Nurse practitioners get advanced training in nursing so they can take their careers a step farther. By getting graduate-level education, they can operate independently or under the supervision of a physician. Many are hired by hospitals or doctor’s offices to provide support and services to an individual physician or team of doctors. A nurse practitioner begins as a registered nurse (RN) and then moves on to get a master’s and sometimes a doctoral degree. Prospective NPs need to consider what type of specialty most interests them and in what type of organization or setting they want to work. Use this guide to learn more about nurse practitioner careers, degrees, salaries and industry trends.
Nurse practitioners (NPs) are a type of Advanced Practice Registered Nurse (APRN) whose specialized education and clinical training allow them to provide higher levels of care and perform a variety of tasks that RNs are not licensed to do. Nurse practitioners often focus on specific areas or populations, including pediatrics, geriatrics, mental health or adult medicine. They may complete an advanced degree program that allows them to practice independently and take on roles similar to that of a doctor.
The rules governing nurse practitioners vary from state to state, but typically include such tasks as performing physical assessments, diagnosing illnesses, ordering and analyzing diagnostic tests and procedures, and managing patient treatment. Nurse practitioners can also prescribe medications within limits. However, the prescribing of controlled substances may be tightly regulated or prohibited in some states.
Depending on the jurisdiction, nurse practitioners may or may not be required to work under the supervision of a physician. As the United States faces a growing shortage of physicians specializing in primary care and internal medicine, more states are passing legislation that allows nurse practitioners to practice independently without physician supervision.
The Bureau of Labor Statistics (BLS) reports that the mean annual wage for nurse practitioners was $97,990 in May 2014, with those who work in hospitals earning the most. APRNs enjoy additional benefits such as flexible work schedules, educational opportunities and even child care services.
States with the highest yearly mean wages for nurse practitioners are as follows:
Use the map below to compare nurse practitioner salary estimates by state.
The first step to a career as a nurse practitioner is earning your credentials as a registered nurse (RN). There are a number of academic paths to reach this particular goal -- specifically, an associate or bachelor's degree from an accredited institution of higher education, or a diploma from an approved vocational training program. (Prospective nurses should note that these diploma programs have become less popular due to the fact that many employers in the healthcare sector now require clinician employees to have a college degree).
Some educational trajectories combine the steps of becoming an RN and earning a bachelor's degree, and some programs offer accelerated tracks for those with previous non-nursing bachelor’s degrees. Students may choose to first become a licensed practical nurse (LPN) on the road to becoming an RN. For both the LPN and the RN credentials, graduates of nursing programs must pass a standardized national examination and also obtain a state license.
Another key milestone for aspiring NPs is earning a bachelor's degree, the usual prerequisite for graduate studies. The undergraduate major is most often nursing, but a limited number of future NPs might begin by majoring in a related field.
Bachelor's degree programs in nursing usually include a substantial clinical component, as well as courses designed to teach skills related to communication, supervision, management, research, community health and quantitative skills.
Entering a Bachelor of Science in Nursing (BSN) program promptly after high school is the most direct route to an immediate post-secondary career in nursing. However, many nurses turn to bachelor's degree studies after first gaining work experience in the field following the achievement of an LPN diploma or associate degree in nursing.
Nurses with an RN credential can opt for an RN-to-BSN “bridge” program, which could take more or less time depending on whether or not students continue working while advancing toward their degree. LPNs can also research various LPN-to-BSN programs.
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There are varying opinions regarding the many potential paths in nursing education, especially the path to advanced practice. Some feel that going straight through nursing school to the master’s level is the most efficient option. Others believe that an extremely accelerated path leaves graduates less rigorously prepared on the clinical level than those who have worked on the front lines of health care as registered nurses prior to seeking certification as an NP or APRN.
Individuals learn a variety of skills on the job, including how to take address a variety of patient problems, how to work effectively and efficiently in different medical and health environments, and how to work with a team of medical professionals and physicians in a clinical setting.
To become a nurse practitioner, candidates must earn a graduate degree. Many graduate schools require students to gain a few years of nursing experience before being accepted into their nurse practitioner programs. Others allow students to gain RN work experience while pursuing their graduate degrees. In either case, real-world RN experience is an essential element to a future as a nurse practitioner and provides an important opportunity to explore potential specialties.
Some nursing graduate schools accept RNs with an associate degree or diploma. Alternatively, a graduate program may be open to individuals who hold a bachelor's degree in a field related to health or science, whereas some may require a Bachelor of Science in Nursing as a prerequisite.
A Master of Science in Nursing (MSN) is the minimum degree requirement for becoming a nurse practitioner. It is also currently the most common degree program in the field, although some experts note a growing movement toward requiring all nurse practitioners to earn a Doctor of Nursing Practice (DNP) degree.
