How to Become an Acute Care Nurse Practitioner

Acute care nurse practitioners (also known as ACNPs) are health care professionals who have the important job of caring for patients who are suffering from serious injuries or acute illnesses.

This guide will discuss common steps on how to become an acute care nurse practitioner, including the general coursework you’ll go through and what your career options are.

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Acute Care Nurse Practitioner Job Duties and Responsibilities

Before you make your mind up to become an acute care nurse practitioner, you should know what their potential day-to-day responsibilities entail. What does an acute care nurse practitioner do? As you’ll learn, there are a broad range of acute care nurse duties.

ACNPs commonly work in hospitals and urgent care centers where they evaluate patients presenting signs of acute illness or injury. As a type of nurse practitioner, they can also prescribe medicine, diagnose illnesses, and perform procedures like intubation, placing stitches or sutures, and induce sedation.

ACNPs also monitor patients, track their progress, set goals leading to the patient’s discharge, refer patients to specialists, and collaborate with discharge planners to determine follow-up guidelines.

With a range of training options encompassing certificates, online Master of Science in Nursing (MSN) programs, and other to postgraduate degrees, selecting a health care course of study that will prepare you for an acute care career may feel overwhelming. Continue reading to find out how to become an ACNP, including a overview of the general education and licensing requirements.

What Are the Education Requirements for an Acute Care Nurse Practitioner?

The process to become an acute care nurse practitioner usually calls for commitment and patience. You’ll need to obtain the correct training to provide high-quality care. An aspiring ACNP must first obtain an undergraduate degree—the Associate Degree in Nursing (ADN) and Bachelor of Science in Nursing (BSN) are two options—before earning their degree to become an advanced practice registered nurse (APRN): either an accredited master’s degree or doctoral degree (DNP) in nursing. They must also become registered nurses (RN.)

A number of graduate programs require students to spend time working as an acute care nurse before admittance, although some offer part-time coursework so students can gain work experience during the course of their study. Acute care nursing programs typically take around two to three years to complete.

Generally speaking, advanced acute care nursing programs include courses on health promotion and maintenance, clinical reasoning in determining diagnoses, advanced pharmacology, and health care research.

What Acute Care Nurse Practitioner Certification is Needed?

Once an aspiring nurse practitioner graduates from their program, they still need to obtain certain certifications before they can care for patients. Certification is a process that confirms a prospective ACNP has the required knowledge and skill to administer care safely.

The American Association of Critical-Care Nurses (AACN) is an organization that grants acute care nurse practitioner certification to future ACNPs. The board certification exams administered by the AACN consists of 175 questions, 150 of which are graded. The remaining questions then get used when compiling statistical data on if those questions should be included on future exams as determined by overall performance.

The American Nurses Credentialing Center (ANCC) also provides certification for ACNPs, specifically those specializing as adult gerontology ACNPs. The current exam contains 200 questions and you’ll have four hours to answer them. To learn more about this certification, including fee information, you can visit the ANCC website.

6 Common Steps to Becoming an Acute Care Nurse Practitioner

We’ve explored educational requirements and certifications. Now, let’s review common steps on how to become an acute care nurse practitioner. But before we do, there’s some preliminary information you should know. Given that every state’s licensure requirements are different, no two journeys toward an ACNP career are exactly alike. However, here are some common steps you may reference to help you kickstart your career as an ACNP.

Step 1: Get Your ADN or BSN

The path to becoming an ACNP begins at the undergraduate level. Although a number of students most commonly choose to enter a Bachelor of Science in Nursing (BSN) program, others opt for a two-year Associate Degree of Nursing (ADN) program.

Like most undergraduate programs, a BSN usually takes about four years to complete. The BSN program prepares students to become RNs and lays the foundation for graduate-level advanced practice coursework. The BSN program usually consists of two years of general education, pre-requisite classes and other core university requirements followed by two years of in-depth nursing classes and clinical rotations.

Step 2: Take the NCLEX-RN Exam

After obtaining your ADN or BSN, the next step is to take the National Council Licensure Examination (NCLEX-RN) developed by the National Council of State Boards of Nursing (NCSBN).

