How to Become a Nurse Practitioner

by Genevieve Carlton

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Nurse practitioners (NPs) are advanced practice registered nurses (APRNs) that provide primary and specialty care. They benefit from strong projected job growth figures and above-average salaries.

If you're wondering how to become a nurse practitioner, this guide takes a step-by-step look at the process. It covers NP job responsibilities, education requirements, certification and licensure, and earning potential. This guide also offers a timeline for completing nurse practitioner requirements.

What Is a Nurse Practitioner?

NPs are healthcare professionals who, in most states, can operate independently from physicians, diagnosing illnesses, prescribing medication, and interpreting the results of medical tests. NPs can work in many fields, including pediatrics, geriatrics, and mental health.

About half of NPs work in doctors' offices, while others work in hospitals and outpatient care centers. NPs who work in hospitals may work irregular shift hours, including nights and weekends. Those in doctors' offices generally work regular business hours.

To work as an NP, a registered nurse (RN) must hold a master's degree or higher from an NP program. An NP must also hold a license and pass a national certification exam.

NPs draw on critical thinking skills to determine the best treatments for patients. A detail-oriented NP can identify small changes in a patient's condition and prescribe treatments accordingly. These professionals also use leadership, communication, and interpersonal skills to interact with patients and other healthcare professionals.

Alternate Job Titles for Nurse Practitioners

  • Advanced practice registered nurse
  • Certified nurse practitioner
  • Certified registered nurse practitioner
  • Licensed nurse practitioner

Specialty Job Titles for Nurse Practitioners

  • Acute care nurse practitioner
  • Adult nurse practitioner
  • Cardiology nurse practitioner
  • Certified pediatric nurse practitioner
  • Dermatology nurse practitioner
  • Electrophysiology nurse practitioner
  • Emergency medicine nurse practitioner
  • Family health nurse practitioner
  • Family practice nurse practitioner
  • Gastroenterology nurse practitioner
  • Gerontological nurse practitioner
  • Internal medicine nurse practitioner
  • Neurosurgical nurse practitioner
  • Obstetrics-gynecology nurse practitioner
  • Orthopedic nurse practitioner
  • Palliative care nurse practitioner
  • Pediatric nurse practitioner
  • Psychiatric-mental health nurse practitioner
  • Surgical nurse practitioner

During a master's program, nursing students complete classes in anatomy, physiology, and evidence-based practice. Programs also incorporate clinical hours to help students build practical experience.

Nursing students also take coursework in their specialty. For example, prospective acute care nurse practitioners (ACNPs) take classes in treating ill and injured patients, while palliative care nurse practitioners complete training in geriatric nursing and hospice care.

Before applying to NP master's programs, each candidate must hold an RN license. Most programs also require a bachelor of science in nursing (BSN) degree, though some offer RN-to-NP pathways for applicants without bachelor's degrees. Students can also pursue doctor of nursing practice (DNP) degrees.

Prospective NPs should only choose accredited graduate programs. Nursing schools with programmatic accreditation meet the highest standards for nursing education, and graduates meet requirements for certification exams. The Accreditation Commission for Education in Nursing and the Commission on Collegiate Nursing Education both accredit nursing programs.

After graduating with a master of science in nursing (MSN) or DNP, NPs must take a national certification exam offered by the American Academy of Nurse Practitioners Certification Board. Each NP must also hold a state license to practice.

Salary and Job Growth for Nurse Practitioners

Median Annual Salary (2019)

Projected Job Growth (2019-2029)

Associate Degree Programs

Some NPs begin their training by enrolling in associate programs in nursing to become RNs. Associate programs develop foundational skills in patient care, evidence-based practice, and nursing practice. Enrollees also explore human development, anatomy, and physiology.

Completing an associate degree in nursing (ADN) generally takes two years for full-time students. In addition to coursework, nursing students complete clinical practicums to build patient-centered skills. After completing an ADN and passing the NCLEX-RN exam, a nursing student qualifies for an RN license. Note that exact licensure requirements can vary by state.

Bachelor's Degree Programs

A bachelor's degree in nursing meets the entry-level requirement for most nursing careers. Prospective NPs often complete BSNs as part of their training, as many master's programs for NPs require a BSN for admission.

During a BSN, nursing students take classes covering pharmacology, public health, and anatomy. Bachelor's students also complete clinical requirements to develop their practical skills. Some BSN programs offer concentrations or electives in emergency care, geriatrics, or pediatrics to prepare enrollees for specialized career paths after graduation.

Completing a BSN generally takes four years for full-time students, though RN-to-BSN programs for current RNs can take under two years.

Master's Degree Programs

A master's degree in nursing meets the entry-level educational requirement for NPs. Applicants to NP master's programs must hold current RN licenses. Some programs require a BSN degree, while others admit RNs with associate degrees.

In master's nursing programs, students learn about advanced patient assessment, pharmacology for NPs, nursing informatics, and advanced research methods. Students also complete clinical hours to strengthen their patient care skills and meet licensure requirements. Most nursing programs require at least 600 clinical hours.

