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How to Become a Nurse Practitioner (NP)

How to Become a Nurse PractitionerPerhaps you or someone you know has received health care services from a nurse practitioner recently. Although the first nurse practitioner training program in the United States dates back to 1965, nurse practitioners are now involved in the delivery of health care to people with a broad range of health problems in a wide variety of settings. By expanding on traditional nursing skills and knowledge, nurse practitioners are able to provide many of the services that, in the past, have been the exclusive province of physicians.

What Does a Nurse Practitioner Do?

A nurse practitioner (NP) is a registered nurse (RN) with graduate education at either the master's degree or doctoral degree level. This advanced education involves developing clinical skills that focus on assessment (history and physical examination, diagnostic testing) and diagnosis of health problems. In addition, NPs provide a treatment plan that includes a range of nursing and medical interventions. These may include writing prescriptions, making referrals and providing patient education. While nurse practitioners have typically been associated with primary care, more NPs are now working in acute care and rehabilitation. Primary care nurse practitioners are certified most often in fields associated with specific patient populations. These include:

  • Pediatrics
  • Family
  • Adult
  • Women's health
  • Geriatric care

Acute care nurse practitioners may practice in specialties such as neonatal care, dermatology or neurology, among others.

Nurse practitioners often are the providers that emphasize preventive care in the primary care setting. NPs perform well-baby and well-woman physical exams, do sports physicals, and give annual physicals for older children and adults. On those visits, patients can expect to discuss any concerns and questions they may have about their health and to be updated on recommendations for vaccines and screening tests appropriate for their age group along with their physical examination. NPs also see patients in office settings to diagnose and treat routine illness complaints. They provide ongoing evaluation and intervention for patients with chronic conditions that are able to be managed in the office setting.

In specialty clinics and inpatient facilities, nurse practitioners often have the following responsibilities:

  • Record patient histories
  • Perform physical exams
  • Prescribe interventions
  • Evaluate health outcomes in collaboration with a health care team

Although nurse practitioners are licensed by the state board of nursing and may practice independently in some states, most states require a collaborative practice agreement with a physician.

What Are the Steps to Becoming a Nurse Practitioner?

Nurse practitioners reviewing chartThe first step is to obtain a Bachelor of Science in Nursing (BSN) and to be licensed to practice as a registered nurse. RNs with an associate degree in nursing (ADN) or diploma in nursing need to complete an RN to BSN program, but graduates of four-year collegiate nursing schools are ready to apply to graduate schools of nursing. Typically, work experience in nursing is considered helpful before pursuing graduate school, but it is not required. A master's degree is required to sit for nurse practitioner certification exams.

Following completion of the degree, certification exams are offered by the American Nurses Credentialing Center (ANCC) as well as the American Academy of Nurse Practitioners (AANP) and the Pediatric Nursing Certification Board (PNCB). After passing the exam, nurse practitioners must apply for an NP license in addition to their RN license from the state in which they intend to practice.

How to Become a Great Nurse Practitioner

As is true in many professions that involve caring for people, a great nurse practitioner is a person who is able to combine in-depth knowledge and clinical skills with a genuine concern for the well being of the individual and family being cared for. This involves keeping current with health trends and practice recommendations, while also developing the ability to listen carefully and compassionately to the concerns of patients and their family members.

Because the delivery of health care is more than ever before an effort involving a multidisciplinary team, nurse practitioners must be able to work collaboratively with other health professionals. This, too, is one of the strengths that most nurses bring to the advanced practice role since RNs often have experience in coordination of patient care.

According to a 2009 salary survey in ADVANCE for Nurse Practitioners, the average annual salary for NPs is $89,579. Variations in income are related to the type of practice and area of the country. The Bureau of Labor Statistics predicts excellent employment opportunities for RNs, with job growth of 22 percent expected between 2008 and 2018. NPs have been proven over the years to provide high quality cost effective care. Improvements in accessibility of health care for the US population should also increase the demand for nurse practitioners in the future.

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