Family Nurse Practitioner

Family nurse practitioners typically provide generalist primary care for patients of all ages.

What do FNPs love about this specialty? The versatility of this path can provide a lot of flexibility in how you choose to shape your career.

“I often steer would-be NPs to Family first because it gives them the largest number of pivot points,” says Dr. Hamilton. “They can practice virtually anywhere, doing just about anything that involves primary care—whether with pediatrics, adults, school-aged children or geriatrics—they do it all and can work pretty much anywhere there’s a need for a primary care provider.”

With that versatility comes variety in the types of health issues you can address as an FNP.

“I love that there is so much variety as an FNP,” says Dr. D’Errico. “I care for patients and families presenting with a broad spectrum of health needs. Some of these are acutely evolving issues, like sudden-onset abdominal pain or a wound needing repair. Other problems are chronic, such as managing elevated blood pressure or diseases such as heart failure.”

What challenges should prospective FNPs know about? Simply put, they have a lot of ground to cover.

“The population focus served by the FNP is broad and complex,” says Dr. D’Errico. “The FNP must be a true generalist. This challenge, although formidable, also makes the FNP widely in demand in many health care settings.”

Dr. D’Errico emphasizes FNPs will need to do a little self-reflection when considering employment opportunities.

“Although this [versatility] is great from an employment perspective, it can be daunting as many prospective employers are not fully aware of the scope of practice of the FNP,” Dr. D’Errico says. “As such, it is incumbent upon the FNP to ensure we are only accepting employment in appropriate settings for our training, education, licensure and certification.”

Pediatric Nurse Practitioner

Pediatric nurse practitioners care for young patients (typically from birth to 21 years old) as they develop into adulthood. Pediatric NPs often subspecialize in working in either acute or primary care.

What do PNPs love about this specialty? Working with kids! They’re cute, goofy, precocious, excitable and can bring a smile to even the most stone-faced clinician.

Many pediatric NPs have long had their hearts set on working with this patient group or have had a positive experience working in pediatrics as an RN. The opportunity to pair serious work with sometimes silly, kid-friendly communication is undeniably appealing for some.

What challenges should prospective PNPs know about? Treating a pediatric patient also means you’re working closely with their families—and that can be a mixed bag. Caring for pediatric patients with chaotic or neglectful home lives can be heartbreaking, and parental beliefs or opinions can run counter to what you know is best for the patient’s health. That’s not an easy position to navigate as a healthcare provider.

Also, while this is not the “narrowest” specialty, the pediatric focus can be a limiting factor for your career options.

Neonatal Nurse Practitioner

Neonatal NPs focus on caring for newborn infants as they make the transition to life outside of the womb.

What do NNPs love about this specialty? It provides an opportunity to take a step up in responsibility in caring for infants in a critical care environment. Dr. Beth Diehl, a neonatal nurse practitioner and Rasmussen University associate professor, says her experience as a nurse in this environment helped her realize becoming an NNP was the right next step.

“I had several years of staff nurse experience and admired the degree of skill and expertise demonstrated by other neonatal NPs,” Dr. Diehl says. “They had great authority and autonomy in patient care management and routinely performed endotracheal intubations, chest tube placements, umbilical artery and vein cannulations. All very impressive stuff!”

Being able to take on a larger role when caring for ill newborns is fulfilling. You’re trusted by families during a time of crisis and helping them work through what can be incredibly challenging circumstances.

What challenges should prospective NNPs know about? Caring for critically ill infants means you’re going to see parents and families navigate some incredibly sad and challenging circumstances.

“[Often] they are grieving the loss of either a full-term pregnancy, a ‘perfect’ child or a healthy baby,” Dr. Diehl says. “Helping them navigate that course is rewarding but challenging, as well.”

A practical potential drawback of this role is that you’re typically going to be working in hospital NICU settings, which operate all day, every day, and that schedule may not appeal to everyone. Additionally, this is a narrow population focus which can limit your options if you eventually decide you want to work with a different patient population.

Women’s Health Nurse Practitioner

Women’s health nurse practitioners care for women of all ages, with a focus on reproductive, obstetric and gynecological health.

What do WHNPs love about this specialty? This specialty is often a passion pursuit. WHNPs are drawn to working with women and helping them navigate important health decisions regarding reproductive health, family planning and OB-GYN care.

This role provides an opportunity to work as a healthcare provider for a historically overlooked patient population and provide the necessary expertise for managing women’s health issues across the lifespan.

Can nurse practitioners change specializations?

The short answer is yes. But there are some important caveats to keep in mind. Depending on your starting point, you may need further education or training to safely (or legally, depending on the regulations of your state) practice in certain settings. That said, there are certainly areas of overlap among the above specializations and some changes in focus are easier to accomplish than others.

For example, a pediatric acute care NP isn’t likely to transition to a psych-mental health NP role without additional training, but a family NP can usually work in a pediatric primary care clinic. In general, it’s easier to transition from a broader population focus to a narrower focus.

Keep in mind there are also subspecialization options you may be eligible to pursue. Common subspecialty options include (but are not limited to):

• Cardiology
• Dermatology
• Emergency care
• Gastroenterology
• Nephrology
• Oncology

While the specifics will vary, many of these subspecialties include professional certification options that may require additional training or education to fulfill.