Registered Nurse vs. Nurse Practitioner

What Is a Registered Nurse?

A registered nurse (RN) assists doctors and other nurses in providing critical care to patients in a variety of settings. These individuals typically hold an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) and have passed the National Council Licensure Examination, or NCLEX-RN.

RNs work in many settings, and their roles and responsibilities depend on their specific work environment and patient population. However, all RNs possess foundational clinical skills related to the nursing process of assessment, diagnosis, outcomes/planning, implementation and evaluation that are applicable across the spectrum of health care settings. 

Traits that will help an RN in their role include:

• Detail oriented and organized.
• Mentally and physically strong.
• Patient and resilient.
• Able to manage stress.
• Critical thinker who uses sound judgment.
• Effective communicator.

What Does an RN Do?

A registered nurse’s responsibilities vary based on the health care setting. Some responsibilities may include conducting patient assessments, dressing wounds and incisions, reviewing and determining treatment plans, helping doctors during surgery, guiding patients in healthy habits and providing emotional support to patients and families. 

The nursing staff in hospitals primarily comprises registered nurses. In this setting and others, registered nurses can also specialize in a variety of areas.

What are RN specializations? Some nurses pursue the various types of nursing certifications available to gain specialty expertise. Common RN specialties include:

• Acute care.
• Infectious disease.
• Women’s health.

Many registered nurses also work in nonclinical roles, such as administration, law and insurance offices.

What Is a Nurse Practitioner?

Nurse practitioners are health care professionals who have advanced education and training beyond the requirements for registered nurses. NPs have at least a master’s degree, and today, many are choosing to pursue a doctoral degree in nursing, or a DNP. Nurse practitioners may specialize in a particular area, such as family nurse practitioner, pediatrics, oncology or women’s health. They are also referred to as advanced practice registered nurses, or APRNs, reflecting the additional education and training they’ve acquired.

What Does an NP Do?

What are the roles and responsibilities of a nurse practitioner? As a specialized nursing professional, an NP can deliver primary and specialty health care to patients. Such care includes diagnostics, treatment and medical counsel. An NP is also able to prescribe medications and create comprehensive treatment plans for patients, sometimes without the supervision of a physician. Although an NP degree is not required to practice in a specialty area, those who specialize in a particular discipline must meet certain training and licensing requirements.

What are NP specializations? Nurse practitioners work in many different types of specialty areas:

• Acute care.
• Adult care.
• Family care.
• Neonatal care.
• Psychiatric and mental health care.
• Women’s health.

Registered Nurse and Nurse Practitioner Roles at a Glance

Although both professionals are nurses, there are distinct differences between RN and NP roles in terms of minimum and continuing educational requirements, licensing and certification, duties, specialization, salary, occupational demand and the ability to prescribe medications. The following provides an overview for each.

For registered nurses:

• Minimum education: Associate Degree in Nursing.
• Continuing education requirements: These requirements for RNs vary from state to state. More information is available from each state's Board of Nursing and the National Council of State Boards of Nursing.
• Licensing and certification: Registered nurses must register with the Board of Nursing in the state where they work and pass the NCLEX-RN exam. An application to take the exam must also be completed as well as payment of a fee. RNs who move to another state must register with the board in that state, although a re-examination may not be required. The Nurse Licensure Compact allows a nurse to have one multistate license, providing the ability to practice in the home state and other compact states for a limited time.
• Duties: A registered nurse’s responsibilities may include any of the following:
  • Providing and coordinating care.
  • Educating patients and the public about health conditions.
  • Providing guidance and emotional support to patients and their families.
  • Assessing a patient’s signs and symptoms.
  • Documenting various aspects of a patient’s care.
  • Administering medications and treatments.
  • Creating care plans for patients and families.
  • Collaborating with other health care professionals.
  • Operating medical equipment.
  • Assisting with diagnostic testing.
  • Answering questions related to informed consent.
• Specialization: There are many types of nursing certifications available — which often carry a requirement for a minimum of two years of clinical experience in that specialty area as part of eligibility to sit for the specialty exam.
• Salary: According to the Bureau of Labor Statistics (BLS), the 2018 RN median annual salary was $71,730 per year.
• Occupational demand: The BLS projects that registered nurse job growth will increase 12 percent from 2018 to 2028.
• Prescribing ability for medications: No, registered nurses are not able to prescribe medications.

