What is a Nurse Practitioner?
Certified nurse practitioners, or advanced practice nurses, are medical professionals who can work without direct doctor supervision. They require both graduate education and years of experience in nursing. As an NP, you would diagnose, educate, and treat patients. You would also need to know how to examine patient health histories and make confident decisions in high-stress situations.
What Does a Nurse Practitioner Do?
Nurse practitioners' duties are very similar to those of primary care doctors, and include ordering tests and interpreting results, diagnosing and treating health problems, and discussing health conditions with patients. In some states, you would actually be referred to as a primary care professional. You could work as a general NP or become specialized in a certain area, like pediatrics or women's health. Some of the many responsibilities of nurse practitioners include:
- Giving immunizations
- Helping patients manage chronic conditions
- Performing physical examinations
- Writing prescriptions (allowed in 49 out of 50 states)
You might also choose to explore a specific area of interest while attending school and completing all educational requirements for nurse practitioners. There are many medical practice fields to choose from, including kinesiology, substance abuse education, or dermatology.
Types of Nurse Practitioners
Nurse practitioners, or NPs, are high-level nurses who are able to treat patients in a similar manner as some doctors. Some are even able to prescribe medicine and treatment without a doctor's consent. In small clinics and communities, you may find that only NPs are available for treating patients. The primary difference between nurse practitioners and doctors is that NPs tend to look at care holistically and with more bedside manner. Within the nurse practitioner field, there are several specializations that you can choose from, just as there are for RNs and doctors. Some types of NPs include:
- Gerontology NP
- Neonatal NP
- Pain management NP
- Family nurse NP
- Psychiatric NP
- Emergency NP
- Surgical NP
Psychiatric Nurse Practitioner
Psychiatric nurse practitioners' education requirements involve becoming an RN and obtaining a master's degree in mental health. A psychiatric NP works in mental health settings, and as the stigma around mental health decreases, there may be more opportunities available. As a psychiatric NP, some of your duties will be to listen to patients, diagnose mental disorders, and prescribe medicine and treatment when necessary.
Along with the educational requirements, all psychiatric nurse practitioners must become licensed RNs and may need to be certified in a specialization such as mental health nursing. While some specialties have their own licensing put together by an association, the NCLEX-RN is always required. Psychiatric nurse practitioners average around $90,000 a year in salary.
Family Nurse Practitioner
According to the American Association of Nurse Practitioners, family health nurse practitioners are the most common type of NP, with 60.6% of NPs taking the role of family NP. On average, family NPs make over $84,000 annually. As a family NP, you'll work very closely with families in a broad range of topics, acting as doctor in some instances, to assess, diagnose, and treat patients. You'll be able to order tests, perform exams, and prescribe medicine and treatment. You may work with other medical staff, such as doctors and technicians, to diagnose more in-depth illnesses or gain additional opinions. You'll also manage overall health plans of patients and promote healthier lifestyles.
The education requirements to become a Family Nurse Practitioner are quite similar to other nurse practitioners. Along with becoming an RN, you'll want to earn a master's in general nursing or family nurse practice. Some nurses earn their graduate degrees and then continue with a certificate in the family health specialization. Of course, as with all other nurse practitioners, you'll need to pass the NCLEX-RN exam.
Neonatal Nurse Practitioner
Roughly 1.3% of nurse practitioners are neonatal NPs with 69.1% of that group working in hospital settings, such as the neonatal intensive care unit (NICU). In a neonatal setting, you'll take care of newborns which are babies from birth up to 28 days old. Most often, these newborns are prematurely born or have medical issues during or after delivery. Some job duties include working with families, helping new mothers with postpartum care, working with incubators, ensuring the proper handling and care of NICU patients, and diagnosing and treating immediate issues.
Education requirements for a neonatal nurse, include becoming an RN and either a master's degree in neonatal care or a master's in nursing with a concentration in neonatal care. Other job requirements for neonatal nurse practitioners also include an RN license and nurse certification.
Pediatric Nurse Practitioner
There are two types of pediatric nurse practitioners: primary care and acute care. Acute care pediatric nurse practitioners commonly provide hospital care for pediatric patients, typically children under the age of 18. As an acute PNP, you'll treat sudden illnesses or injuries.
Pediatric care nurse practitioners (or PNPs) tend to work in hospitals or outpatient clinics. As a primary care PNP, you'll give shots, do routine checks on a child's growth, and help patients live healthy lifestyles to promote growth. You may come across disorders or development issues, as this is a time when little bodies are greatly changing.
To become a Pediatric Nurse Practitioner you'll need at least a master's degree. While becoming an RN introduces you into the career, you'll need to specialize in pediatrics during your graduate studies. Some nurses even continue to earn their DNP (Doctor of Nursing Practice). There is a big payoff, as the average salary for DNPs is roughly $135,830, according to the U.S. Bureau of Labor Statistics in 2015, versus the average of $82,101 for non-DNPs.
Acute Care Nurse Practitioner
Acute care is the medical treatment for a sudden injury or illness. These unexpected ailments must be addressed within a relatively short amount of time. Sometimes, acute care nurse practitioners work in urgent care settings, which see patients who need medical access when their general practitioners are unavailable. Roughly 6.4% of NPs decide to specialize in acute care. Often, those who want to become an acute nurse practitioner choose to work as an RN in acute care settings for a few years prior to continuing their education with a master's degree and possibly a post-graduate certificate specializing in acute care. Acute care nurse practitioners can specialize even further with another focus, such as acute pediatrics, geriatrics, surgery, emergency care, or trauma.
