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What is a Nurse Practitioner?

A nurse practitioner is a medical provider who has completed advanced training. The position lies between that of a registered nurse and a doctor as they are allowed to write prescriptions, diagnose conditions, order tests, and treat ailments. In 16 states a nurse practitioner may work independently; in the other 34 states they must work under the supervision of a doctor. Many are employed in clinics and the offices of physicians as well as nursing homes and assisted living facilities.

A nurse practitioner is licensed and titled under one of five special areas of practice, such as general medicine or psychiatric and holds an advanced degree that reflects their expertise. Many nurse practitioners enter the healthcare field as registered nurses and continue their education to earn the higher degree required to become a nurse practitioner.

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Steps to Becoming a Nurse Practitioner (NP)

  • Step 1: Become an RN

  • Step 2: Choose our area of specialization

  • Step 3: Earn your Master's degree

  • Step 4: Gain experience

  • Step 5: Apply for your national certification

  • Step 6: Apply for your state certification

Although there are alternative career paths to becoming a nurse practitioner the majority who choose this career are already established in the medical community as a registered nurse (RN). All nurse practitioners must be certified by the state in which the work so it's important to check the requirements set forth by your state's licensing board before you begin your education. That way you can be assured the degree you earn will be accepted when you apply for your credential. Here are the steps to pursuing a nurse practitioner career.

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Step 1: Become an RN

Complete an accredited nursing program and earn your RN designation. Keep in mind you'll need a graduate degree in order to become a nurse practitioner and verify your credits will be accepted for your higher degree program. Your RN program will give you valuable experience in the field of nursing and help you decide what area you'd like to practice in when you become a nurse practitioner.

Step 2: Choose Your Area of Specialization

A nurse practitioner is trained in a specific area of medicine and this will determine your choice of graduate school curriculum. For example, if you plan to work with the elderly population you might choose to become an Adult-Gerontology Primary Care Nurse Practitioner and you will need the appropriate coursework to qualify for this field.

Step 3: Earn Your Master's Degree

A Master's degree is the minimum education for a nurse practitioner so you should enroll in a Master of Science in Nursing program. Before you enroll you should verify the accreditation of your school of choice is accepted by the national certification board that oversees your state and that the school offers a degree in the specialization you've chosen to work in. Keep in mind a nurse practitioner is required to have experience in their field in order to qualify for certification; verify your internship will qualify as experience hours towards this goal.

Step 4: Gain Experience

The national boards and most states require a minimum number of supervised direct patient care clinical hours before you are eligible to apply for certification. The standard is 500 hours but may be more depending on your specialization; you should have a clear understanding of the requirements during your last year of school.

Step 5: Apply for Your National Certification

To become nationally certified you will need to submit documentation such as transcripts to verify your education and forms to verify your supervised experience. Once your documents have been accepted you may sit for the national certification exam; upon passing you will be allowed to use the title of Nurse Practitioner followed by your area of specialization.

Step 6: Apply for Your State Certification

In order to work as a nurse practitioner you must be certified by the state as well. Each state determines certification independently so you should contact your state board of licensing to find the requirements you need to submit in order to legally work as a nurse practitioner in your state.

What Does a Nurse Practitioner Do?

A general nurse practitioner typically works in a clinic, physician's office, or hospital on a regularly scheduled shift. Much as a doctor does, the nurse practitioner sees patients, diagnoses ailments, orders tests, and prescribes medication depending on the needs of the patient.

Those who hold a specialization title will work in that field; for example, a psychiatric nurse practitioner will be employed in a corresponding office or facility and treat patients with psychological issues and a gerontological nurse practitioner typically works in a nursing home or assisted living facility and provides medical services to the elderly.

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Some nurse practitioners prefer to work on preventive care and might be employed by a community health facility or school; those who become certified nurse anesthetists will work with a surgical team. As with all nursing fields a nurse practitioner spends much of their day standing and engaged with patients.

What is the difference between a Nurse Practitioner and a Registered Nurse?

