Six Things to Consider Before Applying to Nurse Practitioner School

Tana Bao, BSN, MSN, APRN, NP

As many nurses know, one of the best things about this profession is that the opportunities for the ways one can practice are endless. There are so many ways to be a nurse, and it is a great feeling knowing that you could go from doing, say, critical care nursing one day to public health nursing the next. The landscape of opportunity within the profession is vast, to say the least.

Graduate school is another option that many nurses choose to pursue, namely nurse practitioner (NP) school. While undoubtedly an exciting path, graduate school, and the considerations that come with it in terms of finances, time commitment, etc., can be a lot to think about before committing to a program. As I reflect on my path toward becoming a family nurse practitioner, I wish that I had a little more guidance while weighing my options for school through my own application process.

Here are six things to consider before applying to an NP school that I wish someone had told me about!

What kind of NP do you want to be?

The NP profession has several subspecialties within it. So, going into the application process, you need to have already decided what kind of NP you ultimately want to be since programs are structured to teach whatever specialty you have chosen. As I've mentioned, I am a certified family nurse practitioner, but you can choose to specialize as an adult nurse practitioner (which, as the name implies, is a specialty that does not treat children). On the flip side, you can choose to be a pediatric nurse practitioner or a women's health nurse practitioner, etc. I chose to be a family nurse practitioner because I felt it offered the most flexibility and employer marketability, as I am able to treat and see patients from birth to the end of life. However, my biggest advice here would be that if you, for instance, really dislike pediatrics as a nurse, you might be better off simply going for an adult NP certification instead of family, for instance. You are going to put a lot of time and money into graduate school, so make sure you study something that will allow you to enjoy your practice in the future.

Which degree is the best option?

When you research NP programs, you will see that there are programs that will teach you how to be an NP while earning a master of science in nursing (MSN) versus a doctorate of nursing practice (DNP). The minimum degree you need to sit for NP board certification is the MSN. A doctorate program augments the minimum requirements needed from an MSN program and is considered a terminal nursing degree. A DNP degree is helpful if you want to teach at the University level, as most universities require a terminal degree to be considered for tenure. In addition, the DNP shows that you are prepared to take on leadership and administrative roles within the profession, and it also shows that you are able to translate best evidence into real-life practice. Just be aware that the DNP route will ultimately cost more money since there are, of course, more credit hours that need to be completed. My advice would be to consider what you think you want to do with your NP certification and whether or not the DNP route would be of great added value to you, depending on your personal career goals. Also, how many more credits and time will it take to complete a DNP program vs. an MSN nurse practitioner program? Do you have the funds and mental stamina it will take to complete more courses after what will already be a rigorous and time-consuming program?

How many certifying boards do you need?

Just a heads up that once you finish NP school, you actually have two different, nationally recognized, certifying bodies that you can consider to become certified with. The first is The American Association of Nurse Practitioners (AANP). The second is the American Nurses Credentialing Center (ANCC). I personally have heard through different forums that in rare cases, an employer perhaps preferred the ANCC certification over AANP, but I have yet to find an NP in real life that has had difficulty with securing employment due to the certifying body he/she/they were with. Just know, you only need to be certified with one in order to be able to apply for NP licensure in your respective state. There really is no true need to take both board exams. I will say that I personally did test and pass both board exams, but this was because I wanted to take my exam as fast as possible after graduating NP school. So (and this was totally unnecessary looking back), I paid the fees to both boards to see which would give me my authorization to test the fastest. AANP came through a bit earlier, and I passed AANP in Sep 2019. At that point, since I had already paid the ANCC fee, I figured I would still take their test and did so and passed Oct 2019.

Who is responsible for finding preceptors?

This is easily the most important thing I wish someone had talked to me about before going to NP school. Specifically, will it be your responsibility to find preceptors or will your school take care of it? You need to ask this question to Every. Single. Program.

FACT: I repeat: You need to ask every single program you are considering what the deal is with finding preceptors and clinical placements!

I had a nightmare of a time trying to secure clinical placements on my own – my school offered no help as I was a "distance" student so the responsibility fell on my shoulders to find my own placements. Because I could not find even one preceptor despite cold calling and sending my resume to many different doctors' offices, I ended up moving to my school's brick-and-mortar campus as they would find clinical placements for "local" students living within a sixty-mile radius of campus. I had to therefore spend money on finding an apartment and coordinating everything else that comes with moving which was definitely unfortunate, but in the end, it was worth having the peace of mind knowing my preceptors would be found and I would graduate when I was planning on graduating. My best advice would be to do everything in your power to find a school that promises to find clinical placements for you. You will be so wrapped up in your school work already that the added stress of finding a preceptor is just not worth it.

Is NP school expensive?

Tuition these days is not cheap.

Are you going to be adding on loans to existing undergraduate loans?
Are you going to work part-time or possibly full-time while you try and pursue your graduate degree?
Does your employer offer tuition reimbursement?
How are you going to finance your graduate education?

These are all very important questions to ask yourself. My piece of advice here would be to consider a less expensive (but still accredited) school especially if it will save you a decent amount of money. At the end of the day, employers really don't care where you went to school. They care about whether or not you are board certified and have an active, unencumbered nurse practitioner license. Don't go to a school that will set you back $100K in debt if there is one you can go to for less that will still afford you the same outcome and end goal, which again, is achieving board certification and being able to obtain an NP license.

Why do you want to become an NP?

I implore you to really ask yourself this. Like really have a discussion with yourself as to why you want to be an NP. This is because the NP role is a completely different scope of practice compared to the RN role. It is a heck of a lot more responsibility and it can be scary knowing that all the decisions are on your shoulders as the provider. One of the most basic ways I can describe the difference between being an RN vs. being an NP is as follows: as an RN you go from always confirming and asking for orders, whereas when you are an NP you are the one deciding and placing said orders. As an NP, you decide the treatment plan; you decide the prescriptions, and you are ultimately the one making the medical decisions. There is no longer a provider you can double check with in the same way there is always someone above you as an RN. Please don't get me wrong, it is a great feeling to be an autonomous healthcare provider, but it comes with certain stressors that simply are not there as an RN. The other way the NP role is completely different from the RN role is that as an NP, you are now a billing provider. As in, you are actually generating the billable insurance claims and thus producing revenue for whatever health system you end up working for. This, by nature, is why there is pressure for nurse practitioners and other healthcare providers alike, to see as many patients as possible in a given day – because otherwise, money is not being made. This is a larger issue that this article will not delve into, but my point is that your professional role changes dramatically as an NP. You are going to have to balance capital interests with patient care, and that tug of war can be difficult to balance.

Overall, the nursing profession, regardless of what level you are at, is incredible in that opportunities abound within its numerous specialties. Becoming a nurse practitioner is a great academic and professional goal for many nurses, and I would urge any nurse thinking about becoming a nurse practitioner to consider some of the things mentioned in this article while exploring different NP programs. Going back to graduate school is a big decision and, as such, deserves careful time and thought prior to being pursued. I am more than happy to speak with any nurse directly if they have follow-up questions about this article, so drop a comment or send me a direct message to connect! Thanks for reading!

Tana Bao MSN, FNP-BC, NP-C, RN