There are a number of other nurse practitioner specialties that can be considered. Below is a list of just some of those careers and their education requirements.
| Specialty | Education Required | Major | Treats | Certification | Average Salary |
|---|---|---|---|---|---|
| Dermatology Nurse Practitioner | Master's Degree | Dermatology | Skin Conditions | Dermatology Nursing Certification Board (DNCB) | $92,219* |
| Women's Health Nurse Practitioner | Master's Degree | Women's Health Nursing | Reproductive and Gynecological Issues | National Association of Nurse Practitioners in Women's Health (NPWH) | $82,183* |
| General Nurse Practitioner | Master's Degree | Nursing | All Health | NCLEX-PN | $103,880** |
| Surgical Nurse Practitioner | Master's Degree | Surgical Nursing | Surgical Needs | Certified Medical-Surgical Registered Nurse (CMSRN) | $108,547* |
Along with the previous table, there are even more nursing specialties in which to focus your education and career. Check out some more about nursing specialties below to learn about the career and educational requirements.
- OB GYN Nurse Practitioner - You will work with women in the obstetrics field delivering babies and working with reproductive needs.
- Advanced Nurse Practitioner - You'll provide preventative care for patients.
- Travel Nurse Practitioner - A nurse with several licenses in every state, you will work in various settings wherever there is a medical practitioner shortage for set periods of time.
- Emergency Nurse Practitioner - You'll work in the emergency room or urgent care centers.
- Oncology Nurse Practitioner - You'll work with cancer patients.
- Adult Gerontology Nurse Practitioner - You'll work with elderly patients.
- Trauma Nurse Practitioner - You'll work in emergency situations to help patients with acute illnesses and injuries.
Nurse Practitioner Job Outlook
The U.S. Bureau of Labor Statistics (BLS) considers the job outlook excellent for nurse practitioners. This may be due to the increase in demand for primary care providers met with the fact that NPs can do many of the same things that doctors can.
The BLS projects a 31% job growth from 2016 to 2026, with a demand for 56,600 more NPs during that time. If you decide to become an NP, you can expect more opportunities in areas that are currently underserved by doctors and other medical professionals, like inner cities and rural places in the country. The following table shows the top five states with the highest expected job growth and the five with the lowest number of new jobs projected*:
| States with Highest Job Increase | Growth Percentage* | Number of New Jobs* |
|---|---|---|
| California | 39% | 4,200 |
| Texas | 48% | 3,880 |
| Florida | 47% | 3,830 |
| New York | 32% | 3,660 |
| Georgia | 53% | 1,850 |
| States with Lowest Job Increase | Growth Percentage* | Number of New Jobs* |
|---|---|---|
| Vermont | 21% | 110 |
| Rhode Island | 18% | 90 |
| Wyoming | 37% | 80 |
| Hawaii | 26% | 70 |
| Alaska | 19% | 50 |
Nurse Practitioner Continuing Education
To keep up with state and national licensure regulations, you will need to participate in nurse practitioner continuing education. As an NP, you'll be expected to advance your understanding of regulations, professional conduct, and new medical practices. The requirements for continuing education vary by state, as do the number of hours and the frequency of continuing education courses. Forty-three states have state-specific requirements for their medical professionals, and the numbers of hours necessary vary from under 10 to over 40.
Of the remaining seven states, most of them require their nurse practitioners to meet national continuing education regulations mandated by the American Association of Nurse Practitioners instead of establishing their own CE requirements. This organization offers multiple continuing education opportunities for NPs, including online courses. Additional requirements may be necessary for NPs who are authorized to write prescriptions, but that also varies from state to state.
Nurse Practitioner Scope of Practice
Like continuing education requirements, the scope of your practice as an NP depends on where you work and your particular specialization. In order to better understand the differences between states, it's important to understand three terms.
- Practice authority: Your practice authority means that state regulations decide whether you can work independently or whether you need a doctor to perform certain procedures for you.
- Prescriptive authority: Your prescriptive authority, or your ability to write prescriptions for patients, can vary, though most states allow NPs to write prescriptions in their field.
- Primary care provider: This identifies the initial medical professional to see a patient. A primary care provider can continue to work with the patient or refer them to a specialist if necessary.
Some states grant NPs full practice authority, while others mandate that a doctor signs off on certain procedures or that a doctor must approve any procedure. This is similar to the prescriptive authority of NPs in certain states. Some NPs are able to write prescriptions for patients without the authorization of a physician, while others cannot write prescriptions at all and need a physician to do that for them. These states are referred to as either reduced practice or restricted practice states. Similarly, some states grant NPs the title of primary care providers while others reserve that title only for physicians. If you want to be a primary care physician or handle writing prescriptions for your patients, be sure to examine the requirements in your state.
| Full Practice | Alaska, Arizona, Colorado, Connecticut, DC, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, Wyoming |
| Reduced Practice | Alabama, Arkansas, Delaware, Illinois, Indiana, Kansas, Kentucky, Louisiana, Mississippi, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, South Carolina, Utah, West Virginia, Wisconsin |
| Restricted Practice | California, Florida, Georgia, Massachusetts, Michigan, Missouri, North Carolina, Tennessee, Texas, Virginia |