Nurse Practitioner (NP)

Nurse practitioners (NPs) provide dedicated primary and acute care, similar to physicians, but through a nursing lens. They can diagnose and treat basic health conditions, but they also pay attention to other factors affecting optimal health, such as prevention, counseling, and health education.

Depending on their interest, nurse practitioners can focus on a specialty area and have a subspecialty within that population. For example, a pediatric nurse practitioner can further specialize in cardiology, or an adult-gerontology acute care nurse practitioner can work primarily in dermatology.

Nurse practitioners provide comprehensive care for their patients. They are licensed to prescribe medications, order lab tests or procedures, and refer to other practitioners. However, nurse practitioners may not be allowed to admit patients directly to the hospital, so they would need to collaborate with an attending physician.

In approximately 27 states (including D.C.), NPs can practice independently from physicians. In 13 states, they can work with partial supervision, while in 11 states, NPs have more restricted practices.

Nurse practitioners (NPs) have obtained their advanced practice nursing degrees by obtaining either a master’s or doctoral degree and completing additional clinical hours. Their practice area determines what further education, clinical training, and certifications they need.

The setting where the NP works determines much of their role, but general activities may include:

• Perform initial intake, ongoing management, and follow-up care
• Administer physical exams, order lab work, and other tests or referrals
• Document findings and maintain records
• Order medications
• Create patient-specific care plans
• Perform limited in-office procedures depending on specialty
• Collaborate with other health providers
• Manage nursing and other office staff

Nurse practitioners gain skills to manage the total care of their patients beyond what regular nurses do. They must be able to integrate both medical and nursing knowledge. NPs learn how to perform and interpret assessment findings, arrive at a working diagnosis, and develop a treatment plan.

Nurse practitioners are expected to increase their knowledge about prescribing and administering medications safely. Overall, NPs must learn to think independently, follow their instincts, and utilize strong critical thinking skills.

Nurse practitioners often work in hospitals, clinics, schools, long-term care facilities, urgent care facilities, correctional facilities, and in-home healthcare.

Nurse practitioners manage patients of every age, socioeconomic level, and medical condition.

The American Association of Nurse Practitioners has links to all the national certification organizations.

• American Nurses Credentialing Center (ANCC)
• American Academy of Nurse Practitioners Certification Board (AANPCB)
• American Association of Critical-Care Nurses (AACN)
• Pediatric Nursing Certification Board (PNCB)
• American Association of Nurse Practitioners (AANP)
• National Certification Corporation (NCC)

Nurse practitioners select a study area typically in one of six areas as their focus, and then they can gain certification in the area they trained. After completing additional post-graduate courses and work experience in a secondary area, they can apply for certification in that subspecialty area.

• Family (Nurse Practitioner, FNP): “across the lifespan”
• Adult-Gerontology: acute care or primary care
• Women’s Health/Gender-Related
• Pediatrics (PNP): acute care or primary care
• Neonatal
• Psychiatric/Mental health

There are several additional subspecialties, such as:

• Emergency care
• Cardiology
• Dermatology
• Oncology
• Orthopedics
• Psychology

Nurse practitioners must be BCLS certified and renew their NP license every one to three years, depending on their state. Each state also requires a differing number of CEU hours.

1. Complete an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) degree: takes about two to four years based on the program
2. Pass the NCLEX-RN exam and apply for your RN license after graduation
3. Gain experience working as a registered nurse, though some skip this step
4. Attend an NP nursing program in the specialty area desired. Nurses with ADN degrees can complete their BSN in conjunction with their master’s or doctoral degree. These programs take about 18 months to three years or longer to complete.
5. Take the exam to become a Certified Nurse Practitioner (CNP) after gaining experience

A nurse practitioner must obtain an MSN degree, but some get doctoral degrees.

These doctoral degrees are not to be confused with physicians’ medical doctor degrees.

Nurse practitioners typically make between $99,426 - $134,323, with a median salary of $115,301, according to Salary.com.

The May 2021 Bureau of Labor and Statistics report shows which states have the highest and lowest wages for nurse practitioners. The highest-paid states are California, New Jersey, and New York. The lowest-paid states are Alabama, Kentucky, and South Carolina, which is tied with West Virginia.

American Association of Nurse Practitioners (AANP)

Nurse Practitioner Healthcare Foundation (NPHF)