How to Become an Acute Care Nurse Practitioner (ACNP)

Acute Care Nurse Practitioner (ACNP) Overview

While all acute care nurse practitioners care for patients with acute conditions, their specialties and work settings may vary.

What is an acute care nurse practitioner?

Acute care nurse practitioners are advanced practice registered nurses who specialize in caring for patients with new acute conditions or exacerbated chronic conditions. ACNPs work in a variety of environments—from hospital emergency rooms to urgent-care clinics to operating rooms—and may focus on adults or children. ACNPs do not provide primary care for patients across their lifespan, like family nurse practitioners do.

Should I become an acute care nurse practitioner?

ACNPs help patients with acute illnesses improve their health outcomes. In addition to the opportunity to serve patients, becoming an ACNP may offer nurses the chance to develop their skills as clinical leaders, pursue a high-growth job field, increase their earning potential and become further integrated into interdisciplinary health care teams.

Why are acute care nurse practitioners so important?

The number of nurse practitioners in the U.S.is expected to grow by 40% between 2024 and 2034, according to the U.S. Bureau of Labor Statistics (BLS). NPs are expected to help meet the increased need for preventive and acute care among older adults while also stepping in to replace retiring nurses.

Career Options

There are a number of specialties acute care nurse practitioners can pursue, including pediatrics, adult-gerontology and emergency care.

• Pediatric Acute Care Nurse Practitioner (PNP-AC): PNP-ACs care for acutely, critically and chronically ill children, from newborns through age 21. They may work in pediatric emergency departments, community clinics, pediatric intensive care units and other inpatient specialty clinics.
• Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP): AG-ACNPs provide care for adult and elderly patients with severe illnesses, acute injuries or exacerbated chronic conditions. They typically work in inpatient hospital settings and emergency rooms.
• Emergency Nurse Practitioner (ENP): An ENP is an advanced practice registered nurse specializing in emergency care. They usually work in emergency departments and other urgent-care settings.

Roles and Responsibilities

Before pursuing a career as an acute care nurse practitioner, it’s important to know what will be expected of you in the workplace.

In addition to basic nursing duties, acute care nurse practitioners are tasked with taking patient histories and completing physical examinations, ordering lab tests, diagnosing and treating patients with acute conditions, prescribing medications and other therapies, stabilizing critical-care patients, performing bedside procedures and collaborating with patients’ health care teams to manage patient care. ACNPs may have to work nights or weekends, depending on their workplace, as well as their patients’ needs

Acute Care Nurse Practitioner (ACNP) Salary

Salaries for ACNPs vary by state, specialty, and workplace. The median salary for nurse practitioners in 2024 was $129,210, according to the BLS. Top-paying states for nurse practitioners include California, New York, Oregon, Massachusetts, and Washington

Acute Care Nurse Certification

According to the AANP, about 4 percent of all NPs are certified in acute care. The following certifications are among those available for acute care nurse practitioners:

Acute Care Nurse Practitioner Certification – Adult-Gerontology (ACNPC-AG) from the American Association of Critical-Care Nurses (AACN)

• Eligibility requirements:
  • U.S. RN or APRN license
  • Graduate degree from an advanced practice education program as an adult-gerontology ACNP at an accredited nursing school, including supervised clinical and instructive coursework consistent with adult-gerontology ACNP practice
• Fees: $260-$370
• Renewal requirements for ACNPC-AG: There are three options for renewing certification every five years: practice hours and continuing education (CE) points; practice hours, an exam and pharmacology CE; or CE points and an exam
  • Practice hours and CE points
    • Unencumbered, current license
    • Practice as APRN for 1,000 hours during five-year certification renewal period
    • Completion of 150 CE points
    • Fees: $250-$340
  • Practice hours, exam and pharmacology CE
    • Unencumbered, current license
    • Practice as APRN for 1,000 hours during five-year certification renewal period
    • Completion of 25 pharmacology CE points
    • Passing ACNPC-AG exam
    • Fees: $210-$315
  • CE points and exam
    • Unencumbered, current license
    • Completion of 150 CE points
    • Passing ACNPC-AG exam
    • Fees: $210-$315

Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP-BC) from the American Nurses Credentialing Center (ANCC)

• Eligibility requirements:
  • Current, active U.S. RN license
  • Master’s, postgraduate or doctoral degree from an accredited adult-gerontology acute care NP program, including at least 500 supervised clinical hours in adult-gerontology ACNP role.
  • Three graduate-level courses in advanced physiology/pathophysiology, advanced health assessment and advanced pharmacology
  • Content in health promotion or maintenance, differential diagnosis and disease management
• Fees: $290-$395
• Renewal requirements for AGACNP-BC:
  • Renewal required every five years
  • Current, active U.S. RN license
  • Complete 75 continuing education hours (CH), including 25 CHs in pharmacotherapeutics
  • Complete one or more of eight ANCC renewal categories (academic credits, presentations, evidence-based practice, quality improvement project, publication or research; preceptor hours; professional service; practice hours; and/or assessment)
  • Fees: $275-$375

Emergency Nurse Practitioner (ENP) from the American Association of Nurse Practitioners Certification Board (AANPCB)

• Eligibility requirements:
  • At least 2,000 direct, emergency care clinical practice hours as certified NP, 100 hours of emergency-related continuing education credits and at least 30 continuing education credits in emergency-related procedural skills in past five years;
  • Or, completion of an approved academic emergency care graduate or post-graduate NP program;
  • Or, completion of an approved emergency fellowship program
• Fees: $240-$315
• Renewal requirements:
  • Renewal required every five years.
  • Current FNP certification.
  • At least 100 hours of CE applicable to advanced practice emergency care, including 25 hours of advanced practice pharmacology credits. Precepting an NP or other advanced practice health care interdisciplinary student in emergency care may count for up to 25 CEs outside pharmacology.
  • At least 1,000 hours of clinical practice as an emergency NP during the five-year certification period.
  • Fees: $50

Certified Pediatric Nurse Practitioner – Acute Care (CPNP-AC) from the Pediatric Nursing Certification Board (PNCB)

• Eligibility requirements:
  • Current, active, unencumbered U.S. RN license
  • Graduation from an accredited nursing master’s program, doctoral program with a concentration in pediatric acute care as an NP or a dual primary/acute care program, or graduation from an accredited postgraduate pediatric acute care NP certificate program
  • Passing of Certified Pediatric Nurse Practitioner – Acute Care (CPNP-AC) exam
• Fees: $407 exam cost, including $134 non-refundable registration fee
• Renewal requirements for CPNP-AC:
  • Annual recertification required, plus seven-year cycle requirements
  • Current, active, unencumbered U.S. RN or APRN license
  • 15 contact hours annually
  • 15 hours of accredited pediatric pharmacology over seven years
  • Four PNCB Pediatrics Updates modules over seven years
  • Fees: Varies

Acute Care Nurse Practitioner Resources

The following organizations offer additional information for ACNPs.

• American Academy of Emergency Nurse Practitioners. This organization creates guidelines for emergency health care, encourages continuing education for emergency NPs and supports emergency care training, education and research.
• American Academy of Nurse Practitioners Certification Board. This non-profit certifying body offers several examinations for nurse practitioner certification.
• American Association of Critical-Care Nurses. This professional nurses’ organization offers certification in more than a dozen acute and critical-care specialties.
• American Association of Nurse Practitioners. This membership organization supports education, professional development and advocacy for practicing and aspiring NPs.
• American Nurses Association. One of the largest professional nursing organizations, this group oversees the American Nurses Credentialing Center, which offers board certification exams in a number of nursing specialties.
• Emergency Nurses Association. This professional nursing association is dedicated to advancing excellence in emergency nursing.
• Gerontological Advanced Practice Nurses Association. This professional organization represents advanced practice nurses who care for older adults.
• Society of Trauma Nurses. This professional non-profit organization aims to ensure the highest level of care for trauma patients.

Want to know more about the acute care NP profession? The following paragraphs provide answers to common queries, such as acute care nurse practitioner responsibilities, work settings and more.