Since the enactment of the Affordable Care Act (ACA), more commonly known as Obamacare, the United States has experienced a steady increase in the demand for primary healthcare providers. According to Fortune.com, since the ACA was enacted into law in 2010, approximately 20 million Americans have purchased health insurance.
Additional primary healthcare providers have been needed since that time to meet the increased health services demand. Nurse practitioner (NP) is one mid-level healthcare position helping to fill this void.
What do nurse practitioners do?
NPs are advanced practice registered nurses (APRNs). Their training and authority fall below doctors, but they have more training and authority than registered nurses (RNs).
An NP can perform many of the same essential medical tasks as doctors, such as:
- Prescribe medication
- Examine patients
- Diagnose illnesses
- Refer patients to specialists
- Provide treatment
There are nurse practitioner jobs in a variety of settings and facilities, including:
- Community care programs
- Physician's offices
- Military settings
In about half of the United States, NPs have what is referred to as "full practice authority." In the remaining states, an on-duty doctor must supervise some patient care decisions.
The nurse practitioner career path
If you're interested in becoming an NP, here's a quick guide to the process:
Become an RN.
Be sure to keep your license in good standing.
Get your BSN.
If you do not currently hold a Bachelor of Science in Nursing (BSN), enroll in and obtain your BSN.
Enroll in a Master of Science in Nursing (MSN) program.
BSN to MSN programs take approximately two years and usually consist of coursework (either online or in person) and practical training. We'll go more into MSN programs in the next section.
Choose a specialty.
There are more than eight areas in which an NP can obtain formal certification. Nurse practitioner schooling offers a limited number of specialties within their MSN programs, so study each school's program before you apply. Once you complete the MSN program, you will be eligible to test for national certification. If the NP program you are attending does not offer the specialty you want to pursue, you can also obtain certification through the American Nurses Credentialing Center (ANCC).Here are four popular types of nurse practitioners:
1. Acute Care NP:
May work in the emergency room, ICU, urgent care clinic or operating room. They perform duties such as:
- Conducting rounds on hospitalized patients
- Managing the patient's hospital stay
- Assisting in surgical procedures
- Inserting central lines and intubating
- Performing lumbar punctures and suturing duties
- Ordering diagnostic tests/treatment and formulating a plan based on the results
- Writing orders for nursing and ancillary staff
2. Adult-Gerontology NP:
Specializes in young adults to elderly patients. May work in clinics, long-term care facilities or specialty departments. Specific duties include:
- Performing routine physicals
- Ordering preventive tests and screenings
- Managing chronic conditions
- Educating patients and families on preventive health
3. Emergency NP:
Primarily work in emergency departments or urgent care departments. Specific duties include:
- Diagnosing and treating patients needing emergent care
- Admitting patients from the ED to the floor
- Ordering diagnostic tests/treatments
4. Family Nurse Practitioner:
May work in primary care clinics, hospitals, specialty departments or long-term care facilities. Specific duties include:
- Caring for a patient population from birth through aging and death
- Performing exams on acute complaints
- Performing routine physicals
- Preventive health maintenance
- Ordering diagnostic tests and procedures
Gain APRN licensure in the state where you will practice.
Licensure allows a certified NP to practice in their state legally. Refer to each state's Board of Nursing for licensure eligibility, requirements and cost. Due to the variation in licensure requirements, you must confirm that the NP program curriculum satisfies your state licensure requirements. This becomes particularly important if you are attending an online program or a school that is not in the state where you plan to practice. Nursinglicensure.org is another good resource for the APRN licensure process.
Write a professional resume and cover letter.
Use your resume to outline your education and experience, including internships, volunteer experience and training hours. Be sure to highlight your accomplishments and most valuable skills in a well-written cover letter to show that you are an ideal candidate for the position. (You can learn how to write a resume and how to write a cover letter via LiveCareer.)
Requirements for earning your MSN
If you're trying to enter the workforce as soon as possible, some institutions offer bridge programs for RNs who do not have a BSN. These are called "RN to MSN programs" or ADN (Associate Degree in Nursing) to MSN programs. However, nurses who already have a bachelor's degree in nursing will have the simplest route to earning a master's degree.
Cost of MSN programs varies due to factors such as:
- In-state vs. out-of-state tuition
- Online or in-person coursework
- Whether the institution holds accreditation
An article published by GraduateNursingEDU.org on accredited MSN programs reports the cost ranging between $14,000 - $60,000. According to the article, students cite the cost of in-state vs. out-of-state tuition as the biggest factor when they choose a school.
Some graduate programs require that nurses gain a few years of clinical experience before enrollment. Other schools allow nurses to work concurrently during the program. Regardless, obtaining clinical experience is crucial to your nurse practitioner education as it prepares you to be able to address a multitude of medical concerns and situations. You'll want to highlight this experience and the skills it taught you in your resume.
Some ― but not all ― MSN programs require the GRE, though most require a minimum 3.0 GPA in your undergraduate degree. Refer to your institution's website for specific enrollment requirements.
Future nurse practitioner requirements
There has been talk in the nursing world of making the Doctor of Nursing Practice (DNP) the standard of nurse practitioner education for advanced practice nursing. That would mean that to perform many of the tasks NPs take on today, they would need to earn a DNP. In 2004, the American Association of Colleges of Nursing issued a position statement calling for moving the current level of preparation necessary for advanced nursing practice from the master's degree to the doctorate level by the year 2015.
As of 2019, this proposal has not been put into practice. Remember, though, that every NP is an advanced practice registered nurse who has completed either an MSN a DNP program. If you're a recent graduate who is planning on a career in nursing earning, a DNP may be the better option to become an NP. If you're wondering which program is right for you, this comparison between master's and doctorate programs might help.
As we've mentioned, there is a national shortage of nurses in the United States. Combine the nursing shortage with a physician shortage, an aging population and changing healthcare legislation, and the demand for nurse practitioners is expected to rise 31 percent by 2024.
In the same year, the BLS also reports there will be 171,700 job opportunities for nurse practitioners jobs, positions which garner an average annual salary of $101,260. Recent graduates and registered nurses who want to advance their career need to highlight credentials, work experience and nursing skills in their resume and cover letter.
When you're applying to nurse practitioner programs, LiveCareer's free Resume Builder and Cover Letter Builder will help you customize and improve your application. Although it may take several years to achieve NP status, your hard work will hopefully pay off with a challenging, fulfilling and well-paying career.