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How to Become a Nurse Practitioner (NP)

September 18, 2020 | Staff Writers

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A nurse practitioner receives graduate training in advanced practice nursing to prepare for careers in primary or specialty care settings. Nurses entering this field must complete at least a master’s degree, meet state licensing requirements, and pass a national certification exam in their specialty. NPs may also pursue specializations in areas like general nursing, neonatal and pediatric care, gerontology, and women’s health and family care.

As the demand for healthcare expands across the nation, registered NPs can work in a variety of settings such as medical offices, hospitals, and outpatient clinics. Additionally, they often assume many of the same responsibilities as physicians. Most states authorize NPs to diagnose illnesses, administer medical tests, design treatment plans, and prescribe medication. This guide explores some of the roles and responsibilities of nurse practitioners, available degree options, and licensing and certification requirements to help you launch your nursing career.

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Frequently Asked Questions

What is the fastest way to become a nurse practitioner?

Depending on the degree level, NP programs can take 2-3 years to complete. RN-to-MSN, or RN-to-DNP bridge programs offer the quickest path to a career. These programs usually accept previously earned credits and allow students to fulfill clinical experience at their place of employment.

What is the fastest way to become a nurse practitioner?

Depending on the degree level, NP programs can take 2-3 years to complete. RN-to-MSN, or RN-to-DNP bridge programs offer the quickest path to a career. These programs usually accept previously earned credits and allow students to fulfill clinical experience at their place of employment.

Where are the highest paid nurse practitioners?

California pays its NPs the highest mean salary in the U.S. at $138,670. NPs in California’s San Francisco/Oakland/Hayward and the Vallejo/Fairfield metropolitan areas average over $150,000 a year.

What are the differences between a nurse practitioner and an RN?

Certified NPs must hold an MSN or DNP and requisite state license and certifications. RNs can find employment after completing an associate or BSN and passing the NCLEX exam, but typically work in positions with less autonomy and responsibilities. While NPs often work with physician oversight, NP practice authority varies by state, and in almost half of states, NPs can possess full practice authority (FPA) and can prescribe medications. NPs can also specialize in several areas, including gerontology/geriatrics, mental health, pediatrics, and women’s health.

What are the differences between an NP and a PA?

NPs and PAs offer some of the same healthcare services, but the focus of their training and their responsibilities differ. NPs earn their degree at nursing schools and emphasize patient care for specific populations, while PAs study biology and pathology in medical school programs based on the physician training model. NPs must have experience working as RNs prior to entering MSN NP programs. However, PA programs do not require students to have experience providing direct patient care. Furthermore, PAs cannot practice independently and must be under direct physician supervision, while NPs, depending on the state, can practice independently. Also, NP programs require specialization, in areas including acute care, adult gerontology, and family practice, whereas PA programs are generalized. However, PAs typically specialize once they begin working.

Can nurse practitioners prescribe medication?

Throughout the U.S., NPs who hold unencumbered and current licenses can prescribe medicine, including controlled substances. However, some states limit practice authority over pharmaceuticals and require NPs to enter into a collaborative agreement with a supervising physician.

What can’t a nurse practitioner do?

NPs possess the training to perform the same services as a physician with the exception of surgical procedures. NPs cannot independently operate or complete surgical procedures, however, they can assist in the operating room and often work under a surgeon as first assist. In addition to limited prescriptive authority, some states mandate that NPs work under the supervision of a collaborating doctor.

Are nurse practitioners in demand?

The Bureau of Labor Statistics projects the field to grow 26% in between 2018-28. The increase in NP positions during this 10 year period ranks ahead of the job growth rate for other advanced practice nursing fields.

Advantages of Being a Nurse Practitioner

While both NPs and RNs hold registered nurse licenses, NPs have completed at least an MSN and certification in a population or other specialty area. As advanced practice registered nurses (APRNs), NPs provide a broader set of services than RNs. In many states, NPs operate with full practice authority, which means they work independently and provide the same services as physicians — diagnosing patients, interpreting test results, managing treatment plans, and prescribing medications.

