Nurse Practitioner
A Nurse Practitioner (NP) is an advanced practice registered nurse (APRN) who has completed master's or doctoral-level education and training. NPs are qualified to provide comprehensive care across various patient populations. Their responsibilities include diagnosing and treating medical conditions, prescribing medications, and offering patient education. In many states, NPs can practice independently, providing primary and specialty care without physician oversight.
How to Become | Licensing & Certification | Popular Specialties | SalaryHow Do You Become a Nurse Practitioner?
The process of becoming an NP starts with obtaining the proper education. Many nurse practitioners start as RNs and gain some experience in the field before deciding to take their careers to the next level. However, some accelerated and advanced nurse practitioner programs allow aspiring NPs to gain the knowledge and skills to enter directly into the profession.
Many nurses appreciate that NP programs come in various specialty areas, allowing them to focus their studies on an area of care they are passionate about, such as pediatrics, acute care, or psychiatric care, amongst others.
As advanced-practice registered nurses (APRNs), all nurse practitioners must become properly licensed as NPs and gain any required certifications for their specialty area before they can begin practicing in their state.
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What Are the NP Schooling Requirements?
NPs can choose to earn a Master's of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) in the nurse practitioner specialty of their choice. These can be completed online or on campus. Post-master’s certificate programs and nursing certifications are available for current NPs wishing to switch or expand specialties.
Eligibility requirements for standard MSN and DNP programs often include:
- Graduation from an accredited Bachelor of Science in Nursing (BSN) program for standard MSN programs and BSN to DNP programs (some DNP programs require an MSN)
- Unencumbered RN license
- Transcripts from all schools attended
- Essay or personal statement
- Letters of recommendation (professional or academic)
- Resume or CV
- GRE scores may be required for some schools/programs
Are you curious about what campus-based and online MSN or DNP programs entail? Check out the table below:
| Aspect | MSN | DNP |
|---|---|---|
| Program Length | 2-3 years | 3-4 years |
| Average Credits Needed | 40-60 credits | 65-100 credits |
| Curriculum Focus | Advanced clinical skills, diagnosis, and treatment | Advanced clinical practice, leadership, healthcare policy |
| Key Curriculum Components | – Advanced Pathophysiology – Advanced Pharmacology – Advanced Health Assessment – Primary Care Management – Evidence-Based Practice | – MSN Core (if not already completed) – Advanced Clinical Practice – Healthcare Leadership – Health Policy and Advocacy – Quality Improvement – Evidence-Based Practice and Research |
| Clinical Hour Requirements | 500-700 clinical hours | 1,000 clinical hours |
| Capstone/Project Requirement | Capstone project or thesis (varies by program) | Scholarly project or DNP project focused on improving patient outcomes or healthcare systems |
| Independence in Practice | Prepares for independent practice in many states | Prepares for leadership roles and independent practice |
| Career Focus | Clinical practice as a nurse practitioner | Clinical practice with a focus on leadership, policy, and healthcare system improvements |
| Post-Graduation Roles | Primary care NP, specialty NP, or healthcare provider | Advanced clinical roles, leadership positions, policy advocacy, academia |
| Certifications/Exams | Eligible for NP certification exams (e.g., ANCC, AANP) | Eligible for NP certification exams and leadership roles |
| Online Availability | Many programs are available online, though clinical hours must be completed in-person | Many programs are available online, with in-person clinical and project requirements |
In some cases, aspiring nurse practitioners may be eligible for the following RN to NP bridge programs and accelerated degrees:
Learn more about nurse practitioner programs.
Deciding on an NP Specialty
Nurse practitioners can specialize in many care areas, working with specific populations or medical conditions. Aspiring NPs should consider what specialty they'd like to concentrate in before they apply for a graduate nurse practitioner program, as many of them have specialty tracks. Common nurse practitioner specialties include:
- Acute Care Nurse Practitioner (ACNP)
- Adult Gerontology Nurse Practitioner (AGNP)
- Family Nurse Practitioner (FNP)
- Pediatric Nurse Practitioner (PNP)
- Psychiatric-Mental Health Nurse Practitioner (PMHNP)
- Women's Health Nurse Practitioner (WHNP)
Learn more about Popular NP Specialties.
NP Licensing & Certification
To practice as a nurse practitioner, you must be fully licensed and certified in your state. Each state has its own licensure process, so check with your state's board of nursing for further information.
Certification signifies competence in an NP's chosen specialty area, demonstrating advanced knowledge and skills in patient care.
- NP Licensure Process:
- Licensure is distinct from certification and is essential for nurse practitioners to practice legally in their state of residence.
- State nursing boards outline specific licensure requirements, which can differ from state to state.
- Certified nurse practitioners must apply for licensure with the state board after meeting the specified requirements (a combination of education and clinical practice hours), allowing them to practice their specialized nursing skills within the state.
