As a nurse practitioner in adult-gerontology you’ll specialize in either primary or acute care. (In years’ past, nurse practitioners could choose to earn more general certification in acute care. However, this certification exam was retired in 2014 and replaced with certifications that deal with specific patient populations: adult-gerontology acute care and pediatric acute care.) Of course, there’s a lot of similarities between the acute and primary AGNP role since they serve the same patient population, but as the names imply, the difference comes in the type and level of care they provide these patients, and the settings in which they typically work: Acute Care Adult-Gerontology Nurse Practitioners (ACAGNP) ACAGNPs provide care for patients with chronic, complex, illnesses and critical, acute illnesses. Providing care for adult patients suffering from acute traumatic injuries and medical emergencies like stroke and heart attack, and those experiencing worsening conditions as a result of chronic diseases or illnesses is the hallmark of the ACAGNP. For ACAGNPs, care is episodic in nature, meaning a complex, acute traumatic event or condition has prompted the patient’s need for care. Their expertise is therefore at home in tertiary care settings, such as surgical, intensive care, trauma, and acute care units, although these nursing professionals are valuable assets to long-term care facilities, nursing homes, and other skilled nursing facilities, which are home to the oldest patients who require complex, multifaceted treatment plans focused on preventing future complications. One of the distinguishing characteristics of ACAGNPs is their expertise in both emergent and non-emergent situations, and in acute, onset physiologic instability. ACAGNPs may specialize in a specific area, such as cardiovascular, pulmonary or neurological disease or they may treat a wide array of injuries, illnesses and diseases in general medical or surgical ICU settings. Primary Care Adult-Gerontology Nurse Practitioners (PCAGNP) PCAGNPs, on the other hand, are focused on providing comprehensive, continuous care in a long-term patient-practitioner relationship. They specialize in health promotion and screening, along with diagnosing and treating common acute and chronic medical diseases and conditions. PCAGNPs are the stars of the show in primary care settings, such as private practices, outpatient clinics, women’s health clinics, and specialty practices. These advanced practice nursing professionals are highly valued in rural and undeserved areas where physician-based care is either lacking or non-existent. In fact, PCAGNPs have become lifelines for large populations in sparsely population parts of the country. Immunizations, routine checkups, assessments, and one-on-one counseling are part and parcel of their scope of duties, so on any given day you might find PCAGNPs counseling patients on healthy lifestyle and disease prevention plans…performing annual wellness checkups…overseeing a patient’s medication needs for the treatment of chronic diseases such as high blood pressure and diabetes…and performing routine women’s health services, such as pelvic exams.