These days, medical professionals are at the forefront of our attention: they’re on tv, being interviewed, featured in commercials, and are looked to for advice during these trying times. They’re pretty much the life buoy we cling to in the sea of information and misinformation that we are being bombarded with on a daily basis ever since Covid-19 reared its head.
The Covid-19 crisis has brought some interesting information into focus. In addition to the 22 states that already allow nurse practitioners to practice without having a physician sign off on prescriptions or treatment plans, many governors have signed executive orders to allow greater executive freedom to nurse practitioners in other states as well. This is, of course, due to the health crisis we are facing, but it also speaks volumes to the scope of capability nurse practitioners possess.
Before we get started and look into how to become a nurse practitioner, we should first look at the difference between an NP and a physician assistant.
A nurse practitioner is an Advanced Practice Nurse who is registered and has additional responsibilities regarding patient care, as you will see outlined in more detail below.
A physician assistant, on the other hand, has a master’s degree and works interdependently with licensed physicians who can diagnose and treat illness and disease.
The program length to become a nurse practitioner or physician assistant is actually relatively the same after the bachelor’s degree has been earned. Both are master’s level programs and can be completed within two to three years depending on the actual program you choose.
You can also choose a career as an FNP, who is also an advanced practice nurse but specializes in family care. An FNP works with patients of all ages and over various specialties, while a general nurse practitioner specializes in patient care for a particular age group.
According to the BLS, nurse practitioner jobs are expected to grow 45% by the year 2029. It is an exciting, although challenging, field to be in, and there are many different areas of specialty available such as midwifery, gerontology, anesthesiology, and psychiatry, just to name a few.
As stated above, this is a growing field, and nurse practitioners stand to make over $100,00 annually. But how do you get there? Becoming a nurse practitioner is not an easy or inexpensive journey. Below are the steps you will need to take as aspiring nurse practitioners to join this lucrative and in-demand field.
This is generally a four-year, full-time program, and you will cover such topics as anatomy, physiology, public health, and basic pharmacology. Expect to become more specialized as you advance and be sure to choose topics that you may want to specialize in as an NP. There will also be practicums and internships.
If you have a BA or a BSC in another field, you can still pursue your Master of Nursing or a Doctor of Nursing. You will have to take courses in certain areas to get you up to speed on the knowledge you will need to continue your education.
You must pass an exam on the National Council for Licensure Examination, or NCLE, to become a registered nurse. You will more than likely need to submit to a criminal background check before you are allowed to practice. There are generally fees associated with obtaining your license, but this varies from state to state.
This may not always be easy, as you may have to apply and reapply for positions of interest as they become available, but it is an important part of becoming an NP. There are many different fields to specialize in, and each NP will need to be familiar with their particular area of specialization.
Additionally, many specializations will require supervised work in the area you are pursuing. At this point, you will want to complete fieldwork and choose a master’s or doctoral program in the area you want to specialize in. Again, depending on the state you are practicing in, you may need to complete certifications relevant to your field.
Both graduate degrees will allow you to practice as an NP. There are, however, some notable differences, including the amount of time it takes to complete, what types of work you can expect to be certified for, and what type of salary you can expect.
Which Nursing Board you get your certification from will depend on which area you specialize in. Generally, you will need to show evidence of clinical work, as well as passing an examination and paying a fee.
Again, cost and requirements will vary from state to state. You may need to show proof of a collaborative agreement with a physician and/or acknowledgment of board standards. Fees may be applicable, and there may be yearly renewal requirements that could require recertification from your specialty nursing board.
Besides the amount of education each career path requires, there are many differences between being an RN or an NP. Although both perform hands-on patient care, the responsibilities and allowances of an NP can far surpass that of an RN.
Generally, a BSN will take four years to complete, and includes a general overview in the first year, including subjects such as anatomy and physiology, then branching out into different specializations in the following years. A BSN plus certification as an RN is what you will need to practice as a Registered Nurse.
There will be options and requirements for continuing education and recertification and annual fees to be paid to the board to ensure you continue to be certified. If you aim to become a nurse practitioner, this is usually the first step you will need to take.
Depending on what specialty you would like to pursue, you will have two to five years of education ahead of you, plus hundreds of clinical hours to complete. If you aim to be a registered nurse, this is where your career starts.
Nurse practitioners are generally allowed to treat patients and prescribe medications and treatment plans without clearance from a physician. Some states require expressed permission or proof of collaborative agreement with a practicing physician. Still, there are many where an NP can practice in their own clinic without any supervision, as they have been educated, licensed, and certified in accordance with that state’s guidelines.
