Nurse Practitioners (NP) are registered nurses (RN) with graduate level degrees and are considered advanced practice nurses. They are able to provide health care services to patients in a variety of different settings. Some responsibilities include: assessing, diagnosing, and managing acute and chronic conditions. They are also responsible for prescribing medications as needed as well as health promotion and disease management.
Salaries vary quite a bit from state and specialty. NPs who specialize in acute care or work with surgeons can usually command a higher salary than ones who work in a family practice office. The mean salary according to the Bureau of Labor Statistics in May 2012 is $91,450/year.
It is important for new NPs to understand the negotiating process during the interview and hiring process. Not only is salary negotiable but benefits, loans repayments, vacations and bonuses can be negotiated as well. Knowing how much revenue you bring to the practice can help serve as a point of reference if this is possible to discover this ahead of time. Many websites can give tips on how to negotiate as well as local salary information.
The minimum educational requirements for an NP is a masters in science of nursing. Some programs require some RN experience while others do not. Some colleges offer a route for individuals without a nursing degree; they are generally known as direct entry programs. These types of programs usually require a bachelor's degree in another field as a prerequisite for admission. The American Association of Colleges of Nursing (AACN) recommends (not requires) a minimum of a doctor of nursing practice (DNP) by 2015. However many colleges and universities are moving forward with the DNP requirement and no longer offer the MSN approach. These typically take three to four years to complete, while the MSN requires 2 years of study for individuals who already are RNs.
There are different types of specializations for the NP which include: family nurse practitioner, adult geriatric nurse practitioner, acute care nurse practitioner, pediatric nurse practitioner, psychiatric-mental health nurse practitioner, neonatal nurse practitioner and women's health nurse practitioner. A few programs offer dual degrees such as Vanderbilt University's dual Family Nurse Practitioner/Adult Gerontological Nursing with an Emergency Care focus or Case Western Reserve's Adult-Gerontology Acute Care NP with a focus on Flight Nursing, Cardiovascular Nursing and Oncology/Palliative Care NP focus.
Certification is required in order for NPs to practice is most states. The American Academy of Nurse Practitioner (AANP) is one organization that offers a certification exam. The American Nurses Credentialing Center (ANCC), which is affiliated with the American Nurses Association, also offers a certification exam. There are only small differences between the two. For example, the ANCC allows NPs to earn CEU's by precepting NP students. The AANP exam can actually be taken prior to graduation. Most NP positions require one certification or the other; a few organizations may prefer to hire NPs with a specific certification.
It is imperative that each NP know and understand the requirements of their practicing state. Almost all states require certification from either AANP or ANCC before a license is issued. Prescriptive authority are requirements that must be met in order to legally prescribe medications. To prescribe controlled substances, NPs must apply for a DEA (Drug Enforcement Agency) number. This number is also used to track the number of controlled substances the NP may write as well as for identification purposes by the DEA.
Most states require a NP to have a current collaboration agreement with a physician. These are written agreements in which the physician agrees to oversee a NP's practice. The requirements of these agreements vary from state to state. Some may only require physician agreement in order to prescribe medications only while others may require it for the NP to a diagnose and treat. Some may require the agreement to include written treatment protocols, periodic physician review of the NPs charts, patient referral and consultation, or resolutions of disagreements between the NP and the physician. States where this agreement is not required are considered independent practice states.
NP's work in many areas within health care organizations such as hospitals, mental health facilities, community health centers, physician offices, long term care, urgent care, and hospice. New areas are opening up such as telehealth and home health. In independent practice states, NP's can even open their own clinics and treat patients.
Duties / Responsibilities
Diagnosis and manage patient all types of health conditions
Detailed physical examinations (history and physicals)
Orders diagnostic and/or laboratory tests and interprets results
Orders treatments and monitors effectiveness
Collaborates with other members of the health care team
Performs procedures dependent on area of specialization
Patient and family education and counseling on health conditions
The Bureau of Labor Statistics (BLS) does not differentiate between projected vacancies for nurse practitioners and registered nurses. Many do foresee an explosion of opportunities in many areas of the US due to the current health care climate and shortage of primary health care providers. There may be areas that have few opportunities while others areas may have a high demand.
Understanding the Practice Doctorate in Nursing
The American Association of Nurse Practitioners
Medline Plus article on NPs
National Association for Pediatric Nurse Practitioners
FAQ About Psychiatric Mental Health Nurses from the American Psychiatric Nurses Assoc.
APRN Prescribing Law - State by State (MEDSCAPE 2018)
Bureau of Labor Statistics NP Occupational Employment and Wages (5/2012)