How to Become a Nurse Practitioner

Through diagnoses, health promotion, disease prevention and health education, a nurse practitioner (NP) helps patients to stay healthy. While the responsibilities of a nurse practitioner can be summed up in a few sentences, the specialty areas available for practice are wide-ranging. 

From providing neonatal care in hospitals to mental health care in government agencies, there are several places to launch and maintain an impactful career. If you’re considering the prospects of this profession, you may have a lot of questions.

What’s the required education? Are there certifications or licenses required? Do you need real-world nursing experience? While some states have different requirements and standards to practice, we’ve outlined the key steps you need to take if you’re looking to work as a nurse practitioner.

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  • Choose from one of four APRN specialty areas: AG-ACNP, FNP, NM/WHNP, or WHNP
  • Gain hands-on clinical experience in evidence-based practice

Earn a Master of Science in Nursing online from Simmons University.

  • Accredited by the Commission on Collegiate Nursing Education (CCNE)
  • Preparation to pursue certification as a Family Nurse Practitioner
  • Part-time, full-time, and extended plans of study

Earn your MSN online from USC’s Top-Ranked School of Social Work.

  • Prepares RNs to pursue board certification as family nurse practitioners
  • Earn a CCNE-accredited MSN in as few as 21 months
  • Choose from part-time and full-time study options

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Steps to Become a Nurse Practitioner

There are some common steps you can take to become a nurse practitioner. Prior education, certification and clinical practice are among the many requirements for acceptance to an NP program. Learn more about the specific steps you can take below:

1. Earn your Bachelor of Science in Nursing (BSN).

A nursing diploma or associate degree is sufficient to become a registered nurse. But to become an NP, you’ll need to complete a Master of Science in Nursing (MSN) program. Most MSN programs require a BSN for admission. The baccalaureate degree is designed to equip aspiring nurses with the clinical skills needed for practice. Be sure to select a BSN program that relates to your career goals and fieldwork involving nursing specializations of interest.

2. Become a registered nurse (RN).

Next, you must pass the NCLEX-RN examination to become a registered nurse. Although not required, you can seek nursing specializations while working as an RN.

3. Apply to a Nurse Practitioner program.

Apply to a nurse practitioner program that’s accredited by the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE). You can pursue a master’s degree in nursing (MSN) or postgraduate degree program, and even target online offerings. 

4. Apply for Nurse Practitioner Certification(s).

Each state requires nurse practitioners to achieve national certification. Specific nurse certification requirements vary by state. It’s important to know what makes you eligible for certification as you embark on your education and training. There are many certifications available for nurse practitioners to choose from, such as acute care, pediatric care, cardiology, and more..

Once you have earned your nurse practitioner certification, it is likely it will have to be renewed every five years, according to the ANCC Nurse Practitioner Certification renewal requirements. In addition to renewed certification through the ANCC, renewal through the state is also required and may necessitate additional fulfillment of continuing education contact hours. Keep in mind, that there are other organizations recognized by state boards for certifications. Be sure to check with your state for more information first.

 It may be a goal of yours to pursue further specialization within the field. Once you’ve earned your degree from an accredited NP program, you can obtain certification in your area of specialty. Each licensing body has its own requirements, but they typically include a graduate degree in nursing, a certain amount of nursing experience and a passing score on a certification examination.

5. Apply for State Licensure as a Nurse Practitioner

Finally, apply for licensure as a nurse practitioner from your state board. Be sure to research licensure requirements in your state as they may vary widely from other states. 

Sponsored Online Nursing Programs

Sponsored

Earn an MS in Nursing online from Georgetown University.

  • Earn your MS in Nursing in as few as 19 months
  • Choose from one of four APRN specialty areas: AG-ACNP, FNP, NM/WHNP, or WHNP
  • Gain hands-on clinical experience in evidence-based practice

Earn a Master of Science in Nursing online from Simmons University.

  • Accredited by the Commission on Collegiate Nursing Education (CCNE)
  • Preparation to pursue certification as a Family Nurse Practitioner
  • Part-time, full-time, and extended plans of study

Earn your MSN online from USC’s Top-Ranked School of Social Work.

