Nurse Practitioner (NP) vs Registered Nurse (RN)
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There’s nothing small about nursing. By the numbers, in 2021, there were 3.1 million registered nurses (RNs) in the United States, and the American Association of Colleges of Nursing (AACN) shows nurses outnumber physicians by four to one. The demand for registered nurses and nurse practitioners is fueled by increased patient loads brought on by expanded health insurance, a nursing retirement surge, and the healthcare needs of the large Baby Boomer population. The Covid-19 pandemic has increased the pressure on nurse staffing shortages and has prevented providers from providing patients with timely access to care.
To address these patient-provider log jams, nurse advocacy organizations have been pushing for full practice authority for nurse practitioners (NPs). To support these efforts, many accredited nursing degree and certificate programs offer career pathways for registered nurses (RNs) and nurse practitioners (NPs). This guide outlines the similarities and differences between these nurse practitioners (NPs) and registered nurses (RNs).
Nurse Practitioners (NPs) are advanced practice registered nurses (APRNs), registered nurses (RNs) who have earned a master of science in nursing (MSN), post-master’s certificate, or doctor of nursing practice (DNP) with an NP specialization, and completed additional requirements for professional licensure. NPs see patients in clinical environments or may conduct research, in laboratories, public health, or teaching hospitals.
Nurse practitioners treat primary and specialized care patients. NPs lead nursing teams in hospitals or outpatient clinics. Depending on their state, they can work with full, partial, or reduced practice authority. In states with reduced and partial practice authority, NPs must practice under the supervision of a physician.
A slim majority of states grant NPs full practice authority, meaning they can diagnose and treat patients without the supervision of a physician. NPs can prescribe medications. As with physicians, NPs focus on preventative health, educating patients about science-proven practices to promote health and longevity.
Registered Nurses (RNs) are licensed healthcare professionals who coordinate, manage, and provide clinical and at-home care to patients. Widely considered the backbone of the U.S. healthcare system, RNs prepare patients for clinical exams, record medical histories, and use medical equipment to diagnose and treat patients under the supervision of physicians and NPs.
Depending on state requirements, RNs have either an associate degree of nursing (ADN) or a bachelor of science in nursing (BSN). To become a licensed RN, candidates must take and pass the NCLEX-RN exam after graduating from an accredited two- or four-year undergraduate nursing program.
As is the case with NPs, RNs can choose to work in primary care or specialize by earning a certificate in cardiovascular, oncology, pediatric, or critical care nursing. RNs are well-positioned to pursue APRN careers by enrolling in a graduate or doctoral program to become nurse practitioners.
Regardless of their titles, nurses are consistently ranked as the most-trusted profession in the United States, ranking first for 20 consecutive years on Gallup’s annual ranking of professions with high honesty and ethics.
In short, all NPs are RNs, but not all RNs are NPs. Read on for a side-by-side comparison of nurse practitioners (NPs) and registered nurses (RNs).
Side-by-Side Comparison of Nurse Practitioners (NPs) and Registered Nurses (RNs)
|Nurse Practitioners (NP)||Registered Nurses (RN)|
|Definition||Licensed healthcare professionals who provide primary and specialty patient care, with and without physician supervision.||Licensed healthcare professionals who work directly with patients under the supervision of physicians.|
|Occupational Demand||45 percent (much faster than average) from 2020-2030 (BLS May 2021)||9 percent (as fast as average) from 2020-2030 (BLS May 2021)|
|Number Employed||271,900 (BLS May 2021)||3.1 million (BLS May 2021)|
Master of Science in Nursing (MSN)
Post-Master’s NP Certificate
Doctorate of Nursing Practice (DNP)
Associate’s Degree in Nursing (ADN)
Bachelor of Science in Nursing (BSN)
Accelerated ADN to BSN
Maryville University– Online MSN, DNP, and Post-Master’s Certificate programs
Southern New Hampshire University (SNHU) – Online MSN-FNP program
Drexel University-Online RN to BSN program
Florida International University (FIU) – Online RN to BSN program
|Typical Responsibilities||Care for patients, with or without physician supervision (depending on state-level scope of practice laws); provide primary or specialized healthcare; order tests; prescribe medication; lead teams of nurses; teach nursing education; and conduct research.||Coordinate general or specialized patient care with physicians; educate patients and the public on health issues; and give medical advice and emotional support to patients and their families.|
NCLEX-RN Exam (required)
State-specific requirements and population-focused certification exam (e.g., adult-gerontology, primary care)
NCLEX-RN Exam (required)
|Sample Certification Entities||American Nurses Credentialing Center (ANCC) |
|Average Salary||$123,780 per year (BLS May 2021)||$77,600 per year (BLS May 2021)|
|Scope of Practice|
From the American Association of Nurse Practitioners (AANP):
Full practice authority: Without physician supervision, NPs can evaluate, order tests, diagnose, prescribe, and manage patient treatments (27 states)
Reduced practice authority: At least one element of practice requires NPs to collaborate with a physician (15 states and territories)
Restricted practice authority: NPs must be supervised by a physician to provide patient care (11 states)
From the American Nurses Association (ANA):
Who: RNs and APRNs
What: Protection, promotion, and optimization of health; prevention of illness; facilitation of healing; alleviation of suffering; advocacy for populations
Where: Wherever there is a patient in need of care
When: Whenever there is a need for nursing knowledge, compassion, and expertise
Why: To achieve positive patient outcomes
|The Bottom Line|
NPs are RNs with a graduate or doctoral degree. They are classified as advanced nurse practitioners (APRNs) and provide a wide range of patient care, leadership, and teaching and research roles.
Depending on where they practice, NPs have full, reduced, or restricted practice authority. NPs can prescribe medications.
RNs must have a minimum of an associate’s degree (ADN) or a bachelor of science degree (BSN) in nursing.
They practice nursing under the supervision of physicians or APRNs, depending on the state. RNs can work in primary care or specialize in a wide variety of patient care.
Rachel Drummond is a freelance writer, educator, and yogini from Oregon. She’s taught English to international university students in the United States and Japan for more than a decade and has a master’s degree in education from the University of Oregon. A dedicated Ashtanga yoga practitioner, Rachel is interested in exploring the nuanced philosophical aspects of contemplative physical practices and how they apply in daily life. She writes about this topic among others on her blog (Instagram: @racheldrummondyoga).