NP students can specialize their training by pursuing concentrations like family nurse practitioner (FNP), neonatal nurse practitioner, or psychiatric-mental health nurse practitioner (PMHNP). Earning a master's degree from an accredited nursing school generally takes 2-3 years of full-time study.

Doctoral Degree Programs

An NP can also pursue a DNP or Ph.D. in nursing practice. DNP programs emphasize patient-centered care, while Ph.D. programs focus on research, preparing graduates for careers in academia. During doctoral programs for NPs, students complete research and nursing practice coursework. Doctoral programs also incorporate clinical hours and a clinical research project or research-based dissertation.

Graduates with DNP and Ph.D. degrees qualify for the most advanced roles in the field. Nurses with graduate degrees can pursue tenure-track professor positions or management roles within healthcare organizations. Most doctoral programs take at least four years to complete.

How Long Does It Take To Become a Nurse Practitioner?

NPs are APRNs, which means that they must complete graduate degrees to qualify for advanced licensure in most states. The process takes several years after earning an RN license.

Nurse practitioner qualification requirements include an RN license, a graduate degree from an accredited NP program, passing scores from a national certification board, and a state-issued license to practice as an NP.

RNs who already hold BSN degrees can typically become NPs in 2-3 years.

Professional Licensure and Certification

Like RNs, NPs must complete certification and licensure requirements. Before entering an NP program, nurses must take the NCLEX-RN exam to become RNs. Nurses who choose to work as RNs before applying to graduate programs often benefit from their work experience.

In an MSN program, NP graduate students take courses in their specialty areas and complete supervised clinical experiences. After earning their NP degrees, graduates can apply for certification from national certification boards.

NPs have several certification options, depending on specialty area. For example, the American Academy of Nurse Practitioners grants credentials for FNPs, adult-gerontology primary care nurse practitioners, and emergency nurse practitioners.

The American Nurses Credentialing Center offers credentials for PMHNPs, FNPs, and ACNPs. NPs can also pursue specialty certification from organizations like the Pediatric Nursing Certification Board.

Candidates must meet education requirements to sit for certification exams. Depending on the certification, the exam usually tests NP skills directly related to the specialty. After passing the exam, NPs earn board certification, allowing them to apply for state NP licenses. State boards set a minimum number of supervised clinical hours, which NPs typically meet during their graduate programs. Board-certified and licensed NPs need to renew their credentials on a regular basis, though the exact time period varies by state.

Nurse Practitioner Requirements Overview

  • Each prospective NP must hold an RN license before entering an MSN program. ADNs and BSNs both prepare graduates for RN licensure.
  • RNs with associate degrees can choose RN-to-MSN programs, which are bridge programs that grant BSNs along the way to NP licensure.
  • Some NP programs require nursing experience before applying. They may also request experience in the student's specialty area of interest.
  • An NP student must complete coursework and clinical requirements to earn an MSN or DNP.
  • After earning an MSN or DNP, an NP can apply for professional certification and a state license.

Nurse Practitioner Career Paths

An NP with an MSN or DNP specializes their training during graduate school. They often choose a concentration area and complete clinical requirements in that specialization. For example, NP students can specialize in family practice, acute care, gerontology, pediatrics, or psychiatric-mental health.

In each of these specialties, NPs provide primary or specialty care to patients in hospitals, doctor's offices, and outpatient care centers. Learn more about NP careers with our guide.

How Much Does a Nurse Practitioner Make?

In 2019, the median NP salary was $109,820. The profession ranks among the highest paid in the nursing field.

However, the earning potential for NPs varies depending on location, education, specialty, and experience. As NPs gain experience, their salaries tend to increase. Some parts of the country also pay higher salaries. For example, NPs in Los Angeles earn a mean salary of over $138,000 per year.

Top Paying Cities for Nurse Practitioners
Urban Center Annual Mean Salary
Los Angeles, CA $138,340
New York, NY $128,720
Houston, TX $124,960
Boston, MA $123,690
Dallas-Fort Worth, TX $115,190
Phoenix, AZ $108,610
Source: Bureau of Labor Statistics

Frequently Asked Questions

Do Nurse Practitioners Work Under a Doctor?

In some states, NPs need a doctor's approval for certain procedures. In other states, NPs can work entirely independently from physicians.

How Many Years Does It Take To Become a Nurse Practitioner?

NPs need a master's degree or doctorate in nursing. Most MSN programs take 2-3 years, while a DNP takes an additional 3-4 years. Some schools offer bridge programs, which can enable RNs to earn MSNs or DNPs in less time.

How Long Do You Have to Go to School to Be a Nurse Practitioner?

An NP needs at least a master's degree, which generally takes 2-3 years to complete. An RN-to-NP bridge program may offer a faster route to the career than a typical MSN program.

Does NP Stand for "Nurse Practitioner?"

Yes, NP stands for "nurse practitioner." NPs are also called "advanced practice registered nurses," or APRNs.

Is an MSN the Same as a Nurse Practitioner?

No. An MSN is an educational degree, and it is only one component of the qualifications that NPs need to practice. They must also complete board-certified exams and earn state licensure.

Header Image Credit: andresr | Getty Images

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