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How to Become a Nurse Practitioner?

August 10, 2021 | Staff Writers

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There are many registered nurses (RN) who would like to take their career in the nursing profession one step further. Nurses are an integral part of the ever-changing health care system. Becoming a nurse practitioner retains the best skills of the nursing world and then enhances further medical skills without having to go through the full academic training that a medical doctor must. That is not to say training to become a nurse practitioner is not intense, but it allows an RN flexibility when returning to school to advance their education. Allowing nurses to pursue further schooling and specialization through a nurse practitioner program enhances their RN experience. 

A nurse practitioner will already be a registered nurse but will have advanced education and can provide care beyond the legalities of an RN. They can provide a wide range of health care to families, individuals and communities in many different ways. They can work in a hospital, community clinic, private practice or online as a support system in hard-to-reach areas. They are partners with other health care professionals such as doctors, social workers, midwives, and other nurses, as well as those working in the field of mental health and pharmacists. 

Nurse practitioners can diagnose, treat and advise patients about their health and can also prescribe medication as needed. Many can practice without physician oversight depending on the state they are practicing in. Similar to doctors, NP’s can specialize in various fields such as acute care, pediatrics, geriatrics, mental health and more.  Nurse practitioners help offset the increasingly high costs of healthcare for many and offer extended access to the healthcare they wouldn’t normally have. 

Reasons to Become a Nurse Practitioner 

If you have studied and become a registered nurse, you will have realized that your career in the medical field brings satisfaction with helping people. This is what it means to be not only a nurse but a nurse practitioner. It is a field that is challenging and while filled with trials, it can be extremely gratifying as well. Being a good nurse practitioner can have an extensive impact on patients, especially for those who are not able to regularly access a physician. Your health and people skills can be significantly beneficial in a world where good healthcare is not always easily accessible by all patients. 

While making a difference in the healthcare world is a good reason for becoming a nurse practitioner, many other reasons also make becoming one a good career choice. There is significant job growth in the field and there are several employment opportunities that can fit within your career plan. Here are some of the top reasons that becoming a nurse practitioner is rewarding: 

  1. Intellectual Challenge – Becoming a nurse practitioner is not an easy task. You cannot simply take some courses as an extension of your nursing designation. Nurse practitioner school and the medical practice afterwards are not for the faint of heart but is rewarding as much as it is challenging. Starting on the path towards becoming a nurse practitioner means that there is a journey ahead of working with people in need and the ability to address complex problems. It is all intellectually stimulating and a great way to increase the complexity of your work in the healthcare field.  Finding the right nurse practitioner program will challenge you intellectually and medically. 
  2. Autonomy – Becoming a nurse practitioner means that you have the ability to practice on your own. It offers nurse practitioners the ability to be self-reliant and, in many states, work without the oversight of a physician. The opportunity to work independently is a reason many nurses choose this route in the healthcare field. Independent practice and the ability to work in various specialty fields is a wonderful opportunity for those who want to be self-sufficient. 
  3. The Authority to Prescribe – The ability to prescribe needed medicine, health care treatments and medical equipment increases the ability to care properly for patients. It enhances patient care and allows the nurse practitioner to fully fill their roles in the healthcare field. The ability to prescribe is a significant reason nurses choose to be a nurse practitioner over a physician. They feel they can fulfil their medical calling with this trust of care. They are also able to order lab and diagnostic tests as well as interpret their results which means they can manage patient’s medical needs without having to refer them to doctors simply for diagnostic tools. The effect of NP on health outcomes is comparable to those of medical doctors. 
  4. Educational Costs – NPs work hard and earn a good nurse practitioner salary while doing it. The bonus is that nurse practitioner school is more affordable than medical school. While costs will escalate if there is a desire to specialize as a family nurse practitioner (FNP), a pediatric nurse practitioner, or neonatal nurse practitioner. It is still not as costly as it would be to do a doctoral degree and then specialize as well. The job is well compensated and while the cost of schooling is not cheap, it is certainly less than getting a doctorate in medicine. 
  5. Salary & Benefits – The salary of a nurse practitioner is a reason that certainly is enticing. The average salary in the United States for a nurse practitioner is approximately $108,000. This will vary depending on where they are practicing and if they specialize. At an average hourly wage of $51, it is a good salary. The highest-paid tend to be those working as psychiatric nurse practitioners which are then followed by neonatal nurse practitioners. If practicing in an emergency or urgent care setting, the pay is higher as well. Those focusing on women’s health or in a college health center are on the lower end of the pay scale.