The NCLEX-RX exam is a pass/fail exam which covers four areas: safe and effective care environment, health promotions and maintenance, psychosocial integrity, and physiological integrity.

Before registering for the NCLEX-RN, prospective ACNPs must obtain their authorization to test (ATT) from their state’s regulatory commission. The ATT is typically sent out by email.

Once the exam is scheduled, it’s important to devise a test plan in advance—make sure you know when and where to show up, make sure you have the required ID on you, and study for the test ahead of time.

The actual questions change year to year, but broadly speaking, they’ll be mostly multiple choice with a mix of other formats like fill-in-the-blank questions.

Step 3: Gain Relevant Clinical Work Experience

Before entering an MSN or other postgraduate program, acute care nurse practitioner candidates are generally required to gain one or two years of experience working as a registered nurse. However, some programs allow a candidate to gain their work experience as an RN while in the program.

RNs often gain their experience working in a hospital, but can also work in private practice offices and other clinical settings.

It may be helpful to think of this step not as a requirement, but as an opportunity to get hands-on experience treating acute and chronic conditions. Time in the field may help a prospective ACNP decide if that career path is right for them. Furthermore, it may give candidates the opportunity to decide if they want to narrow their focus even further, by working as an adult gerontology acute nurse practitioner or a pediatric acute care nurse practitioner.

Once you are accepted into a postgraduate program, you can expect to gain even more clinical experience for an acute care nurse.

Step 4: Obtain Your Acute Care Nurse Practitioner Degree

Once you’ve obtained your undergraduate nursing degree, taken your NCLEX-RN exam and successfully become an RN in your state, and completed your relevant clinical work experience, the next step entails enrolling into an acute care nurse practitioner program. This can be either an MSN in acute care nursing practice or a DNP. You can expect to complete two or three years of schooling, depending on whether a candidate chooses a master’s or doctoral program. It could take a little longer, depending on if the prospective ACNP is going to school full-time or part-time. Of course, each program is different and some offer expedited paths to obtaining your degree. Take time to investigate the specifics of each program you’re considering. Learn more about applying to nursing school.

As part of your program, you’ll gain hands-on experience by completing faculty-supervised clinical hours related to the acute care nursing role you’re aiming for. Many programs require a minimum of 500 hours.

Step 5: Become a Board-Certified Acute Care Nurse Practitioner

After earning your MSN or DNP, it’s time to get board-certified. Certification ensures that a prospective acute care nurse practitioner has the required knowledge to safely treat patients. Aspiring nurse practitioners seek certification in the area in which they’d like to practice. As previously detailed, there are two national credentialing bodies for ACNPs.

An ACNP’s certification must be renewed every five years to prove their continued competence1. While renewal requirements vary by certification body and the type of certification, ACNPs generally need to complete a certain number of continuing education (CE) hours, which can vary according to each state’s requirements.

In addition to seeking renewal through the board, you may need to also seek renewal through your state.

Step 6: Commence the Search for Acute Care Nurse Practitioner Jobs

Once you’ve completed your graduate-level program and completed your required clinical experience, and passed your certification exam, it’s time to start looking for a job.

This task may seem daunting, but there are a number of resources available to help you on your journey. The American Association of Nurse Practitioners (AANP) maintains a database of open ACNP positions, which you can search based on location, specialty, and other criteria. The AANP job center enables you to upload your resume, allowing prospective employers to find you.

The AANP job center also provides resources on how to conduct a successful job search, including tips on how to write an effective resume, ace a job interview, or improve your networking skills.

You may search for open acute care nurse jobs elsewhere, namely on job search boards like LinkedIn, Monster, and Indeed. Finally, your MSN program may offer career counseling opportunities or job leads—so be sure to check if these services are available to you and make use of them. Learn more about nursing degree salaries and nurse practitioner careers.

ACNP Specialties: Become an Adult Gerontology Acute Care Nurse Practitioner

Once you begin your journey to becoming an acute care nurse practitioner, you might find that you want to specialize in a particular area. One specialization you could pursue is Adult Gerontology Acute Care Nurse Practitioner (AGACNP). These NPs provide acute care to adults, often older adults or geriatric patients, in hospitals and other clinical settings1.

