Nurse practitioner

What is a nurse practitioner?

When people think about being a nurse, they most often think about the person in the hospital who gives medication and carries out the doctor's orders. But there are several professional levels of nurses, and different professional levels do different things. Near the top of the nursing professional ladder is the nurse practitioner. This highly qualified health care provider is a nurse with the some of the most advanced education and training, who has the professional qualifications to work as a direct care provider, or as part of a medical team in some of the most challenging and demanding settings.

There are four areas of advanced practice nurses: nurse anesthetist, nurse midwife, clinical nurse specialist (CNS) and nurse practitioner. Each of these areas requires graduate level educations and extensive clinical training. But while the nurse anesthetist, nurse midwife and CNS focus in very specific areas of nursing and health care, the nurse practitioner's education and training allows them to care for broad sections of the population as a first-contact care provider. While a nurse practitioner will need to select a specialty population, their education and training prepares them to offer overall management of health, wellness and disease prevention, as well as direct care.

Health care is a growing field, and the need for more nurses is one of the most significant work-force issues in the industry right now. The US Bureau of Labor anticipates the need for nearly one million new and replacement nurses in the field by the year 2018. Because of this increasing demand, the field offers much higher than average job security.

What are the qualifications of a nurse practitioner?

A nurse practitioner is a nurse with a master of science or other graduate degree in nursing who has completed the necessary specialty courses and demanding clinical hours to sit for the national certification examination. A nurse practitioner chooses a population specialty: family, women's health, pediatric or neonatal, acute care, psychiatric or geriatric. Once the education and training requirements are met, a nurse practitioner candidate applies to one of the regulatory agencies for certification in their specialty area.

Nurse practitioners are licensed through their state nursing boards, and specific guidelines for application and education requirements do vary slightly from state to state, so be sure to research your state's specific guidelines. In addition, each state independently regulates NPs' scope of practice by specifically defining nurse practitioner jobs to include what they are or are not allowed to do. There are some differences between the states, but many states allow nurse practitioners to prescribe medications or other treatments, order tests and diagnose conditions.

Where do nurse practitioners work?

Because physician shortages are a challenge in many areas, nurse practitioners are an incredible resource for providing primary care. While nurse practitioners do not have the same level of medical education, training, or expertise as a physician, their qualifications make delivering primary care in many settings – including medical offices, skilled nursing facilities, free-standing clinics or ambulatory care centers – an excellent way to ensure quality health delivery when there are not enough doctors to go around.

In addition to selecting a population in order to receive their national board certification, nurse practitioners can specialize in a wide variety of clinical areas that include: cardiology, dermatology, neurology, orthopedics and emergency care, to name only a few.

What makes a nurse practitioner unique?

In addition to the greater capacity to give care and the greater responsibility that nurse practitioners have, the core philosophy of the NP is to provide health care that focuses on health and wellness as much as it focuses on response to illness and injury. Nurse practitioners study health promotion and health education, they are often active in health care policy and patient advocacy, and they are proponents of overall health management. Nurse practitioners commit themselves to a whole-person approach to health care that includes promoting a healthy lifestyle. 

Geriatric Nurse Practitioner

What is a geriatric nurse practitioner?

The nurse practitioner profession is relatively new and was initially developed in the mid 1960’s in order to satisfy the growing need for advanced practice nurses, particularly those trained to handle specialized roles. In essence, nurse practitioners bridge the gap between registered nurses (RNs) and medical doctors (MDs). In recent decades the nurse practitioner profession has continuously sought definition in regards to scope of practice and is now regulated through national certification by professional organizations and advance practice nurse licensure granted by state nursing boards.

According to the Gerontological Advance Practice Nurses Association (GAPNA), GNPs are advanced practice nurses with specialized nurse practitioner education in the diagnosis, treatment and management of acute and chronic conditions generally

What education is required to become a geriatric nurse practitioner?

Although registered nurses are only required to earn an undergraduate degree to practice, geriatric nurse practitioners must attain a graduate degree at the master’s or post-master’s level of education. However, GNPs are encouraged to eventually earn a Doctor of Nursing Practice (DNP) degree because, according to the Gerontological Advance Practice Nurses Association, the DNP degree better reflects current clinical competencies and better prepares graduates for changes anticipated within the health care system.

