A nurse practitioner is a highly trained nurse who has the ability to diagnose and (in some parts of the United States) even prescribe medications for patients. Nurse practitioners are a form of Advanced Practice Registered Nurse (APRN). They are educated to a higher level than registered nurses and have more experience too.
The most common kind of nurse practitioner is the Family Nurse Practitioner (FNP). These nurses provide primary care in clinics and doctor’s offices and fill a valuable role in the health care system. Nurse practitioners reduce the workload faced by doctors because a general nurse practitioner can serve as an initial contact point for people who have minor acute illnesses. A nurse practitioner can act as an initial contact point, providing health counseling and advice, then referring those who need further tests or more advanced treatments to a doctor or specialist as required.
To qualify as a nurse practitioner, a person will first need to become a registered nurse, then complete some further postgraduate study. This could be in the form of a master’s degree or a DNP program. Nurse practitioners are required to keep up with a program of continuing education and have extensive clinical experience.
What a nurse practitioner does
Nurse practitioners are not doctors, but they fill a similar role in the health care space. They work closely with doctors, consulting with them as required and often working with the same patients in the same practices. Nurse practitioners can diagnose and are authorized to dispense a wide variety of medicines, although in some states a doctor may be required to co-sign a prescription. In other states, nurse practitioners have the authority to prescribe by themselves.
What are the roles and responsibilities of a nurse practitioner?
The Nurse Practitioner role was created in 1965, and over the last several decades the scope of practice of this type of nurse has gradually evolved as the National Council of State Boards of Nursing has refined the qualifications, training, and codes of practice that nurses in this role must adhere to.
Nurse practitioners take on a primary role in health care and are authorized to:
- Provide primary, specialty, or acute care
- Diagnose illnesses
- Treat conditions
- Provide health counseling
- Prescribe a limited range of medications
- Offer evidence-based health education and services
- Assess patients based on their medical histories
- Develop individual treatment plans
- Maintain health records
- Follow up on treatments
- Collaborate with other health professionals to provide a high standard of care
Family nurse practitioners often work in the offices of primary care physicians and serve diverse populations. Some nurse practitioners specialize in a more focused area such as pediatrics and are focused on educating children and their families, empowering them to make healthy lifestyle choices, and serving as an advocate for the child when it comes to their care.
What is the difference between a nurse practitioner and a registered nurse?
A Registered Nurse (RN) is a nurse who is educated to associate’s degree or bachelor’s degree level and who has passed the NCLEX-RN licensure examination. These nurses are a step up from Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) in terms of qualifications and have the experience to work in a variety of settings but they usually work under the supervision of a doctor, psychiatrist, or other specialists.
Nurse Practitioners are Advanced Practice Registered Nurses who are educated to master’s degree or doctoral level. General nurse practitioners have an understanding of evidence-based healthcare, leadership and treatment protocols that allows them to work in a primary care position without needing to be directly supervised by a General Practitioner.
Some nurse practitioners choose to specialize in a specific area of health care, becoming a Pediatric NP or Neonatal NP. These specialists are able to treat acute illnesses and can often work closely with their patients, giving them more attention and information than a doctor might be able to provide.
For example, a Pediatric NP might offer advice on toilet training, coping with temper tantrums, or helping a parent cope with a child who is a fussy eater. Doctors are frequently overworked and as such lack the resources to tackle these issues. It’s this sort of care that makes nurse practitioners such an important part of the communities they work in.
Nurse practitioners also serve a triage role in the mainstream population. It’s often easier to get an appointment with a nurse practitioner than it is to get one with a doctor. Someone who has a minor issue such as an upper-respiratory infection or skin condition could be seen quickly by a nurse practitioner and given the support they need to recover, freeing up time in the doctor’s calendar for patients who need their expertise.
Nurse practitioners are not able to replace doctors. They can order tests, diagnose some ailments and offer general advice, but more complex medical issues must still be treated by doctors. This means interdisciplinary care is an important part of the profession. It’s important for nurse practitioners to be able to communicate clearly, record their work accurately, and ensure continuity of care for their patients.