    With good pay often comes good benefits.  Many get paid time off, paid liability insurance, continuing education support, health insurance and a retirement plan. These are just a few of the benefits as they vary based on the employer. 
  6. Employment Opportunities – This is one of the fastest-growing professions at the moment. Working in clinics, emergency services, private practice, telehealth plus clinical roles as teachers, researchers, lobbyists, speakers and health strategists, the list of job opportunities continues to grow. Nursing is one of the jobs that are most in-demand which dovetails into being a nurse practitioner. The system wants trained medical workers that reduce the overall cost of patient care without threatening the level of patient care. 

Steps to Becoming a Nurse Practitioner 

The journey to becoming a nurse practitioner takes some fortitude and planning. The length of time it will take depends on the student and the path chosen. It is important to get the correct degrees and certification plus decide on specialization if you want to do that as well. However, here are some of the most common steps needed to obtain your nurse practitioner’s designation. 

Step 1: You must become a registered nurse with a nursing degree from a recognized school and nursing program. This happens after you have graduated high school and then work towards either an associate or bachelor’s degree at an accredited post-secondary institution. Doing this means you will have the foundational skills needed for the NP role. The ability to coordinate care, assess conditions, administer meds, teach patients about health and support patients as well as their families are all crucial learning experiences working as an RN as part of a medical team. 

If a student chooses to do this after completing a bachelor’s program that isn’t in the nursing field then that can often still be used to fast-track them rather than having to go back and redo a bachelor’s degree. They may choose to be a licensed practical nurse so they can do their nursing education while getting experience and doing school. There is a need to take science courses and if going the Bachelor of Science in Nursing (BSN) then that will take about 4 years and should include clinical education as well. While this is a longer path to becoming a nurse practitioner, it is the preferred route as it has the foundation for specialties you may wish to pursue. Here are the general options: 

  • Doing a BSN after high school 
  • Taking an associate degree in nursing then doing extra coursework to get your BSN
  • Becoming an LPN then doing extra coursework to get your BSN
  • Use a bridge program that moves from RN to BSN
  • Enroll in an LPN program that then moves to a BSN. 

Step 2: When nursing school is complete and you have a nursing degree, then the next step is to find employment. For some they may already be working in healthcare settings, others may need to gain some experience before heading into the next degree program. It is important to recognize that being a working nurse hones critical skills that can only be gained by caring for patients on the job. There are competencies that can’t be taught through a textbook. Communication, collaboration and working in a team setting are all important. 

Experience may also help foster a love of a particular specialty. Nurses that start out in settings such as medical, surgical, orthopedics, geriatrics or as a family nurse all have the open door to further learning. There are other areas in psychiatry and midwifery that can also be looked at when specializing. Having 2 years of clinical experience can be a significant benefit when moving into a nurse practitioner career. Usually, one to two years of clinical work provides a strong foundation, depending upon the setting and goals for future specialization.

Step 3: Next step is to get your graduate degree. This will be your Master of Science in Nursing (MSN degree). This is the minimum requirement for a general nurse practitioner. The prerequisites will vary depending on the nursing school chosen. While being a licensed RN is a requirement there will also be a need for clinical experience, references and transcripts. 

  • BSN from an accredited school 
  • Have a license in good standing
  • Work experience
  • Meet FNP program requirements for clinical practicum

Step 4: Licensing and certification are the next steps to becoming a nurse practitioner. Every state says NP have to be licensed. Requirements may vary from state to state so make sure you understand what your state is going to ask for when it comes to your qualifications. You will also have to pass a national exam for certification as well that is overseen by a body that is accredited. These exams usually consist of 200 questions that are completed within 4 hours. It is important to note that nurse practitioners have to renew the national certification every five years and show their ongoing competencies. 