Aspiring geriatric nurse practitioners interested in enrolling in graduate degree programs can either find them available through onsite colleges and universities or through online schools. Right now there are over a hundred different geriatric nurse practitioner programs located throughout the United States. These GAPNA-approved programs are offered in the following states: AL, AR, CA, CO, CT, DE, FL, GA, HI, IL, IN, IA, KS, KY, MD, LA, MA, MI, MN, MS, MO, NE, NV, NJ, NY, NC, ND, OH, OR, PA, RI, SC, TN, TX, UT, VA, WA, and WI.

Students that do not reside in these states or who just simply prefer the convenience of online learning can take advantage of the many great distance learning or online programs that result in degrees for geriatric nurse practitioners. Some examples of the degrees and certificates awarded by these online programs include: Doctor of Nursing Practice in Geriatric Nurse Practitioner, Master of Science in Gerontology, Gerontology Health Care Certificate, Master of Arts in Gerontology, and Geriatric Care Management Certificate.

How do geriatric nurse practitioners become nationally certified?

One of the great milestones in a geriatric nurse practitioner’s career is gaining national certification. Right now, the American Nurses Credentialing Center (ANCC), in accordance with the professional standards set forth by the American Nurses Association (ANA), has created a written examination that thoroughly tests a geriatric nurse practitioner’s level of educational and clinical competency prior to employment.

Before a geriatric nurse practitioner is permitted to sit for the examination, several eligibility criteria must be completed. First, all geriatric nurse practitioners must be state licensed as registered nurses. In addition, the ANCC requires all candidates to be graduates of geriatric nurse practitioner programs accredited by the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNA).  These nurse practitioner programs must result in a master’s degree, post-master’s certificate or doctorate degree. Educational programs must have presented students with courses in pathophysiology, health assessment, and pharmacology as well as content pertaining to disease management and prevention, diagnosis, and health promotion.

Once these eligibility conditions have been met, geriatric nurse practitioners may qualify for ANCC examination. National certification is granted upon successfully passing this competency examination, and certification renewal is mandated every five years.

What is the employment outlook for geriatric nurse practitioners?

According to the United States Bureau of Labor Statistics (US BLS), nursing professionals are expected to benefit from a 22% increase in employment between 2008 and 2018. Nurse practitioners are predicted to be in particularly high demand throughout inner cities and more rural areas of the country as these are often medically underserved locales.

Geriatric nurse practitioners will continue to experience growing career opportunities as a result of a large aging population. Presently, the US BLS reports that the industries that are employing the highest numbers of nurses include: general medical and surgical hospitals, offices of physicians, home health care services, nursing care facilities, and outpatient care centers. Furthermore, the states with the highest concentration of employed nurses are South Dakota, Massachusetts, Mississippi, Rhode Island, and Delaware.

What is the salary outlook for geriatric nurse practitioners?

Along with employment growth, geriatric nurse practitioners can also anticipate rising salary averages. In fact, the 2009 National Salary and Workplace Survey for Nurse Practitioners reported that the average annual salary for nurse practitioners rose from $81,397 in 2007 to $89,579 in 2009, which equates to a 10% increase in salary.

Individual salaries and wages can be greatly influenced by an employee’s level of experience and education. Industry of employment and location can also impact salaries. The US BLS lists the top paying industries for nursing occupations as follows: medical equipment and supplies manufacturing, federal executive branch, as well as civic and social organizations. The top paying states for geriatric nursing professionals include: California, Massachusetts, Hawaii, Maryland, and New Jersey.  

Adult Nurse Practitioner

What is an adult nurse practitioner?

An adult nurse practitioner is an advanced practice nurse that has earned a graduate-level education and undergone specialized training to deliver medical and health care services specifically for the adult population. These specialty care providers assist patients by assessing, diagnosing, and treating both acute and chronic health afflictions.

