(NP) Nurse Practitioner
How Long Does Becoming a NP Take
Average salary: NP
Nurse Practitioner (NP)
NPs are Advanced Practice Registered Nurses (APRN) that provide a broader scope of practice. Their exact range of responsibilities depends on state regulations- some areas allow nurses to practice independently in clinics or hospitals, while others require them to work with doctor or physician oversight. Regardless, NPs can expect more independence, higher salaries and more career opportunities compared to the average registered nurse.
Annual Salary: $115,800 per year
How Long Does Becoming an NP Take?: 2-6 years
In collaboration with healthcare providers or other individuals, Nurse Practitioners provide primary, acute and specialty health services in a clinical setting. Their exact responsibilities vary, depending on their facility, but they can expect to carry out the following tasks:
Diagnosing and treating acute or chronic conditions
Recording and evaluating medical histories, including diagnoses and symptoms
Ordering, performing and interpreting diagnostic tests
Detecting sudden changes in a patient’s condition and adjusting treatment plans accordingly
Creating care plans and explaining them to patients
Carrying out physical examinations and patient observations
Offering counsel to patients and patient families and educating them on disease prevention
Communicating with and working alongside other healthcare providers
A nurse practitioner’s independence largely depends on their state laws and regulations. For example: nurses can prescribe medication in all 50 states but they can only administer controlled substances in 49. If you operate in one of the 23 “full practice” states, you operate without the supervision of a doctor or a physician. Examples include Washington, Hawaii, North/South Dakota, Arizona and Colorado. Reduced Practice states (Utah, Illinois, Ohio, New York) and Restricted Practice states (California, Texas, Oklahoma, Georgia) restrict certain aspects of NP practice. In these states, NPs need doctors to approve certain patient care decisions. For a list of states and their state practice environments, you can refer to the AANP’s official map.
At the bare minimum, NPs need a master’s degree and a board certification in their chosen speciality. Their field is determined before they apply to a program and is typically based on prior work experience. This is reflected in how nursing programs typically require a minimum amount of relevant work experience before they accept you. Some specialties include:
Optionally, NPs can specialize further into subspecialties, with the help of additional classes and certification exams. These do not need to be based on prior experience, and are focused on specific conditions, body organs, environments or sub-populations. Some sub-specialties include:
Allergy and Immunology
Occupational and Environmental Health
How to Become an NP
The process of becoming a Nurse Practitioner is a huge investment, both materially and timewise. This segment will guide you through the process of becoming an NP, at every step of the way.
1. Become a Registered Nurse
Before anything else, you need to be a certified registered nurse. You can achieve this by acquiring either your Bachelor's Degree in Nursing (BSN) or Associates Degree in Nursing (ADN), before taking and passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN). There may be state-specific requirements that you can check on your State Board of Nursing website. Although you can become an RN with just your ADN, in most cases you will need the BSN to qualify for most graduate programs. ADN nurses can opt for an accelerated RN to BSN course that lets them acquire their bachelor’s requirements in one to two years.
2. Acquire Work Experience
While students can opt to skip directly to working for their graduate programs. Alternatively, you can gain a couple of years of experience as an RN before you pursue further education. Many NP programs require one to two years of experience before you can enroll. Additionally, this lets you earn some money while you figure out what NP specialization you would like to work towards.
3. Find a graduate program
Once you acquire your BSN and RN license, you can apply for a graduate program of your choice. Becoming a nurse practitioner requires at least a Master of Science in Nursing (MSN) at the bare minimum. Some students take a step further and opt for the Doctor of Nursing Practice (DNP), which is the highest form of education available to nursing students. If you opt for the former, be sure to choose one with a specialized nurse practitioner track. No matter what track you have to meet the program prerequisites before you can enroll. While the specifics can differ depending on the school, they typically look something like this:
One to two years of clinical experience
Active RN license
GRE, for some schools
Letter of intent
Filled-out school application, fees, and references
Bachelor’s degree or equivalent
What works best for you may depend on your situation and preferences. MSNs typically prepares you for clinical practice, while DNP grooms students for leadership positions. There are also talks for moving the minimum NP requirements from MSN to DNP in the future, although this has not materialized yet.
If you are an ADN nurse but you do not want to spend an extra year earning your BSN, you have options. There are RN to MSN programs that let you complete your BSN and MSN at the same time. There is also an ADN to MSN Track that lets you bypass the BSN requirements altogether, although this is time-consuming.
4. Earn Your APRN Certification
Before you can practice, you need to obtain your nurse practitioner license. After graduation, you need to complete and pass a national board certification exam specific to your population focus. Once you accomplish this, you can apply for licensure with your state board of nursing. Since specific licensure requirements will differ from state to state, it is recommended that you contact your local State Board of Nursing or visit their website for clarification on that end.