NPs earn a significantly higher mean annual salary of $111,840 compared to $77,470 for RNs. As the need for preventive and primary healthcare increases across the country, NPs can expect a 28% increase in job growth between 2018-28, much higher than projected employment rates for RNs. NPs find particularly strong employment prospects in medically underserved areas in rural or inner-city environments

Nurse Practitioner Degree Programs Online

An online nurse practitioner degree allows nurses to continue working while acquiring advanced training. Many programs feature asynchronous course delivery that provide students with the flexibility to log-in to courses at their convenience. Bridge programs enable nurses who already hold an associate or bachelor’s degree to complete their graduate training in three years or less.

In response to the growing demand for NPs, many top-ranked ccredited nursing programs have established online degree options. Many RNs pursue online DNP programs, as doctoral degrees have gained acceptance as the preferred terminal degree for APRNs. These rigorous programs prepare graduates for leadership and research roles. Online RN-to-DNP degrees provide a good fit for working registered nurses interested in advancing into senior practice, administrative, or teaching and research roles.

Nurse Practitioner Education Requirements

To qualify for state NP licensure and certification in a practice area, nurses must complete graduate training leading to an MSN degree or the more advanced DNP diploma. While degree requirements vary by school and degree level, the following sections can help prospective NPs understand general admission and graduation requirements, concentrations, and program length for both degrees.

Master of Science in Nursing Program

Admission Requirements for an MSN Degree

Students may follow several different paths to an MSN. RNs who complete a BSN may enroll in a traditional or online MSN program. While some programs do not require an undergraduate degree in non-nursing fields, students will have to complete their BSN prior to completing the MSN. Various NP bridge programs provide a popular option for students who have only completed their associate degree.

All state nursing boards require NPs to hold a valid RN license by passing the National Council Licensure Examination for Registered Nurses. Students who enter MSN programs after completing their associate degree in nursing or their BSN usually have already obtained their RN license.

MSN students are trained in professional core and clinical specialty areas. While every program offers a distinctive curriculum, core coursework typically covers patient assessment, pharmacology, physiology and pathophysiology, evidence-based research, and ethics. All MSN programs require practicum experiences ranging from 500 clinical hours to over 1,000 hours for specialized practice roles in fields like anesthesiology or midwifery.

Concentrations for an MSN Degree

  • Adult-Gerontology

    In this specialization, MSN students provide primary and acute care to individuals from adolescence to older adulthood. Degree candidates can focus their training on a specific setting or target group, such as rural areas or underserved communities. Specialty coursework includes physiology across the lifespan, advanced practice nursing, and population health.

  • Midwifery

    Due to significant shortages in maternity care providers, nurse midwives represent one of the nursing field’s fastest-growing occupations. Nurse midwifery programs train students in prenatal, birth, and postpartum care. Degree-candidates also learn to perform gynecological services and educate patients about birth control and family planning. This specialization prepares graduates to work in diverse settings, including hospitals, birth centers, and university health clinics.

  • Nurse Anesthesiology

    Nurse anesthesiologists provide anesthesia and related care to patients undergoing surgery. In this specialization, distance-learners assess patients and implement quality care plans to meet individual needs. They also learn to support patients through the perioperative period, acting as advocates and providing emotional support. Specialty classes include advanced pharmacology and pathophysiology.

  • Psychiatric/Mental Health

    Mental health challenges are widespread across the U.S. and often coincide with physical ailments, such as diabetes, obesity, and cardiovascular diseases. This specialization prepares students to provide comprehensive health services through the lifespan. Degree candidates may focus their training on a particular group, such as children, veterans, or ethnic minorities.

  • Neonatology

    Neonatal nursing students learn to care for preterm and full-term infants with chronic illnesses, genetic disorders, and life-threatening conditions. Degree candidates witness high-risk births, attend neonatal surgeries, and practice infant resuscitation as part of their clinical training. Coursework includes embryology, applied family dynamics, behavioral health, and neonatal physiology.