- NP Certification Info:
- Nurse practitioners can pursue certification in a specialty area concurrently within the MSN/DNP program or through independent study from organizations like ANCC or other learning institutes.
- Some specialties may not offer formal certifications; instead, NP students can focus on areas of specialization during their program to gain clinical competency.
- Eligibility criteria for certifications obtained outside of an MSN/DNP program vary, and students are advised to research specific requirements for their chosen specialty.
- NP Certification Examination:
- Upon completing a specialty program, nurse practitioners can take a certification examination, such as the Family Nurse Practitioner Exam, to earn titles like FNP-C (Family Nurse Practitioner Certified).
- Certification signifies competence in an NP's chosen specialty area, demonstrating advanced knowledge and skills in patient care.
Popular Nurse Practitioner Specialties
There are many areas of specialization that nurses can pursue. Some of the most popular NP specialties include:
Acute Care Nurse Practitioner (ACNP)
An Acute Care Nurse Practitioner (ACNP) specializes in the care of patients with acute, complex, and critical conditions. They work in settings like hospitals, intensive care units, and emergency departments, providing diagnosis, treatment, and management of severe and rapidly changing health issues.
Adult-Gerontology Nurse Practitioner (AGNP)
An Adult-Gerontology Nurse Practitioner (AGNP) provides primary and specialized care to adults, including older adults and the elderly. They focus on health promotion, disease prevention, and managing chronic conditions in adult and aging populations across various healthcare settings.
Family Nurse Practitioner (FNP)
A Family Nurse Practitioner (FNP) provides comprehensive healthcare to individuals of all ages, from infants to the elderly. They deliver a range of services, including diagnosing and treating illnesses, prescribing medications, and promoting preventive care for families and communities.
Pediatric Nurse Practitioner (PNP)
A Pediatric Nurse Practitioner (PNP) specializes in providing healthcare to infants, children, and adolescents. They offer services such as diagnosing and treating illnesses, managing chronic health conditions, and promoting healthy growth and development in young patients.
Psychiatric-Mental Health Nurse Practitioner (PMHNP)
A Psychiatric-Mental Health Nurse Practitioner (PMHNP) specializes in diagnosing, treating, and managing mental health conditions for patients of all ages. They provide therapy, prescribe psychiatric medications, and offer holistic care for individuals with mental health and substance use disorders.
Women's Health Nurse Practitioner (WHNP)
A Women's Health Nurse Practitioner (WHNP) specializes in providing comprehensive healthcare to women throughout their lifespan. They focus on reproductive and gynecological health, including prenatal care, family planning, and managing conditions related to women’s health.
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What Does a Nurse Practitioner Do?
Nurse Practitioners play a unique role in the healthcare system by blending the compassionate, patient-centered approach of nursing with the advanced medical expertise typically associated with physicians. NPs demonstrate leadership through patient advocacy, evidence-based practice, and care coordination, ensuring high-quality, patient-centered outcomes. While RNs play a crucial role in executing care plans, NPs operate with more autonomy, often serving as primary care providers who can work independently in many states.
Common Nurse Practitioner Tasks and Duties
NPs have many responsibilities and duties. These may include:
- Promote family-centered patient care
- Provide acute and preventive care (check-ups)
- Take a patient's medical history
- Maintain their own patient panel
- Order diagnostic testing/therapies
- Order prescriptions
- Assist in surgery
- Admit, transfer, and discharge hospitalized patients
- Collaborate with specialty departments as needed and refer patients appropriately
- Assess patient/family needs
- Provide education to patients/families
Nurse Practitioner Scope of Practice
The scope of practice for nurse practitioners encompasses a wide range of healthcare services, and in many states, NPs can practice independently. An NP’s level of independence is known as "practice authority." Practice authority for NPs varies by state and is generally categorized into three levels:
1. Full Practice Authority
In full practice states, NPs have the authority to evaluate patients, diagnose conditions, order and interpret tests, and initiate treatment, including prescribing medications, without the need for physician oversight. This level allows NPs to practice independently and is recognized by about half of the U.S. states.
2. Reduced Practice Authority
In reduced practice states, NPs can perform many of the same functions as in full practice states, but they are required to have a collaborative agreement with a physician for certain aspects of patient care, such as prescribing medications. This limits some of their autonomy.
3. Restricted Practice Authority
In restricted practice states, NPs must have direct supervision or delegation from a physician for key elements of care. This significantly limits their ability to practice independently and often requires close collaboration with a physician for most clinical decisions.
These varying levels of practice authority impact how NPs deliver care and their role within the healthcare team, with full-practice NPs having the most autonomy.
Learn about the difference between an RN and a nurse practitioner.