Another part of an adult nurse practitioner’s job responsibility is to educate, counsel, and communicate effectively with both patients and their families regarding any and all relevant information pertaining to current and future care. Adult nurse practitioners

Since the scope of practice for adult nurse practitioners continues to evolve and expand to meet the increasing needs of public and private health care, professionals are frequently engaged in continuing education and research to improve quality care and keep up-to-date with occupational trends.

In terms of credentials, all adult nurse practitioners must be certified by a recognized certifying body such as the American Nurses Credentialing Center (ANCC) and obtain occupational licensure from the Board of Nursing specific to the state in which they intend to practice.

What level of education is required of adult nurse practitioners?

Right now, all adult nurse practitioners must hold a master’s degree, post-master’s certificate, or doctorate degree in order to qualify for entry-level positions in the United States. However, doctorate programs are becoming more common because by 2015 all adult nurse practitioners will need to earn a Doctor of Nursing Practice (DNP) prior to employment. Students usually gain entrance into graduate degree programs by first earning a Bachelor of Science in Nursing (BSN) and obtaining a registered nurses (RN) license in the state in which they are pursuing an education and career. Currently the American Academy of Nurse Practitioners (AANP) endorses dozens of accredited on-campus adult nurse practitioner programs across the nation. These programs are available in the following states: AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, IL, IN, KS, KY, LA, MA, MD, MA, MI, MN, MO, MS, NC, NE, NH, NJ, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, VT, WA, WI. There are two such programs offered in Washington, DC as well.

Students are also increasingly showing a preference for online nurse practitioner schools and universities that offer adult nurse practitioner degree programs that can be completed from the convenience of home, and while employed full time as an RN. Students that enroll in an adult nurse practitioner program can expect curriculum to consist of both nursing theory education and applied supervised clinical training. Upon completing graduate programs, students may earn one of the following degrees: BSN to DNP in Adult Acute Care Nurse Practitioner, Doctor of Nursing Practice, Master of Science in Adult Health Nurse Practitioner, and Post-Master’s in Adult Nurse Practitioner (Certificate).

How does an adult nurse practitioner become nationally certified?

Most adult nurse practitioners become nationally board certified by the American Nurses Credentialing Center (ANCC). The certification process was created to establish professional standards in education and training for nurse practitioners to ensure that patients across the country receive the highest level of quality care. To become eligible for certification, adult nurse practitioners must first acquire a current registered nurse (RN) license. All adult nurse practitioners are also required to complete a graduate program specifically designed for the specialty. These adult nurse practitioner programs must be accredited by either the National League for Nursing Accrediting Commission (NLNAC) or the Commission on the Collegiate of Nursing Education (CCNE) and instruct in health assessment, health promotion, pharmacology, pathophysiology, disease prevention, differential diagnosis, and disease management.

In addition, this program must also include at least 500 hours of supervised clinical training within its curriculum. Once this specialized education and training criteria has been completed, adult nurse practitioners are qualified to register for written examination by the ANCC. Those that successfully pass examination can officially practice under the professional title of “board certified adult nurse practitioner” (ANP-BC). 

Where do adult nurse practitioners typically find employment?

According to the American Academy of Nurse Practitioners (AANP), in 2010 there were approximately 140,000 nurse practitioners employed throughout the United States. However, since medical patients are making close to 600 million visits to nurse practitioners each year, the demand for these qualified professionals to accommodate patient needs continues to rise. As a result, colleges and universities nationwide are providing graduate degree programs to academically prepare an estimated 8,000 new nurse practitioners annually.

Currently, adult nurse practitioners are employed in variety of medical and health care settings such as medical clinics, public health departments, community hospitals, home health care agencies, offices of physicians, long term care facilities, and private practices. Adult nurse practitioners can also find employment in non-medical settings like academic institutes, research centers, retail-based clinics, health maintenance organizations (HMOs), and professional associations.

Employment opportunities for adult nurse practitioners are more prevalent in metropolitan areas because high population densities rely more heavily on health care professionals than more rural regions. Additional nurse practitioner education, training, and certifications in sub-specialties within the field may also enhance one’s job prospects. Examples of sub-specialties within the general nurse practitioner field include: sports medicine, neurology, emergency care, endocrinology, occupational health, dermatology, orthopedics, and urology.