There is also a need for supervised clinical hours, but the amount will vary depending on the state. This is required to help nurse practitioners deal with complex patient issues and use diagnostic reasoning to solve the presentations. This supervised clinical work helps teach assessment, creating a treatment plan including medication and further health care assessment and support. 

Step 5: Moving forward with specialization. This is an optional step but can increase job opportunities with this extra education. This will be an area of focus that is specific. Each specialization will vary in the educational demands. 

Types of Degrees Available for Nurse Practitioners

While bachelor’s and master’s degrees are fairly straightforward as listed above are required for those aspiring nurse practitioners, there is further work that needs to be done moving forward aside from clinical practice and nurse practitioner programs. Nurse practitioners have their RN degrees already but also then have advanced university degrees as well. After these degrees are obtained, they have to prepare for the nurse practitioner exam to be licensed in their state and recognized nationally. 

Beyond the required degrees, there are advanced degrees and NP certification available depending on if a nurse practitioner chooses to be a generalist or a specialist. If a specialty is chosen, that will affect the duties performed and populations being supported beyond the regular trained duties of a nurse practitioner.  Here are specialist degrees a nurse practitioner has available: 

  • Acute Care Nurse Practitioner (ACNP) – This specialist designation allows an advanced practice registered nurse to offer care to patients who have acute, critical or chronic illnesses. An ACNP works as part of a health care team for both adult and pediatric patients. This specialty can work in an emergency clinic or hospital room or a care facility that is deemed short-term. In this work, the ACNP is educated to make hard, life-changing decisions to support patient care. It is an extremely challenging yet gratifying career journey. 
  • Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) – This degree or certification is similar to the ACNP but is trained to specifically work with older adults. The goal is to both stabilize and better the health of those they are caring for who are suffering from acute, critical or chronic conditions. This support is often given in either emergency or short-term care environments such as Hospice. They will monitor and evaluate a patient’s condition along with their response to care and treatment. These nurse practitioners are also trained to adapt patient management plans as required. 
  • Adult-Gerontology Primary Care Nurse Practitioner (AG-PCNP) – A specialist degree in this area looks at health care that is preventative along with the ability to manage acute and chronic health problems in patients over the age of 12. This care can include wellness exams, family education in regard to disease prevention and diagnostic screening. This work can be done on medical units, in family care clinics, student health centers or ambulatory care centers. 
  • Cardiac Nurse Practitioner – This designation means the nurse practitioner is responsible for assessing a patient’s cardiovascular health, assessing results and then managing treatments as needed. They will work closely with physicians both in private practice and hospitals. This focus can include working with patients who have high cholesterol and blood pressure, congestive heart failure and heart issues such as arrhythmia. 
  • Family Nurse Practitioner (FMP) – This designation is similar to those doctors who are generalists and good family doctors. An FNP program is going to make sure the student is going to know how to offer a wide breadth of family-focused health support. It will focus on all ages including infants and seniors. FNPs tend to work with physicians to offer practice support and care enhancement. 
  • Gerontological Nurse Practitioner (GNP) – This specialist category covers the AG-ANCP and AG-PCNP. This is an advanced degree that will be focused on the geriatric category of patient care. It is advanced practice nursing.
  • Neonatal Nurse Practitioner (NNP) – An NNP covers the specialty of the care and treatment management of both preterm and full-term children who are also considered high risk or who have long-term health diagnosis. These nurse practitioners tend to work in units such as NICU or other pediatric-centred places of care. They will care for and support ill babies and their families. They work as part of a health care team to diagnose, assess and treat young patients. 
  • Oncology Nurse Practitioner – A nurse practitioner who works in this specialty is going to work with doctors and surgeons as well as families and caregivers to help support cancer patients as they go through treatment. There is a specific focus on managing the physical and psychological needs of the patient and their family. These nurse practitioners could work in private practice, hospitals and palliative care. They could also be a nurse educator who offers educational programs including cancer prevention and other care topics. 
  • Orthopedic Nurse Practitioner – A specialty that manages the care of patients that need support with a range of musculoskeletal diagnosis. This work can include prescribing medication for managing pain, assessing and analyzing x-rays and working to improve patient care and recovery. This nurse practitioner is usually part of a care team that includes physiotherapists and orthopedic specialists. They will often be part of the orthopedic follow-up care team as well. 
  • Pediatric Acute Care Nurse Practitioner (PNP-AC) – If working with children and youth is where you want to specialize then this is a good area to get a degree. The nursing practice includes care for children ranging in age from newborn to 21 years of age. They will have an acute, critical or chronic illness. The work setting is wide-ranging from community agencies, pediatric units, emergency departments and Pediatric ICUs. The focus is on both the child and family when it comes to treatment and support. 
  • Pediatric Nurse Practitioner – This degree focuses on wellness, disease prevention and managing various health diagnoses for those under 21 years of age. It will include a patient assessment to make sure that proper growth and development milestones are reached. 
  • Psychiatric and Mental Health Nurse Practitioner (PMHNP) – This is a highly specialized area where the work happens in inpatient psychiatric settings, mental health facilities, schools and more. The work will center on assessment, diagnosis and treatments for those who have mental health disorders. It will also include discerning genetic and other risk factors for patients. A nurse practitioner with this designation will have to have had extensive training. Their expertise will allow them to be certified to prescribe medication as well as administering psychotherapy. 
  • Women’s Health Nurse Practitioner (WHNP) – This designation is becoming more prevalent as the need for gender-specific health care is more noticeable. These nurse practitioners will have a degree that includes the care of women from adolescence until menopause. They will cover all areas of women’s health including prenatal care, infertility, high-risk pregnancy, peri-menopause and many more. 