Another possibility is to earn a master's degree in nursing and then a PhD in a related field, particularly for those with career goals related to healthcare administration, nursing education or research. Graduate programs provide in-depth study of medical ethics, diagnosis, and anatomy among other subjects.
Regardless of graduate degree level, the curriculum for a nurse practitioner follows the general course of study for an advanced practice registered nurse (APRN), with specialized NP education and training. Students focus on a specialty such as family and primary care, women’s health, geriatrics or psychiatry.
Graduate nursing studies include both classroom education and clinical training. Coursework covers a broad range of subjects including anatomy, physiology and pharmacology, as well as field-specific classes that explore pediatrics, family or primary care, gerontology, health systems management and more. Students pursuing a master's (MSN) degree can plan for approximately 18 to 24 months of full-time study, while DNP programs typically require a two- to three-year full-time education commitment.
All states mandate that nurse practitioners be licensed. Each state has its own specific licensing requirements, and it is essential that individuals understand those requirements before beginning their education and training. States typically publish a list of approved graduate-level programs that qualify toward nurse practitioner licensing in that particular jurisdiction. Nurse practitioner licensure candidates must hold a master's degree in nursing and a valid state RN license, and also pass a national certification examination.
National certification for nurse practitioners is available from various professional associations, depending on a candidate's chosen area of specialization. National organizations that certify NPs include the Pediatric Nursing Certification Board, the American Academy 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.
Some professional organizations recommend that Advanced Practice Registered Nurses obtain additional credentials relating to a specific area of specialization or a certain patient population. Opportunities for advancement increase with education, certification and work experience in one or more specialties. Even without this additional specialization, nursing professionals are lifelong learners, since maintaining certification requires a certain amount of continuing education credits throughout one’s career.
Examples of specialization as an APRN include Acute Care Pediatric Nurse Practitioner (ACNP), Adult-Gerontology Acute Care Nurse Practitioner (AG ACNP), Family Nurse Practitioner (FNP) and Pediatric Nurse Practitioner (PNP).
To become a nurse practitioner, students must first get their basic nursing education by obtaining an associate in science degree to become a registered nurse (RN) or by completing a four-year bachelor’s degree in nursing (BSN). Once they have completed their undergraduate education, students can enroll in a graduate program to obtain a master’s degree in nursing (MSN), which is required to become a licensed nurse practitioner.
Admission into a master’s degree program typically requires clinical experience, letters of reference, and a declaration of a specialty. Coursework in specialty areas can vary but typically include lab work and a comprehensive exam. Upon completion of a master’s degree, students must pass the national certification exam and obtain a license to practice.
Those interested in becoming a nurse practitioner have a few different options at the undergraduate level. Student can choose to earn an associate degree first, eventually moving on to a bachelor’s or start with a four-year program. A bachelor’s degree in nursing prepares students for a job as a registered nurse (RN) and also provides the educational foundation for a master’s degree in the field. This program typically combines classroom-based learning with a clinical component. Students take a variety of introductory courses on topics such as emergency care, health assessments, nutrition, public and global health, and current trends in nursing.
Students with an associate degree and who have already earned RN certification may be able to complete an RN to BSN program in two years. Others would obtain their bachelor’s degree in four years. Students may also opt to take an accelerated BSN to MSN bridge program at an accredited school.
After completing a BSN program, students have the skills and experience to develop complete nursing treatment plans, treat patients for various illnesses and medical conditions, perform routine lab work, administer medications and injections, and educate patients about how to improve their health habits. They are trained to work in a variety of medical and clinical settings, including physician’s offices, public medical and surgical hospitals, and at nursing care facilities.
Below are examples of common courses aspiring NPs may encounter during their undergraduate studies:
An introduction to the role of a nurse focusing on health patterns, cultural diversity, and the role of a nurse in society today. An in-depth study of the nursing process and basic requirements of clinical judgment.
An introduction to basic research methods and empirical inquiry in the field of nursing. Students acquire an advanced understanding of nursing research and its applications in evidence-based practice.
Foundational course that introduces students to the illness component of health care. Emphasizes environmental factors linked to the development of certain illnesses and how various pathological changes can manifest in a patient or population.
Identifying pharmacodynamics of the major classification of drugs and how certain medications are administered based on pathophysiologic conditions. Topics include drug safety, ethical and legal responsibilities of nurses and care providers, drug development and evaluation, and pharmacology research related to nursing practice.
Comprehensive course covering the basics of first aid in an emergency setting, as well as advanced topics in disaster planning, incident command, triage and oxygen therapy.
