Nurse Practitioner Career Overview
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Are you ready to earn your online nursing degree?
Credit: FatCamera / E+ / Getty ImagesNurse practitioners (NPs) specialize in patient populations and hold advanced nursing degrees. They focus on acute care, family healthcare, oncology, or mental health. NPs are licensed as advanced practice registered nurses (APRNs) and earn national board certification in their specialty areas.
NPs are primary care providers who perform many of the same services as physicians. They often have greater autonomy than registered nurses. Some jurisdictions, depending on state regulations, allow full practice authority, while others require a collaborative agreement with a doctor.
Continue reading to learn more about NP careers.
How Long to Become
6-8 years
Job Outlook, 2022-2032
38% Growth
Average Annual Salary
$129,480
Source: BLS
Popular Online MSN Programs
Learn about start dates, transferring credits, availability of financial aid, and more by contacting the universities below.
What Does a Nurse Practitioner Do?
NPs provide clinical care for patients and are authorized to diagnose health conditions, order tests, and prescribe medications. NPs’ scope of work varies depending on their specialization area, the population they serve, and the state where they practice. One of their main roles within healthcare is to address the shortage of physicians and bring down healthcare costs.
In some states, NPs must work under the supervision of a physician or in collaboration with one. In other states, they have full-practice authority, which gives them professional autonomy. Some states, like Florida, grant NPs full-practice authority after a set number of clinical practice hours are completed.
NP specializations usually correspond with patient populations. For example, pediatric nurse practitioners work with patients from birth to age 21, and women’s health nurse practitioners serve women. Certain states let NPs establish private practices, but regulations vary.
Depending on the setting, an NP’s key skills and responsibilities may include these tasks:
Key Responsibilities
- Ordering medical tests
- Diagnosing medical conditions
- Prescribing treatment, including medication
- Counseling and educating patients
- Leading nursing departments or teams
- Supervising the work of other clinical staff
- Promoting community and population health
Career Traits
- Clinical knowledge
- Judgment under pressure
- Communication skills
- Integrity
Key Holistic Skills for Nurse Practitioners
- Empathy and Compassion: As a nurse practitioner, you need both traits to understand and build relationships with patients and their families. Compassionate and empathetic nurses who see their patients as whole people may offer improved patient care.
- Communication Skills: Because NPs spend so much time explaining medical diagnoses and treatments to patients and their families, they need clear, concise, and empathetic communication skills. Working with other healthcare professionals also requires good communication skills.
- Leadership Skills: Nurse practitioners often take on leadership positions. NPs should be prepared to coach and mentor other nurses, lead problem-solving efforts, contribute to team building, and help build a positive culture.
- Critical-Thinking Skills: Critical-thinking skills help NPs provide better care, improve patient safety, and recognize changes in a patient’s medical status. It can also lead to innovation and better decision-making.
Key Medical Skills for Nurse Practitioners
- Basic Emergency and Urgent Care Skills: A solid grasp of basic emergency and urgent care skills allows NPs to quickly assess and address medical issues. Examples include dressing, suturing, and stapling wounds, providing intravenous therapy, respiratory system assessment, and chest tube management.
- Vital Sign Monitoring and Checking: Knowing how to monitor and check vital signs, including pulse rate, body temperature, blood pressure, and respiration rate, helps NPs find and monitor healthcare problems.
- Patient Education: Skilled NPs provide health education and counseling to patients and their families. They help patients understand diagnoses and treatments, make lifestyle changes to improve health conditions, and learn how to provide at-home care.
- Technology Skills: As technology’s role in the healthcare system grows, nurse practitioners use technology to help diagnose, monitor, and treat patients. They also need technical skills to complete medical forms accurately, send prescriptions, and order labs or procedures.
History of Nurse Practitioners
The first nurse practitioner program started in 1965 in Colorado. That same year, Medicare and Medicaid expansion increased the number of Americans who qualified for coverage and could seek primary healthcare.
In 2018, an estimated 56,000 NPs practiced in the U.S. The rise of the NP profession came in response to the lack of primary care physicians available to meet this need.
Nurse practitioners play an important role in helping address the continuing primary care shortage, lowering healthcare costs, and improving patient satisfaction. They stand out from other healthcare providers by examining patient health and well-being from a whole-person perspective.
Throughout their history, NPs have advocated for policy changes to improve healthcare and access, particularly for children, low-income individuals, and other marginalized groups.
Where Do Nurse Practitioners Work?
Physicians’ offices employ more than 40% of nurse practitioners, followed by outpatient care centers at 23% and hospitals and offices of other health practitioners at nearly 10%. The remainder work in settings like home health care services.