The main differences between these two careers are the amount of education and scope of work. An RN must be a graduate of a school of nursing and may only have an Associate's degree (some states require a Bachelor degree). A nurse's primary role is to provide care to patients in a hospital setting; in a physician's office it is their responsibility to prepare the patient for their visit by taking basic information as well as simple checks such as blood pressure and weight of the patient.

A nurse practitioner must already be an RN, complete at least a Master's degree, and hold national certification as well as state certification in their area of expertise. They examine patients the same way doctors do and hold most of the same duties, such as prescribing medicine and ordering tests in order to make a diagnosis of an ailment. In some states they may open their own practice and work independently; in other states they must be under the general supervision of a licensed physician.

Nurse Practitioner Skills to Acquire

Along with your medical training there are many skills a nurse practitioner must have or develop in order to perform their job. Here are some of the most common skills you should acquire before you enter the field:

  • Reading comprehension: must be able to research and comprehend diverse topics related to patient care
  • Social perceptiveness: reading body language and other reactions of patients
  • Active listening: the ability to listen and understand what people are trying to relay and asking pertinent questions to glean more information
  • Speaking: able to clearly convey ideas and directions so others understand
  • Active learning: absorbing new ideas and advances within the field of medicine
  • Critical thinking: being able to reach a conclusion by looking at all sides of an issue
  • Ethical decision making: required to make a confident diagnosis on each patient
  • Effective communication: ability to communicate verbally and in writing, in person and via phone or computer
  • Attention to details: in the patient-nurse practitioner relationship
  • Ability to work: with a wide range of personalities and ethnic populations
  • Working independently: must be able to perform duties without direct supervision of a doctor
  • Highly organized: must be able to utilize time to maximize each day
  • Leadership skills: will be supervisor to nurses and others within an office, clinic, or hospital

Alternative Paths

Because a nurse practitioner is required to hold an RN license there are limited alternative paths to this career. If you are sure this is the field in which you wish to make your career you might enroll in a Master of Science in Nursing (MSN) degree before becoming an RN and streamline your education. The downside of this path is the lack of experience working as an actual nurse and exposure to the various specialties.

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You also might choose to earn a Bachelor of Science in Nursing (BSN) degree that is transferable to a Master's program. This will allow you to earn your RN designation and gain experience while minimizing the educational requirements to complete your graduate degree.

Nurse Practitioner Career & Salary

Where Might You Work?


Almost half of all nurse practitioners are employed by private physician practices and community health clinics. The next highest employer is general medical and surgical hospitals, followed by outpatient care centers, offices of other health practitioners, colleges and universities, and nursing homes.

Depending on the state in which you practice a nurse practitioner might own their own medical practice, visit patients in their homes, or be in charge of the medical clinic of an assisted living facility or retirement community.

Because of the high demand for medical care, you can expect to find employment opportunities in virtually any facility that provides medical treatment or consultation. Keep in mind that the baby boomer generation is reaching retirement age and will require more medical attention in the upcoming decades; they may also be relocating to retirement communities and assisted living campuses and employment in those areas will rise exponentially to meet this need.

Potential Career Paths

Although your education and certification will qualify you as a general nurse practitioner there are a total of five career paths you can take. These are called areas of specialization and each has its own educational, experience, and certification requirements. Here's a brief look at each of the nurse practitioner titles and what type of practice they are typically employed in:

General Nurse Practitioner
the basic title, a general nurse practitioner may work independently or within a healthcare team such as a physician's office or group.

Family Nurse Practitioner
much the same as a general nurse practitioner, a family nurse practitioner is qualified to work with all age groups and are typically employed by physician offices, clinics, and hospitals.

Gerontological Nurse Practitioner
the certified gerontological nurse practitioner has advanced training in the specific needs of the elderly population. This specialization is in high demand at nursing homes, assisted living facilities, and similar facilities that are focused on the senior population.

Psychiatric Nurse Practitioner
a psychiatric nurse practitioner, also called a mental health nurse practitioner, works within the mental health field and performs many of the same duties as a psychiatrist.

Certified Registered Nurse Anesthetist
certified registered nurse anesthetists administer anesthesia to patients undergoing surgery. This is a highly specialized area of the field and requires additional certification from the American Association of Nurse Anesthetists (AANA).