What is the average salary for adult nurse practitioners?

The AANP Nurse Practitioner Compensation Survey of 2008 reported that the average total income for full-time adult nurse practitioners was $92,110/yr. One the other hand, non-salaried nurse practitioners earned an average wage of $42.58/hr. Despite these figures, average salaries often vary according to factors such as practice setting, geographic region, and experience. For instance, adult nurse practitioners that work in urgent care settings typically earn $112,030/yr., whereas those employed in community health centers can expect to earn closer to $84,120/yr.

Geographic location can similarly affect adult nurse practitioner salaries. Professionals that practice in western states like Alaska, Hawaii, California, Nevada, Oregon, and Washington tend to benefit from mean incomes of $106,840/yr. However, nurse practitioners that work in the central plains states such as Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota often earn lower mean incomes around $85,870.

Finally, the amount of work experience an adult nurse practitioner has also influences salary earnings. Professionals with between one and five years of experience typically receive $87,650/yr. However, those with between twenty-one and twenty-five years of experience often earn a much higher salary of $104,100/yr.

Becoming a Nurse practitioner

How do I know if becoming a nurse practitioner is right for me?

The first step to becoming a nurse practitioner is the decision that you do, in fact, want to be a nurse. It's a good idea to research the profession and decide if it's a good fit for you. Talk to nurses, volunteer at medical centers or speak to educators at a local training center.

Once you've gained some familiarity with the field, consider the time investment required to become a nurse practitioner. While the rewards of being a highly qualified and fairly independent practitioner are high, so is the investment in time and energy that go with it.

What kind of education do I need to become a nurse practitioner?

A nurse practitioner is a registered nurse with a master of science or other graduate degree that includes education and clinical training in a specialty population. This RN then applies for National Board certification from one of several national certification agencies and takes the required examination.

Step one is the education. Some individuals decide to make their way into the profession in small steps that will allow them to work

The typical education necessary for a nurse practitioner is a Master of Science in Nursing, or a Doctorate of Nursing from an accredited school. Nurse practitioner schools in the United States are accredited by one of two organizations: the National League for Nursing Accreditation Commission (NLNAC) and the Commission for Collegiate Nursing Education (CCNE). In addition, because nursing is a licensed profession in all fifty states, each state's board of nursing must also approve programs.

For full time enrollees, the usual length of time it takes to complete a nurse practitioner education is four to seven years. Someone who is considering becoming a nurse practitioner and who already has a baccalaureate degree in another field may also want to consider registering in an accelerated program. These programs can be completed in three years, but they are typically very intense, being scheduled year-round without summer or holiday breaks. These programs pack into three years the same amount of instruction that a traditional program would cover in six years.

What other requirements are there to become a nurse practitioner?

Once coursework has been completed and a student has received his or her master's degree, they must apply for an RN license in his or her state of residence, if they do not already hold one. This will require passing the National Clinical License Examination (or, NCLEX), completing all application documents, paying all fees and meeting other state specific requirements (background checks, filing fingerprints with the state, etc.)

The organization that principally certifies nurse practitioners in the United States is the American Nurses Credentialing Center, although there are other agencies that may certify a candidate in clinical specialty areas. This organization coordinates national testing for NP candidates in the various population specialties. The ANCC establishes eligibility requirements for all their certification areas. This typically includes:

  • A Master of Science or Doctorate in Nursing from an accredited university
  • A valid RN license
  • 500 faculty supervised clinical hours
  • Coursework specific to the specialty area

Once proof of eligibility has been submitted, a candidate can apply to sit for the national certification examination in his or her specialty area.

Once this examination has been passed and the certification has been issued, a candidate files a second licensing application with his or her state to apply for a nurse practitioner license.

It is important to note that "board approved" and "accredited" do not mean the same thing. Board approved refers to a state's board of nursing; most states require that the learning institution applicants attend be state approved. Accredited means that a nursing program meets the requirements established by one of the national accrediting agencies. While all states require nurse practitioner programsto meet their standards in order for applicants to be licensed, the ANCC (as well as most other specialty certification agencies) require that the program also be accredited by a national certifying agency. Make sure to research programs before enrolling to ensure that both sets of requirements will be met so that the licensing and certification processes go smoothly.

