Nurse practitioners are clinical experts in disease prevention, health promotion, diagnoses, and the treatment of health conditions, who very often serve as primary care providers. In fact, the American Association of Nurse Practitioners (AANP) reports that each year Americans make more than 916 million visits to the more than 205,000 nurse practitioners licensed throughout the United States.
Nurse practitioners focus their practice on the health and well-being of the whole person, with a special focus on health education and counseling designed to help patients make healthier lifestyle choices.
Nurse practitioners are licensed as advanced practice RNs in all states and other jurisdictions, and credentialed through national certifying bodies that ensure the integrity and uniformity of skills specific to various patient types and areas of specialty.
The nationally recognized nurse practitioner patient population focus areas are:
- Acute care
- Adult health
- Family health
- Neonatal health
- Gerontological health
- Oncology
- Pediatric health
- Women’s health
In addition to being certified in a specific population area, nurse practitioners often further specialize in one or more areas of medicine, such as:
- Cardiovascular
- Dermatology
- Allergy/immunology
- Neurology
- Hematology
- Oncology
- Emergency
- Occupational health
- Gastroenterology
- Pulmonary/respiratory
- Endocrinology
- Urology
- Orthopedics
- Sports medicine
Job Duties, Work Settings, and Responsibilities of Nurse Practitioners
Nurse practitioners provide care in any number of settings, such as private practice, clinics, hospitals, schools, public health departments, and nursing homes, among many others.
Nurse practitioners are crucial to today’s health care system for a number of reasons:
- Nurse practitioners adhere to a strict set of professional standards and therefore serve not only as healthcare providers, but also as mentors, educators, administrators, and researchers. Their participation in the development of health policy at the local, state, national, and international levels makes them very influential within the global healthcare community.
- Through high-quality healthcare and patient counseling, nurse practitioners are able to lower healthcare costs for patients through shorter hospital stays and fewer emergency room visits.
- Nurse practitioners serve as a practical solution to the primary care shortage facing America.
Nurse practitioners work both autonomously and in collaboration with other healthcare professionals. They provide a full range of acute, primary, and specialty health care services, including:
- Diagnosing and treating acute and chronic conditions
- Managing the overall care of patients
- Prescribing medications and other treatments (Nurse practitioners hold prescriptive privileges in all 50 states and the District of Columbia and can prescribe controlled substances in all states but Florida and Alabama.)
- Ordering and interpreting diagnostic tests, such as x-rays and lab work
- Counseling patients and educating them on both disease prevention and positive lifestyle choices
How to Become a Nurse Practitioner: Education, Certification, and Licensure
In all states and jurisdictions, becoming a nurse practitioner follows a similar process that involves graduate-level education (MSN or DNP), national certification and, finally, state licensure:
Graduate Education
All nurse practitioners must possess advanced clinical education and training, which is accomplished through a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) program.
The didactic and clinical courses of an MSN program arm nurses with the specialized knowledge and clinical competency necessary to serve as nurse practitioners in acute care, primary care, and long-term care settings.
Because a graduate degree is most often pursued after first completing a pre-licensure program (nursing diploma, Associate Degree in Nursing (ADN), or Bachelor of Science in Nursing (BSN) program), traditional BSN and MSN programs (or direct entry MSN programs) are often overlooked in favor of schools that offer RN to MSN programs. Specialized RN-MSN programs for nurse practitioners are specific to patient population focus and are designed specifically for licensed RNs looking to complete both their BSN and MSN coursework through a streamlined and often accelerated process.
RN to MSN programs take into account an RN’s pre-licensure education and training, thereby allowing most RNs to transfer about 30 credits toward undergraduate education requirements. Most of today’s RN to MSN programs offer dedicated online study designed to accommodate the busy lifestyle of practicing nurses.
National Certification and State Licensure
In all licensing jurisdictions, nurse practitioners must undergo national certification, a rigorous process that is only open to nurses that have earned an MSN at minimum.
There are a number of national certifying bodies that offer population-focus and specialty area certifications for nurse practitioners. The type of certification a nurse practitioner may pursue depends not only on the population focus of the nurse’s MSN program, but upon the certification types (and certifying bodies) recognized by the board of nursing for the state in which they intend to be licensed:
- American Academy of Nurse Practitioners
- Adult nurse practitioner
- Adult gerontology nurse practitioner
- Family nurse practitioner
- American Academy of Nurse Practitioners
- American Nurses Credentialing Center
- Acute care nurse practitioner
- Adult nurse practitioner
- Adult-gerontology acute care nurse practitioner
- Adult-gerontology primary care nurse practitioner
- Adult psychiatric-mental healthcare nurse practitioner
- Family primary care nurse practitioner
- Gerontological nurse practitioner
- Pediatric primary care nurse practitioner
- Psychiatric mental health nurse practitioner
- American Nurses Credentialing Center
- Pediatric Nursing Certification Board
- Pediatric primary care nurse practitioner
- Pediatric acute care nurse practitioner
- Pediatric Nursing Certification Board
- National Certification Corporation for the Obstetric, Gynecologic, and Neonatal Nursing Specialty
- Women’s healthcare nurse practitioner
- Neonatal nurse practitioner
- National Certification Corporation for the Obstetric, Gynecologic, and Neonatal Nursing Specialty
- AACN Certification Corporation
- Adult-gerontology acute care nurse practitioner
National certification must be achieved before applying for state certification/licensure as an Advanced Practice Registered Nurse (APRN)–Nurse Practitioner. National certification and state recognition as a nurse practitioner requires evidence of training and continuing education to ensure continued competency.
Nurse Practitioner Salaries
According to the May 2011 AANP National Nurse Practitioner Compensation Survey, the majority of nurse practitioners worked as either family nurse practitioners (38 percent) or adult nurse practitioners (30 percent).
The most prevalent work settings for nurse practitioners were private physician’s offices (26 percent), hospital outpatient clinics (14 percent), and hospital in-patient clinics (11 percent).
Seventy percent of all nurse practitioners surveyed worked in communities that had a population of more than 50,000, and more than 80 percent saw between 2 to 4 patients per hour.
The average salary for nurse practitioners, as of 2011, was $94,050, with a mean, hourly salary of $46.12. The average base salary for full-time nurse practitioners was $91,310, and the mean, total salary was $98,760, an increase from $92,110 in 2008.
The 2011 AANP survey found that salaries (total income) for nurse practitioners varied according to practice setting and clinical specialty:
Clinical Specialty
- Acute care: $105,200
- Adult: $ 96,160
- Family: $96,910
- Care gerontology: $97,990
- Neonatal: $124,540
- Pediatrics: $92,250
- Psychiatric/mental health: $111,220
- Women’s health: $91,730
Practice Setting
- Private practice: $111,750
- Private physician: $95,680
- Community health center: $92,110
- Rural health clinic: $92,560
- Hospital outpatient clinic: $98,720
- Occupational employee health: $99,030
- Emergency room/urgent care: $115,070
- In-patient hospital unit: $103,650
- Veteran’s administration facility: $111,110
Resources for Nurse Practitioners
- American Association for Nurse Practitioners
- National Association of Nurse Practitioners in Women’s Health
- National Association of Pediatric Nurse Practitioners
- Gerontological Advanced Practice Nurses Association
- National Academy of Dermatology Nurse Practitioners
- National Association of Neonatal Nurse Practitioners