Depending on their graduate program, an aspiring AGACNP might have the option to further specialize in their field during their graduate studies while gaining the required clinical experience to prepare them for adult gerontology acute care nurse jobs. Concentrations can include cardiology, nephrology, transplantation, oncology, neurosurgery, endocrinology, trauma, and rehabilitation.

ACNP Specialties: Become a Pediatric Acute Care Nurse Practitioner

Conversely, prospective ACNPs can specialize as a pediatric acute care nurse practitioner treating infants, children and adolescents who require care for acute or chronic conditions1. MSN programs within this specialty area will thoroughly prepare you for pediatric acute care nurse jobs.

These patients are often suffering from complex health issues and critical acute illnesses, and they require a caretaker with advanced skills and the ability to monitor and manage complex health issues. Treating acutely ill children may be rewarding for you because your care can help them live a more active and comfortable life. However, a pediatric acute care nurse practitioner must also care for patients through situations many people find emotionally difficult, like treating a child during the end of their life.

What are the Continuing Education Requirements for Acute Care Nurse Practitioners?

In order to maintain their certification, ACNPs aim to stay up to date on evolving standards of care, treatment, and other advances within the field. One way to do that is to complete continuing education for acute care NPs. Specific continuing education (CE) requirements vary by state, but most of them require fulfilling set CE targets.

As an example, if an ACNP is renewing their certification through a national governing body like the American Association of Critical-Care Nurses (AACN) they are required to obtain 150 CE points, 25 of which must be in pharmacology.

Be sure to check requirements for continuing education for acute care nurses in your state.

Important Skills that Can Help You Become an Acute Care Nurse Practitioner

Working as an ACNP can be demanding. The specialization often requires ACNPs to work with patients suffering from more acute or critical conditions than one may generally see in a primary care setting. Obtained through years of schooling and clinical experience, skills acute care NPs have are wide-ranging. The following skills may be useful for acute care NPs, but may not necessarily guarantee a job nor success on the job. In other words, each patient and health care team are different, and the skills that acute care nurses use at any given time will change depending on those factors.

  • Communication Skills
    The ability to effectively convey the course of treatment to patients and give instructions to other members of the patient's attending team may be particularly helpful, especially in fast-paced environments. ACNPs may also demonstrate creativity in determining the severity of the patient’s condition when the patient is unable to communicate this on their own. As such, ACNPs can benefit from effectively communicating directives in fast-paced, often hectic working environments prone to frequent interruption. The ACNP’s ability to clearly communicate needs and directives to team members may help to ensure the patient receives the care they need when they need it.
  • Flexibility
    ACNPs are often quick on their feet, able to endure constant interruption, as their pagers and other communication devices may frequently signal them to attend to another patient while they are already in the process of administering care to someone else. Additionally, nurses in hospitals, urgent care centers, and other facilities generally have to attend to high volumes of patients at once. Therefore, ACNPs often need to get themselves up to speed quickly and coordinate the most effective treatment possible in the brief window of time their workload allows them to spend with each individual patient.
  • Leadership Skills
    Because the patients ACNPs treat are generally suffering from more serious conditions than you’d find in a primary practice setting, ACNPs often have to make difficult decisions under strenuous circumstances. To help with that process, ACNPs try to keep a level-head while determining the course of treatment and issuing instructions to the care team.

Becoming an acute care nurse practitioner entails hard work, from years of schooling to certifications, but it may be worth it for you. If this is a career path that you’re interested in, make sure you thoroughly research all your program options to identify one that aligns with your personal goals, and familiarize yourself with state requirements when it comes to licensing and certification. Still thinking about which nursing career to pursue? Explore which nursing degree might be right for you.

1 https://www.aacn.org/certification/preparation-tools-and-handbooks/~/media/aacn-website/certification/get-certified/handbooks/acnpcagexamhandbook.pdf?la=en Return to footnote reference

Last Updated January 2021