How to choose your nurse practitioner specialty

Nurse practitioners, nurse midwives and nurse anesthetists, also referred to as advanced-practice nurses, are registered nurses with at least a master’s-level education and additional clinical preparation that allows them to coordinate patient care and provide primary or specialty health care for a specific population, such as children, women, or individuals with mental health and addiction disorders.

With many options available, how do you choose the advanced-practice nursing specialty that’s right for you? Here are three things to consider to help narrow your choices.

Do you want to work adults, children or both? Do you want to work mostly with women or with infants? Do you want to focus on treating patients with mental health and addiction disorders? Your answers to these questions offer pivotal insight into determining which advanced-practice specialty would provide the best career path for you.

Advanced-practice nurses focus their education and clinical training on one of six populations:

• Adult-gerontology
• Lifespan/family
• Neonatal
• Pediatrics
• Psych-mental health
• Women’s health/gender-related

If you know you don’t want to work with patients younger than 13, for instance, you can eliminate the family, neonatal and pediatric populations, which require ongoing clinical experience with children or infants to maintain certification in the field.

Do you want to work in a hospital setting, especially in an emergency department or intensive care unit (ICU), treating patients with severe illness, injury or trauma? Or, would you rather work in a primary-care focused setting? Determining where you want to work also serves as an important factor in your decision.

Adult-gerontology acute care, pediatric acute care and neonatal nurse practitioners typically work in hospital-based settings or hospital outpatient clinics and receive training to provide critical care procedures. Adult-gerontology acute care nurse practitioners, for example, can perform suturing, lumbar and emergency airway punctures and place chest tubes and central lines.

By contrast, family, adult-gerontology primary care and women’s health nurse practitioners and nurse midwives typically work in community-based settings, such as physician practices, retail clinics, long-term care facilities or dermatology, oncology or women’s health specialty clinics that do not provide critical care. These advanced-practice nurses diagnose and manage common and complex conditions and focus on disease prevention and education.

It’s important to note that, while some hospitals still hire primary care nurse practitioners, namely to work in emergency department settings, many organizations require nurses to obtain acute care nurse practitioner certifications. This is because primary care nurse practitioners are not certified to perform life-saving procedures that acute care nurse practitioners can perform.

Advanced-practice nurses must receive graduate-level education and training by earning a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP), the terminal or highest-level practice-focused degree, in their specialty.

Master’s-prepared advanced-practice nurses receive fully adequate education and hands-on experience in their specialty to offer the kind of safe, quality, affordable and accessible care that’s in high demand across the nation. The DNP builds on traditional master’s programs to include instruction in evidence-based practice, quality improvement and systems leadership.

What benefits does a DNP offer? It allows nurses to more easily move up in health care administration and opens doors to academic positions at all levels of nursing education. It also serves to differentiate nurses in larger job markets.

On a broader level, other health professions – medicine, dentistry, pharmacy, psychology, physical therapy, audiology – require doctoral-level education, and nursing continues to move in this direction, which means the DNP could soon become the standard for advanced-practice nurses.

Take this short quiz to point you to the right advanced-practice specialty program for you at the University of Cincinnati College of Nursing.

Note: Though nurse anesthetists are considered advanced-practice nurses, our Nurse Anesthesia DNP program is not included in this quiz. To learn about the nurse anesthesia specialty, visit our Nurse Anesthesia program page.