Steps to becoming a nurse practitioner:

  1. Explore the various educational and professional paths to becoming an NP, and decide which is best for you. This may mean pursing an associate's degree first to become an LPN/LVN or RN, then participating in a RN to BSN bridge program and ultimately working to earn a master of science in nursing to become a nurse practitioner. For the most academically ambitions, this may mean committing to six consecutive years of schooling and clinical training to achieve NP status without first becoming an LPN/LVN.
  2. Once you've decided on the rout you wish to take to enter the profession, research programs to be sure those you are considering meet both state and national certifying agency requirements.
  3. Study for and successfully complete the National Clinical License Examination (NCLEX-RN) in order to be certified by the American Nurses Credentialing Center (ANCC).
  4. Pursue that dream job and enjoy a successful career as a nurse practitioner among the best educated, most highly skilled and elite of all allied health professions.

Nurse Practitioner Training

When discussing any program for nurse practitioners, the curriculum can be divided into two sections: education and training. While education refers to the coursework and labs that educate aspiring nurse practitioners, training refers to the hands-on experience that allows practitioners to train their skills. All NP programs, whether traditional campus-based programs, online programs, standard-paced or accelerated, include a substantial training component. Hands-on training usually begins after the first few courses, and NP candidates should have many hundreds of hours of clinical training behind them by the time they apply to sit for their national certification exam.

Who establishes the training requirements for nurse practitioners?

Part of becoming a nurse practitioner requires meeting two sets of training guidelines. The first is the licensing criteria from your state's nursing board. In most cases, the requirements include attending a board approved learning institution as well as proof of certification from a recognized certifying agency, such as the American Nursing Credentialing Center. The certification agency then has its own requirements to be met before a candidate is eligible to take the examinations and become certified. While many states have requirements that are similar to those of the ANCC, they may not be exactly the same, and a candidate wanting to practice within their specialty area as a nurse practitioner needs to meet the training requirements to be both licensed and certified. For the ANCC, a candidate must have 500 clinical hours in order to sit for the examination. If a state's requirements are higher, then the state's guideline must also be met in order for the candidate to receive their NP license, even though they've qualified for their certification with 500 clinical hours.

How do nurse practitioners train?

Nurse practitioners train by shadowing and then practicing as nurses. Early in their programs, students observe experienced nurses and ask questions. As nurses move through their programs, they are given more and more responsibility for the care they are delivering until by the end of their training program they are operating independently under only the general and hands-off supervision of the attending practitioner. Nurses who enter NP programs with existing nursing degrees may find that they are placed directly into hands-on clinical experiences, with less shadowing and observation than a student new to the field. A faculty supervisor and designated master-nurse/nurse practitioner are assigned to an NP student at all times and in all settings.

Nurse practitioner schools strive to help NPs-in-training to do as much of their practical work as possible in their specialty population. Specialty selections may include: pediatric, geriatric, family, adult, acute care and psychiatric, advanced diabetic management and school nurse. NP candidates should select their specialty population fairly early in the program, as the ANCC requires that certain specialty-oriented courses be taken in order to be eligible to sit for the certification exams. Fieldwork that allows the candidate access to their specialty population must then be coordinated.

Where do nurse practitioners get their clinical training?

Nurse practitioners can work in nearly all medical environments, but their specialty usually determines where much of the clinical training happens. While early practice in assessment happens in the classroom with fellow students, practice quickly moves to outside clinical environments where NP students encounter patients with real problems.

Nurse practitioner students can practice their skills in physician practices, in medical centers, in ambulatory surgery centers, in family practice clinics, in pediatric specialty units and in trauma centers. While most programs establish clinical rotations that expose nurse practitioner students to a wide variety of clinical conditions, the program can also move the NP student into their clinical specialty area to create the most qualified provider. NP students who are working to become acute care NPs often find the bulk of their clinical experience is organized in hospitals. Family nurse practitioners may spend some time in the acute hospital setting, but may also find more of their clinical experiences occur in a general practitioner's office. Pediatric nurse practitioner students spend part of their clinical training in hospitals, especially those that have neonatal or pediatric intensive care units (NICU/PICU's), but may also spend part of their clinical training in pediatric physician practices.

