Nurse Practitioner Career Overview
Updated September 30, 2022 · 6 Min Read
Find out about nurse practitioner careers, including responsibilities, pros and cons, and compensation. Learn more about a fast-growing career with an average salary over $100K.
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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:
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Key Soft Skills for Nurse Practitioners
- Empathy and Compassion: If you meet a nurse practitioner, they will tell you that you need both of these 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 are often looked upon as leaders. 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 Hard 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 wounds, providing intravenous therapy, assessing the respiratory system, 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. This can help them 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.
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%).
Hospital Outpatient
NPs generally serve as primary care providers or specialists in hospital outpatient settings, assessing and diagnosing patients, prescribing treatment, advising patients on care, and referring patients to physicians for additional care when needed.
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.
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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.
Advantages to 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
Disadvantages to Becoming an NP
- Strenuous education, board exam(s), and licensing requirements
- High potential for burnout due to demanding schedules
- Emotional stress from witnessing patient suffering
- Paperwork and regulatory administrative burdens
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: 46% job growth for all NPs between 2021-2031
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.
- Salary: $97,940
- Job Outlook: 46% job growth for all NPs between 2021-2031
Neonatal Nurse Practitioner
Neonatal nurse practitioners provide nursing care for newborn infants, generally in hospitals. While they care for infants, they also work with the new parents.
- Salary: $110,330
- Job Outlook: 46% job growth for all NPs between 2021-2031
Adult Nurse Practitioner
Adult nurse practitioners provide primary care for adults in a range of healthcare settings, including hospitals, health systems, and independent practices.
- Salary: $102,570
- Job Outlook: 46% job growth for all NPs between 2021-2031
Psychiatric Nurse Practitioner
Psychiatric nurse practitioners, also known as mental health nurse practitioners, specialize in providing mental health treatment, in both inpatient and outpatient settings.
- Salary: $112,950
- Job Outlook: 46% job growth for all NPs between 2021-2031
Women's Health Nurse Practitioner
Women's health nurse practitioners specialize in women's health, especially obstetric and gynecological (ob/gyn) health. They typically work in hospitals, health systems, and independent practices.
- Salary: $96,500
- Job Outlook: 46% job growth for all NPs between 2021-20301
How Much Do Nurse Practitioners Make?
Nurse practitioner salaries vary based on experience, speciality, and geography but average a median pay of $123,780 per year. The highest-paid NP specialty is psychiatric care with a median annual salary of $125,000 and the lowest is family care at $107,000.
The U.S. Bureau of Labor Statistics (BLS) projects that NPs will be the fastest growing occupation in the country over the next decade with an increase of 46% from 2021 to 2031. Employment growth tends to follow population growth, especially older adult population growth. Between 2020-2030, NP employment in Arizona is expected to rise by 100.8%, by 78.6% in Georgia, and by 73.4% in West Virginia.
| State | Annual Mean Wage | Total Number of NPs |
|---|---|---|
| California | $151,830 | 17,400 |
| New Jersey | $137,010 | 6,690 |
| New York | $133,940 | 15,190 |
| Washington | $130,840 | 3,730 |
| Massachusetts | $129,540 | 7,330 |
| Metropolitan Area | Annual Mean Wage | Total Number of NPs |
|---|---|---|
| San Jose — Sunnyvale — Santa Clara, CA | $197,870 | 1,220 |
| Napa, CA | $184,700 | 90 |
| Vallejo — Fairfield, CA | $180,380 | 130 |
| San Francisco — Oakland — Hayward, CA | $177,160 | 2,550 |
| Yuba City, CA | $159,260 | 2,550 |
| Industry | Average Salary |
|---|---|
| Emergency Departments | $135,000 |
| Veterans Affairs (VA) Hospitals | $124,000 |
| Home Health Care | $125,000 |
Frequently Asked Questions about Nurse Practitioners
How long does it take to become a nurse practitioner?
The NP designation takes at least six years of school to earn plus time working as an RN. Most full-time students need four years to earn a BSN degree versus two for an ADN plus 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.
Can nurse practitioners prescribe medicine?
NPs can prescribe medications, including controlled substances. Some states require a certain number of credit hours in pharmacology while others require NPs or newly credentialed NPs to work in collaboration with a physician. Others grant NPs full-practice authority, meaning they do not require a physician's collaboration or supervision.
What are the most popular nurse practitioner specialties?
According to a 2019 AANP study, the specializations with the highest concentration of NPs are family practice at about 65%, adult care at about 13%, and adult gerontology at about 8%.
What is the difference between an RN and NP?
An RN has a two- or four-year degree in nursing, or a nursing diploma, whereas an NP has at least an MSN and board certification as an NP. While all NPs are RNs, not all RNs are NPs.
Professional Organizations for Nurse Practitioners
Related Nurse Practitioner Career Resources
Page last reviewed November 30, 2021
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