Registered nurses, on the other hand, always practice under supervision and in accordance with a physician. Although they are very present in the treatment of patients, they do not make decisions regarding the treatment plan, nor are they licensed to prescribe medications.
Depending on what a nurse practitioner specializes in and what nursing degree they hold, there are many different work environment possibilities for someone who chooses this career path. Many nurse practitioners will practice in a clinic setting, meaning they will have regular business hours.
Registered nurses can also find themselves working these hours depending on what type of nursing specialization they chose to pursue in school, but many end up working shifts in hospitals.
Shift work for both NPs and RNs can range in length, but generally, nurses in hospitals work three or four 12 hour shifts per week, often with the option of overtime if there are staff shortages.
There are almost countless areas to specialize in as a practical nurse. You will have to ensure that you choose to pursue areas that will help you achieve your career goals. It is not necessary to know exactly what area you want to specialize in from the first day of nursing school, and you may find that there are areas you become interested in once you have some experience in them.
That being said, the more time you spend in your chosen area of specialization, the better it will be for your ultimate goal. There are far too many to list in entirety, but here are some of the more popular choices an NP can specialize in.
To become a certified nurse midwife, you will have to take a particular path. You will have to get your Bachelor of Science in Nursing (BSN degree), or if you already have a BA or BSC, you will need to update your education with some additional courses. Then you will need to get your Master of Science in Nursing (MSN degree) and then pursue accreditation from a Nurse-Midwifery program.
Some institutions will allow you to choose a midwifery stream during your MSN degree work. You will then have to take an examination through the American Midwifery Certification Board and apply for state licensure to practice as a CNM.
A CNM is an Advanced Practice Registered Nurse or APRN. You will have varying abilities to prescribe medications and treatment plans depending on what state you work in as an advanced practice nurse. Wherever you find work, a CNM is a very specific and exciting career path.
Your day-to-day work will entail caring for female patients, as well as their partners, when there are reproductive issues at hand. The scope of your practice will include females of all ages, from adolescents to women beyond their reproductive years. It will include caring for more than just reproductive health and being present during childbirth.
You will also provide postnatal care to mothers and infants during the first 28 days post-delivery, as well as assisting during cesarean sections, and bringing your knowledge and training to emergency situations during labor and delivery.
The hours you work will depend on many variables, but most CNMs work in clinics and hold regular hours during the week. As you may be present during childbirth and emergency situations, you may also be on call.
According to the BLS, the annual wage for a CNM is $115,450, with those in the 10th percentile making $67,710 and those in the 90th percentile making $179,770.
The top five schools to become a CNM are as follows:
To become a CRNA, you will need to go through the basics steps for becoming an NP. First, you will have to get your nurse practitioner license to practice as a registered nurse in your state, with most states needing a Bachelor of Science in Nursing and a passing score on the NCLEX-RN exam.
The next step is to apply to a CRNA program. These are accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs or the COA. These nursing programs are Doctorate of Nursing programs and take two to five years to complete, depending on the program and your previous qualifications. You may need to take a BSN to DNP program before applying to a CRNA program.
You will then have to apply for the National Certification Examination from the National Board of Certification and Recertification for Nurse Anesthetists, or NBCRNA. You will have to retake the examination every four years.
Not only does this protect your patients by guaranteeing you have updated knowledge, but it also protects the value of your credentials. All states require a passing score on this exam to practice as a CRNA.
As with all other nursing streams, you will have to apply for a license to practice in your state. There will more than likely be fees associated with this licensure.
CRNAs are a highly qualified type of nurses with a high amount of responsibility. As a CRNA, you will administer all types of anesthesia, monitor respiration during procedures, and identify and treat emergency situations. You may also be responsible for pain management and post-procedural care, as well as emergency care and patient care during labor and delivery, depending on where you are working.
If becoming a CRNA seems like a long process to a potentially stressful job, it is. But it is also highly rewarding. And your salary will reflect the long hours you have put into studying and working. The BLS predicts a 14% growth rate over the next ten years in this career path, and the median pay sits at $189,190.
The top five schools to become a CRNA are as follows:
As with other nurse practitioner career paths, to become a GNP, you will first have to earn your Bachelor of Science in Nursing (BSN), then take an exam through the NCLEX to become licensed as a registered nurse in your state.
From there, you will then want to work as an RN in an area where you will have hands-on experience with the elderly population, such as in a nursing or retirement home, in palliative care, or a hospice setting. Many different streams of NP require hours logged in-clinic, and this stream is no different.
The next step in becoming a GNP is to enroll in a master’s degree program or Doctor of Nursing program, which generally takes between two to five years, depending on which program you choose. You will need to be certified by the American Nurses Credentialing Center. You will need at least 500 hours of supervised clinical practice experience in a gerontological setting to practice as a GNP.