A master of science in nursing is the minimum educational requirement to become a licensed nurse practitioner. Many programs combine professional core courses that dig deeper into subjects learned at the undergraduate level with clinical courses that focus on a particular specialty. These include patient-focused roles that cater to a specific population as well as educator roles designed to serve other nurses and industry professionals. MSN degree programs can also prepare an individual for a career as a clinical nurse leader, nurse administrator or nurse educator, and can lay the groundwork for those who wish to pursue a doctor of nursing practice (DNP) degree. In most cases, the Master of Science program can be completed in two years.
At this level, students develop advanced problem solving and leadership skills necessary for more senior nursing positions, as well as the interpersonal communication skills with both patients and peers that will serve them in these roles. They also add to their clinical abilities by learning how to perform advanced scientific research that can contribute to the field’s knowledge base. Master’s programs prepare students to work and practice in a variety of medical and clinical settings, including hospitals, emergency rooms, community clinics, health maintenance organizations, urgent care settings, and correctional facilities.
Listed below are some common courses that nursing grad students may encounter in their MSN program:
Prepares students for leadership roles in health care by applying evidence-based research to practice within an organization. Topics may include research critique, research translation, risk adjustment, and research ethics.
Provides a framework of nursing and ethics as it applies to nursing practice. Students complete professional exercises to enhance their understanding of ethical issues affecting nurses and effective ways to respond to them.
Develops statistical literacy and statistical reasoning skills for direct application of recent research and findings. Students learn how to understand and apply discoveries published in research articles and journals.
In-depth study of clinical uses of different drug groups and how they affect bodily functions and responses, including side effects and drug interactions of commonly-administered drugs.
Focuses on current theories and research related to the promotion of health and disease prevention basics for individuals and communities. Students learn the role of a nurse practitioner in such areas, with an emphasis on counseling, screening, and education. May include a practicum component.
Students pursuing an MSN degree to become a nurse practitioner will need to choose a concentration or specialty. These include family nursing, neonatal nursing, nurse management, and other specialized fields.
This part of the educational track requires students to complete advanced courses, participate in workshops, and perform clinical work in the chosen field.
Students can choose what populations they prefer to work with--such as children or older adults--and in what setting, such as hospitals or retail environments. Some of the most popular nurse practitioner specialties include:
Individuals who want to work with older patients may pursue this specialty, which focuses on adult lifespan management and evaluation, as well as acute care of adult and older patients. Students may need to complete up to 700 clinical hours in conjunction with a series of courses focused on pharmacology, health assessments, public policy in health care, and physiology.
Individuals interested in primarily serving families, younger children, and women can choose this concentration of study. Coursework may include theoretical frameworks and application of nursing care principles specifically for families and pediatric primary care, and a lab component. Students may need to complete up to 700 clinical hours in conjunction with courses covering key topics such as primary care for adolescents and adults, pediatric primary care, and advanced physiology, to name a few.
Those who wish to work primarily with children--from infancy through adolescence--can choose this concentration of study. Courses may include pediatric primary care, child development, and psychopharmacology. Students may need to complete up to 620 clinical hours in pediatric primary care, and will take core courses in advanced physiology, pharmacology, and pediatric care.
Neonatal patients need very specialized care. Students pursuing this concentration need to complete extensive clinical work and specialty courses in advanced pediatric health, pharmacology, and nursing care for high-risk newborns. Students typically complete up to 1000 clinical hours. This is among the top-paying nurse practitioner specialties in the United States.
Students interested in serving as a mental health nurse practitioner can complete advanced coursework in areas of mental health disorders and psychiatric nursing practice, as well as a practicum, gaining crucial experience as a family psychiatric mental health practitioner. Clinical hours and specific requirements vary by school.
The DNP degree program is a practice doctorate, which means graduates focus on using research and findings to influence their practice. The American Association of Colleges of Nursing (AACN) has proposed that this degree be the requirement for all advanced practice nurses by 2015.
At this level, students measure outcomes of various clinical initiatives on patient groups and populations, and learn critical skills to focus their research and reporting efforts on ways to improve healthcare systems and care delivery. Completing a doctoral program prepares students to serve as leaders in the healthcare setting by providing scientific, research-based knowledge to healthcare providers, researchers, and community leaders.
