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    How To Go From Registered Nurse to Nurse Practitioner (RN to NP)

    Many nurses are choosing to advance their educations and their careers by going back to school to become nurse practitioners (NP). In fact, according to the American Association of Nurse Practitioners (AANP), there are over 270,000 NPs in the United States alone, with more than 26,000 new NP graduates who entered the profession as of 2017.

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    NPs are masters-level educated nurses who work as practitioners in a variety of specialties, from women’s health to surgical to cardio, and everything in between. 

    “Many times, the average nurse practitioner student has been practicing as a registered nurse for 10 years or so,” explained Ken Miller, the former president of the AANP. “They just get to a point in their career that they want more autonomy. There is just such a need for this profession because of the Affordable Care Act.”

    Miller added that between 30 and 40 million more people have been added to the primary care system after finally getting health insurance. “But no single discipline can handle that. So, the nurse practitioners are picking up a lot of that primary care that needs to be done,” he said. “They also can own their own clinics. In fact, there are 250,000 nurse-owned and managed clinics across the country.”

    Working as a nurse practitioner is so desirable that the U.S. News & World Report ranked the profession as #2 Best Health Care Job of 2017 and #2 in the 100 Best Jobs overall in 2017. 

    Interested in becoming an NP yourself? Here’s what you need to know about working as a nurse practitioner and how to go back to school to become an NP. 

    Career Overview

    There are many different kinds of nurse practitioner specialties and subspecialties. In general, nurses who earn an advanced practice degree will either operate as,

    1. Nurse Practitioner (NP) 
    2. Certified Nurse Midwife (CNM). 

    In the past, nurses could also work as a Certified Registered Nurse Anesthetists (CRNA), but the guidelines have recently changed to now require CRNAs to receive their doctorates. 

    NPs or CNMS can work full or part-time and most often work in hospitals, clinics, or private practices. NPs are practitioners who can own and operate their own practices in several states across the country and can choose from virtually any specialty, from pediatrics to dermatology to surgery. 

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    Nurse Practitioner Salary and Job Outlook

    According to the Bureau of Labor Statistics (BLS), the job outlook for NPs is also considerably higher than many other professions, 

    • Nurse Practioner jobs are expected to grow by 31% 
    • The average salary for a full-time NP was $113,930 as of May 2018

    Benefits of Becoming a Nurse Practitioner

    Why become an NP? There are many reasons–both personal and professional–that may drive a nurse’s decision to pursue an advanced degree. The opportunities abound for this profession.

    Becoming an NP allows for increased autonomy, more specialized and intense training in your field of interest, more freedom and flexibility with your career, and usually, a higher wage.

    • Operate your own clinic. Because NPs are independent practitioners, they also have the ability to operate and own their own clinic, depending on their own state rules, and have enhanced clinical skills, such as the ability to prescribe medication for treatment. 
    • Nurse practitioners can prescribe medications in all 50 states (Florida is the only state that won’t allow them to prescribe narcotics) and order testing for their patients. No matter what the specialty, he/she will spend the majority of time at work assessing, examining, diagnosing and treating patients.
    • Nurse Practitioners can diagnose patients with diabetes or high blood pressure and then help them manage it. They can order and then interpret laboratory tests and X-rays. They also are there to educate and support patients’ families through the bad moments. 
    • Nurse Practitioners have the authority to work independently in most states. However, in some states, nurse practitioners are required to have a supervisory contract in place with a physician. 
    • Nurse practitioners have a chance to work in all types of settings including hospitals, doctors’ offices, urban and rural clinics, college campuses and within corporations. 
    • NPs have increased opportunities to advance in their fields and expand their practice beyond solely bedside nursing. 

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    Transitioning from an RN to an NP

    In order to become an NP, you will have to earn a Master’s degree as an NP or CNM. At the bare minimum, you will need to be an RN before enrolling in an NP program, although there are different pathways available depending on if you already have your Bachelor’s degree or have earned an associate’s or diploma-based RN. 

    Depending on where you choose to do your coursework to become a nurse practitioner, the options are varied. Programs across the country offer full-time, part-time and online choices. Some take one year full-time, others can go for years with part-time classes and clinic work.

    Many of these programs provide a pathway to becoming a nurse practitioner for a variety of nurses who may have different levels of prior experience including those who are already RNs, BSNs, and MSN. For working nurses, online nurse practitioner programs allow students to choose their own pace and work around their busy nursing schedules to complete the training are a convenient option.

    Typically, the requirements to enroll in an NP program include:

    • One to two years of clinical experience 
    • Active Registered Nurse (RN) license
    • Bachelor’s degree, or equivalent
    • Minimum GPA
    • Some schools require a GRE
    • Letter of intent
    • References
    • Completed school application and fees

    In general, NP programs take around two to three years to complete. The following education pathways are available to become a Nurse Practitioner: 

    • ADN-NP. If you have an associate’s degree in nursing and have worked at least one year as a nurse, you can enroll in a bridge entry program, that allows you to essentially bypass getting your Bachelor’s degree and go directly from an associate’s to a master’s. You will take an additional “bridge” year to get you caught up, then began the regular NP program classes. Because there is an additional bridge year, this option will take longer than a strict NP-only program. 
    • Diploma RN-NP. RNs who have completed a diploma program can also enter into bridge direct entry NP programs but may need to meet with a school counselor to guide their program, and/or take additional prerequisites before enrolling. 
    • BSN-NP. One of the most common options, a BSN-NP program takes you from a Bachelor’s of Science in Nursing (BSN) directly into a master’s NP program. Some students choose to enroll directly from their BSN undergraduate program or work in a clinical setting before advancing their education. 
    • Non-nursing MSN-NP. If you’re not a nurse but have a master’s degree in another field, you can enroll in an accelerated NP program. Essentially, you take an accelerated nursing program in about one year for the first portion of the program to be eligible for the NCLEX, then you continue on to the NP coursework for the second half of the program. Many schools also recommend that with this option, course participants take at least a year between the first and sections to gain hands-on clinical experience as well. 

    No matter which program you complete, at the end of your education, you will have to sit for the nurse practitioner certification exam for your practice specialty, similar to the NCLEX for your RN license. Successful passage of the exam will grant you a Nurse Practitioner license.

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    Is a Doctorate Required to Become an NP? 

    It is not a requirement that Nurse Practitioners earn a doctorate degree unless they are pursuing a CRNA certification. As of January 2022, it will be required that all CRNA applicants enter into a doctorate program, according to the American Association of Nurse Anesthetists. Outside of working as a CRNA, however, NPs have a masters-level education. There may also be additional educational requirements if you plan on working as an NP educator and the American Association of Colleges of Nursing is often discussing the future possibility of transitioning all NP programs into doctoral-level programs, although there is not a final decision that has been made on that switch. 

    Top 5 NP Programs

    U.S. News & World published their list of the 2020 top Nurse Practioner programs in the United States. 

    #1 – John Hopkins University, Baltimore: $37,056 per year

    #2 – Duke University, Durham: $1,769 per credit (full-time)

    #3 - University of Pennsylvania, Philadelphia: $42,698 per year (full-time)

    #4 – Emory University, Atlanta: $1,906 per credit (full-time)

    #5 – Columbia University, New York: $82,232 per year

     

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    References

    Aanp.org

    Bls.gov

    Aana.com

    Aacnnursing.org

    Rochester.edu

    U.S News & World

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    Nurse.org

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