5 Steps to Becoming a Nurse Practitioner


    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.

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    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). Nurse Practitioners have more authority than Registered Nurses and have similar responsibilities to that of a doctor.

    Nurse Practitioners can serve as a primary care or specialty care providers and typically focus their care on a specific population such as families, children, or the elderly. As clinicians, they focus on health promotion and disease prevention in their patients. 

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    Part Two What Do Nurse Practitioners Do?

    NPs are health care providers that can prescribe medication, examine patients, order diagnostic tests, diagnose illnesses, and provide treatment, much like physicians do.

    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.

    Nurse Practitioner Scope of Practice

    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 Practitioner Scope of Practice by State

    Map of nurse practitioner NP practice authority in US

    Part Three Nurse Practitioner Specialties

    In addition to being a general nurse practitioner, NPs can also specialize in a specific population. They will often attend a nursing program that allows them to specialize in this area and obtain clinical competency, they'll also need to become certified in the specific specialty area.

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

    Family Nurse Practitioner

    Family nurse practitioners or Family Practice Nurse Practitioners (FNPs) provide primary health care services for individuals and families throughout the lifespan. They often act as a primary care provider for their patients and this can be especially rewarding for those who enjoy developing long-term relationships and getting to know people over time.

    Acute Care Nurse Practitioner

    Acute Care Nurse Practitioners (ACNPs) are advanced practice registered nurses that provide care to patients in acute care and/or hospital settings. Acute Care NPs see patients when they are sick, admitted to the hospital, or after a surgical procedure and/or trauma. Their focus is solely on caring for the adult population with complex diseases.

    Pediatric Nurse Practitioner

    Pediatric Nurse Practitioners are Advanced Practice Registered Nurses whose sole focus lies in treating children from infancy through the time they become adults. They see patients on a one-on-one basis, offering care ranging from well check-ups and immunizations to diagnosing illnesses and treating chronic and acute conditions. 

    Emergency Nurse Practitioner

    Emergency Nurse Practitioners assess, diagnose and manage injuries and illnesses that need urgent care. They are able to work with or without supervision, determining which patients need the most immediate care, making decisions about treatment, monitoring patient conditions and providing education and consultation.

    Adult-Gerontology Nurse Practitioner

    Adult-Gerontology Nurse Practitioners specialize in the care of adults from adolescence all the way up to geriatric care. They work with patients and their caregivers on managing chronic conditions, diseases, and other health conditions.

    Psychiatric Nurse Practitioner

    Psychiatric Nurse Practitioners or Psychiatric Mental Health Nurse Practitioners (PMHNPs) specialize in the mental health needs of adults, children, families, groups, and/or communities. They help individuals cope with different psychiatric disorders and illnesses and can also help people with substance abuse disorders. 

    Neonatal Nurse Practitioner

    Neonatal Nurse Practitioners care for premature and sick newborns including diagnosing them, providing treatment plans, and prescribing medication. They can also can assist in delivering patients in certain settings. 

    Women's Health Nurse Practitioner

    A Women’s Health Nurse Practitioner (WHNP) specializes in the comprehensive care of women throughout their lives. They focus on reproductive, obstetric, and gynecological health and usually work in a primary care office setting, rather than a hospital or delivery room.

    Orthopedic Nurse Practitioner

    An Orthopedic Nurse Practitioner focuses on the care and treatment of patients suffering from musculoskeletal problems. These can include disease and/or injuries of the bones, muscles, joints, and supporting connective tissue. 

    Part Four 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. 

    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. 

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

      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 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 doctoral degrees like  Doctor of Nursing Practice (DNP) programs, which is the highest level of nursing education available. 

    5. 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. 

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    Part Five Nurse Practitioner Salary

    Nurse practitioners earn an average annual salary of $115,800 in the United States 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.

    Source: BLS, Data extracted October 23, 2020.

    NP Salaries by State & Cost Of Living

    State Mean Annual Avg Hourly Cost of Living
    Alabama $99,570 $47.87 -8.80%
    Alaska $115,890 $55.72 +31.60%
    Arizona $111,480 $53.60 -1.95%
    Arkansas $105,840 $50.88 -11.50%
    California $138,660 $66.66 +34.80%
    Colorado $106,760 $51.33 +2.10%
    Connecticut $115,140 $55.36 +30.70%
    Delaware $112,430 $54.05 +10.80%
    District of Columbia $111,950 $53.82 +49.20%
    Florida $101,510 $48.80 -1.00%
    Georgia $105,670 $50.80 -8.60%
    Hawaii $124,000 $59.62 +67.40%
    Idaho $110,860 $53.30 -10.40%
    Illinois $107,860 $51.86 -4.50%
    Indiana $106,380 $51.14 -12.10%
    Iowa $109,910 $52.84 -8.30%
    Kansas $100,550 $48.34 -9.60%
    Kentucky $99,560 $47.87 -9.60%
    Louisiana $106,240 $51.08 -5.60%
    Maine $106,960 $51.43 +12.00%
    Maryland $111,800 $53.75 +25.00%
    Massachusetts $122,240 $58.77 +34.7%
    Michigan $108,660 $52.24 -11.80%
    Minnesota $122,850 $59.06 +34.70%
    Mississippi $110,740 $53.24 -14.00%
    Missouri $105,050 $50.50 -9.20%
    Montana $109,120 $52.46 +0.80%
    Nebraska $105,450 $50.70 -8.70%
    Nevada $115,970 $55.75 +4.50%
    New Hampshire $110,680 $53.21 +0.80%
    New Jersey $123,810 $59.52 +21.00%
    New Mexico $111,930 $53.81 -4.30%
    New York $122,550 $58.92 +35.20%
    North Carolina $105,890 $50.91 -5.80%
    North Dakota $110,950 $53.34 -98.90%
    Ohio $103,780 $49.89 -7.00%
    Oklahoma $113,200 $54.42 -11.40%
    Oregon $113,430 $54.53 +15.40%
    Pennsylvania $101,950 $49.02 +2.80%
    Rhode Island $115,310 $55.44 +22.10%
    South Carolina $100,680 $48.41 +0.50%
    South Dakota $102,230 $49.15 +2.80%
    Tennessee $96,510 $46.40 -10.20%
    Texas $115,440 $55.50 -9.30%
    Utah $105,240 $50.60 -7.20%
    Virginia $109,110 $52.46 +0.20%
    Vermont $105,840 $50.88 +12.00%
    Washington $126,920 $61.02 +7.10%
    West Virginia $103,170 $49.60 +4.30%
    Wisconsin $112,130 $53.91 -3.10%
    Wyoming $118,110 $56.78 -8.30%

    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 Six 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 Seven 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

    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. 
    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. 
    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. 
    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.
    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. 
    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. 
    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. 
    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. 
    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. 
    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 Eight 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:

    Part Nine A Real Nurses NP Journey

    If you're thinking of becoming an NP, your journey is going to be very different depending on where you're at now. Nurse Haskins shares her journey from CNA to NP and all the different positions she had along the way. 

    Find out what it's like to be a nurse practitioner, how to get there from wherever you're starting out, and what you need to know if you're considering this career.

    Part Ten Scrubs Discounts for NPs

    If you want to be a Nurse Practitioner, or any kind of nurse for that matter, you're going to need scrubs. Luckily for you, Nurse.org has discounts for some of the most popular nursing brands!*

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    *Indicates an affiliate link. At no additional cost to you, Nurse.org will earn a commission if you click through and use this service.

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