How Do I Become an Acute Care Nurse Practitioner?

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Acute care nurse practitioners are advanced practice nurses (APRNs) trained to provide short-term care in complex and sudden healthcare situations. They act to stabilize patients using evidence-based practice, paying thought to managing complications from disease or injury as well as promoting optimal health. Overall, these licensed autonomous caregivers treat patients holistically to address acute, critical, and chronic problems.

This specialization can be divided into two subfields, pediatric and adult, and with both populations, these invaluable healthcare providers serve as patient advocates in hospitals, rehab centers, birthing clinics, urgent care settings, and other areas.

Certifications & Requirements to Become an Acute Care Nurse Practitioner

Across all nurse practitioner (NP) specializations, practitioners typically need at least a master’s degree to qualify for credentialing. For both pediatric and adult-gerontology acute care NPs—also referred to as PNP-ACs and AG-ACNPs—some choose to pursue a master of science in nursing (MSN), although the doctor in nursing practice (DNP) is rapidly becoming the preferred credential, particularly for those interested in leadership or academia. In fact, in 2004, the American Association of Colleges of Nursing (AACN) recommended adopting the DNP as the new standard in education for NPs by 2015, but this has been delayed. As of September 2017, NPs with an MSN still qualify for all certification and licensure, although this may change in coming years.

The three main national certifying organizations for acute care NPs are the American Nurses Credentialing Center (ANCC); the American Association of Critical-Care Nurses (AACN); and the Pediatric Nursing Certification Board (PNCB). The details for each of these certifying agencies are below.

Steps to Becoming an Acute Care NP

Here is one possible path to becoming an acute care NP in either the pediatric (PNP-AC) or adult-gerontology (AG-ACNP) specialization:

STEP 1: Graduate from high school. Prospective PNP-ACs and AG-ACNPs are encouraged to excel in math and science courses in order to facilitate one’s acceptance into a competitive undergraduate program. Many bachelor’s programs in nursing prefer candidates with high marks in subjects such as biology, calculus, chemistry, and geometry. Additionally, students at this stage are encouraged to seek out volunteering opportunities in healthcare environments.

STEP 2: Earn a bachelor of science in nursing or BSN (4 years). While some aspiring acute care providers may begin with an associate degree in nursing and garner experience on the job, the more direct path to joining this career is to complete a four-year undergraduate program—the typical prerequisite for admissions to a master’s degree program. Bachelor of science in nursing (BSN) degrees typically include courses such as microbiology; human nutrition; statistics; anatomy and physiology; and the foundations for nursing practice. Students are encouraged to seek out undergraduate programs accredited by either the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN) to qualify for most graduate programs in nursing. Furthermore, particularly for the online NPs programs, candidates must have at least a 3.0 GPA during their undergraduate coursework.

STEP 3: Become a registered nurse or RN (less than 1 year). Undergraduate programs in nursing prepare students for the first major nursing examination: the National Council Licensure Examination for Registered Nurses (NCLEX-RN).

STEP 4: Garner experience in an acute care setting (1-3 years). To qualify for admissions to an NP program, RNs generally need at least one year of experience in an acute care setting. Acute care nurses can work in intensive care units (ICUs), emergency rooms, trauma centers, neonatal intensive care units (NICUs), and other environments.

STEP 5: Earn a graduate degree in nursing: an MSN (2 years) or DNP (4 years). PNP-AC and AG-ACNP programs are available at both the master’s and doctoral level. To earn admissions to a graduate NP programs, candidates generally need:

  • Completed application fee
  • Official transcripts from a CCNE- or ACEN-accredited BSN program
  • Proof of undergraduate prerequisite courses
  • At least a 3.0 GPA
  • At least one year of professional experience
  • Letters of recommendation
  • Graduate Record Examination (GRE) or Miller Analogies Test (MAT) scores
  • Proof of health insurance, immunizations, or a drug screening
  • Statement of purpose (500-600 words)
  • Test of English as a Foreign Language (TOEFL) or International English Language Testing System (IELTS) scores for non-native speakers of English

It’s important to note that PNP-AC students should seek out programs recognized by the Pediatric Nursing Certification Board (PNCB), and AG-ACNP students should seek out those with approval from the American Association of Critical Care Nurses (AACN).

In addition to at least 500 hands-on practicum hours, the courses in a PNP-AC program may include:

  • Advanced child health nursing
  • Advanced pathophysiology
  • Pharmacotherapeutics for advanced practice
  • Research methods
  • Evidence-based practice

In addition to at least 500 hands-on practicum hours, the courses in a AG-ACNP program may include:

  • Advanced physiology and pathophysiology
  • Geriatric and end-of-life concepts for advanced practice nursing
  • Complex patient analysis and treatment
  • Differential diagnosis for advanced practice
  • Advanced diagnostic and therapeutic skills

Please visit the following pages for more information on NP programs: acute care NP programs, pediatric NP programs, adult-gerontology NP programs, and online NP programs.

STEP 6: Obtain national and state board certification (timeline varies). In addition to varying state licensure requirements for NPs, PNP-ACs and AG-ACNPs must seek out national certifications. As mentioned above, there are three main organizations which offer credentialing to these advanced healthcare professionals: the American Nurses Credentialing Center (ANCC); the American Association of Critical-Care Nurses (AACN); and the Pediatric Nursing Certification Board (PNCB). The prerequisites, exams, and timelines vary for each.

The ANCC provides one relevant certification for practitioners: the AGACNP-BC. This five-year credential costs $270 for ANCC members ($395 for non-members). To qualify, candidates must have:

  • Active RN license
  • Master’s, post-master’s certificate, or doctoral degree from a CCNE- or ACEN-accredited program
  • Proof of coursework in advanced physiology and pathophysiology, health assessment, and pharmacology, health promotion and maintenance, and differential diagnosis
  • Passing score on an examination

The AACN provides one relevant certification for practitioners: the ACNPC-AG (Adult-Gero). This five year certification costs $255 for AACN members ($360 for non-members), and has the following eligibility requirements:

  • Current, unencumbered RN license
  • Completion of an approved graduate program in nursing
  • Passing score on an examination

Please note that for qualifying RNs, the AACN also offers CCRN (Pediatric) and CCRN (Adult) certifications which don’t require master’s degrees.

Finally, the PNCB offers one relevant credential for practitioners: CPNP-AC. The exam costs $385. To be eligible, candidates must have:

  • Active RN license
  • Master’s, post-master’s certificate, or doctoral degree from a CCNE- or ACEN-accredited program
  • Minimum of 500 clinical hours
  • Proof of coursework in advanced physiology and pathophysiology, health assessment, and pharmacology
  • Passing score on the examination

STEP 7: Maintain NP licenses, registrations, and certifications (timeline varies). For detailed breakdowns of how to renew national NP certifications, please check out the following handbooks:

Renewal typically involves the payment of a fee; the completion of continuing education (CE) hours; and the submission of an application. Some of the organizations with CE and other resources for acute care NPs include, the American Association of Nurse Practitioners (AANP), the National Association of Pediatric Nurse Practitioners (NAPNP), and the National Organization of Nurse Practitioner Faculties (NONPF), to name a few.

Please contact state licensing board for detailed information about regional credentialing.