Registered nurse vs. nurse practitioner: Understanding the key differences

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Written By Berry Mathew

The ever-evolving world of healthcare relies upon the skills and experience of nurses, who occupy two essential roles with critical differences: Registered nurses (RNs) and nurse practitioners (NPs). Both positions involve nursing, yet their education requirements, scope of practice, and patient care responsibilities vary significantly. Aspiring nurses, patients, and other healthcare professionals may benefit from having a deeper understanding of these distinctions. This blog post will explore the core differences between RNs and NPs, examining the education and training involved, the scope of each profession, and their roles in caring for patients.

By carefully exploring the distinctions between nursing roles, we aim to offer a greater understanding for those considering a nursing career or who wish to better understand RNs and NPs as part of the healthcare infrastructure.

Education and training

The educational requirements for these two professions can vary depending on the program and state where a nurse plans to practice.

  • Registered nurse

RNs have the opportunity to pursue their educational and training goals in various ways.

  • Diploma in nursing

Diploma programs in nursing provide hands-on clinical experience and theoretical coursework to prepare graduates for the rigorous licensing exam, NCLEX-RN. However, diploma programs are becoming less common due to an increasing preference for nurses with higher qualifications.

  • Associate degree in nursing (ADN)

An associate degree in nursing is a two-year program offered by community colleges and some universities. ADN programs combine theoretical coursework with hands-on clinical experience. Graduates are prepared to provide direct patient care in various healthcare settings and are eligible to take the NCLEX-RN exam to become licensed RNs. While an ADN is an accessible and relatively quick path to a nursing career, many healthcare facilities increasingly seek nurses with bachelor’s degrees.

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  • Bachelor of Science in Nursing (BSN)

The Bachelor of Science in Nursing (BSN) is a comprehensive four-year degree program offered by universities and colleges that provides a well-rounded education in nursing theory, research, public health, and leadership. This specialized program also prioritizes developing critical thinking, communication, and decision-making skills. After completing the requirements of the BSN program, graduates can take the NCLEX-RN exam to become a licensed RN. With a BSN, nurses gain access to many more positions in the field, particularly in leadership or specialized roles. Additionally, it serves as an essential foundation for those wishing to pursue higher levels of education, such as a nurse practitioner program.

Licensing and certification


To obtain licensure as a registered nurse in the United States, all nursing graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN), a standardized adaptive exam developed by the National Council of State Boards of Nursing (NCSBN). The exam includes multiple-choice, fill-in-the-blank, and interactive questions covering four key areas – safe and effective care environment, health promotion and maintenance, physiological integrity, and psychosocial integrity. With a minimum of 75 questions and a maximum of 265, it tests knowledge, skills, and abilities relevant to successful nursing practice.

  • Optional specialty certifications

RNs have the opportunity to showcase their extensive knowledge and unique skills by obtaining specialty certifications delivered by professional nursing organizations. To be eligible for these credentials, nurses must meet prerequisites such as having a certain number of clinical hours in the area of focus and completing a specialized certification exam. Some common specialty certifications for RNs include:

  • Critical care registered nurse – for nurses in critical care settings, such as intensive care units, cardiac care units, and emergency departments.
  • Oncology certified nurse – for nurses providing care to patients with cancer.
  • Certified pediatric nurse – for nurses specializing in the care of pediatric patients.
  • Certified medical-surgical registered nurse – for nurses in medical-surgical settings, such as general hospital units or outpatient surgical centers.

A specialty certification can enhance a registered nurse’s professional credibility, increase employment opportunities, and potentially lead to higher salaries. While these certifications are optional, many nurses choose to pursue them as a means of professional development and career advancement.

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  • Nurse practitioner

NPs are highly qualified healthcare providers equipped with an advanced level of knowledge and experience. Through additional training, NPs can diagnose and treat illnesses, write prescriptions, and offer patient education and guidance. They must meet the necessary educational requirements and receive a license or certification to practice.

  • Educational requirements

For those wishing to take on the profession of an NP, it is essential to obtain a Bachelor of Science in Nursing (BSN) degree and become registered as a nurse (RN). After accruing experience through work as an RN, individuals can pursue further education with either a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP), both of which supply the necessary knowledge and expertise expected of NPs.