RN to NP Transition
Between the higher salaries, greater independence and wider scope-of-practice, it is not hard to see why many RNs want to advance their careers and become NPs. To this end, there are a number of bridge NP programs for nurses of varying experience and education levels. Each of these tracks even offer full-time classes, part-time classes and more flexible online classes. To get you started, here are a couple of the RN to NP training programs available to you:
1. ADN to NP
This track is available for RNs with an associate’s degree and at least one year of experience. It essentially allows you to bypass your bachelor’s degree requirements and go directly to your master’s studies. However there is a bridge year that catches students up on everything they missed from their bachelor’s curriculum. As a result, the program is longer than most other tracks. This program takes approximately three to four years to complete.
2. Diploma RN to NP
If you have completed a diploma program, you can apply for bridge direct entry NP Programs. Since there are typically additional prerequisites, it is likely that you will need to consult with a school counselor before you enroll.
3. BSN to NP
If you have your bachelor’s degree, the BSN to NP track will immediately start you at your master’s studies. Out of all the NP bridge programs, this is the most common and straightforward path. Students can start their graduate studies immediately after getting their bachelor's degree, though some opt to get a few years of clinical experience under their belt. These programs typically take around two years to complete.
4. Non-nursing MSN to NP
If you have a master’s degree in a non-nursing field, you are eligible for an accelerated NP track. Your first year will be an accelerated nursing program that will let you become eligible for the NCLEX-RN. After you pass this exam, you can proceed to the nurse practitioner coursework in the program’s second half. If you take this program, most schools recommend getting hands-on clinical experience in between the first and second halves.
How to Pay for Your Nurse Practitioner Program?
As terminal degree programs, NP tuitions are some of the steepest. Very few people can cover the costs outright. While options are slightly lower for graduate studies, you still have a wide variety of financial aid programs available to you. Availability depends almost entirely on your circumstances, but there is an assistance program for everyone.
If they offer such services, your employing hospital could potentially reimburse you for your educational costs. Consult your human resources to see whether or not you are eligible for this service.
When a student is awarded a scholarship, they are provided with financial aid that they do not need to repay. Most scholarships are merit-based, but a number of them have different criteria based on factors such as religion ,ethnicity, volunteer services and more.
You can check with FAFSA as well as a number of online scholarship databases to see whether or not you qualify for federal scholarships provided by the government. If you avail of a private scholarship, be sure to see whether or not the sponsor is reputable. You do not want to accept a scholarship from just anybody, lest it be a scam. Finally, most scholarships have deadlines within the year for applications. You want to make sure that you send your application within this window.
Similar to scholarships, grants are financial aid that you do not need to pay back (provided that you graduate nursing school). Unlike scholarships, they are primarily determined by financial need. They can be used to pay for tuition, clinical uniform, supplies, housing and books. What you receive is strictly determined by your financial situation.
Send an application to FAFSA to see if you qualify for any grant programs. Keep in mind that grants for graduate students are not as plentiful as they are for undergraduates.
This is the most common form of student financial aid. Unlike scholarships or grants, you eventually have to repay your loan costs. Since these loans also incur interest, you usually end up paying more than the initial loan. The exact terms will depend on a tender and a number of other factors. There are a number of loans available to you, and picking the right type for your situation is paramount.
The majority of medical students use federal student loans, and it is not hard to see why. Since they are funded by the US Department of Education, interest rates are lower and there are less to no hidden fees. Since you are enrolling in an NP program, you do not qualify for an unsubsidized loan. Graduate students can avail of unsubsidized loans that gain interest while they study.
Meanwhile, private student loans are offered by banks, credit unions, educational institutions, and other independent entities. Certain educational bodies may offer Federal Perkins loans that are specifically offered to low-income students. For the most part, these loans are not subsidized and their interest rates are significantly higher. Because of the potential added cost, you have to shop around with scrutiny to find the best offers. Do not look at the offers at face value: evaluate hidden costs, what happens if you cannot keep up financially with later payments, and how repayments are structured.
Different loans have different repayment structures. You can only pay back your federal loans after graduation, while private loans can be paid off while you study. If you take up your master's, your federal loan payment can be deferred even further. In most cases, however, loans have to be repaid within 10 years after graduation.
There are generally two kinds of repayment plans:
Standard: The loaner repays a monthly set amount.
Graduated: Payments start low and increase every two years. They will not grow larger than three times the monthly payment.