Nurse practitioner students who are already working nurses can often organize a portion of the clinical training hours in their current work environments.

Nurse Practitioner Program

What is the coursework like for a nurse practitioner student?

Because becoming a nurse practitioner carries with it the potential to be a primary care provider with all the responsibility for diagnosing, prescribing tests and medication, ordering treatments and providing health management, the education for nurse practitioners is rigorous and challenging. A nurse practitioner needs to be deeply familiar with all the body's systems, disease processes, preventative care and medicine, and pharmacology. An NP must be aware of the most current diagnostics and therapies, and understand the dynamics of health maintenance.

Some of the classes an NP might take include:

Family Nursing
Research Methods
Health Assessment
Health Policy
Mental Health Nursing
Nursing Care of Older Adults
Legal and Ethical Issues in Nursing
Pediatric Nursing
Community Health

Additional classes that may be more broadly classified as nursing theory, or nursing seminars discuss professional issues in nursing and primary care, including health promotion, health policy and the changing role of nurse care providers, patient advocacy and critical thinking.

How are nurse practitioner courses different than other nursing programs?

Courses in MSN programs that are oriented towards student successfully passing the national certification examinations take clinical nursing education further and to greater levels of complexity than associate's or bachelor's programs. While the basics of

Are courses the same at every NP program?

Courses at different learning institutions may vary slightly, but accredited institutions follow course guidelines that are set on a national level. Two institutions accredit nursing programs in the United States: the National League for Nursing Accreditation Commission (NLNAC) and the Commission for Collegiate Nursing Education (CCNE). The primary organization in the United States that offers certifications for nurse practitioners, The American Nurses Credentialing Center, requires that a candidate attend an accredited nursing program. All accredited programs revolve around a core curriculum set by the accrediting agency, so programs at different learning institutions, even in different states, will bear a strong resemblance to one another. One advantage to this system is that a nurse practitioner that is licensed to practice in one state will find reciprocity with other states, because the requirements for education and clinical training are comparable no matter where an education was received.

Are nurse practitioner program all class-based?

Although a challenging and thorough classroom based education is the foundation of any nursing program, nursing is by definition a hands-on profession. Practical clinical training is essential to the development of a qualified health care provider, and nurse practitioner programs ensure that their graduates have received enough hours in real-world clinical settings to be exceptionally skilled practitioners. The ANCC, requires candidates to have completed at least 500 faculty supervised clinical hours in order to be eligible to sit for the national exam.

Can I take any classes online?

Many nurse practitioner schools are now offering part or all of their curriculum online. Many traditional brick-and-mortar institutions are finding that offering some of their courses online is a benefit to students who are also working or who have families. Additionally, some programs now offer entire programs online. These programs are typically limited to candidates who either have current nursing degrees or non-nursing baccalaureate degrees, but the convenience of a curriculum available online is an advantage to many students who otherwise could not attend an intensive program at a remote university. These programs are just as challenging as their traditional counterparts, and many of them do not accommodate self-paced learning. Also, the clinical component of the NP program is still mandatory, but many students are able to locate local medical facilities that will allow them to organize a practical experience. Most online programs also have coordinators that will help students organize practical experiences in their home communities.

Nurse Practitioner Job Description

How is a nurse practitioner different from other kinds of nurses?

Nurse practitioners are different from LPNs and RNs in terms of the depth of their education and training and in the amount of autonomy they have in the delivery of care.

Both LPNs and RNs work under the supervision of an attending physician or nurse practitioner. Nurse practitioners often work in a collaborative relationship with physicians, but in some states NPs are not required to have this kind of a professional relationship with a physician at all. This is due to the fact that in many settings NPs are the direct care provider, and are allowed to assess and diagnose as well as order treatments and prescribe medication. LPNs and RNs do not have the authority under their licenses to engage in these activities within any state.