Educational requirements for nurse practitioners
Nurse practitioners are educated to a high level. It takes at least six years to become a nurse practitioner, with many nurses spending far longer in education and working as a nurse before they reach this level of the profession. Nursing is a diverse occupation and there are many routes into employment as a Registered Nurse.
Once someone has entered the profession, they have many options for specialization, but the most common option is to study a master’s degree and take a certification to become an advanced practice nurse or a nurse practitioner.
What degrees should you earn if you want to be a nurse practitioner?
Registered nurses are nurses that have earned either an associate’s degree or a bachelor’s degree then passed the licensure exam. While it’s possible to work as a nurse with just a two-year degree, most nurses choose to pursue the BSN, which is a four-year degree.
Many hospitals prefer nurses who have a BSN, and in some parts of the country, such as New York, it’s required for nurses to earn the BSN within ten years of passing the NCLEX-RN, because the extra two years of education equates to a significant increase in the standard of patient care the nurses are able to provide.
To become a nurse practitioner, a nurse must be educated to at least the master’s degree level. The most common route to master’s level qualifications is graduate entry for those who have a bachelor’s degree but there are some institutions offering an RN to MSN pathway, also known as a bridge program.
Some institutions offering these qualifications include:
- Western Governor’s University’s Nursing Programs
- Chamberlain University’s Online RN to MSN Program
- Southern New Hampshire University’s RN to MSN Online Program
After completing either a master’s degree or a bridge program, the next step is to take the certifications required for your chosen specialization. Depending on how long you have been working as a nurse, you may also need to build up some clinical experience before you are certified as an advanced practice registered nurse.
The cost of earning a BSN plus an MSN is likely to be in excess of $100,000, which is a significant financial commitment. Most nurses apply for scholarships or bursaries to reduce the cost of tuition. Some nurses apply for a Nurse Corps Scholarship, which covers the cost of tuition plus reasonable expenses in return for a period of service after qualification.
Some hospitals offer funding to support nurses who are continuing their education. In addition, nurses who work in a not-for-profit hospital have the option of applying for student loan forgiveness after a minimum service period.
The salary increase enjoyed by a nurse practitioner means most nurses will recoup the cost of their training after a couple of years of employment. Nurses who study part-time while working will most likely find the financial burden easy to cope with, but those who struggle to meet the costs of their program should discuss their situation with their university’s student finance team because there is a lot of financial help available for learners of all ages.
What fieldwork is required to become a nurse practitioner?
The number of clinical hours required to become a nurse practitioner varies depending on the specialization you are interested in, and also the institution you would like to study for your doctorate or master’s degree with. Most advanced practice nursing certificates require about 2,000 hours of clinical practice.
Some examples of certifications that a pediatric nurse practitioner might want to aim for include the CPNP-PC for primary care or the CPNP-AC for acute care. There are similar certifications for psychiatric-mental health, family nurse practitioners, and other specializations.
It’s possible to get 2,000 hours of clinical experience by working in a given department full-time for one year, but most newly qualified Registered Nurses will either split their time between a few departments or work part-time while studying. This means it’s more likely to take two or three years to get the experience required to complete their certification.
How long do you have to go to school to be a nurse practitioner?
In most cases, it takes six to eight years of study and on-the-job training to become an APRN or a nurse practitioner. This includes studying for the BSN then completing an MSN or a doctoral-level qualification. Many people take longer than six to eight years to complete their training because of the number of nursing practice hours required and the extra time it takes to complete a nurse practitioner program when studying part-time.
Those who wish to pursue a highly specialized position as an APRN, for example becoming a psychiatric nurse practitioner or a nurse anesthetist may find their training takes even longer. Once they’re qualified, the learning does not stop. APRNs are required to engage in an ongoing program of continuing education alongside their nursing practice to ensure their skills are always current and up-to-date, and that they’re staying abreast of the latest developments in their field.
