Meet a Family Nurse Practitioner
If you're thinking about becoming a family nurse practitioner, you're not alone. In fact, 69.7% of nurse practitioners are primary care family nurse practitioners (FNPs). Nursing as a career is one of the most trusted professions. The combination of trust and the rising need for primary care practitioners has led to a growing need for family nurse practitioners.
While many FNP responsibilities are centered on providing primary care, some are unique to the facility or position. Keep reading to discover the role of an FNP, how much they make, and how to enter the field.
First, let's hear from a nurse practitioner who practiced in the emergency room (ER) for 11 years before completing her education and passing her boards to practice as an FNP.
Q&A With a Family Nurse Practitioner
Joelle Y. Jean, RN, FNP-BC
Joelle Jean has been a nurse for more than 10 years and family nurse practitioner for over three years. She has a background in pediatric emergency room, labor and delivery, and primary care medicine. Her passion for the nursing profession and writing led her to her current role as a senior writer for NurseJournal.
Q: What led you to pursue a career as a family nurse practitioner, specifically?
That's easy! I wanted autonomy. I wanted to be able to make decisions for my patients without taking orders from anyone. I wanted to be able to make a difference in my patients' lives by teaching about preventative care and following them throughout the course of their care — seeing them improve in their health.
As an FNP, New York State law states you have to work with a collaborating physician for 3,600 hours, or about three years, before you can work independently. I loved the idea of also eventually opening up my own wellness clinic.
Nursing has been the best career choice for me. Like my mother, I became a pediatric ER nurse for 11 years. I also was an assistant nurse manager for a few years, and then went back to school to get my master's. I am currently a family nurse practitioner and a senior writer for nursejournal.org. Nursing has allowed me to pursue my two passions: caring for people and writing.
Q: You have experience in pediatric emergency rooms, labor and delivery, and primary care medicine. What did your journey through these different settings look like?
Pediatric Emergency Rooms
When you tell people you work in the ER, they automatically assume you see traumas everyday, but a lot of the patients come in for minor illnesses like fever, dehydration, or broken bones. I loved being a pediatric ER nurse. I loved being able to make kids feel comfortable and also educating parents on how to care for their child.
In the pediatric ER, I had great coworkers who I now call my friends. I also met my husband in the pediatric ER!
Labor and Delivery
I wanted a change after being in the pediatric ER for nine years, so I decided to go into labor and delivery. I specifically worked in the postanesthesia care unit, caring for moms after they give birth by C-section. Although I was able to witness live births (AMAZING) and care for moms and their newborns, I missed the pediatric ER and my coworkers, so I went back after a year.
Following the last years in the pediatric ER, I pursued my master's in nursing part time and completed in 2017. I became an FNP and went straight into primary care.
Family Nurse Practitioner
My first job was at a doctor's office. I was able to see all types of patients. What I loved most about my role as an FNP was working with patients in the community. These patients loved the doctor I worked with so I was able to see them often. My second job was working at a clinic. I loved this job as well because it was fast-paced, and I was working on my own.
Q: While no day is the same, what is a 'typical' day like for a family nurse practitioner?
My schedule varied, but I mostly worked 3-4 times a week and every other weekend, 10-hour shifts. When I got into work at 9 a.m., I would check my schedule for the day and perform daily tasks like check the refrigerator temperature and count medication in the fridge. We also had to make sure the medications weren't expired.
I typically saw 10-15 patients a day. Their ages ranged from 18 months to 100 years old. The clinic I worked in allowed patients to schedule ahead and I also took walk-ins. I also provided telehealth within the clinic.
Why a patient came into the clinic varied. I cared for patients with stomachaches, sore throats, flu-like symptoms, and urinary tract infections. I also saw patients who needed vaccinations for travel or school [and] school and employee physicals.
Once in awhile, I would get a very sick patient and would have to call an ambulance. This is where working in the ER paid off. After a while, you can tell if a person really needs a higher level of care just by looking at them for a few seconds.
Q: What are some of the greatest challenges to being an FNP?
Some greatest challenges are lack of mentorship. Nursing can be a very toxic environment — nurses 'eating their young' and bullying — not sure where this culture comes from. The challenges are being scared to ask questions because someone may yell at you or not having the support you need, especially as a new nurse or new NP.