What your day looks like as a GNP will vary depending on where you work. Your work will consider all of the common illnesses that affect seniors, such as depression, dementia, incontinence, osteoporosis, osteoarthritis, diabetes, and cancer, as well as acute care, such as from falls and dehydration.
As a GNP, you will also be responsible for diagnosing and treating patients and prescribing medications and patient care plans. Your work can take you anywhere from private homes to hospitals, and the hours you work will be reflective of that.
Although salaries for GNPs vary depending on how much experience you have and where you are practicing, the BLS states that the median salary for a GNP is $113,930 as of 2019. Job growth in fields such as these will always be high as our population ages.
The top four schools to become a GNP are as follows:
Becoming a PMHNP is similar to becoming any other type of specialized NP, with the first step being earning your Bachelor of Science in Nursing (BSN). Choose courses, fieldwork, and internships that will complement your chosen field. After graduation, you will need to obtain a license in your state to practice as a registered nurse and then pass the NCLEX-RN examination.
Your next step to becoming a psychiatric nurse practitioner is to apply to an accredited program. The Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN) are the two bodies that accredit these postgraduate nursing programs. You can choose to pursue a master’s degree or a doctoral program for this accreditation.
This is another nursing stream in which supervised clinical hours are important. You will need 500 hours of faculty-supervised mental-health-related work to become certified.
You will then need to pass the psychiatric-mental health nurse practitioner exam, which the American Nursing Credentialing Centre administers. After passing, you will be able to apply for licensure to practice in your state. There will be different requirements in each state, and the renewal of your license will also have different requirements, including continuing education.
A PMHNP performs an important role for many who suffer from issues with mental health. As a PMHNP, you will assess, diagnose, and treat patients who require quality care. In this nursing stream, you must be very engaged with your patients as you may be treating them for months or even years, so developing a professional NP-patient rapport is essential.
The BLS puts the median annual wage for a PMHNP at $126,970. As research and understanding of mental health and the issues surrounding it grows, so, too, will the need for mental health practitioners.
The top five schools to become a PMHNP are as follows:
The Pros and Cons of Becoming a Nurse Practitioner
As with any career, there are pros and cons to becoming a nurse practitioner of any specialty. Here, we’ll explore an overview of some of the best and worst of being in this field, as we’ve learned from nurse practitioner Jennifer Schlette:
Anticipates quite a strong need for NPs in the coming years. With many states relaxing
Restrictions on NP’s prescribing medications and having a physician’s permission to practice, the outlook for the future of nurse practitioners is bright.
That being said, there are definitely some negative aspects to this, as with any career path.
Top Schools for Nurse Practitioner Programs
Dedicating the time, effort, and money to your dream of becoming a nurse practitioner starts with researching which schools will help you reach your goals in the best way possible. Below, we’ve listed some of the top schools to help you achieve your NP degree.
According to CollegeChoice.net, these are the top five ranked schools for pursuing your NP program degree:
Located in Austin, Texas, this school has an 83% graduation rate. Applicants are expected to have a BSN and a minimum of two years of related clinical experience to apply. If you have a BA or a BSC, you will also need an associate degree and related work experience. You will also need a minimum GPA of 3.0.
Nursing concentrations include psychiatric-mental health nurse practitioner, adult-gerontology nurse practitioner, primary care pediatric nurse practitioner, family nurse practitioner, and leadership streams.
This school is located in Provo, Utah, and has an 86% graduation rate. Brigham offers a generic Family Nurse Practitioner program that leads to an MSN degree. This program focuses on research methods and clinical nursing practice, with streaming, decided with the help of the faculty.
Acceptance into this program relies on a GRE score. Students must also have a BSN and a minimum GPA of 3.0.
This school is located in Villanova, Pennsylvania, and has a graduation rate of 91%. This program can be completed in approximately two years if you choose to take it full time. There are on-campus and online options.
Villanova offers an MSN program with a Family Nurse Practitioner track. Students will not need prior work experience to apply for this course.
This school is located in Nashville, TN, and has a 94% graduation rate. Vanderbilt offers a Master of Science in Nursing, with concentrations in emergency, neonatal, and adult-gerontology primary care nurse practitioner programs.
You will need a GPA of 3.0 to attend this program, and students with a BSC need a three-credit statistics course to apply.
Emory is located in Atlanta, Georgia, and has a 90% graduation rate. Emory offers an MSN with streams in family, emergency, women’s health, and pediatric primary care nurse practitioner programs.
You will need to be an RN with licensure in Georgia or a multi-state license to apply. Seven hundred fifty supervised clinical hours will need to be completed while enrolled in the program.