What responsibilities do nurse practitioners have?

A nurse practitioner is often responsible for the holistic management of a patient's health. As a direct care provider, a nurse practitioner is often the first point of clinical contact. While the NP is responsible for the diagnosis and treatment of a patient's condition, the core philosophy of the profession of nurse practitioners is to manage health and wellness. Nurse practitioners are strongly oriented toward health education and promotion as well as disease prevention. They are strong advocates for healthy lifestyles and are committed to assisting their patients with maintaining or improving their overall health.

Job descriptions often vary depending on clinical specialty, although some activities are generally the same across all settings. All nurse practitioners are expected to assess conditions, make an accurate diagnosis in response to patient complaints, order diagnostics, and, where allowed by state licensure, prescribe appropriate medications and treatments. Nurse practitioners' education is meant to prepare them to identify complex cases beyond their scope of intervention in order to appropriately refer patients to physicians. Additional responsibilities may include fielding advice calls from patients, assisting with procedures, counseling patients and families about issues related to illness and disease and performing physicals.

Job descriptions may also vary from one state to another. Because the scope of practice is set on the state level, there are differences across the country. In some states, a nurse practitioner is allowed to prescribe medications, but not in all. This means that in certain states an NP job may include dealing with more complicated conditions that require medical management, but in other states an NP's job may be more oriented towards patient assessment and treatment in collaboration with a physician.

Where does a nurse practitioner work?

An individual nurse practitioner's work site corresponds to his or her specialty area. As a profession, the places where nurse practitioners provide quality care are tremendously varied, and a new NP student has many choices to consider.

Nurse practitioners are filling gaps in physician services in the United States where access to health care is increasing, but medical schools are challenged to educate and train doctors fast enough. Nurse practitioners often partner in physician practices to allow a practice to see all the patients that are requesting care. Nurse practitioners work in hospitals where they may be the first clinical contact for preliminary diagnosis before a physician is brought into the case. Nurse practitioners may be the principle care providers in freestanding clinics or ambulatory care centers where a physician is not always available on site. Nurse practitioners often work in home health agencies, skilled nursing facilities or outpatient surgery centers.

Some nurse practitioners may choose a nurse educator emphasis. This education typically varies from the traditional NP program in terms of coursework and clinical training and is oriented toward training a nurse practitioner to teach and train NP students. Practicing nurse practitioners with traditional certifications may respond to NP programs that are in need of qualified instructors and may find themselves teaching classes even though they don't possess a nurse educator background.

What are the employment prospects for nurse practitioners?

Those interested in knowing how to become a nurse practitioner may be encouraged to learn that employment prospects for NPs are predicted to be excellent. Health care is a growth industry, and nurses of all kinds make up a large percentage of health care providers. Because nurse practitioners in some states are allowed to work very independently, this allows them to fill gaps where primary care providers are in short supply. In states where NP's are required to work under the supervision of or in collaboration with physicians, a qualified provider that can complete preliminary assessments and start clinical management for patients is a valuable extension of both primary care services and clinical specialty care.

Nurse Practitioner Salary

Nurse practitioners, also known as advanced practice registered nurses, work as primary or specialty care providers. They may consult with physicians about potential patient care, prescribe medicine, perform exams, and help patients figure out ways to improve their overall health.

In terms of salary, the Bureau of Labor Statistics reports that the annual median wage for nurse practitioners in 2012 was higher than the national average wage. This may change depending on geographic location, education, and prior work experience.

Is it difficult to find a job in this field?

According to bls.gov the growth potential for this field will be faster than average for all occupations from 2012 through 2022. The number of people in the country who have health care will expand due to the American Care Act, and as more people reach retirement age they might need more services as well. Some states are also expanding the duties that an APRN is able to perform, allowing them to act in the same fashion as physicians.

Is there room for advancement in this field?

Moving into an APRN position is already an advancement in terms of nursing careers, but there are still a few ways you can move up. You can work as an administrator or manager. If you have earned your doctoral degree you may be able to become an educator or a researcher.

Are there any licensing requirements for this field?