  • Prepares RNs to pursue board certification as family nurse practitioners
  • Earn a CCNE-accredited MSN in as few as 21 months
  • Choose from part-time and full-time study options

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13 Types of Nurse Practitioner Specializations

The specialty you choose will often influence the specific duties you perform as a nurse practitioner, as well as the population you support. There is a variety of specialties to pick from. Below is an overview of a few of them.

Acute Care Nurse Practitioner

An acute care nurse practitioner (ACNP) is an advanced practice registered nurse (APRN) who provides care to patients with acute, chronic or critical conditions. Working in collaboration with other members of the health care team, ACNPs can provide care to adult or pediatric populations. They might work in an emergency room or short-term care facility. An acute care nurse practitioner is trained to make difficult, life-altering decisions that are in the best interest of patients, which can make it both a challenging and gratifying career path. Acute care nurse practitioner programs can be completed online, providing flexibility for working professionals.

Adult Gerontology Acute Care Nurse Practitioner (AG-ACNP)

An adult-gerontology acute care nurse practitioner (AG-ACNP) provides advanced nursing care to older adults with acute, chronic, or critical conditions. In order to stabilize and improve the health of patients, an AG-ACNP must work in tandem with a host of health care professionals, often in an emergency or short-term care environment. By efficiently evaluating the patient’s condition and responses to treatment, an AG-ACNP continuously adapts the patient management plan as needed.

Adult Gerontology Primary Care Nurse Practitioner (AG-PCNP) 

An adult gerontology primary care nurse practitioner (AG-PCNP) focuses on preventive health care and management of acute and chronic health issues in adults (age 12 and older). From conducting wellness exams and educating families on disease prevention to performing diagnostic screenings, AG-PCNPs have multiple duties in a variety of health care settings, including internal medicine units, clinics, student health centers and ambulatory care centers.

Cardiac Nurse Practitioner

A cardiac nurse practitioner is responsible for performing comprehensive cardiovascular assessments, interpreting results and managing treatments. Working closely with physicians in settings as varied as private practice cardiology offices and hospitals, cardiac nurse practitioners typically care for patients experiencing symptoms of high cholesterol, high blood pressure, congestive heart failure and arrhythmias.

Family Nurse Practitioner

A family nurse practitioner (FNP) provides a wide range of family-focused health care services to patients of all ages, from infants and adolescents to adults and seniors. FNPs will often take on some of the roles of a physician, though FNPs generally work in close conjunction with them. If you are not able to relocate for school, an online FNP program may be an option to consider.

Gerontological Nurse Practitioner

A gerontological nurse practitioner (GNP) treats patients from adult ages to those in the geriatric category. You might find a gerontological NP in a hospital, treatment center, clinic or private practice.  Adult gerontology acute care nurse practitioners (AG-ACNPs) and adult gerontology primary care nurse practitioners (AG-PCNPs) are two types of gerontological NPs. To become either one, you’ll need an advanced degree and training.

Neonatal Nurse Practitioner (NNP)

A neonatal nurse practitioner (NNP) is an APRN who specializes in the care and treatment of preterm and full-term infants who are high risk or have long-term health conditions. They usually work in the NICU. NNPs may provide advanced medical management and support to families of very ill babies during times of significant stress. They work collaboratively with other health care providers in acute and non-acute settings to assess, diagnose and manage the health of the youngest of patients. 

Oncology Nurse Practitioner

An oncology nurse practitioner works closely with physicians, surgeons, families and palliative caregivers to help cancer patients through all stages of their treatment. These nurses are trained to manage the physical and psychological needs of the oncology patient and their family in a range of medical settings, including hospitals, cancer care centers, private practices and palliative care centers. They may also work in nontraditional environments, delivering educational programs on cancer prevention and related topics.

Orthopedic Nurse Practitioner 

An orthopedic nurse practitioner is certified to manage the care of patients who experience a range of musculoskeletal conditions. From prescribing medications for pain management to analyzing X-rays of a hip replacement, orthopedic NPs collaborate with other members of the health care team, such as physical therapists, to evaluate and treat patients. Orthopedic NPs can work in physicians’ offices, clinics and hospitals and often help plan follow-up care to ensure patient needs are met.

Pediatric Acute Care Nurse Practitioner (PNP-AC)

A pediatric acute care nurse practitioner  provides care to newborns and children up to 21 years old who are acutely, critically or chronically ill . Their expertise is needed in community agencies, hospitals, pediatric emergency departments and pediatric intensive care units, among other settings. They work with patients, families, health care professionals and multidisciplinary ethics communities. With the guidance of a pediatric acute care NP, children and their families may be able to better prepare for sensitive lifecycle moments and treatment milestones.