A master’s degree from an accredited institution like Rockhurst University is a great boon to your nursing career. But, you may be wondering, what can you do with a master’s in nursing? An MSN degree offers RNs a chance to unlock new career opportunities and take over more advanced nursing roles. In just two years, this program equips RNs with the necessary knowledge, research, and leadership skills to pursue various paths in their nursing career. These are some of the options available for those with an MSN degree:

  • Nurse practitioner
  • Clinical nurse specialist
  • Nurse educator
  • Nurse administrator
  • Nurse researcher

Licensing and certification

To practice as an NP, individuals must obtain both national certification and state-specific licensure. National certification is obtained by passing an examination administered by one of several national certification bodies, such as the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners Certification Board (AANPCB).

State-specific licensure requirements vary by state but typically involve completing an application and providing proof of education, certification, and experience. Some states also require NPs to work under the supervision of a physician or have a collaborative agreement with a physician.

Becoming an NP requires significant education and training beyond the requirements of a registered nurse. Individuals must complete an MSN or DNP program, pass a national certification exam, and obtain state-specific licensure. Despite the additional requirements, many individuals choose to become NPs due to the higher earning potential, greater autonomy in patient care, and opportunities for specialization and leadership roles. As the demand for healthcare professionals continues to increase, NPs will continue to play an essential role in meeting the healthcare needs of individuals and communities.

Scope of practice

RNs and NPs have different roles in patient care due to their education, training, and licensure levels. While both provide essential services, there are marked distinctions between their scope of practice.

  • Registered nurse

RNs deliver essential general nursing care to patients in healthcare settings such as hospitals, medical clinics, residential care facilities, and homes. Under the guidance of physicians and other healthcare professionals, they utilize their expertise to offer comprehensive care services within the scope of general nursing.

  • General nursing care

RNs are essential to providing quality nursing care for patients. They monitor and record vital signs, administer medications, provide wound care, and support patients with activities of daily living, such as bathing, dressing, and eating. Additionally, RNs closely monitor patient conditions and promptly report any changes to the healthcare team.

  • Collaboration with the healthcare team

RNs’ scope of practice is based on mutually beneficial collaboration with other healthcare professionals. This includes physicians, NPs, and other nursing staff in order to develop, implement, and evaluate patient care plans. On top of that, RNs strive to ensure their patients and their families understand the care plan and potential outcomes by communicating clearly so they may track progress toward individual healthcare goals.

  • Patient education and advocacy

Patient education and advocacy are integral parts of the role. RNs ensure that patients and their families are equipped with the necessary information to make knowledgeable decisions in regard to healthcare. This involves providing medication instruction, exploring treatment possibilities, and offering guidance in managing long-term medical issues. In addition, they act as advocates by safeguarding their patients’ rights and ensuring their opinions are respected and heard within the healthcare sphere. This may consist of helping patients wade through complex medical matters, responding to queries on care, and assisting in end-of-life decision-making.

Nurse practitioner

With their full range of capabilities, NPs provide the following:

  • Advanced nursing practice

NPs specialize in providing expert nursing care. They conduct comprehensive health evaluations and employ evidence-based practice to diagnose illnesses and oversee the management of chronic conditions. NPs pride themselves on customizing care for each patient, offering more than simple nursing services.

  • Independent and collaborative care

NPs and RNs each boast different levels of autonomy when it comes to their practice. NPs, for example, have the prerogative to administer primary care services without a supervising physician’s oversight. This grants them the power to diagnose and treat patients for both acute and chronic conditions and make referrals to specialists when appropriate. NPs also collaborate with other healthcare experts, such as physicians, pharmacists, and therapists, to ensure seamless and integrated patient care.

  • Prescriptive authority and ordering diagnostic tests

NPs possess the prescriptive authority to write medications for their patients, depending on which state they practice in. Certain states allow NPs full prescriptive authority without a collaborative agreement with a physician, whereas others require such an agreement for this privilege. An additional benefit of being an NP is the capacity to order and evaluate diagnostic tests, including laboratory work, imaging studies, or other procedures. With the ability to prescribe medication and review diagnostics, NPs are able to administer care more efficiently and make informed decisions regarding their patients’ treatment plans.

Responsibilities in patient care

Another way to distinguish RNs from NPs is the role each plays in patient care.

RNs are responsible for the following:

  • Assessment and monitoring

Monitoring and assessing a patient’s condition is fundamental to an RN’s work. This includes taking vital signs, observing patients for changes in their physical or mental state, and gathering data to help inform treatment decisions. RNs may also perform diagnostic tests, such as drawing blood, and interpret the results to determine the best course of action. They are responsible for continually monitoring patients’ progress and adjusting care plans as needed.