Yes. You must hold a registered nursing license in order to practice. You must also pass a certification exam before becoming a nurse practitioner. This certification is a requirement from most states in order to hold one of the nurse practitioner titles. You can inquire about certification information from the National Council of State Boards of Nursing, the American Nurses Credentialing Center, or the Pediatric Nursing Certification Board.

Nurse Practitioner School

What degree is necessary to become a Nurse practitioner?

In order to become a nurse practitioner, it is necessary to have a Master of Science Degree in Nursing (MSN), or have a Doctorate of Nursing. Because of the complexity of the cases they are responsible for, and because of the amount of autonomy they are given when practicing, it is essential that a thorough and rigorous nurse practitioner education and clinical training program be completed. While the basic license requirement to become a nurse practitioner is an RN license, which can be acquired with an associate's or bachelor's degree, all state nursing boards, as well as the national agencies that grant certification for nurse practitioners, require an MSN. This ensures a stronger and deeper education, as well as additional clinical hours.

While neither an LPN/LVN nor an RN designates a population or clinical specialty, a nurse practitioner is required to do so. The national certification exams administered by The American Nurses Credentialing Center (ANCC) are specific to specialty areas, and an NP student can select his or her specialty area fairly early in the education process. A portion of courses and clinical hours

How do you become certified as a nurse practitioner?

To become certified as a nurse practitioner, you need to meet the eligibility requirements for taking the national examination administered by one of the two national certification agencies. The ANCC is the primary certifying agency recognized by the states as having the authority to confer certification to nurse practitioner candidates, although there are other agencies that confer certifications in clinical specialty areas.

The requirements the agencies set include: completing a graduate level nurse practitioner program at either the master's or doctoral level that includes courses specific to the student's specialty area, being licensed as an RN, completing 500+ clinical hours of practical experience, and passing the national NCLEX examination. The examinations are typically given several times a year around the country, and many specialty area examinations are now offered online.

Once evidence of meeting the requirements is provided, and the examination is passed, the agency can confer the certification to the applicant.

What if I already have a degree in nursing?

If you have already earned a degree in nursing, you are further ahead in the educational process than someone who has not studied nursing before. There are many MSN programs that operate as "bridge" programs, where instead of starting from scratch, the candidate is converting an existing degree in nursing to a more advanced one. In these programs, education builds on existing education and does not require a student to repeat coursework or clinical experiences that they completed to get their earlier degree.

What if I already have a degree, but it's not in nursing?

Candidates who have earned their degree in a subject other than nursing can still be eligible for either traditional nursing educations or certain accelerated programs that only have liberal arts requirements to be met. Students who have baccalaureate degrees in non-nursing areas may find that they need to complete certain prerequisite courses in biology, anatomy and physiology before their application can be accepted.

Can I get my nurse practitioner degree online?

Many nurse practitioner schools offer online programs designed for candidates that want to complete their MSN online in preparation to sit for the national nurse practitioner examinations. These are often accelerated programs in which the courses are tightly scheduled, and many of them require that the candidate has already earned a bachelor's degree in a non-nursing area. Those interested in learning how to become a nurse practitioner on a time limit should consider an accelerated program, which may allow them to complete a regular master's degree program in a reduced timeframe.

Most online programs are not self-paced. The student is expected to maintain the schedule of each class as set by the instructor. Typically lectures and homework assignments are viewed and completed online, and the schedule allows the nurse educators to assess comprehension for each student while the program is progressing. Exams for courses are also completed online. In these programs identifying a local medical center for practical experience may be necessary, and most programs will have a coordinator to help students identify possible sites and to help with coordinating a practical experience.

Request Information from Nurse Practitioner Colleges

The nurse practitioner schools, colleges, and universities below offer some of the best training available to medical degree seeking individuals. Request information from multiple registered nurse practitioner schools in order to compare programs and find the best degree for you.

Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners, Occupational Outlook Handbook, Bureau of Labor Statistics, 2012,

National Council of State Boards of Nursing,

American Nurses Credentialing Center,

Pediatric Nursing Certification Board,

Nurse Practitioner Schools