Nurse Practitioner: Job Description, Salary, and How to Become One

Nurse Practitioners (NPs) have advanced-level training that gives them the authority to work within an expanded scope compared to registered nurses (RNs).

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Becoming a nurse practitioner (NP) significantly enhances your clinical skills, offers a higher salary, and provides excellent career prospects. According to the Bureau of Labor Statistics, the demand for NPs is projected to grow by more than 100,000 positions between 2021 and 2031, far exceeding the average growth rate for most occupations.

While the benefits are substantial, it's important to thoroughly understand the responsibilities and requirements of this advanced nursing role to determine if it aligns with your career goals

What Is a Nurse Practitioner?

NPs are advanced practice nurses who hold either a master's or doctoral degree and have passed a national certification exam. Their education provides advanced-level training that grants them the authority to work within an expanded scope compared to registered nurses (RNs).

NPs are equipped to deliver both primary and specialized care to patients, demonstrating the following skills and responsibilities:

  • Performing comprehensive assessments and health histories
  • Coordinating care to assist with patient admission and discharge
  • Ordering laboratory assessments, diagnostic tests, and other treatments
  • Providing holistic primary and secondary care to manage acute and chronic conditions
  • Utilizing patient care and healthcare technologies
  • Staying current with emerging technologies and treatments
  • Prescribing medications and developing treatment plans
  • Educating patients on health maintenance and disease prevention
  • Collaborating with other healthcare professionals to provide integrated care
  • Advocating for patient needs within the healthcare system

Through these capabilities, NPs play a critical role in enhancing patient outcomes and improving access to healthcare services.

Steps to Become a Nurse Practitioner

Becoming a Nurse Practitioner (NP) isn't easy. NP programs are rigorous, packed with evidence-based curricula, and require at least 500 clinical hours with actual patients. Knowing the steps before you start can make the process much easier. Here's a comprehensive guide to help you navigate the journey:

Step 1: Obtain Your ADN or BSN

You must first be a licensed RN a Bachelor of Science in Nursing (BSN) degree before applying to and being accepted into an NP school.

If you have an ADN or other entry-level degree, you must enroll in and complete a bachelor's degree in a nursing program before advancing your nursing education. Alternatively, you can enter a bridge RN to MSN program that will offer an accelerated pathway to obtaining your BSN and MSN degrees.

Step 2: Pass the NCLEX-RN

Most nursing schools require you to take and pass the national board certification exam known as the NCLEX-RN, required for an RN license. Once you pass, you must also follow all the steps to become fully licensed in your state.

Step 3: Obtain Relevant Nursing Experience 

After you obtain your RN license to practice, you may need to gain real-world experience. Many NP programs require at least two years of clinical nursing experience as a prerequisite. However, other programs allow you to go directly into the NP Program without clinical nursing experience.

Step 4: Research and Choose an NP School, Specialization, and Pathway

Finding the best college of nursing can be challenging. A few things to consider as you begin looking at NP programs include the following:

  • Pass rates on the state exam administered by the American Nurses Credentialing Center (ANCC) or American Association of Nurse Practitioners (AANP)
  • Faculty-to-student ratios
  • Format of the program, such as in-person, online, and blended
  • Length of time it will take you to complete
  • Full-time and part-time options
  • Personal learning style and specific learning modalities used
  • Wrap-around support services offered to help you succeed
  • National versus regional accreditation
  • MSN versus DNP
  • Specialization, such as family nurse practitioner, adult-gerontology primary care, women's health, and others

Another consideration will be your pathway to NP, 

Another consideration is your pathway to becoming an NP. Here are the most common NP educational pathways to consider:

  • Master of Science in Nursing (MSN):

    • Audience: RNS with an associate or bachelor's degree in nursing looking to advance their clinical skills.
    • Duration: Typically 2-3 years.
    • Focus: Prepares graduates for advanced clinical roles in various healthcare settings. The program includes coursework and comprehensive clinical training.
    • Outcome: Graduates are eligible to sit for their respective NP certification exams depending on their chosen specialization.