  • Care planning and implementation

Nurses work diligently to create personalized care plans for each patient based on their assessments. This plan outlines the objectives of treatment and expected results, as well as the necessary interventions to be taken by medical professionals, including physicians, NPs, and therapists. After the plan is confirmed, nurses take charge of carrying out the various interventions, from administering medications and providing wound care to helping with everyday activities. They also educate and support patients and families so they can better manage health conditions and promote self-care.

  • Documentation and communication

For RNs, creating accurate documentation and sharing it effectively is integral to providing patient care. RNs must ensure they keep detailed, current records on patients’ medical histories, assessments, care plans, and treatment progress in order to ensure continuity of care and successful collaboration between healthcare team members. Plus, they serve as a crucial link between patients and their families by offering updates on the patient’s condition, responding to queries, and addressing any worries. In addition, RNs fulfill the role of patient advocate, actively speaking up for the patient’s needs and guaranteeing their voice is taken into account when making decisions.

NPs are responsible for the following:

  • Comprehensive patient assessment

As part of their advanced practice role, NPs are responsible for conducting comprehensive patient assessments. This involves taking a detailed patient history, performing physical examinations, and reviewing relevant diagnostic tests. NPs are trained to evaluate patients holistically, considering not only their physical symptoms but also their mental, emotional, and social well-being. This comprehensive approach enables NPs to identify potential health issues early on and develop appropriate treatment plans tailored to each patient’s unique needs.

  • Diagnosis and treatment planning

NPs are in the advantageous position of diagnosing and creating treatment plans for their patients. They can prescribe medications, request and interpret tests, or refer people to experts if required. Furthermore, NPs collaborate with other medical personnel to ensure that each patient obtains top-notch care. They also inform patients about their conditions, potential treatments, and any related adverse outcomes, thus enabling them to make enlightened decisions about their well-being.

  • Patient management and follow-up

NPs are integral to their patients’ long-term care, actively monitoring progress and continually adapting treatment plans as needed. NPs provide much-needed guidance, support, and encouragement to help ensure that patients adhere to their prescribed plan of action. Additionally, they collaborate with a variety of healthcare providers and specialists to offer comprehensive and integrated medical services.

Comparing career paths

A career in nursing is a noble endeavor, but it can be challenging to choose the right path. Two of your options are RNs and NPs, each providing essential services in the medical field. Knowing the benefits and challenges of either line of work, as well as the factors to take into account, is vital when deciding which role to pursue.

Registered nurse

There are many advantages to choosing to be an RN.


  • Shorter educational requirements (typically an associate’s or bachelor’s degree)
  • Flexibility to work in a variety of healthcare settings, including hospitals, clinics, and nursing homes
  • Opportunity for career advancements, such as becoming a charge nurse or nurse manager
  • Opportunity for specialization in a particular area of nursing, such as pediatrics or oncology


  • The limited scope of practice, with less autonomy and responsibility than NPs
  • Lower earning potential than NPs
  • Limited ability to prescribe medication or order diagnostic tests
  • It can be physically demanding, with long hours and exposure to infectious diseases

Nurse practitioner


  • Advanced educational requirements, with a master’s or doctoral degree in nursing
  • Increased scope of practice, with the ability to diagnose and treat patients independently
  • Higher earning potential than RNs
  • Opportunity for specialization in a particular area of medicine, such as family practice or cardiology


  • Limited flexibility in terms of work settings as NPs are typically employed in clinics or private practices
  • Greater responsibility and liability than RNs
  • It may require additional certification or licensure beyond the basic nursing requirements
  • May face resistance from physicians or other healthcare providers who are not familiar with the NP role

Factors to consider when choosing a nursing career

Other factors to keep in mind when deciding on which nursing career path to take include:

  • Educational requirements
  • Personal interests
  • Career goals
  • Work-life balance
  • Salary and benefits

Final word

In conclusion, the roles of a registered nurse and a nurse practitioner are distinct, with varying levels of education, scope of practice, and patient care responsibilities. While RNs focus on providing general nursing care and collaborating with the healthcare team, NPs are trained to provide advanced nursing care, including independent and collaborative care, prescriptive authority, and ordering diagnostic tests.

Both roles offer unique advantages and disadvantages, and it’s crucial to consider personal factors such as career goals, desired level of autonomy, and preferred work environment when choosing a nursing career path. Additionally, ongoing education and training are essential for RNs and NPs to stay up to date with the latest healthcare practices and technologies.

Overall, both RNs and NPs play a crucial role in providing high-quality patient care and improving healthcare outcomes. Whether you choose to pursue a career as a registered nurse or a nurse practitioner, the nursing profession offers a fulfilling and rewarding career path that can positively impact the lives of patients and their families.