Nursing Salaries

Occupation Entry-Level Mid-Career Late-Career
Certified Nurses Assistant $19,000 $29,000 $45,000
Licensed Practical Nurse $31,000 $45,000 $61,000
Licensed Vocational Nurse $35,000 $50,000 $67,000
Registered Nurse $45,000 $66,000 $92,000
Nurse Anesthetist $143,000 $160,000 $179,000
Family Practice Nurse $91,000 $102,000 $107,000
Mental Health Nurse $49,000 $67,000 $92,000
General Nurse Practitioner $79,000 $98,000 $122,000
Midwife $91,000 $101,000 $110,000
Nursing Educator $71,000 $74,000 $85,000
Nurse Administrator $73,000 $82,000 $96,000

**Salary info provided by PayScale

Career Outlook

The job outlook for those pursuing a career as a nurse practitioner is excellent and one of the fastest growing fields in the country. Nurse practitioner job growth is projected at 36% over the next decade, much faster than the growth of all occupations. In comparison, the national growth for all occupations is 9%; the need for registered nurses is projected to grow 15%.

The field itself is competitive due to the extensive education required. That being said, because the demand is so high there are many scholarships and grants available for those who decide to become a nurse practitioner.

As follows the basic rule of supply and demand nurse practitioners can expect their income to increase as they gain experience in the field. On average you can expect your salary to rise five to seven thousand dollars for every five years experience you gain; this amount will most likely change with future modifications of the healthcare system.

In 2017 the median salary for all nurse practitioners was $103,880. The lowest ten percent, typically reflecting those just entering the field, earned $74, 840. The highest ten percent, reflecting those with the most experience, earned a median salary of $146,630 per year.

Keep in mind location is a factor in the salary of a nurse practitioner; for example, one residing in California has an average salary 17% higher than the national median and one working in Chicago earns 5% less. It's a good idea to look at state cost of living expenses before relocating to another state because of an offer of a desirable salary.

Advancing From Here

Although becoming a nurse practitioner is an excellent career choice, you might choose to earn a terminal degree and advance your career further. A Doctor of Nursing Practice will allow you to develop nursing informatics systems, oversee large nursing staffs, teach at nursing schools, and help draft nursing policies. You might also choose to expand your education in your area of specialization by earning further certification. Here are some examples of advanced occupations and certifications you might choose to earn:

  • Women's Health Nurse Practitioner
  • Hospitalist Nurse Practitioner
  • Urgent Care Nurse Practitioner
  • Pediatrics Nurse Practitioner
  • Acute Care Nurse Practitioner
  • Internal Medicine Advanced Registered Nurse Practitioner

Because the field of nurse practitioners is evolving and highly sought after, you can take your career as far as you're willing to advance. The highest levels of nursing professionals are the Chief Nursing Officer, who is in charge of the entire nursing operations of a major hospital or the Chief Nursing Executive, who is involved in the analysis, development, and integration of health policies on the state or national level.

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Frequently Asked Questions

Can nurse practitioners prescribe medicine?

Some states require pharmacology credit hours and some states require new nurse practitioners work with a trained physician in order to prescribe medicine. In some states nurse practitioners are trained to prescribe medication without supervision.

What do nurse practitioners wear?

Nurse practitioners do not have to follow a dress code. Some nurse practitioners wear scrubs but most are not required to. They can wear business casual and a white lab coat.

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

Registered nurses generally hold associate or bachelor's degree in nursing. Nurse practitioners generally have a master's or a doctoral degree in nursing. Nurse practitioners have more autonomy and responsibility.

What is the quickest way to become a nurse practitioner?

The quickest way to become a nurse practitioner is to earn a two year Associate of Science in Nursing then obtain a registered nurse license. Then you will need to work 1-2 years in the field before joining a two to three year registered nurse to Master of Science in Nursing bridge program. This process takes around 4-5 years.

What is the job outlook for nurse practitioners?

The outlook for nurse practitioner is great. The Bureau of Labor Statistics predicts that nurse practitioner jobs will grow by 31% by 2030. That is much higher than the average growth rate for all careers.

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