Hospital Outpatient
NPs generally serve as primary care providers or specialists in hospital outpatient settings. They assess and diagnose patients, prescribe treatment, advise patients on care, and refer patients to physicians for additional care.
Hospital Inpatient
In a hospital inpatient setting, NPs also assess and diagnose patients and prescribe treatment as part of a patient’s ongoing care. They may also lead nursing teams and oversee the work of other clinical staff.
Private Group Practices
In a private group practice, NPs may serve as primary care providers or specialists. They see patients, assess conditions, and prescribe treatments, escalating a patient to seeing a physician or specialist NP as necessary.
Why Become a Nurse Practitioner?
Any occupation has pros and cons, and NPs are no different. The list below compares the key qualities of an NP.
Benefits of Becoming an NP
- High demand and NP salaries considerably above the national average
- Personal satisfaction from providing patient care
- Potential for career advancement in clinical or administrative roles
- Opportunities to specialize and practice more independently
Challenges of Becoming an NP
- Strenuous education, board exam(s), and licensing requirements
- High potential for burnout due to demanding schedules
- Emotional stress from witnessing patient distress
- Paperwork and regulatory administrative burdens
How to Become a Nurse Practitioner
Becoming a nurse practitioner is a multi-step process that starts with an undergraduate nursing degree and a registered nurse (RN) license. After gaining experience as an RN, aspiring NPs complete a graduate nursing program, followed by board certification and advanced practice licensing.
- 1
Earn an ADN or a BSN.
Students can earn an associate degree in nursing (ADN) in two years or a bachelor of science in nursing (BSN) in four years. Some students prefer to earn the ADN first, allowing them to see if they like the work and environment. Others prefer to start with the BSN and begin work at a higher level of responsibility and pay.
- 2
Pass the NCLEX-RN to become an RN,
Master of science in nursing (MSN)-NP programs require experience in nursing. To practice as an RN, you must pass the National Council Licensure Examination for RNs (NCLEX-RN) examination, which measures a graduate’s readiness to begin practice as a registered nurse. It asks questions about safety, health promotion, and patient physical and psychological needs.
- 3
Earn an MSN.
Students typically take two years of full-time study to earn an MSN degree. Admission for most MSN programs requires or prefers students with at least two years of RN experience. MSN-NP programs also require a valid, unencumbered state nursing license.
- 4
Pass the national nurse practitioner certification board exam.
This examination, like the NCLEX-RN exam, assesses a graduate’s readiness to work in the field as an NP. It typically comprises 150 multiple-choice questions. However, several certifying bodies have differing exams depending on your MSN-NP specialty track, such as family nurse practitioner, adult-gerontology primary care nurse practitioner, and pediatric nurse practitioner.
- 5
Get state licensure as an NP.
Each state has its licensing requirements, but all require NPs to earn an MSN or doctor of nursing practice (DNP) degree and pass the national board exam.
Nurse Practitioner Concentrations and Specializations
Popular nurse practitioner specializations include women’s, family, and neonatal health. We explain these and other specialties below. Licensure and national certification requirements vary by state and specialization.
Family Nurse Practitioner
Family nurse practitioners (FNPs) comprise the largest percentage of NPs. FNPs care for patients of all ages and life stages, providing preventative care and treatment for illnesses, conditions, and injuries. They work in clinics, hospitals, and private practice.
Adult-Gerontology Nurse Practitioner
Adult-gerontology NPs (AGNPs) specialize in acute or primary care and see patients in clinics, hospitals, and long-term care facilities. AGNPs perform physical exams and diagnoses for adults of all ages. Acute-care AGNPs treat existing illnesses and are more likely to work in hospitals, while primary-care AGNPs focus on preventative care.
- Average Base Salary:$109,713
- Distribution of NPs:Primary care 8.9%; Acute care 6.1%
Psychiatric Nurse Practitioner
Working in clinics, hospitals, psychiatric facilities, and substance abuse centers, these professionals focus on behavioral and mental health. Often specializing in patient populations, such as military/veterans or pediatrics, psychiatric NPs diagnose conditions, formulate treatment plans, and educate patients and caregivers.
Women’s Health Nurse Practitioner
Women’s health NPs care for women of all ages, providing healthcare specific to women, including gynecology and obstetrics. They find employment in hospitals, clinics, and fertility centers and often collaborate with physicians and nurse midwives.
Neonatal Nurse Practitioner
Employed primarily in hospital neonatal intensive care units, these professionals care for infants born prematurely or with illnesses. They provide acute and critical care to newborns and ongoing treatments like incubation, tube feedings, IV lines, and medications.
