6 Steps to Becoming a Nurse Practitioner | Salary & Programs


    GUIDE
    April 21, 2020
    Nurse practitioner administering a blood pressure test to a patient

    Nurse Practitioners earn a higher salary, have more responsibility and more career opportunities than many other types of nurses. This guide will cover what a nurse practitioner does, how much they make, how to become one, and more.

    Part One What is a Nurse Practitioner (NP)?

    A Nurse Practitioner (NP) is an Advanced Practice Registered Nurse (APRN) that has earned either a Master's of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) as well as completed additional training and certification.

    As a result of this advanced training, Nurse Practitioners have more authority than Registered Nurses and have similar responsibilities to that of a doctor. In certain states, they have full-practice authority, meaning they do not have to be supervised by a doctor.

    Nurse Practitioners can serve as a primary or specialty care providers and typically focus their care on a specific population such as families, children, or the elderly. Some popular specialties for nurse practitioners include General Nurse Practitioner, Family Nurse Practitioner, Gerontological Nurse Practitioner, Pediatric Nurse Practitioner, and Psychiatric Nurse Practitioner. 

    Part Two What Do Nurse Practitioners Do?

    NPs can prescribe medication, examine patients, diagnose illnesses, and provide treatment, much like physicians do.

    Nurse practitioners have full practice authority in 20 states, meaning that they do not have to work under the supervision of a doctor. In the remaining states, NPs still have more authority than RNs, but they need a medical doctor to sign off on certain patient care decisions.

    Nurse practitioners are increasingly becoming integral to medical teams as more and more hospitals and healthcare facilities are utilizing their expertise.

    Their experience as working nurses gives them a unique approach to patient care, while their advanced studies qualify them to take on additional duties that are usually left to physicians. In fact, as reported by the Kaiser Family Foundation (KFF), it’s estimated that NPs can provide 80-90 percent of the care that primary care physicians offer.

    Map of nurse practitioner NP practice authority in US

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    Part Three How to Become a Nurse Practitioner

    If you're looking to become a nurse practitioner, you'll need to complete the following steps.

    1. Become a Registered Nurse

      The first step to becoming a nurse practitioner is becoming a registered nurse. You'll do this by enrolling in either an Associate Degree in Nursing (ADN) or Bachelor's Degree in Nursing (BSN) program. 

      ADN programs are shorter and cheaper, typically 2 years and available at community colleges, while BSNs are 4 years and taught at universities and private schools. You can become a registered nurse through either method, however, employers generally prefer to hire nurses who have a bachelor's degree in nursing and it's typically a prerequisite to getting into a graduate program, which you'll need if you want to become a nurse practitioner. 

      That being said, many nurses enjoy the chance to gain nursing experience and start working right away that the ADN program provides. 

    2. Get Your Bachelor's Degree

      If you don’t already hold a BSN, you may want to enroll in and earn your Bachelor’s in Nursing Science degree. Nurses who have their ADN can enroll in accelerated RN-BSN programs, many of which can be completed online. It is possible to go straight from your ADN to an MSN program, however, if you want to skip the step of earning your Bachelor's degree. More on that in step four.

    3. Gain Nursing Experience

      Some nurses may choose to skip this step and go right into enrolling in a graduate program, while others choose to get a few years of experience under their belt before continuing their education. Nurses who go this route benefit from the added experience and the ability to start working and save money graduate school. 

    4. Enroll in a Graduate Program (MSN or DNP)

      Graduate programs are intensive and take a minimum of two years to complete. The simplest route to becoming a nurse practitioner for RNs who already have their bachelor's degree is by earning a master’s degree.

      For RNs without bachelor's degrees, there are institutions that offer special bridge programs that help nurses who do not have bachelor’s degrees, or hold them in a different field, to earn their advanced degree in nursing. These are called RN-to-MSN programs. You may also see such programs called ADN-to-MSN (which means Associate Degree in Nursing to Master’s).

      Some institutions offer Doctor of Nursing Practice (DNP) programs, which is the highest level of nursing education available. Once enrolled, be prepared to take in-depth coursework including anatomy, pharmacology, and other nursing-specific studies. In addition, most programs also require clinical rotation hours.

    5. Pay for Your Graduate Program

      Deciding how to finance an advanced degree as an MSN can seem like a daunting task, and that’s ok. Luckily, there are many options to help offset or lessen the burden of the cost, including grants, scholarships, and student loans -- federal and private. If you're already paying off existing student loans, you can also consider refinancing them to a lower interest rate to save money. 