Pediatric Nurse Practitioner

A pediatric nurse practitioner works alongside pediatricians to provide primary care to infants, young children and adolescents up to 21 years old. Like all nurse practitioners, they focus on promoting wellness, preventing disease and managing common health conditions. Once pediatric nurse practitioners assess their young patients, they analyze data, lab work and diagnostic tests to assure key growth and development milestones are being met. Along the way, they empower patients and their families with health care education to achieve those key milestones.

Psychiatric and Mental Health Nurse Practitioner (PMHNP)

A psychiatric and mental health nurse practitioner (PMHNP) works with patients of all ages in varied settings, such as inpatient psychiatric facilities, state psychiatric facilities, mental health centers, schools, correctional facilities and home health providers. PMHNP duties include assessment, diagnosis and treatment of individuals with mental health disorders and identifying genetic or individual risk factors. Because of their extensive training and expertise, PMHNPs are certified to prescribe medication and administer psychotherapy.

Women’s Health Nurse Practitioner (WHNP)

A women’s health nurse practitioner (WHNP) provides primary health care services to women from adolescence and continuing through pregnancy and menopause. A WHNP might share birth control options with a patient or provide prenatal counseling. WHNP programs help students build knowledge about infertility, high-risk pregnancies and other women’s health topics.

Should I Become a Nurse Practitioner?

In addition to the many educational requirements involved in becoming a nurse practitioner, it is important to consider what else makes this career path a good fit for you. Some people are drawn to this patient-centered profession because they are passionate about helping others, and this passion often comes through in their day-to-day work.

According to the American Association of Nurse Practitioners, Americans make more than 1 billion visits to NPs each year. This tells us that NPs are central to patient care and education. While a nurse practitioner’s clinical expertise is fundamental to the quality of care they provide, their soft skills may help them to be effective on the job, too.  

Since you’ll spend a lot of time liaising with patients, their families and health care professionals, being personable can be a useful social trait to have. Additionally, NPs are often confronted with time-sensitive health care issues. So, it’s crucial that they strive to excel at decision-making under duress and show leadership. Job outlook might also affect your decision to work as an NP. Because of aging populations and greater emphasis on preventative care, the U.S. Bureau of Labor Statistics (BLS) projects that nurse practitioner employment will surge 28% by 2028. What about NP pay? The median nurse practitioner salary in May 2019 was $109,820, according to the BLS.

Sponsored Online Nursing Programs

Sponsored

Earn an MS in Nursing online from Georgetown University.

  • Earn your MS in Nursing in as few as 19 months
  • Choose from one of four APRN specialty areas: AG-ACNP, FNP, NM/WHNP, or WHNP
  • Gain hands-on clinical experience in evidence-based practice

Earn a Master of Science in Nursing online from Simmons University.

  • Accredited by the Commission on Collegiate Nursing Education (CCNE)
  • Preparation to pursue certification as a Family Nurse Practitioner
  • Part-time, full-time, and extended plans of study

Earn your MSN online from USC’s Top-Ranked School of Social Work.

  • Prepares RNs to pursue board certification as family nurse practitioners
  • Earn a CCNE-accredited MSN in as few as 21 months
  • Choose from part-time and full-time study options

Sponsored

What is a Nurse Practitioner?

Nurse practitioners are registered nurses who hold a master’s in nursing degree or doctoral degree in nursing, as well as a certification from an approved national licensing body, such as the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners, and from a state nursing licensing board. 

Generally, RNs may choose to become NPs to further their career prospects. Certification is available for a variety of specialties such as acute care, adult care, pediatric care, gerontology, family care, and women’s health. Each licensing body has its own requirements, but they typically include at minimum a graduate degree in nursing, a certain amount of nursing experience and a passing score on a certification examination. 

Be sure to check with your state boards of nursing to determine which certifications are accepted in your area, as the requirements for becoming licensed vary state by state.

What Does a Nurse Practitioner Do?

The nurse practitioner’s scope of practice encompasses direct patient care, including diagnosing and treating illnesses. As stated, many NPs hold specialty licenses that dictate their patient population and level of care. 