For nurse practitioners:

• Minimum education: Master of Science in Nursing.
• Continuing education requirements: According to the American Association of Nurse Practitioners, renewal of certification for NPs is required every five years. Methods of renewal and eligibility requirements vary depending on the type of certification being renewed and the credentialing organization.
• Licensing and certification: Nurse practitioners must pass the NCLEX-RN exam, as described by the National Council of State Boards of Nursing (NCSBN), usually prior to starting graduate school. NPs must also meet state-specific nurse licensing requirements. Approved in 2015, the APRN Compact allows an advanced practice registered nurse to hold one multistate license with practicing privileges in other compact states. The compact will be implemented when 10 states have enacted the legislation.
  • Specialization: The AANP lists five certification boards through which NPs can obtain various types of specialty certifications:
    • American Academy of Nurse Practitioners National Certification Board
    • American Nurses Credentialing Center Certification Program
    • American Association of Critical-Care Nurses Certification Corporation
    • Pediatric Nursing Certification Board
    • National Certification Corporation
  • Duties: Some NP duties are the same as those for registered nurses, but NPs can also perform advanced functions, including ordering and evaluating test results, referring patients to specialists and diagnosing health conditions. NPs can work independently or in collaboration with physicians. In most states, they can prescribe medications, but scope of practice varies per state.
  • Specialization: The AANP reports some of the most common NP specialty areas as the following:
    • Family
    • Adult
    • Adult—gerontology primary care
    • Adult—gerontology acute care
    • Acute care
    • Pediatrics—primary care
    • Women’s health
    • Psychiatric/mental health—family
  • Salary: The 2018 NP median annual salary was $107,030, according to the
  • Occupational demand: The BLS indicates that NP job growth is expected to increase 28 percent from 2018 to 2028.
  • Prescribing ability for medications: Yes, in most states, nurse practitioners can prescribe medications, but the scope of practice varies. It is important to check state-specific regulations for the most updated information.

Salaries of RNs and NP

How much do RNs and NPs make? The salaries of RNs and NPs are substantially different. According to the BLS, the 2018 RN median annual salary was $71,730 per year. On the other hand, the 2018 NP median annual salary was $107,030, as per the BLS. The reason for the difference in salary is the extended role and scope of practice of NPs as well as their additional education (a master's degree in nursing or doctorate in nursing).

In May 2018, the median annual wages for nurse practitioners (including nurse anesthetists and nurse midwives) in the top industries in which they worked were as follows, according to the BLS:

The median annual wages for registered nurses in the top industries in which they worked were as follows, according to 2018 data from the BLS:

Career Outlook for RNs and NPs

The BLS projects that registered nurse job growth will increase 12 percent from 2018 to 2028, faster than the average for all occupations. Growth will occur for a number of reasons, including an increased emphasis on preventive care, growing rates of chronic conditions such as diabetes and obesity and an increased demand for health care services as the baby-boom generation lives longer and leads more active lives.

The nurse practitioner profession is expanding as well. According to the BLS, this field is one of the fastest growing of all the health care professions: NP job growth is expected to increase 28 percent from 2018 to 2028.

In large part, this is due to the multiplying demands for health care and the ability for NPs in many states to carry out medical services that were once reserved for physicians.

So, where do RNs and NPs work? Both types of nursing professionals are in high demand across the health care industry. They work in a variety of settings:

• Physicians’ offices.
• Outpatient treatment facilities.
• Home health care.
• Correctional facilities.

Since NPs can perform medical services in many states, it is common for outpatient and urgent care facilities to rely on NP staff.