    6. Earn Your Advanced Practice Nursing Licensure in Practical Nursing

      The specifics for NP licensure are set by the individual states, which means that you will have to search the requirements to become an NP in the state that you plan to work in. There is also talk of a national model for NP licensure, but currently, it does vary from state-to-state. You can view complete state-by-state requirements to become an NP here and be sure to check with the school you plan on attending. 

    7. Begin Working as a Nurse Practitioner

      You can find work in hospitals, nursing homes, and other healthcare or medical facilities. Some NPs choose to take a step back from hands-on patient care to pursue managerial or administrative positions.

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    Part Four Nurse Practitioner Salary

    Nurse practitioners earn a national average annual wage of $115,800 according to the U.S. Bureau of Labor Statistics, which places their income at more than double the average annual salary for all other occupations.

    Nurse Practitioners make, on average, around $30,000 more than Registered Nurses each year. And, compared to an LPN’s annual wages of $46,240, becoming an NP will more than DOUBLE your earnings.

    Nurse Practitioner salaries can vary by location, place of employment, experience, and specialty. So, after you become an NP, additional specializations can drive your salary up even higher, and give you more career opportunities.

    Nurse Practitioner Salaries by Specialty

    General Nurse Practitioner $115,800
    Family Nurse Practitioner $105,898
    Adult-Gerontology Nurse Practitioner $90,102
    Psychiatric Nurse Practitioner $107,309
    Pediatric Nurse Practitioner $121,659
    Acute Care Nurse Practitioner $110,076
    Women's Health Nurse Practitioner $91,454
    Orthopedic Nurse Practitioner $100,035
    Emergency Nurse Practitioner $113,840
    Neonatal Nurse Practitioner $124,756

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    Part Five Nurse Practitioner Career Outlook

    Nursing is already a stable, in-demand career. But becoming a Nurse Practitioner can give you even more job security.

    The BLS predicts that nurse practitioner jobs will increase by 26 percent from 2018 to 2028. Much faster than most other careers.

    The need for primary care is also expected to rise over the next five years because of the aging population. NPs will help meet this increasing demand, especially in underserved areas.

    Part Six Which Schools Have the Best NP Programs?

    There are numerous NP programs throughout the country, our panel of nurses ranked them based on reputation, certification pass rate, cost, accreditation, and acceptance rates and determined these are some of the best options out there. Because nursing careers take different forms, the top 10 NP programs are ranked in no particular order.

    Top 10 Nurse Practitioner Programs

    1. University of Virginia

    Annual In-State Tuition: $21,382 Annual Out-of-State Tuition: $34,054

    Online: No

    Program Length: 22 months

    One of the best public schools for nurses in the nation, the University of Virginia offers nine different routes to becoming an NP. All programs lead to an MSN and are accredited by the relevant accrediting body. Like most schools, requirements vary depending on the track. Regardless, UVA estimates that full-time students complete an NP degree in two years while part-time students take three years. Applicants should have at least one full year of RN experience. 

    2. Yale University

    Annual Tuition: $48,795

    Online: No

    Program Length: 22 months

    Nurses who get accepted into this Ivy-league school enjoy one of the NP programs in the nation. Yale University's MSN options let students immediately begin studying in one of eight specialization areas. Yale estimates that full-time students take two years to complete any specialization, with credit requirements ranging from 49-57. NP students can also expect to complete at least 700 clinical hours, though some specializations require 1,000. 

    3. Duke University

    Annual Tuition: $47,817 (based on per-credit tuition rate)

    Online: Hybrid

    Program Length: 22 months

    The Duke University School of Nursing offers eight MSN specialties that lead to APRN licensure. Students complete most of their courses online, though they must attend some on-campus activities and complete clinical in-person. This blend gives students more flexibility to focus on their clinical hours over required coursework. Duke also requires at least 800 clinical hours for each of its specializations, though students likely complete more. 

    4. University of Pennsylvania

    Annual Tuition: $51,094

    Online: Hybrid

    Program Length: 16 months

    With flexible options for full-time, part-time, and non-nursing students, the University of Pennsylvania might serve more future NPs than any other school ranked here. Penn also pushes nursing students to succeed quickly with most NP programs taking just 16 months to complete. Nursing students can also select a minor with their specialization, great for anyone with a specific career field in mind. Penn allows students to complete some of their coursework online, though anticipate spending most of your time studying in-person. 