Understanding the distinction between a DNP degree program and a Ph.D. in nursing is important. While a DNP focuses on practical application of nursing practice theories and research, a PhD in Nursing prepares students for scholarly research to advance the field.
|DNP||PhD in Nursing|
|Objective||Highest level of nursing practice. Prepares NPs to lead and apply existing research to real world settings and issues.||Highest level of nursing science. Prepares students to conduct research to advance the field of nursing as well as global healthcare.|
|Curriculum Focus||Knowledge to apply and translate research into practice. Focuses on integrating existing and new research theories into healthcare organizations.||Theoretical, methodological, and analytical approaches to nursing knowledge. Focuses on how to conduct intensive and academic research to further the field.|
|Final Project Requirement||Practice-oriented capstone project||Completion and defense of a dissertation|
DNP degree programs are designed for nursing executives. It provides a strong focus on developing leadership skills for clinical practice. Students learn how to influence and manage teams to reach a common goal, how to motivate groups, and how to share and communicate research data effectively.
Some courses in a DNP program demand the application of advanced research methods. Students learn how to interpret and evaluate data, and employ various research tools and techniques to produce cohesive reports and papers to influence decision-makers.
Graduates learn how to apply research findings to practice. Such skills are vital for influencing leaders and organizations in the healthcare field and may also be in demand for public policy and policy-making initiatives.
DNP graduates often work as part of a team of medical professionals that includes researchers, advocates, and other specialists. They learn effective collaboration skills, understanding the role and responsibility of each team member, and how to take advantage of modern technologies and applications that make communication and collaboration easier.
Students gain advanced skills in systems-level thinking. They learn essential healthcare policy leadership skills, how to use information technology to their advantage, and how to implement various clinical programs based on research and recent findings.
Students who need some flexibility in their schedules because of work obligations or family responsibilities may consider an online NP program. Students need to verify that the program is offered by an accredited school, and should ensure they have the technological resources to complete the coursework remotely. Since nursing programs typically require a clinical component, students may need to attend campus-based classes or labs for a portion of their studies.
Those who have already completed a certification program as an RN, or have taken nursing and science courses that are transferrable to a four-year degree program, may be able to complete an online degree in two to four years. Transfer requirements vary by school.
Some important things to look for with online NP programs include:
A quality education starts with experienced faculty members. Take some time to learn about the instructors teaching various classes. Former or current nurses, nurse educators, and healthcare managers may provide valuable insights about the job and industry. Many online schools post detailed bios of faculty members to give students a chance to see what type of educational background and professional experience teachers bring to the class.
Online curricula typically require students to participate in online forums or discussion groups, attend webinars and e-mail faculty members regularly. Students may need to participate in discussion groups about nursing trends, healthcare policies, and subjects related to nutrition and health. Students should find out the level and frequency of communication that is expected so they can manage their time accordingly. Reviewing a sample curriculum, with details about discussion forum activity and general communication requirements, can make it easier for students to choose a program that works with their schedule and availability.
Online NP degree programs will have a clinical component in which students may need to perform lab work or participate in hands-on training on campus. Students may want to familiarize themselves with the physical facilities they will be using, as well as find out what settings may be used for clinical experiences in case the student does not live near a campus location. They should also check with the school to find out what types of certifications and licenses they need to have in order to complete clinical training.
Nurse practitioners (NPs) must have strong active learning and active listening skills to communicate effectively with doctors, medical professionals and patients. They learn critical thinking and decision making skills during their training that they can use to make sound decisions when working with patients. Nurse practitioners also have a strong command of the English language, and develop social perceptiveness skills and reading comprehension skills to perform at their job. Basic job skills include computer skills and experience working with various types of medical tools and technologies.
NPs are also trained to use computers and medical software programs, such as GE Healthcare Centricity EMR, eClinicalWorks software, and PCC Pediatric Partner. Most practices and medical centers also require nurses to be proficient with Microsoft Office Suite programs and Microsoft Outlook for email communications.
The U.S. Bureau of Labor Statistics reports that the job outlook for nurse practitioners and related occupations is expected to grow 31 percent from 2012 to 2022. Nurse practitioners may find more employment opportunities in areas of healthcare legislation, preventive care and healthcare services targeting the baby boomer population.
Some of the most in-demand career paths and specialties for nurse practitioners and related healthcare professionals in 2015 and beyond include:
In addition to serving as a nurse practitioner, individuals with this training can explore a number of related healthcare career paths and specialties that suit their particular areas of interest and expertise.
Nurse practitioners and people in related occupations can earn close to $100,000 annually, depending on the place of employment and specialty. According to the BLS, annual wages for nurse practitioners and related careers are as follows:
Students who want to move forward with a career as a nurse practitioner need to choose a school that provides foundational courses to obtain a master’s degree--the minimum educational requirement. The school offering the program must be accredited by reputable organizations such as the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN), formerly known as the National League for Nursing Accrediting Commission (NLNAC). Nurse practitioner master’s degree program requirements vary by school, so students need to determine what types of certifications, undergraduate degrees, and examinations are required for admission.
This search tool can help students find the best nurse practitioner program for all degree levels: