Ep #128: How to Choose Your NP Specialty Path

Welcome to the Real Deal NP Club. Whether you’re hoping to become a real deal nurse practitioner or you already are one, this is the place for you to get the resources you need as you tackle this massive transition into practice. We’re your hosts, Sarah Michelle, Chief Nursing Officer of Blueprint Test Prep, and Anna Miller, Director of Nursing Content. And we’re here to hang out with you each week like your best friends in the NP space. Let’s dive in. 

Hello, hello everyone, it’s Anna here, and welcome back to the Real Deal Nurse Practitioner Club podcast. Today I’m going to do a little bit of a review, and no, not on board exam content like you might think, but rather on some of the different types of NP specialties. 

Maybe you’re listening to this podcast and you’re thinking about going to NP school, or maybe you already have a certification but you’re thinking about going back to school for another one. I know we, as nurses, love to keep ourselves busy. And there are so many different opportunities and specialties for NPs, and it can seem overwhelming. So I’m going to go over each specialty you can certify in and hopefully help you make any big decisions that you might be considering. 

Now, the most common nurse practitioner specialty is as a family nurse practitioner or FNP, and followed by adult gerontology primary or acute care. So that’d be AGPCNP or AGACNP, and psychiatric mental health or PMHNP. And this one is very, very quickly becoming the second most popular, and it’s really growing in popularity to help ease the demand for mental health providers. 

Then we have women’s health and even pediatric nurse practitioners. And you can then explore various subspecialties through formal programs or by accumulating experience in a specific field and passing a certifying board exam like an emergency nurse practitioner, or ENP, for example. 

So as you embark on this journey to becoming a real deal NP or another real deal NP, there are lots of things to consider when choosing your specialty. But also when it comes to being an NP, there’s no one-size-fits-all approach. Each real deal NP takes on a specialized role that aligns with their interests, skills, and experiences. So let’s get started. 

Let’s start with FNP because this is the most popular of all the nurse practitioner specialties with over two thirds of all NPs choosing this certification. An FNP can treat patients of all ages from infants and children to adults and older adults in the primary care setting. They diagnose and manage acute and chronic illnesses, prescribe medications, order and analyze diagnostic tests, and provide preventive care. 

And FNPs can work in a variety of settings which is why it’s such a popular option. They can work in primary care offices, outpatient specialty clinics like cardiology or endocrinology, asthma and allergy, and even urgent care centers. 

Now let’s talk about adult gerontology primary care nurse practitioners as this is another primary care certification, but it’s a little bit different. AGPCNPs provide care for patients from adolescence through older adulthood in primary care and community-based settings like internal med offices, nursing homes, assisted living facilities, and outpatient specialty clinics. And again these NPs focus on diagnosing, managing, and treating chronic illnesses while also helping patients manage their health. 

And then the other side of the spectrum of adult gerontology NPs would be our acute care, so AGACNPs. And these are going to specialize in treating adolescent and adult patients with acute and critical illnesses. And they tend to work as hospitalists in high stress situations like intensive care units or surgical units. 

Now, AGACNPs are trained to handle complex medical conditions like a heart attack, a stroke, respiratory failure, or kidney failure, and they work very closely with physicians and other health care professionals to really deliver the best possible care. 

And if working specifically in the emergency department is a dream of yours, there is an additional certification available as an emergency nurse practitioner or ENP, but most times you become an FNP first and then complete additional training to sit for an ENP board certification. 

While you can sit for the ENP boards based on emergency department clinical experience, there are a growing number of postgraduate programs for ENP certification specifically. 

Next up are pediatric nurse practitioners, and as the name suggests they care for children from birth to young adulthood. And they have specialized training in providing primary health services to children, including preventive care like immunizations, well child exams, and health screenings. 

PNPs also diagnose and treat common acute and chronic health problems in children including allergies, ear infections, and developmental delays. And there’s also a separate certification as a pediatric acute care nurse practitioner, or PNPAC, which is similar to that adult counterpart I mentioned but it is for pediatrics specifically in acute care environments. 

Now, if you really, really enjoy working in acute care with infants and toddlers specifically, then the neonatal nurse practitioner or NNP certification might be for you. According to the National Association of Neonatal Nurse Practitioners, NNPs provide primary, acute, chronic, and critical care to neonates infants and toddlers through age two. And in addition NNPs select and perform clinically indicated advanced diagnostic and therapeutic invasive procedures. 

And then we have women’s health nurse practitioners, or WHNPs. And these are going to specialize specifically in women’s reproductive health including prenatal care, contraceptive counseling, fertility, and gynecologic conditions. They perform routine checkups, preventive care, and contraception counseling. 

WHNPs also diagnose and treat acute and chronic health conditions related to women’s reproductive systems. And while WHNPs assist with prenatal care, they do not deliver babies. And so if that’s what you really, really want to do maybe a certified nurse midwife is a better path. 

And then lastly let’s talk about one that is growing like crazy, and that would be our psychiatric mental health nurse practitioners or PMHNPs. They specialize in mental health services for patients of all ages. So they can provide therapy, medication management, and support for mental health disorders. And they can work in a variety of settings including hospitals, community mental health centers, or private practices. 

And I know, I know that was a lot of information so do not get overwhelmed. The key is to find what interests you and what aligns with your long-term career goals. I know I personally picked the FNP route because even though I have a very strong passion for women’s health I also could see myself one day wanting to work in pediatrics or maybe in urgent care and I liked the flexibility that an FNP certification gave me. 

So that brings me to how do you choose the right NP specialty for you? And first you really want to identify either who or what it is that inspires you. So really think about what resonates with your passion for learning and support and patient care and really give this some thought. 

Do you absolutely adore spending time with children or with older adults? If so then you might want to consider becoming a pediatric or even adult gero nurse practitioner. Or does providing that what you call cradle-to-grave care speak to your heart? Then becoming a family nurse practitioner and working in primary care could be the perfect fit for you as it gives you that ability to care for patients from infancy to older adulthood. 

But on the other hand if you are really inspired to make a difference in the field of mental health, pursuing a career as a PMH NP could be an excellent choice. And this has become a really popular path since the pandemic, which is excellent because the need for psychiatric providers has increased as well. 

And maybe if you’re already working as a registered nurse in a hospital setting, becoming an acute care NP can open up even more exciting hospital-based opportunities in the future. 

I highly, highly recommend shadowing a clinician or even just chatting over coffee with someone already in various fields to just gain better insight before you fully dive in. And this can just give you a better idea of what their experience is within that specialty and what they love or even find challenging about it. 

And next I want you to visualize the kind of lifestyle you enjoy and what really fits into your life. Because when considering which of the different specialties to choose from, it’s important to think about where and how you’d like to work. 

Nowadays there’s a very high need for nurse practitioners so there are plenty of opportunities after graduation. If you’re already in the health care field you’re familiar with the difference between working in a hospital and an outpatient clinic. For example, working in the hospital means the schedule and the environment are quite different from those of outpatient clinics. 

Outpatient clinics typically follow regular weekday and holiday hours, while hospitals may involve rotating shifts including holidays and even on-call duties. Now of course there are some specialties that offer more flexibility than others and that is another important thing to take into consideration when choosing a path or a specialty. 

And remember that you don’t have to figure it all out now. Okay? When you are considering the different nurse practitioner specialties, remind yourself that it’s absolutely okay for your specialty to evolve over the years. Clinicians often begin with a broad experience such as working in primary care or as a hospitalist, and then through these experiences they pivot to a sub specialty or pursue additional certifications. And I am telling you no matter what NP certification you get, there are so many different paths that you can take. 

Okay, that was a lot but just remember choosing your NP specialty is something that might take time and thought in order to pick the one that’s right for you. If you head on over to npreviews.com we have a ton of resources for you whether you’re thinking about becoming a nurse practitioner or you are already on your NP journey. 

But thank you so much for tuning in to this quick episode. We hope you enjoyed this episode today and be sure to follow us on our podcast and our YouTube and Facebook page. Until next time. 

As an extra bonus friends, if you’re looking for support no matter what phase of your nurse practitioner journey that you’re currently in, I have communities available for both students and new nurse practitioners. In these communities, we work to uplift one another and grow this profession together every single day. Links to join will be included for you in the show notes. 

Thanks for listening to the Real Deal Nurse Practitioner Club. If you want more information about the different types of support that we offer to students and new nurse practitioners, you can visit npreviews, with an S, dot com. We’ll see you next week.