    5. Emory University

    Annual Tuition: $45,732

    Online: Hybrid

    Program Length: 22 months

    With nine APRN specializations available through the MSN, Emory University gives nursing students plenty of options. Each track takes four semesters to complete full-time and seven semesters part-time. While earning the degree, nurses complete at least 700 hours of supervised clinical experience. Emory also allows nursing students to complete some courses online, though some distance students outside of Georgia may have trouble finding clinical placement opportunities. Before applying, nurses should complete at least one year of RN practice. 

    6. Georgetown University

    Total Program Cost: $97,416

    Online: Hybrid

    Program Length: 19 months

    Among the most prestigious universities in the nation, Georgetown University boasts one of the best nurse practitioner programs. While Georgetown only offers four specializations for NPs, the results are excellent. For example, graduates of the FNP program earned 100% and 97.83% first-time pass rates for ANCC and AANP certifications, respectively. Also, students can complete most of their coursework online, aside from two on-campus intensives and clinicals. Full-time students usually graduate in just 19 months while part-time students take closer to 27 months. 

    7. University of North Carolina - Chapel Hill

    Annual In-State Tuition: $23,554 Annual Out-of-State Tuition: $41,280

    Online: Hybrid

    Program Length: 22 months

    Created specifically for current RNs looking to get an advanced certification, the University of North Carolina - Chapel Hill's advanced practice MSN lets nurses choose from five specializations. Students can complete some of the courses online, though UNC does require all nurses pursuing an APRN license to study full-time. This requires nurses to complete the program quickly, with some students earning their MSN in just 1.5 years. However, specific program lengths vary by specialization. 

    8. Vanderbilt University

    Total Program Cost: $110,386

    Online: No

    Program Length: 22 months

    One of the top schools for Advanced Practice Certification pass rates, Vanderbilt University students can study toward 13 different APRN specialties. While Vanderbilt does not allow online education for NP students, it does use a "modified block" approach, grouping courses into one block. This lets students commute to campus, complete all their courses in one block, then return home. This ranking looks at the cost and length of an MSN, though Vanderbilt offers DNPs that lead to APRN licensure. 

    9. Boston College

    Total Program Cost: $77,522

    Online: No

    Program Length: 36 months

    Boston College's DNP program, offered through the Connell School of Nursing, takes just 36 months for direct-entry BSN holders to complete. Nurses with an MSN can complete the program in even less time. While most APRN specialties only require an MSN, a DNP can lead to higher salaries and employment rates. Boston College graduates also perform well on certification exams with some specializations boasting a perfect first-time pass rate. 

    10. Columbia University

    Annual Tuition: $71,488

    Online: No

    Program Length: 36 months

    Another school that only offers NP specializations at the DNP level, Columbia University lets nursing students choose from seven different specialties. Students complete clinicals across the New York area at locations including Mt Sinai, NYP, and Memorial Sloan Kettering. A DNP at Columbia University may take three or more years to complete, but students only need a BSN and a current RN license to apply. 

    Methodology

    This list is based on a number of factors including:

    • Reputation
    • NCLEX pass rate
    • Tuition
    • Acceptance rate, when available
    • Only ACEN or CCNE accredited schools are eligible 

    Nurse Panel

    Our selection panel is made up of 3 Registered Nurses with years of experience and multiple degrees:

    • Tracy Everhart, MSN, RN, CNS
    • Tyler Faust, MSN, RN
    • Kathleen Gaines, MSN, BSN, RN, BA, CBC

    Part Seven Resources for NPs

    If you’re considering taking this nursing career leap, it’s a good idea to take advantage of the resources and information offered by various national professional nursing associations. Some examples include:

    Each of these organizations shares industry news, tools and advice to help you choose an appropriate program of study, information on accreditation, and more.

    Becoming a nurse practitioner is a lot of work, but with that title comes a rewarding and lucrative career. If your goal is to take your RN career to the next level, look into becoming an NP.

    Part Eight Nurse Practitioner Specialties

    1. Family Nurse Practitioner
    2. Psychiatric Nurse Practitioner
    3. Pediatric Nurse Practitioner
    4. Acute Care Nurse Practitioner
    5. Neonatal Nurse Practitioner
    6. Women's Health Nurse Practitioner
    7. Orthopedic Nurse Practitioner
    8. Emergency Nurse Practitioner
    9. Adult-Gerontology Nurse Practitioner

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