Pain Management
Working in pain management as an NP involves administering and monitoring medication and providing non-pharmaceutical options like acupuncture and chiropractic care. Common workplaces include cancer and surgical units in hospitals or rehabilitation facilities.
- Average Base Salary: $121,929 (June 2024)
Emergency Room Nurse Practitioner
ERNPs collaborate with teams of healthcare providers to help patients experiencing medical emergencies. This fast-paced career involves assessing, diagnosing, and treating patients undergoing trauma, severe injuries, and emotional crises. Other responsibilities may include supervising RNs and educating patients.
- Average Base Salary:$134,786 (June 2024)
Pediatric Nurse Practitioner
Pediatric nurse practitioners (PNPs) specialize in primary or acute care of infants, children, and teens. PNPs see patients in physicians’ offices, hospitals, and outpatient care centers. Acute care specialists work in emergency rooms, intensive care units, and urgent care clinics.
- Average Base Salary:$100,580
- Distribution of NPs:Primary care 2.4%; Acute care 0.6%
How Much Do Nurse Practitioners Make?
NPs are among the highest-paid nursing professionals. They earn an average annual salary of nearly $130,000. NP salaries can vary by level of education and experience, specialization area, workplace, and geographic location.
For example, NPs in home health care services make an average salary of $146,850, compared to $139,860 for those employed at outpatient care centers, according to the Bureau of Labor Statistics (BLS).
NPs in California earn the highest salaries in the U.S. However, the cost of living in the Golden State is particularly high compared to other states.
Job prospects look especially promising for NPs. The BLS projects a 38% rise in employment for NPs from 2022 to 2032, the fastest growth rate among occupations nationwide.
The table below lists the top five states for NP salaries and the average annual salaries.
| State | Average Annual Salary |
|---|---|
| California | $161,540 |
| Nevada | $148,670 |
| Washington | $145,400 |
| New Jersey | $145,030 |
| Oregon | $144,950 |
Highest-Paying Workplaces for Nurse Practitioners
NP salaries vary by workplace settings, but the most common industries that employ NPs, including physicians’ offices, hospitals, and higher educational institutions, do not necessarily offer the highest salaries. Job-seekers hoping to earn top dollar may want to explore the workplaces listed in the table below.
| Workplace Setting | Median Total Salary |
|---|---|
| Business Support Services | $180,570 |
| Residential Intellectual and Developmental Disability, Mental Health, and Substance Abuse Facilities | $158,140 |
| Business, Professional, Labor, Political, and Similar Organizations | $153,580 |
| Home Health Care Services | $146,850 |
| Other Ambulatory Health Care Services | $144,570 |
Frequently Asked Questions about Nurse Practitioners
It takes at least six years of school to become an NP, plus time working as an RN. Most full-time students need four years to earn a BSN degree vs. two for an ADN and two years to earn a master’s degree in nursing. Most schools require or strongly recommend at least two years of work as an RN before applying to an MSN-NP program.
Professional Organizations for Nurse Practitioners
AANP | The American Association of Nurse Practitioners
AANP comprises 118,000 members and is the largest professional NP association in the United States. The organization is one of the certifying boards for NPs, writing and administering certification exams. AANP also publishes research on the profession, provides members with continuing education, advocates for the nurse practitioner profession, and holds an annual conference. Most members are NPs, but there are six membership categories, including students and retirees.
NONPF | National Organization of Nurse Practitioner Faculties
NONPF is the national membership association for nurse practitioner education. The organization advises on the nursing practitioner program curriculum and effective NP education. Membership is open to nursing schools, students, retired faculty members, and current NP school faculty members.
NPWH | National Association of Nurse Practitioners in Women’s Health
NPWH aims to ensure the highest possible quality of care from nurse practitioners specializing in women’s health. The association educates, researches, and advocates for policies that advance the profession. Most members are NPs, but there are membership categories for students and those who work in women’s health.
NBNPA | National Black Nurse Practitioner Association
NBNPA is located in Houston, Texas, and was founded in 2010 to create a professional community and support Black NPs. The association advocates for health equity among underserved communities and provides scholarships and other philanthropic support.
AAENP | American Academy of Emergency Nurse Practitioners
AAENP, based in Scottsdale, Arizona, provides continuing education, establishes guidelines for emergency care nursing, and conducts advocacy for emergency nurse practitioners. Membership is open to any emergency care provider or student of emergency care, but only NPs may pursue certain leadership roles.
Page last reviewed on June 30, 2024
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