I was definitely bullied as a new nurse, and it definitely gave me thicker skin throughout my career. There are plenty of nurses that would agree. Despite the bullying, I still love the profession and you are guaranteed to find your tribe in the first year or so.
Q: And the greatest rewards?
The rewards are hands down the patients. When I worked as an FNP in the clinic, I only had 20 minutes to see the patients. You can learn a lot from someone in 20 minutes! Having that 20 minutes forced me to not only care for their illness, but to see them as a human. Everyone has a story and I love a good story! I miss that the most.
Q: What advice would you give to those looking to pursue a career as a family nurse practitioner?
The advice I would give someone who is looking to pursue a career as an FNP is that your career is a journey not a destination, just like life. Find something you are passionate about. If you're like me and have many passions, don't be afraid to move to another position.
If you work as an FNP in some states, you can eventually work independently, open your own practice, or get involved in policy making. Lastly, take business classes. You're probably an awesome FNP, but you want to learn the business side as well.
What Does a Family Nurse Practitioner Do?
"The advice I would give someone who is looking to pursue a career as an FNP is that your career is a journey not a destination, just like life. Find something you are passionate about. If you're like me and have many passions, don't be afraid to move to another position." — Joelle Jean, RN, FNP-BC
The first nurse practitioner program opened in 1965 and was developed by the University of Colorado for pediatric nurse practitioners. Since then the field has expanded to include primary care from birth to death and many nursing specialties. An FNP is an advanced practice registered nurse (APRN) whose practice includes patients of all ages.
An FNP has a broad scope of practice but can also get nursing certifications in specialty areas. These can include pain or diabetes management. While these advanced certifications are not necessary, they do demonstrate advanced clinical knowledge. According to the American Association of Nurse Practitioners (AANP), the top three areas where FNPs work are in hospital outpatient clinics, private physicians' offices, and private group practices.
These professionals are an essential part of healthcare. They provide wellness guidance, manage patient caseloads at hospitals and in clinics, and work alongside physicians and other healthcare professionals to provide care for sick, injured, and healthy patients. FNPs are passionate about improving the lives of their patients.
FNPs can work in hospitals, urgent care, outpatient and community clinics, and physicians' offices. They can also work in educational, government, or occupational settings. FNPs may have full, reduced, or restricted practice depending on the state.
These are some common FNP responsibilities:
How to Become a Family Nurse Practitioner
The path to becoming a nurse practitioner and an FNP begins by choosing nursing as a career and completing a four-year bachelor of science in nursing (BSN) degree to practice as a registered nurse (RN). Some nurses start their careers in a different field as Jean described. Several bridge programs allow you to move from one bachelor's degree to nursing or from an associate degree or BSN to NP.
Once you have graduated from an accredited program with your BSN and have passed the National Council Licensure Examination for RNs, it's wise to get several years of experience practicing as an RN. Some master of science in nursing (MSN) programs counsel their candidates to have at least two years working in a hospital before taking on a more independent nurse practitioner role.
It is important to attend and graduate from an accredited MSN program to sit for the Family Nurse Practitioner Certification Examination. Once certified, you must also pass the requirements for your state board of nursing to practice as an APRN in your state. This often includes holding an active RN license.
How Much Do Family Nurse Practitioners Make?
NP roles have been rapidly expanding in the past 10 years which has affected nurse practitioner salaries. How much FNPs are paid depends on several factors, including location, the type of organization, experience, education, and certifications. According to the AANP, the annual base salary for FNPs was $107,000 in 2019 with a total income of $114,000 with benefits.
The income level for different work settings varied from $104,000 in a private physician's practice to $124,000 at a Veterans Administration facility. According to the U.S. Bureau of Labor Statistics (BLS), the top five highest-paying states are:
- New Jersey
- New York
An NP's salary is also somewhat dependent on years of experience. Those with five or fewer years in practice have an average annual salary of $104,000, while those with 16-20 years have an average annual salary of $118,000.
Nursing benefits are an important part of the compensation package. According to the AANP, 80% or more of NPs surveyed reported receiving paid vacations, health insurance, continuing education for nurses reimbursement, dental insurance, and professional malpractice insurance.
While salary and benefits should not be the only reason for choosing a career, it is helpful to understand how much you may be paid as an FNP. According to the BLS, the median pay for nurse practitioners is $117,670, which is over double the average annual salary of $56,310 for all occupations.
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