a post-master ACNP Certification to qualify for the specialty. These certificate programs take about one and a half to two years to complete depending on whether you start as an MSN RN or an MSN APRN. 

It's important to note that the CCNE has set a mandate for APRNs to have doctorate-level education, intending to make the DNP standard entry-level credential for APRNs by 2025. 

When choosing a pathway for your graduate-level nursing education, ensure the program is nationally accredited by one of the following: Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), or the National League for Nursing Commission for Nursing Education Accreditation (CNEA). This guarantees that the ACNP program adheres to ACNP education and future practice standards. 

All graduate-level education pathways for NP students require a minimum of 500 direct patient care clinical hours. Each ACNP program may have slightly different clinical hour requirements, but to be eligible for your ACNP certification exam, you must complete at least 500 clinical hours in accordance with current regulations.

4. Pass the National APRN FNP Certification Exam 

Like the NCLEX-RN requirement for RNs, becoming an ACNP necessitates passing a certification exam to work as an APRN. The certification exam for ACNP practice is available through the American Association of Critical Care Nurses (AACN) or the American Nurses Credentialing Center (ANCC).

5. APRN Licensure

Apply for state APRN ACNP licensure in the state you plan to work.

As an RN, becoming an ACNP can be a fulfilling and meaningful career transition. This path allows you to offer advanced patient care, work with interdisciplinary teams, and have greater autonomy and responsibility in your nursing practice.

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Erin Lee

About Erin Lee, BSN, RN

"Do not go where the path may lead, go instead where there is no path and leave a trail." -Ralph Waldo Emerson

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CiaMia

CiaMia, BSN, MSN, DNP, RN, APRN, NP

367 Posts

Specializes in Neuro/NSGY, critical care, med/stroke/tele. Has 7 years experience.

Hi! Slight error above - AANP does NOT offer acute care NP certification.

Certification is either ANCC (AGACNP-BC), or AACN (American association of critical care nurses - the same entity that administers the CCRN certification) (ACNPC-AG)

Erin Lee

Erin Lee, BSN, RN

22 Articles; 35 Posts

Specializes in Critical Care, Procedural, Care Coordination, LNC. Has 11 years experience.
CiaMia said:

Hi! Slight error above - AANP does NOT offer acute care NP certification.

Certification is either ANCC (AGACNP-BC), or AACN (American association of critical care nurses - the same entity that administers the CCRN certification) (ACNPC-AG)

😳 You are very correct, thank you for bringing that oversight to my attention! Submitted for a revision to update from AANP to AACN! So many nursing associations to keep straight! 

KatieMI

KatieMI, BSN, MSN, RN

1 Article; 2,675 Posts

Specializes in ICU, LTACH, Internal Medicine. Has 10 years experience.

The Board exam for ACNPs is not "FNP". It is quite different exam, ACAGNP. Content of both exams has not much in common (I passed both). 

One doesn't have to "obtain experience" before entering either MSN or DNP pathway. There are plenty of programs, including big names, admitting students directly from undergrade and even direct BSN to DNP programs. Some of them (for example, Georgetown University) cost more and take longer than an average medical school.

Post-graduate certificate programs are generally one year long. Most of them (except famous "mills" like Marywille) require experience working in acute care as an NP, although what is considered "acute care" is totally up to each program. Half of my class (post-graduate certificate program) were working in walk-in clinics, urgent care and such - and many of them happily returned there after graduation. Another half worked in hospital setting in all types of specialities from ICU to ER to hospital medicine + acute subspecialities. 

ACAGNPs and FNPs do exactly the same job for exactly the same money in many settings (aforementioned urgent care, walk-ins, LTC/SNF/acute rehab, combo "office+rounds" in specialties, etc.), and the question "can an FNP work in acute care" is more about every facility's credentialing policies than anything else. More facilities start to require ACAGNP certification as a requirement for credentialing - as well as either previous experience or "residency" (which can be anywhere from good to ugly as currently there are no standards or regulations for these activities). 

Salary of ACNPs is generally lower than one of ER NPs in the same area because almost all ER NPs are trained to do procedures while many ACNPs do not do them at all or do only those which are required by their specialty (although crazy wide local varietes are possible). 

CCNE can mandate whatever they want and set whatever deadlines they like. No one except CCNE (schools, prospective ACNP students, ANCC, AACN and employers) is particularly interested in forcing additional +/-2  years of classes  which would add little to clinical knowledge but a lot of  $$$$$  onto prospective students and potentially depleting job market which is already quite hot and with no much doubts will became even hotter in coming years. The talks of getting LPNs out of acute care and making BSN entry degree, with supporti ng evidence, are going on for like over 30 years now while LPNs are actively recruited to work in hospitals. I bet it will be the same story with "mandatory"  DNP for acute care. 

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