Education and Training Requirements to Become a Nurse Practitioner 

As outlined above, education and training are fairly rigorous if the goal is to become a nurse practitioner. This is even more true when choosing a specialty within the healthcare field. Here is a summary of the education and training requirements along with all the details needed to successfully become a nurse practitioner. 

Education and Training Required

  • High school diploma
  • Bachelor’s Degree in nursing (BSN) – there are various paths to this end, but it must be from an accredited school. This can include an Advanced Practice Registered Nurse (APRN) degree. 
  • Register as an RN and be actively working – nursing certification must be in good standing
  • Work experience is often part of the requirements heading into doing a master’s degree
  • Meet all program requirements for a nurse practitioner program
  • Master’s degree from an accredited school that can include an msn degree (Master of Science in nursing) along with the nursing practitioner
  • Meet program requirements of a clinical practicum
  • Licensing and certification with both state and federal boards as a nurse practitioner

Options – Additional healthcare degrees for specialization can include those listed above and can also include the education to become a nurse anesthetist, psychiatric nurse practitioner and nurse midwife. These degrees vary in requirements state to state as well as school to school. 

There is also the option to move beyond a master’s degree and complete a doctorate. Getting a Doctor of Nursing can lead to other career paths that can include leading a clinical experience for others who are an aspiring nurse practitioner, teaching as a nurse educator, doing research and increasing patient care ability. 

Further Nurse Practitioner Details

The work that goes into being a nurse practitioner is extensive but allows flexibility of the nursing role along with multiple employment opportunities that would not be possible without this advanced nursing education and practice. The healthcare world is shifting as the pressure becomes higher for health care in particular demographics. This pressure is exacerbated as health care programs, institutions and insurers all look to cut costs and streamline health care for communities. 

Being a nurse practitioner can change these dynamics by bringing quality care to people without the cost of a full-time physician. That does not negate the importance of physician-driven health care, but it does allow flexibility in areas that are currently eating up time and money in areas that could be under a nurse practitioner purview. 

Choosing to become a nurse practitioner means numerous employment opportunities that are not only extremely satisfying to do work in, but offer a good salary and independence in the workplace. Whether your focus is on a general nurse practitioner degree or one that is specialized, you will have the ability to do more and care for patients beyond current nursing guidelines. 

If you live in a state where you do not need much physician oversight, you have the opportunity to work in not only private practice but in underserved areas that are desperate for health care. The ability to work independently combined with the ability to move to underserved areas makes the field of nurse practitioners one that has immense career prospects that can bring satisfaction and a good salary to the practitioner. It is a career that while requiring advanced education will also benefit not only the student when they complete their course of study but the community they work in as well. 

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