Types of nurse practitioner careers
The job title of nurse practitioner covers many different specializations, including:
- Pediatric nurse practitioner
- Neonatal nurse practitioner
- Psychiatric-mental health nurse practitioner
- Family nurse practitioner
- Acute Care nurse practitioner
- Emergency nurse practitioner
- Adult-gerontology nurse practitioner
- Women’s health nurse practitioner
- Orthopedic nurse practitioner
Pediatric nurse practitioner
These nurse practitioners work with children and their parents or guardians, offering help and advice about common health conditions as well as behavioral issues and common milestones in child development. They help parents navigate the challenges of ensuring a child grows up to be fit and healthy.
Neonatal nurse practitioner
This field of nursing focuses on newborn babies, including those that were born prematurely. In some cases, they may assist with the delivery of the baby, but more commonly they are responsible for diagnosing ailments, prescribing medication and devising treatment plans.
Psychiatric-mental health nurse practitioner
A psychiatric-mental health nurse practitioner usually works in a community setting diagnosing common mental health issues, devising plans of treatment, and delivering therapy or counseling sessions. Sometimes they deliver treatments in an individual setting, but in many cases, they offer group or family therapies. They work with patients over a prolonged period of time, offering follow-up appointments and monitoring a patient’s recovery. In many states, they provide psychopharmacological treatments.
Family nurse practitioner
Family nurse practitioners work with people of all age groups, providing primary health care. They are usually found in doctor’s offices or clinics and may have the opportunity to deliver long-term care, getting to know the patients within their communities. These nurses help reduce the workload of the doctors they work with by providing care for patients with minor acute ailments. They can order tests, diagnose and prescribe, and will refer patients with more serious illnesses to the doctor or another specialist for further treatment.
Acute care nurse practitioner
This type of nurse practitioner usually works in a hospital setting. An acute care nurse practitioner is an advanced practice registered nurse who works with patients after they are admitted to the hospital or immediately after surgery. They assess the condition of the patient, provide the necessary care and keep medical records. Acute care nurse practitioners work with adult patients who require more complex care than a registered nurse can provide.
Adult-gerontology nurse practitioner
Nurses who specialize in adult-gerontology work with adults of all ages, from adolescence through to geriatric care. They focus on people with chronic conditions. Adult-gerontology nurse practitioners are often found in long-term care settings or work as a part of a hospital, but they may do house visits and have a long-term relationship with their patients.
Women’s health nurse practitioner
These nurses focus on caring for women and deal with reproductive, gynecological, and obstetric health. Typically, these nurses are found in primary care settings rather than in hospitals. They focus on general women’s health rather than neonatal care or midwifery, so they are rarely based in hospitals.
Orthopedic nurse practitioner
Orthopedic nursing is focused on the health of the musculoskeletal system. These nurses help patients who have suffered from trauma or injury, or who have diseases affecting their bones, joints, muscles, and connective tissues. They may support doctors and physiotherapists in the care of these patients.
In addition to the above, there are other advanced practice nurses such as nurse anesthetists, and nurse-midwives who are qualified to the nurse practitioner or advanced level. All of these nurses are highly respected in their specific areas of health care and have a lot of autonomy and ability to operate without having to have a doctor or other specialist sign off on their work.
When you qualify as a registered nurse, you’ll have the opportunity to work in a number of different departments under the supervision of more senior nurses. During this time you can gain experience in acute care settings, the ICU or OR, working with children, in neonatal care, or other areas.
Take advantage of this time to find out which areas of health care interest you the most and to get a feel for the working conditions in different areas. Do you enjoy the busy nature of the emergency room? Are you fascinated by psychiatric care? Would you prefer working in a clinic where there’s a more predictable flow of patients and you may get a chance to build up a long-term clinical relationship with people in your local community?
The beauty of nursing is that there are so many different types of jobs available, so you can find something that suits your interests and personality.
Where do nurse practitioners typically work?
Nurse practitioners have the opportunity to work in a variety of settings, depending on their specializations. Some work in clinics or outreach centers, filling a gap in areas where there is a shortage of GPs. Others may work in long-term care settings, serving as the senior nurse and providing primary care for residents.
Nurse practitioners may also be found in veteran centers, hospitals, or private clinics. Psychiatric-mental health nurse practitioners may work in substance abuse rehabilitation centers, colleges, prisons, eating disorder clinics doctor’s offices, or other settings, running group or individual therapy and counseling sessions, and working with people who are in need of mental health support.