For instance, a neonatal nurse practitioner works with infants, typically in a NICU. A women’s health nurse practitioner, on the other hand, provides direct patient care, diagnostics and treatment to women of all ages.

As a whole, NPs serve as mentors, counselors, researchers, educators and consultants in the following areas:

  • Assessment of patients through medical histories, physical evaluations and any necessary tests.
  • Diagnostics, with a focus on unique risk factors and needs of individual patients and their families.
  • Development of individualized treatment plans and follow-up on courses of treatment.
  • Patient and family education on health issues.

Where Do Nurse Practitioners Work?

Depending on their specialty area of care, skilled nurse practitioners can provide services to adults, children and families in a variety of medical settings in all 50 states and the District of Columbia. These may include:

  • Community clinics: serving individuals from the community who may have fewer resources or be uninsured.
  • Hospitals: staffing emergency rooms, maternity wards, critical care units or another area depending on their specialization.
  • Private practices: delivering family, pediatric and women’s health care and providing personal attention to patients who a doctor may not have the time to attend to. 
  • Long-term care facilities: delivering geriatric, hospice and palliative care services.
  • Health departments: working alongside government leaders in handling public health concerns.
  • Schools: providing care onsite, as well as visiting classrooms and helping students understand various health care topics. 
  • Home health care agencies: caring for an in-home patient who requires intensive or specialty care.
  • Mental health care facilities: overseeing patients in mental health centers, psychiatric facilities, correctional facilities and schools.

Nurse Practitioner Certifications

Certification is available for a variety of specialties, and each licensing body has its own requirements. In addition to minimum educational requirements, you can generally expect to complete a certain amount of nursing experience and an examination in order to obtain your certification. There are many organizations, boards and centers that certify specific roles as a nurse practitioner, including:

We’ve outlined some of the major nursing certifying bodies and their correlating abbreviations for your reference. Be sure to check with your state boards of nursing to determine which certifications are accepted in your area, as the requirements for becoming licensed vary state by state.

FAQs

We’ve highlighted some key steps to becoming an NP, as well as the different NP specializations available. But you might still have some questions about how NPs differ from the doctors they work so closely with, or how you can prepare for the ANCC nurse practitioner certification exam. Here are some common questions and answers about NP scope of practice and more:

What is an APRN?

APRN, which stands for advanced practice registered nurse, is an umbrella term for nursing professionals who have earned a master’s or doctoral degree in order to take on advanced roles in health care. According to the National Council of State Boards of Nursing, APRNs include the following: clinical nurse specialists (CNS), nurse practitioners (NP), certified nurse midwife (CNM) and nurse anesthetists (CRNA).

Many RNs who are looking to advance their careers earn a master’s or doctoral degree and choose to pursue work as an APRN. In addition to having more autonomy and an increased scope of practice, nurses may see an increase in pay as a result of becoming an APRN.

Can nurse practitioners prescribe? 

Yes. Some nurse practitioners are given prescriptive authority to varying degrees across the United States. Some states allow a larger degree of prescriptive authority to nurse practitioners, while others regulate this prescriptive authority more closely.

View our state-by-state breakdown of NP prescriptive authority and check with your state’s board of nursing for the most up-to-date information.

How do nurse practitioners become certified?

National certification for NPs is available from various professional associations, depending on your chosen area of specialization. National organizations that certify NPs include the Pediatric Nursing Certification Board, the American Association of Nurse Practitioners,and the American Nurses Credentialing Center, which is a subsidiary of the American Nurses Association. Eligibility for certification typically requires at least an RN license, a degree from an accredited institution and a certain number of supervised clinical hours.

How do I prepare for the nurse practitioner exam?

Each certifying body has a set of eligibility requirements for the nurse practitioner certifications that they offer. Exams for the various certifications also differ so it’s important to research what prep tools are available and develop a study plan. 

To prepare for the ANCC nurse practitioner certification exam, review the ANCC General Testing and Renewal Handbook (PDF, 373 KB), which contains a general overview of testing processes and procedures and information on maintaining certification. ANCC provides test content outlines that identify the areas included on the examination. This serves as your roadmap to the exam, including the percentage and number of questions in each of the major categories of the scored portion of the examination. You can print the outline and take notes on each objective to guide your study process.

