Nurse Practitioner Career Overview

Becoming a nurse practitioner (NP) involves more training and clinical authority than a registered nurse (RN) but less than a physician. Nurse practitioners are authorized to prescribe medications, order diagnostic tests, and diagnose conditions. They can also assist in surgical procedures, suture, and practice independently in a number of states (Arizona, Massachusetts, Oregon, and several others).

Some popular NP specializations include family health, pediatric health, women's health, and psychiatric/mental health. Nurse practitioners may work for hospitals, nursing homes, private practices, and clinics.

According to the U.S. Bureau of Labor Statistics, the mean annual wage for NPs in the United States is $118,040, and the number of job opportunities is growing.

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 in which they practice. One of their main roles within healthcare is to address the shortage of physicians and bring down healthcare costs.

In some states, they need to work under the supervision of a physician or in collaboration with a physician; in other states, they have full-practice authority, giving them professional autonomy.

NP specializations usually correspond with patient populations. For example, pediatric nurse practitioners work with patients from birth to age 21, and women's healthcare nurse practitioners serve women. Certain states let NPs establish their own private practices, but regulations vary.

Nurse practitioners may experience challenges like long hours, high levels of stress, and the threat of burnout. COVID-19 has been especially hard for nurses, with some reported rates of burnout quadrupling six months into the pandemic.

Depending on the setting, a NP's key skills and responsibilities could include the tasks below:

Primary 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

Skills Learned

• Clinical knowledge
• Judgment under pressure
• Communication skills
• Integrity

Credit: SDI Productions / E+ / Getty Images

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 serve an important role in helping to address the continuing primary care shortage, lowering healthcare costs, and improving patient satisfaction. Nurse practitioners stand out from other healthcare providers by looking at patient health and well-being from a whole-person perspective.

Throughout the profession's 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?

Most NPs specialize in family practice. While NPs work in nearly every healthcare setting, they are most likely to work in physicians' offices (4.1%), outpatient care centers (2.29%), or offices of other health practitioners (.96%).

Why Become a Nurse Practitioner?

There are pros and cons to any occupation, and NPs are no different. You can compare key qualities of an NP found in the list below.

How to Become a Nurse Practitioner

To become a nurse practitioner requires a bachelor of science in nursing (BSN), graduate degree, and state licensure.

1. Earn an associate degree in nursing (ADN) or a BSN.

Students can earn an ADN in two years or a BSN in four years. Some students prefer to earn the ADN first; this provides the opportunity 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 receive registered nurse (RN) licensure.

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 the MSN degree. Admission for most MSN programs require or give preference to students with at least two years of experience as an RN. 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, there are several certifying bodies with differing exams depending on your MSN-NP specialty track, such as family nurse practitioner, adult-gerontology primary care nurse practitioner, pediatric nurse practitioner, among others.

5. Get state licensure as an NP.

Each state has its own licensing requirements, but they all include earning an MSN or doctor of nursing practice (DNP) degree and passing the national board exam.

Nurse Practitioner Concentrations and Specializations

Popular nurse practitioner specializations include women's health, family health, and neonatal health. We explain these and other specialties below. Licensure and national certification requirements vary by state and specialization.

Pain Management Nurse Practitioner

Pain management nurse practitioners work with patients experiencing chronic or acute pain and prescribe treatments.

• Salary: $102,247
• Job Outlook: 52% job growth for all NPs between 2020-2030

Family Nurse Practitioner

A family nurse practitioner typically works as a primary care provider for patients of all ages in different healthcare settings. Most nurse practitioners work as family NPs.