  • Doctor of Nursing Practice (DNP):

    • Audience: Experienced nurses or MSN holders aiming to reach the pinnacle of clinical practice or enter health policy or educational leadership.
    • Duration: Usually 3-4 years.
    • Focus: Focuses on clinical practice at a higher level, preparing NPs to integrate research into practice and manage complex patient care. DNP programs often include a significant capstone project that showcases clinical expertise.
    • Outcome: Prepares NPs for leadership roles in clinical settings, health policy, and education.

  • Post-Graduate Certificate:

    • Audience: Nurses who already hold an MSN or DNP but wish to switch specialties or gain additional expertise.
    • Duration: About 1 year.
    • Focus: Offers specialized training in a new area of practice, supplementing previous advanced nursing education.
    • Outcome: Equips nurses with additional expertise in their new specialty, preparing them for certification.

  • Direct Entry NP Program:

    • Audience: Individuals with a bachelor's degree in a non-nursing field.
    • Duration: Typically 3-5 years.
    • Focus: Provides an accelerated path into nursing for those without a nursing background, starting with foundational nursing courses before advancing to specialized NP training.
    • Outcome: Prepares graduates for initial licensure as RNs and subsequently for advanced practice roles as NPs.

These pathways are designed to provide the education and clinical experience needed to handle diverse patient care needs and to lead healthcare teams effectively. Choosing the right program depends on your current educational background, career goals, and the specific healthcare area you wish to specialize in.

Step 5: Enroll and Apply to a Graduate Level Nursing Program

NP programs are rigorous, and the application process is too. Common steps you'll need to complete include:

  1. Take and pass all required entrance exams or prerequisite graduate-level coursework.
  2. Complete the physical application, which includes demographic and academic information.
  3. Write a meaningful and personal letter of intent describing why you want to become an NP
  4. Request and provide two or more letters of recommendation from others who know you as a person and a nursing professional. Choose colleagues or nursing leaders who can speak to your dedication, clinical excellence, moral and ethical practice, and personability.
  5. Complete an in-person or online video interview with one or more College of Nursing faculty and staff. Think of this as your first NP job interview. Dress professionally as you would for a job interview—research and practice the most common nurse practitioner school interview questions to be prepared.

Step 6: Complete the NP Program 

Requirements during the NP Program focus on both academic and practical training essentials for specialized care.

  • Course Completion: Successful completion of all required advanced nursing courses.
  • Clinical Hours: MSN programs typically mandate a minimum of 500 postgraduate clinical hours, with 750 hours being the preferred standard. DNP programs generally require a minimum of 1,000 clinical hours.
  • Capstone or Thesis Project: Some programs require a culminating project that demonstrates a thorough understanding of a complex nursing issue.
  • Maintaining RN Licensure: Students must keep their RN license active throughout their studies.

Step 7: Pass the National NP Certification Exam

Like the NCLEX-RN is required to become an RN, NPs are required to take a certification exam to work as an APRN. The certification to practice as an NP can be taken through various organizations, and the specific exam you take will depend on your NP concentration.

Here are the main organizations for NP certification:  

Step 8: Apply for APRN NP Licensure 

Once you have graduated from nurse practitioner school and passed the certification exam, you are eligible to apply for state APRN licensure. Each state board of nursing may have different requirements and practice regulations, so make sure to review these requirements and ensure that your NP Program is approved by the state board of nursing before applying to school, as this will ensure your eligibility to obtain your APRN license in the state of your choice.

Step 9: Start your awarding career as a Nurse Practitioner! 

Once you begin working as an NP, be sure to stay informed about continuing education and licensing requirements to maintain your NP status and eligibility. This will ensure you remain up-to-date with the latest advancements in healthcare and continue providing high-quality care to your patients.

Nurse Practitioner Specialties

NPs can specialize in various care settings, though they may require additional training or certifications in addition to NP school. Some schools focus on a specialty, providing students with the education needed to work in a specific medical niche.  