Nurse Practitioner Salary and Job Outlook
As healthcare needs rise, the demand for highly educated healthcare providers such as nurse practitioners is only expected to grow. With a competitive salary and numerous leadership opportunities, becoming a nurse practitioner is a desirable prospect for many nurses. Learn more about NP Salaries and check out the job outlook overview below:
| Aspect | Details |
|---|---|
| Growth Projections | 45% increase from 2022 to 2032 (much faster than average for all occupations) |
| Job Outlook | High demand due to the increasing need for primary care providers, aging population, and emphasis on preventive care |
| Median Annual Salary (2023) | $124,000 (varies by city/state, education level, experience, and specialty) |
| Top-Paying States | California, New Jersey, New York, Washington, Massachusetts |
| Work Settings | Hospitals, outpatient clinics, private practices, nursing homes, schools, and public health organizations |
Nurse Practitioner FAQs
Nurse practitioners practice under the rules and regulations of the Nurse Practice Act of the state in which they work. NPs can prescribe medication in every state and in the District of Columbia. The degree of independence with which they can prescribe drugs, medical devices (crutches, boots, etc.), or medical services varies from state to state. In many states and the District of Columbia, NPs have what is called "Full Practice Authority" - meaning they can practice independently without physician collaboration or supervision. Many nurse practitioners have their own practices and can be reimbursed by Medicare, Medicaid, or other third parties.
States that don’t allow Full Practice Authority for NPs may fall under what is called “Reduced Practice Authority”. This means that NPs must have a collaborative agreement with a supervising physician in order to practice and prescribe meds.
States that don’t fall into either of these two categories are considered Restricted Practice states, which require even more regulations, including career-long oversight, delegation, or management by another medical team member.
There are many organizations that advocate for full practice authority for nurse practitioners to include prescriptive privileges, including the American Association of Nurse Practitioners (AANP).
The short answer is…yes!
Nurse Practitioners (NPs) are able to treat patients in most cases without the supervision of a doctor, ruled by guidelines on what they can and cannot treat. Nurse practitioners play a crucial role in helping administer medical attention to individuals in need, including women in labor. Their training teaches many aspects of health care, and the delivery of babies is among those aspects.
While RNs who work in labor and delivery might deliver a baby if the doctor doesn't make it into the room fast enough, the only nurses specifically trained and legally allowed to deliver babies are Certified Nurse-Midwives, also known as CNMs. Certified Nurse-Midwives assist at around 8 percent of all deliveries in the United States, according to the American College of Nurse-Midwives. Certified Nurse-Midwives advocate for client-driven birth choices with minimal medical intervention.
In some states, a collaborative agreement may be required for a nurse practitioner to practice. This agreement is a document that establishes a “joint practice” between the NP and MD. It usually includes:
- The parties involved
- Date of initiation of the agreement
- The scope of practice of the NP with regards to diagnosing, treating, and prescribing (specific scope of practice is regulated by each state)
- Documentation review requirements
- Physician availability requirements
Based on the state of practice, the amount of time closely spent with an MD is variable. Some states allow NPs to practice and prescribe independently, and they can even open and run their medical clinic. Other states require physician oversight and periodic documentation review. Some states require physicians to be on-site while others allow for telephonic consultation.
Regardless of state requirements, nurse practitioners should feel comfortable collaborating with physicians if needed. For example, if faced with a challenging case, the NP should collaborate with a physician to ensure the proper treatment is rendered. For the most part, nurse practitioners and physicians have a cohesive, respectful relationship. Physicians appreciate the high-quality care they deliver to patients, as well as the assistance they provide to an MD’s practice.
Generally, it takes students around six years to complete the education and training to become nurse practitioners.
Registered nurses looking to advance to nurse practitioners must first start with a Bachelor of Science degree (BSN) in nursing. This takes about four years to complete.
The minimum degree needed for an entry-level NP is a master’s degree in nursing (MSN), which takes an additional two or more years beyond the BSN. There are some opportunities for motivated students to complete an accelerated MSN program to save some time, and direct-entry MSN programs offer an accelerated route for students who hold a non-nursing bachelor's degree. The time it takes to complete these specialized pathways will vary based on the education a student comes into the program with.
This depends on each student's needs. Some employers support and work with nurses as they advance their career, and allow time off for classes and study time. However, some cannot accommodate employees without interrupting operational need. Moreover, sometimes it is not financially possible for nurses to reduce hours, or family obligations are too great for them to take on the demand of graduate school. Nurses should discuss with their employer and families to see if, and which type of NP program would work to meet their individualized needs.
It can take two to four years to obtain an MSN depending on the student’s starting point. This is if the student attends full-time. Generally, the first semester is primarily lecture/classroom courses. Clinicals may be one or two days a week. Online NP programs allow for more flexibility and self-directed learning, which is an excellent choice for nurses who work.
Because NP programs can be demanding, it can be difficult to work full time. However, the beauty of being an RN is that there are a variety of positions available. Nursing is not always a nine-to-five job. Nurses can work nights, evenings, weekends, on-call, or per diem. Luckily, this allows for more flexibility in terms of going back to school.
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