In addition to the content outline, other detailed information related to specific exams is available, including a test reference list and sample test questions with answers. The ANCC website has more information and resources on nursing certification. Once you review them, you can make a study plan and stick to your schedule while also incorporating breaks to avoid getting overwhelmed. 

Can I become a nurse practitioner without prior nursing experience? 

If you’re interested in pursuing an NP career with no prior nursing experience, you can take advantage of a wide variety of programs designed for aspiring professionals. Direct-entry, accelerated, bridge and online options offer students with different academic backgrounds the chance to take necessary foundational courses in nursing as part of the master’s curriculum to streamline their degree.

Direct-entry nurse practitioner programs allow non-nurses to earn a graduate degree in nursing. These accelerated programs often take around four years, with the general prerequisite nursing courses completed in the first two years of study. Once you pass these courses and become eligible for nursing licensure, you can complete your degree and earn an MSN.

What is the difference between a nurse practitioner and a doctor?

Nurse practitioners and medical doctors are committed to preventing disease and promoting well-being. Both professionals are able to diagnose conditions, treat patients for ailments and write prescriptions. However, states and cities have differing laws and regulations that may require physicians to oversee NPs. Still, some states allow NPs to work without oversight.

The key differences in the two occupations lie in education and credentials.

Education 

  • NP: NPs typically earn a bachelor’s degree in nursing and at least a master’s degree in nursing, with the availability of the Doctor of Nursing Practice (DNP) degree and post-master’s NP certificates.
  • Doctor: According to the Association of American Medical Colleges (AAMC), medical doctors (MDs) and doctors of osteopathic medicine (DOs) must earn a bachelor’s degree (e.g., pre-med, biology, chemistry or another relevant area) and complete medical school as well as a post-graduate residency.

Timeline: 

What is the difference between a nurse practitioner and a physician assistant?

Both nurse practitioners and physician assistants (PAs) are licensed health care providers. While neither is a medical doctor, each takes on the role of assessing patients, making diagnoses and prescribing medication. Both professions offer the opportunity to work in nearly all medical settings, but in many states, the NP is granted permission to work independently of physicians, whereas a PA cannot.

In terms of education, an NP attends a nursing school to attain (and continually maintain) an RN certification, while a PA goes to a medical school or center of medicine. From there, NPs will follow a patient-centered model, focused on wellness, disease prevention and health education, while physician assistants follow a disease-centered model, focused on the biologic and pathologic components of health. 

Certification requirements for NPs and PAs vary based on the national certifying agency’s requirements.

What is the difference between a nurse practitioner and a registered nurse?

Both nurse practitioners and registered nurses work closely with patients to monitor health and manage treatment for acute and chronic illnesses. However, the educational qualifications, work environments and responsibilities can be vastly different.

RNs can enter the profession with a minimum of an associate degree in nursing (ADN), but NPs must have either a master’s or doctoral degree. More than 60% of RNs work in hospitals, while many  NPs work in physicians’ offices.

The biggest difference between the two professions is the level of autonomy given to NPs. In most states, they can see patients on their own or refer them to a doctor or specialist as necessary. They can also diagnose illnesses and prescribe medications, but an RN cannot.

Sometimes, RNs go on to become NPs to further their careers, since salaries and leadership opportunities tend to be better. According to the BLS, registered nurses earned a median pay of $73,300 in 2019, while NPs earned a median annual salary of $109,820. The difference in salary is not just due to an extended role and scope of practice. Other factors, such as the employer, can play a role in how much an NP earns. 

What is the difference between a nurse practitioner master’s degree and a doctorate degree?

There are two main post-baccalaureate degrees for NPs to pursue: the Master of Science in Nursing and the Doctor of Nursing Practice. 

Currently, the MSN remains the minimum educational standard for advanced practice nursing roles. However, some nursing candidates may choose to look beyond this degree in the pursuit of meeting the increasing demands of patients, improving the quality and outcomes of care, and achieving senior-level leadership positions in clinical care and nursing systems.

The American Association of Colleges of Nursing recommends that aspiring NPs pursue the doctorate for just this reason, stating the DNP degree widens the candidate’s understanding of advanced nursing issues and better prepares them for the future of the profession. Overall, those with DNPs move to affect the efficiency and safety of care while contributing insights to wider applications of health policy. Generally, doctoral-trained nurses generally earn higher salaries and may enjoy more opportunities for advancement.

Information on this page was last retrieved in July 2020.