Some of the most common NP specialties you can choose are below. 

Family Nurse Practitioner (FNP)

FNPs provide primary care to patients. They assess, diagnose, and treat acute and chronic illnesses with medications, procedures, and other specialized treatments. They also offer preventative care and educate and counsel patients to live healthy lifestyles. 

Becoming an FNP requires attendance in an FNP program, requiring rigorous training in family medical care and an advanced nursing curriculum. After graduation and passing the state exam, FNPs can work in medical offices, hospitals, and other healthcare facilities. 

Neonatal Nurse Practitioner (NNP)

These specialized NPs care for neonates or infants between birth and four weeks. They often work in neonatal intensive care units or other specialty nurseries. In addition, Neonatal NPs provide skilled care to moderately and critically ill infants. These patients may be born prematurely, at high risk, or with an underlying condition. 

Pediatric Nurse Practitioner (PNP)

NPs in this specialty provide care to patients under the age of 18. They work in emergency departments, hospitals, and primary care offices. They see patients with acute and chronic illnesses and provide preventative care like assessments and immunizations. 

Pediatric NPs also educate and support their patient's parents and guardians and teach about normal human growth and development and how to assess milestone achievement. Finally, they must be aware of various conditions that commonly occur throughout childhood and how to manage each independently or by collaborating with other specialty care providers.

Adult-Gerontology Nurse Practitioner (AGNP)

Geriatrics is the care of older adults. These NPs provide primary care to seniors in primary care practices, home care agencies, and senior care facilities like long-term care and assisted living. 

They diagnose acute and chronic illnesses, educate on self-care strategies, and provide holistic treatment plans. In addition, geriatric NPs help older adults make decisions about their aged years and end-of-life care as needed. They must be able to support aging patients to maintain dignity and independence while also advocating for needed care in various care settings.

Psychiatric-Mental Health Nurse Practitioner (PMHNP)

Advanced practice nurses treating patients with mental illnesses are known as psychiatric NPs. Some states allow these providers to diagnose and prescribe medications for mental conditions and substance abuse problems. Other states may limit the scope of practice. Psychiatric NPs work in community health settings, hospitals, and private practices. 

Emergency Nurse Practitioner (ENP)

The primary setting of emergency NPs is the emergency department or urgent care centers. These clinicians treat patients of all ages for acute and emergent care needs. They diagnose, prescribe, and administer treatments of various kinds.

They may work in both rural and metropolitan healthcare systems. These professionals must remain current on the most recent medical and technological advancements to provide holistic care to patients. 

Acute Care Nurse Practitioner (ACNP)

An Acute Care Nurse Practitioner (ACNP) is a specialized nurse practitioner who provides care for patients with complex, acute, and critical conditions. ACNPs work primarily in settings like hospitals, intensive care units, and emergency departments, where they manage and treat patients experiencing severe illnesses or injuries. They are trained to perform advanced diagnostic and therapeutic procedures.

  • Adult-Gerontology Acute Care Nurse Practitioners (AG-ACNPs) focus on adults and elderly patients, providing advanced care for acute and chronic illnesses.
  • Pediatric Acute Care Nurse Practitioners (PNP-ACs) specialize in caring for infants, children, and adolescents with acute and critical health conditions, often working in pediatric intensive care units and emergency departments.

Women's Health Nurse Practitioner (WHNP)

Some NPs specialize in women's health. These NPs provide gynecologic, reproductive, and sexual health care. In addition, they diagnose and treat disorders of the female reproductive system and may work in private practice, community health centers, or hospitals. 

Women's health NPs can work with patients in different stages of life. For example, they may care for women during and after pregnancy or those experiencing perimenopause and after menopause. 

Oncology Nurse Practitioner

Oncology NPs specialize in the care of patients living with cancer. They assess, diagnose, and treat various types of cancer and must stay current on cutting-edge technologies and treatment modalities. These advanced practice nurses may work in hospitals, oncology centers, and private practices. 