  • Pediatrics

    Pediatric nurse practitioners provide vital, patient-facing healthcare services for children from the time that they’re born to the time that they’re considered adults. They see patients on a one-on-one basis, offering care ranging from well check-ups and immunizations to diagnosing illnesses and treating chronic and acute conditions.

  • Family Care

    Family nurse practitioners (FNPs) are registered nurses with specialized graduate education who provide primary health care services to people of all ages. FNPs perform physical exams, order diagnostic tests and procedures, diagnose and treat illness, prescribe needed medications, and teach individuals and families how to develop healthy lifestyles to promote health and prevent disease.

  • Acute Care

    Acute care nurse practitioners (ACNPs) provide care to patients in acute care and/or hospital settings. Differing from primary care nurse practitioners, acute care NPs see patients when they are sick, admitted to the hospital, or after a surgical procedure and/or trauma.

  • Nursing Experience

    An applicant with no correlating nursing experience cannot apply for the concentrations listed above. Most MSN programs require at least 1-2 years of experience in the associated speciality.

How Long Does it Take to Complete an MSN Program?

The time it takes to complete an MSN can vary based on program length and specific school requirements, such as the program structure and possible specializations. Typical MSN programs take full-time students about two years to complete. Part-time learners typically take around three years to satisfy their program requirements.

Students usually complete around 30 credits of coursework that focuses on nursing core courses, specialty subjects, capstone experiences, and clinical requirements. Some programs feature accelerated formats that allow degree-seekers to complete more credits during a semester to earn their degree faster. In accelerated programs, learners can complete their degree in as little as one year of full-time study. Students can also shorten their program length through transfer credits.

Specializations also impact how long it takes to complete degree requirements. Some concentration areas require more clinical hours than others. For instance, students pursuing specializations in neonatology or nurse anesthesiology must satisfy more clinical hours than those pursuing specializations in geriatrics or women’s health.

Internships for MSN Students

Prospective NPs must complete internships and practicums in addition to their MSN classes. Clinical training provides students with hands-on experience, such as conducting patient assessments, creating care plans, and providing health services. These practical experiences allow students to gain a comprehensive understanding of the care they can provide as NPs. They also fulfill requirements for state licensure, professional certification, and career entry.

MSN students usually complete three clinical hours per classroom hour. Learners often rotate through various clinical sites, including university medical centers, emergency care clinics, public hospitals, trauma wards, and regional anesthesia centers.

Certification groups, like the ANCC and AANP, require a minimum amount of hours in order to sit for boards. For example, the ANCC requires a minimum of 500-faculty supervised clinical hours in order to sit for their FNP certification exam.

Doctor of Nursing Practice Program

Admission Requirements for a DNP Degree

Recommended by the American Association of Colleges of Nursing as the required terminal degree for all APRNs, the doctorate in nursing practice prepares graduates for the profession’s top leadership, research, and teaching positions. The DNP builds on the clinical and research training typically acquired at the master’s level to develop evidence-based practice skills.

While entrance requirements vary by program, some schools offer BSN-to-DNP bridge programs that allow students to meet their MSN and doctoral requirements together in an accelerated format. DNP students must hold an unencumbered RN license and one year of professional nursing experience.

The DNP curriculum emphasizes organizational and practice-oriented leadership and research applications for practice care. Most DNPs require a practice-oriented capstone project. Students entering the program without sufficient clinical hours in a previous master’s program may have to complete a residency requirement.

Concentrations Offered for a DNP Degree

  • Public Health

    This concentration trains students to identify and accommodate the healthcare needs of individuals and communities. With an overall emphasis on population health, degree-candidates explore topics, such as primary prevention, health promotion, and program management. By specializing in public health, graduates can pursue research positions and clinical roles in hospitals, home health settings, and specialty clinics.

  • Executive Leadership

    This concentration prepares learners to become nurse leaders, using evidence-based practices to improve healthcare outcomes and strengthen organizational efficiency. Distance learners explore clinical research methods, professional ethics, and community health initiatives. The executive leadership concentration also teaches students to balance stakeholder interests with a patient’s values and needs.

  • Nursing Education

    With training in nursing education, students can become college instructors, clinical trainers, and program developers. This concentration teaches learners to employ curriculum design methods, apply teaching strategies, and construct models for assessing educational outcomes. Degree candidates also explore challenges in the field, including student body diversity and healthcare equity.

  • Health Informatics

    Students learn to integrate computer and information science to improve communication, decision-making, and patient-centered care. Degree-candidates work with management systems to define, analyze, and protect healthcare data. By applying these skills, nursing informatics specialists oversee their organization’s data standards and workflow.

How Long Does it Take to Complete a DNP Program?

As employment opportunities for APRNs expands, a growing number of schools have established traditional and online DNP options and accelerated bridge programs to prepare nurses for career advancement in clinical and nonclinical roles.

Depending on the program format, DNP students may complete anywhere from 35-95 credits. Students enrolled in BSN-to-DNP bridge programs may spend three or more years to earn their degree, while an MSN-to-DNP may take only one or two years of full-time study.

As a practice-focused degree, the DNP connects clinical training to leadership, economic, and administrative skills. The curriculum comprises core courses that emphasize essential foundational advanced practice nursing competencies, classes in NP direct care, and specialized training in management, organizational and professional leadership, health policy, and health informatics.

Getting Licensed as a Nurse Practitioner

Regardless of where they intend to practice, all NP candidates must hold an MSN or DNP degree and an active and unrestricted RN license. Before NPs can receive their state license, they must pass a national certification exam to practice in their specialty area. Although each state’s nursing board establishes its own rules and procedures, APRN requirements have become more standardized as states move toward adopting similar licensure models. NP candidates should always refer to their state board to verify eligibility.

In addition to a valid NP license, many employers require certification in basic and advanced life support, including cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) training.

How to Become a Certified Nurse Practitioner

Certified nurse practitioners have acquired advanced training in specialty areas, such as family practice, pediatrics, or acute care. While state licensure is required for all RNs, NPs seek certification voluntarily. CNPs established their competency in a practice or population area and maintain ongoing professional development.

Several organizations — including the American Nurses Credentialing Center, the National Certification Corporation, and Pediatric Nursing Certification Board — offer certification in NP specialties. While these national agencies administer CPR examinations, each state nursing board determines which certifying organization it recognizes.

NPs applying for certification must complete all required clinical and didactic requirements through graduate training, and pass the certifying exam in their specialty. Once they obtain certification, CNPs must fulfill a minimum number of clinical hours and acquire continuing education credits to keep their credentials active.

Financial Aid for Nursing Students

An APRN degree carries a significant price tag, with costs as high as $100,000. The price of the degree depends on several factors, including the type of institution, program length, and the opportunity costs incurred by leaving a job or reducing hours in order to pursue the degree. Fortunately, several financial aid and scholarship programs targeted for nursing students can help defray educational expenses.

As a first step, all prospective students should complete the Free Application for Federal Student Aid (FAFSA) to determine their eligibility for scholarships, grants, loans, and work study programs. Before enrolling in an NP program, students should take the time to explore resources for all nursing scholarship opportunities, including those designed specifically for MSN degree-seekers.

Many hospitals provide tuition reimbursement or tuition remission for affiliated MSN NP programs. For example, the University of Miami Health system offers tuition remission up to $6000/year for employees seeking MSN NP degrees.

Reviewed by:

Expert Reviewer: Elizabeth Clarke, FNP, MSN, RN, MSSW

Elizabeth Clarke, FNP, MSN, RN, MSSW

Elizabeth Clarke is a board-certified family nurse practitioner. A native of Boston, MA, Clarke tired of the cold and snowy winters and moved to Coral Gables, FL in order to complete her undergraduate degree in nursing at the University of Miami. After working for several years in the UHealth and Jackson Memorial Medical systems in the cardiac and ER units, Clarke returned to the University of Miami to complete her master of science in nursing. Since completing her MSN degree, Elizabeth has worked providing primary and urgent care to pediatric populations.

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