When you apply for Nurse Practitioner (NP) school, you have to choose and apply for a specialty or track. The specialty you choose will determine what types of patients you will take care of in your future job. It will also affect your scope of practice (aka what you can do in your state) and also where you can work. There are at least 9 Nurse Practitioner population focus/ specialty/ tracks to choose from. These three terms – population focus, specialty, and track – basically refer to the same thing. To keep it simple, I’m going to use track throughout this article.
Typically, you have to choose your track at the time of application, though you could apply to more than 1 and make your decision based on what program and tracks you get admitted to. Some people know ahead of time and are committed to a specific track; whereas, others are less sure and spend a lot of time weighing the pros and cons.
There are three factors you should consider when choosing your track/specialty. Firstly, who are the patients you want to take care of? Secondly, what settings do you want to work in? And lastly, what does a typical day look like in that role, and what does the job involve?
9 Nurse Practitioner tracks or specialties to choose from:
- Family
- Adult-Gerontology – Acute
- Adult-Gerontology – Primary Care
- Women’s Health
- Pediatrics – Acute
- Pediatrics – Primary Care
- Neonatal
- Psychiatric Mental Health
- Midwifery
As you’re deciding between these tracks, I thought it would be helpful to lay out exactly what a Nurse Practitioner within that population track does, where they work and provide job description samples
Looking at job descriptions for a career or population focus you are considering can be a helpful way to determine if it’s right for you. Job descriptions provide great insight into what a typical day might look like for you if you choose that Nurse Practitioner specialty or track.
Family NP
Who you take care of: all ages – newborn to the elderly and everyone in between. You often receive training in prenatal care but it’s not very common to practice somewhere you use this skillset
Where you may work: Often primary care/family medicine, but there are opportunities to work in the hospital, ER, or specialty clinics.
Job description: FNP position at Northland Community Health Center
- Interviews patients to obtain history, performs physical examinations, orders lab, and other tests, prescribes medications and treatments for patients across the lifespan.
- Provides continuity in managed care for patients with pre-existing long term problems.
- Makes referrals for secondary and tertiary care.
- Performs medical procedures according to privileges issued.
- Provides health maintenance visits, evaluates for immunizations and provides anticipatory guidance and referrals; performs contract and special physical examinations such as Head Start, employment, etc.; performs STD (sexually transmitted disease) and family planning screening and education.
- Documents and codes all patient contact accurately and legibly in the medical record.
Adult-Gerontology Acute Care NP
Who you take care of: adolescents (age 13+) – the elderly
Where you may work: In the hospital or less often specialty clinics. Often as hospitalists or within a specialty either inpatient or outpatient.
Job description: a position at Catskill Regional Medical Center
- The Hospitalist Nurse Practitioner (NP) is responsible for overseeing the in-patients assigned. Hospitalist NPs are responsible for providing direct patient clinical care and managing medical problems of acutely ill, hospitalized, adult patients. The Hospitalist NP is a part of the interdisciplinary team to improve efficiency and facilitate a continuum of care for patients from admission to discharge.
Adult-Gerontology Primary Care NP
Who you take care of: adolescents (age 13+) – the elderly. You often receive training in prenatal care but it’s not very common to practice somewhere you use this skillset
Where you may work: The training is oriented towards working in primary care/family medicine, but there may be opportunities to work in the hospital, ER, or specialty clinics
Job description: an Internal Medicine position at the University of Wisconsin
- The Nurse Practitioner functions as an independent healthcare provider who, working collaboratively within a multidisciplinary health team, is responsible for providing comprehensive care to both well and ill patients in an outpatient setting. He/she demonstrates a high degree of clinical expertise in working with patients with acute and chronic illnesses commonly encountered in adults ages 18 years and older in general internal medicine. He/she is responsible for assessment, diagnosis, treatment, management, education, health promotion, and care coordination for patients and families with acute and chronic health needs.
Women’s Health NP
Who you take care of: women starting at reproductive age (usually 13+) and throughout the rest of the lifespan; you can provide prenatal care as well
Where you may work: women’s health clinics or OB/GYN offices
Job description: a position at the United Health Centers’ Women’s Health Clinic
- Provide primary health care that includes health education and preventative care along with diagnostic and therapeutic procedures with a focus on reproductive, obstetric, and gynecological health.
- Comfortable seeing a wide range of Obstetrical and Gynecological conditions
- Manage patient care for routine well woman’s exams, follow up appointments, family, and prenatal care with in-office procedures performed.