Orthopedic Nurse Practitioners

Orthopedic NPs specialize in treating disorders and injuries of the musculoskeletal system. They treat conditions of the bones, joints, muscles, and other structures. 

They often see patients with injuries and attempt to rehabilitate their joint or muscle injuries before prescribing surgery. However, if the condition requires surgical intervention, they work with the patient before and after the procedure to minimize deterioration and then rehabilitate the joint after surgery. 

Nephrology Nurse Practitioner

A Nephrology Nurse Practitioner (NP) specializes in the care of patients with kidney-related conditions, including chronic kidney disease, dialysis, and kidney transplants. They work in various settings, such as nephrology clinics, hospitals, and dialysis centers.

Occupational Health Nurse Practitioners

Occupational health is the care of patients in or around employment locations. NPs specializing in occupational health help employers identify and resolve workplace hazards and provide standard care to employees. 

They may work with injured workers or provide education on preventative measures to remain safe and healthy at work. In addition, they may work in onsite health clinics, community-based clinics, or hospitals and must stay current on occupational health strategies. 

Cardiology Nurse Practitioner

Cardiology NPs specialize in cardiac care and treat patients with various heart conditions. They provide ongoing care to those with heart disease and for patients before and after simple and extensive cardiac surgeries. They work in private care settings and hospitals. 

Nurse Practitioner Salary in 2024

According to the most recent data from the Bureau of Labor Statistics (BLS), the median salary for NPs is just over $128,490, or about $61,78 per hour. The job growth for NPs is around 40%, which is much higher than the average job growth for other jobs.

Top-paying states for NPs are:

  • California: $161,540.00
  • Nevada: $148,670.00
  • Washington: $145,400.00
  • New Jersey: $145,030.00
  • Oregon: $144,950.00

It's important to note that the BLS data does not differentiate between NPs with an MSN or DNP. So, the above information is for all advanced practice nurses and may not correlate well to the specific degree and profession of your choice. However, it provides reliable data for determining your projected earnings.

ZipRecruiter further breaks down NP salaries by specialty, with salary ranges as follows: 

Compare several specializations further with our comprehensive nursing salary guide.

Benefits of Becoming a Nurse Practitioner

There are many benefits to pursuing a career as an NP. A few of the most significant benefits include:

  • Autonomy: APRNs enjoy a significantly higher level of independence than registered nurses. They can practice independently or under the oversight of a medical physician while providing acute and chronic medical care.
  • Flexibility: NPs are needed in many care settings, allowing them to find a schedule that fits their life. They can work 8, 10, or 12-hour shifts in offices, hospitals, community health settings, or remotely, offering much flexibility.
  • Pay: The average NP in the U.S. earns around $124,000 annually, compared to the average RN salary of $86,070 per year.
  • Meaningful Work: NPs have a broader scope of practice than RNs, allowing them to provide more comprehensive and holistic care. They connect deeply with their patients, offering compassionate care that many find fulfilling and exciting.
  • Career Growth: The demand for NPs is growing, providing numerous opportunities for career advancement and specialization in areas such as family practice, pediatrics, women's health, and psychiatric-mental health.
  • Job Security: With the increasing need for healthcare services, NPs enjoy strong job security and are in high demand across various healthcare settings.
  • Impact on Patient Care: NPs play a crucial role in improving patient outcomes by providing high-quality, patient-centered care. Their ability to diagnose, treat, and manage patient health contributes significantly to the overall healthcare system.
  • Professional Development: NPs have opportunities for continuous learning and professional development through certifications, advanced degrees, and specialized training programs.
  • Work-Life Balance: Many NPs find that their flexible work schedules allow for a better work-life balance, helping them manage professional and personal responsibilities more effectively.
  • Leadership Opportunities: NPs often take on leadership roles within healthcare teams, contributing to policy development, healthcare planning, and quality improvement initiatives.

This article was fact-checked and reviewed by Melissa Mills, BSN.

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