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If you are already a registered nurse (RN), becoming a nurse practitioner (NP) means greater autonomy, specialization, and leadership in the workplace. Broadly speaking, NPs can diagnose patients, prescribe medications, and in some states, open a private practice. Given these advantages, a career as an NP is rewarding – consistently ranked highly among job satisfaction lists – and in increasingly high demand as the fastest-growing segment of the health care workforce.
The Difference Between RN and NP
Both RNs and NPs are crucial to providing quality patient care, and because all NPs must also be RNs, there is often career overlap. However, their day-to-day scope of practice differs. Nurse practitioners have a graduate-level education — either a master's or doctoral degree in nursing. This makes themadvanced practice registered nurses (APRN), an umbrella term that also applies to registered nurse anesthetists (CRNA), clinical nurse specialists (CNS), and certified nurse midwives (CNM). Because of their additional education, NPs generally have more responsibility than RNs as primary or acute caregivers for their patients.
Unlike RNs, NPs can diagnose patients, create treatment plans, and, in many states, have prescriptive authority without physician oversight. Additionally, in states where NPs have full practice authority (FPA), NPs can establish private practices. (In states where NPs have reduced or restricted practice, they must work in collaboration with a supervising physician.)
Required Education for Nurse Practitioners
The pipeline to becoming a nurse practitioner includes education and training that prepares the NP to deliver care with clinical excellence. NPs must first obtain a Bachelor of Science in Nursing (BSN), typically during their four-year undergraduate studies. Registered nurses who have an associate degree in nursing (ADN) can also get their BSN through a two-year RN-to-BSN program. These programs are often online to accommodate the fluctuating schedules of most registered nurses.
Once an RN has their BSN, prospective NPs must complete a focused graduate master’s or doctoral nursing program. All states require that NPs hold a Master of Science in Nursing (MSN); by 2025, most entry-level NP positions may also require a Doctor of Nursing Practice (DNP). (This is different from the Doctor of Philosophy [Ph.D.], which prepares nurses for a career in research or academia rather than practice.)
MSN programs usually take between 18 months and three years to complete, though the specific timeline will depend on educational experience. For example, a nurse with a bachelor’s degree in nursing could complete an MSN program in two years with full-time coursework. There is also an option for a direct-entry MSN, for individuals with a non-nursing bachelor's degree to earn their BSN and MSN at the same time. These programs take two to three years.
Similarly, the overall length of a DNP program will depend on the applicant's background. For example, it might take a registered nurse with an MSN one or two years full-time, to four or more years if part-time, to obtain their DNP. It is possible to pursue a BSN-to-DNP degree, though many programs list at least one year of full-time nursing experience as a requirement (so working as a registered nurse prior to pursuing an advanced degree may be desirable). These programs often take three to four years to complete.
Specialties That NPs Can Choose
Unlike RNs, nurse practitioners choose their specialty prior to, or during, the course of their education. Start by reviewing the specialties on a prospective school’s website, since not all programs offer the same trainings. Once NPs-to-be finish their core coursework, they undertake specialty courses and clinic hours pertaining to their population or vertical focus. These will prepare them to be licensed as one of the following:
- Family Nurse Practitioner (FNP)
- Adult-Gerontology Nurse Practitioner (AGACNP or AGPCNP)
- Women’s Health Nurse Practitioner (WHNP)
- Pediatric Nurse Practitioner (PNP)
- Neonatal Nurse Practitioner (NNP)
- Psychiatric Mental Health Nurse Practitioner (PMHNP)
For most of these licenses, nurse practitioners decide whether to work with patients in acute or primary care situations. For example, a nurse practitioner who specializes in care across the adult lifespan might be either an Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) orAdult-Gerontology Primary Care Nurse Practitioner (AGPCNP). Learn more abouttypes of nurse practitioner specialties.
Throughout their career, NPs will have the option to switch or expand their scope of specialties, typically by attending a program like a one-year post-master's certificate program.
National Board Certification Exam for NPs
Once a prospective NP has obtained their degree, they'll need to get certified in order to practice. Such certification is mandated by most state boards of nursing (BON), and available through a governing board that issues tests for program graduates, like theAmerican Nurses Credentialing Center (ANCC).
Select states, including California and New York, do not require this exam for NPs who have completed a program approved by their state board. However, most insurances still require these credentials for third-party reimbursem*nt, even if the state does not.
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