A nurse-midwife will most likely work out of a hospital or private clinic but will have the opportunity to do home visits in some cases, working closely with a few families in the run-up to the child’s birth.
Benefits of a nurse practitioner career
Working as an advanced practice nurse or a nurse practitioner can be incredibly rewarding. This highly specialized field gives nurses the chance to work with a variety of patients, and provide high-quality health care to the population they work with. Nurse practitioners are hugely respected by other health care professionals and enjoy a level of autonomy and freedom within their scope of practice.
Nurse practitioners are in high demand, so are likely to be able to find employment in any city. Someone who is qualified to this level should benefit from job stability and a variety of employment options. In some states, nurse practitioners have full practice rights. This means they have the ability to have their own practice if they have the ambition to do so. I
What are the advantages of having a nurse practitioner career?
Becoming a nurse practitioner is a logical progression of a career as a registered nurse, especially for those who wish to remain involved with patient care. Some experienced nurses decide that after working on the frontlines for a while they’d like to go behind the scenes, becoming a nurse educator, informatics nurse, or moving into public health or leadership.
These roles offer nurses who are older and have family commitments or who simply don’t want to be on call and have unpredictable working hours a chance to use their nursing skills in a different setting. Not all nurses want to retire from patient care when they move up the ranks, however, and for those nurses roles such as FNP or clinical nurse specialist make a lot of sense.
Nurse practitioners often benefit from more predictable working hours, especially if they work in clinics or outreach centers that are open only during standard working hours. They have a chance to serve a specific part of the population and have a more stable and predictable workload.
Many nurse practitioners enjoy having a wider scope of practice than their registered nurse counterparts and find their jobs fulfilling and mentally challenging. After investing in many years of education and training, these nurses relish the chance to apply their skills and use evidence-based practice to deliver a high standard of care to their patients.
What is the average salary of a nurse practitioner?
According to the Bureau of Labor Statistics, nurse practitioners have an average salary of $115,800. This is far higher than the average salary for registered nurses, of $73,300. Nurses who are educated to the postgraduate level are in high demand, with the BLS expecting that job openings in the field will increase by 45% between 2019 and 2029.
This increase in demand is partly due to the retirement of existing NPs, and partly due to the aging population in the United States. As the population grows and the average age of the population increases, this means there are more people requiring acute health care and more people with chronic conditions too. The health service is already facing heavy demands, and this is only likely to continue.
Nurse practitioners can offer primary care to people in areas where there is a shortage of doctors, and fill an important role in between the day-to-day practical care offered by Registered Nurses and the more specialist care provided by doctors, surgeons, psychiatrists, and other experts. This role should not be underestimated.
What are the long-term career options for a nurse practitioner?
For many nurses, qualifying as a nurse practitioner represents the crowning achievement of their career. However, there are some further progression options available. Currently, nurses can qualify as a nurse practitioner if they hold an MSN degree. There’s no requirement to earn a DNP. This may change in the coming years, as there has been some discussion about the idea of requiring nurse practitioners to hold a DNP.
Some MSN-qualified nurse practitioners opt to study for a DNP purely for their own education or because they’d like to learn as much as possible about policies, leadership, and evidence-based practice. Others opt to study for a Ph.D. in nursing so they can go down the research route at a later date, moving into academia once they feel their days in the field are done.
Another option open to nurse practitioners who are looking to move out of primary care is the field of public health. The job experience, education and overall skills required to qualify as a nurse practitioner will stand an applicant in good stead for any role they choose to pursue, including roles involving public policy and health care.
Many senior nurses move into nurse educator positions later in their careers, supporting younger nurses with their continuing education requirements and helping them plan their career progression. They may also be responsible for onboarding newly qualified LPNs, LVNs, or RNs and guiding them as they learn the procedures at their new hospital.
Nurse practitioners have the freedom to move into almost any area of nursing. Many see the title itself as being the pinnacle of their careers, however, having chosen a specialization and decided to devote their working life to providing care for that segment of the population.