Pediatric Acute Care NP
Who you take care of: children from birth to early adulthood (up to age 21)
Where you may work: Hospital, sub-specialty clinics, or the ER
Job description: from a position in UCSF’s Pediatrics Department
- The Pediatric Nurse Practitioner-Acute Care (PNP-AC) provides family-centered care to meet the specialized needs of infants, children, adolescents, and young adults with unstable chronic, complex acute, and critical health conditions.
- PNP-ACs care for pediatric patients that require complex monitoring and ongoing management of intensive therapies in a variety of settings with a focus on restorative care during rapidly changing clinical conditions.
Pediatric Primary Care NP
Who you take care of: children from birth to early adulthood (up to age 21)
Where you may work: outpatient – private practice, clinics, school-based clinics, home care, or outpatient sub-specialty clinics
Job description: Share Our Selves Community Health Center
- Job responsibilities include well-child exams from birth to 18 years of age and sick visits including acute and chronic care.
- Primary Care for the pediatric population, including well-child exams and childhood immunizations.
- Perform routine developmental screenings.
- Diagnosis and treatment of common childhood illnesses.
- Teaching and counseling of children and their families on issues related to health.
- Completing triage duties, ordering and interpreting the results of laboratory, x-ray, and other tests; determining and implementing courses of treatment, providing and monitoring the results of treatment, and adjusting as needed.
Neonatal NP
Who you take care of: premature or ill newborns
Where you may work: Hospital – labor and delivery and the NICU
Job description: from a large hospital in California
- The NICU Neonatal Intensive Care Nurse Practitioner cares for patients in the intense Level III NICU providing the highest level of care for babies born prematurely, with complicated deliveries, and medical issues shortly after delivery.
- The Nurse Practitioner NICU will act as the primary caregiver for patients in need of immediate and focused care daily and be responsible for examinations, diagnoses, stabilization and treatment, rehabilitation, and family support of Intensive Care babies.
- The Neonatal NP will work with premature infants and those with serious defective disorders in this large NICU and provide devoted round-the-clock patient assistance.
Psychiatric Mental Health NP
Who you take care of: individuals of all ages with mental health needs
Where you may work: outpatient – private practice, family medicine or community health clinics that have a mental health practice or inpatient at psychiatric hospitals
Job description: a position at A Strong Mind Psychiatry outpatient clinic
- Manage psychotropic drugs for their patients (children, adolescents, and adults suffering from mental health-related issues including but not limited to depression, bipolar disorder, addiction, anxiety, personality disorders).
- Conduct psychiatric assessments and evaluations and work autonomously with collaborating physician support.
Midwifery or Certified Nurse Midwife
Who you take care of: Women starting at reproductive age and including their routine gynecologic care, prenatal care for low-risk/healthy women, and labor and delivery care. You also provide care of newborns in the first few weeks after delivery. You may provide primary care services to women.
Where you may work: private practices, in hospitals and birthing centers, OBGYN offices, or women’s health clinics. You can also do home births as a midwife.
Job description: a Certified Nurse Midwife position at Hugh Chatham Memorial Hospital – Women’s Center
- Provides independent and collaborative primary healthcare and management of care to women before, during, and after pregnancy.
- Essential Functions: Obtains patient history and performs assessment via observation, interview, and examination. Plans, implements, and evaluates patient care plans. Monitors, records, and communicates patient condition as appropriate.
- Provides care for obstetric patients to include pregnancy-induced hypertension, gestational diabetes, multiple gestations, and routine labor management. Manages patients with epidural infusions, Pitocin protocols, and other labor pharmaceuticals. Performs appropriate emergency interventions and manages complications.
- Collaborates with the on-call obstetrician to assess or manage low to moderate risk intrapartum patients.
- Rounds on OB and postpartum.
- Provides education/counseling to the patient and patient’s family with respect to pregnancy, childbirth, care of the newborn, contraception, family planning, and gynecological care.
Nurse Practitioner Specialty and Tracks Summary
Choosing a Nurse Practitioner specialty or track is an important decision when you’re applying to NP school. The specialty/track you choose will lead you down different paths as it determines the types of patients you take care of, the setting you can work in, and ultimately, what you’ll do on a day to day basis at work. If you’re still on the fence, take some time to talk with Nurse Practitioners in your life and ask what they like and dislike about their choice. It may be helpful to read through some more job descriptions for the track you’re considering to see whether you might enjoy the work.
I’d love to hear – what track are you most interested in? If you’re already in school or are a Nurse Practitioner, what specialty or track did you choose and why?
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