If you cannot repay your loans, most loans have repayment plans that can be deferred in times of financial hardship. Be sure to discuss whether or not a loan has this option before you apply.
If you meet certain requirements, you may qualify for loan forgiveness. This applies mostly to federal loans, although some private loans offer similar benefits.
The Public Service Loan Forgiveness Program is the most common loan forgiveness program. Once you have made a minimum of 120 qualifying monthly payments, the remaining balance for all your federal loans may be forgiven. Just be sure that you do not default your payments and you must be under a qualifying repayment plan while working for a qualifying employer such as:
Full-Time Volunteer on AmeriCorps or Peace Corps
Federal, state, local or tribal government organization
Non-profit organizations that are or are not tax-exempt under Section 501(c)(3) of the Internal Revenue Code
Additionally, some individual hospitals also provide loan forgiveness after a certain amount of years of service. Typically, these are smaller community hospitals in rural areas.
The F. Edward Hébert Armed Forces Health Professions Scholarship Program is an incredibly generous scholarship provided by the US armed forces. In exchange for military service as an NP, the army will pay for the majority of your education costs. Alternatively, you can avail of the Military Tuition Assistance Program if you are enlisted in military or reserves, along with a GI Bill Top-Up program that covers other college-related expenses. Be sure to think carefully if you apply for these programs, as military service is a tremendous personal and professional commitment.
Go out there!
Becoming a nurse practitioner is a massive investment that takes countless hours of work and dedication. The price to entry is even steeper than it normally is, for healthcare programs. However, there is a reason more and more adults are going back to school. Those who commit to the path are rewarded with higher pay, professional independence and a broader scope of practice. Paying those fees may be tricky, but there are avenues. As long as you the right financial assistance for you, you will be able to cover the expenses of your NP education.
Top 10 Highest Paying NP Specialities
Many NPs opt to provide more general care services, which is a valid and profitable career path. If that is not for you, though, NPs have the option to specialize in specific populations or forms of care. In this segment, we will go over 10 of the highest paying NP specializations in the industry. Do note that your earning potential will always be strong as an NP, even if some specialities are more in-demand than others. The listed salaries are also accurate as of March of 2022 and are subject to change in time.
1. Family Nurse Practitioner
Family Nurse Practitioners are responsible for holistic and family-focused healthcare services to every age group, gender, disease, and body system. They provide continuous preventative care measures to avoid future complications. This can involve prescribing medication, consulting on healthy lifestyle choices, wellness checkups, and more. Because of their diverse skill set, FNPs have the option to work collaboratively in traditional hospitals and clinics, or independently in their own practices.
The average annual salary for FNPs currently sits at $105,898, according to ZipRecruiter.
2. Psychiatric Mental Nurse Practitioner
Similar to psychiatrists, Psychiatric Nurse Practitioners prescribe continuous treatment and medication to patients struggling with mental health issues. These conditions can range from depression to anxiety, to substance abuse issues and more. These NPs are also responsible for designing treatment plans and providing counsel on how to address their recurring behavioral issues.
Though it is a mentally-draining line of work, NPs are well-compensated for their efforts. Payscale reports that Psychiatric NPs make $112,452 annually. Glassdoor.com conversely has a higher estimate of around $119,702.
3. Aesthetic Nurse Practitioner
Aesthetic Nurse Practitioners are responsible for cosmetic medical procedures that are meant to change and improve their patients’ appearance. These NPs evaluate their patients, explain the risks and processes of different cosmetic procedures and provide extensive post-surgery care. Compared to other NPs, Aesthetic nurse practitioners are more commonly found in private settings, rather than in hospitals. This includes medical spas or even their own cosmetic practices.
Their average annual salary currently sits at $100,377, as per Ziprecruiter.
4. Pediatric Nurse Practitioner
Pediatric nurse practitioners provide primary care to children of all ages and backgrounds, from infancy to adolescence. Responsibilities can range from preventative care to diagnosing/treating chronic illnesses to standard wellness checkups. With consistent and comprehensive care, they are responsible for ensuring a child’s healthy physical and emotional development.
At the time of writing, Indeed places the median annual salary for pediatric NPs at $121,659.
5. Emergency Nurse Practitioner
For nurses who thrive in high-pressure environments, this profession was made for you. Emergency Nurse Practitioners are responsible for assessing, managing, and diagnosing life-threatening conditions that require immediate attention. This includes injuries, episodic illnesses, and chronic conditions flaring up. Because of the urgency in their line of work, ENPs have the authority to practice without physician oversight in many states.
An ENP’s median salary sits in the $118,094 range, according to Salary.com.
6. Acute Care Nurse Practitioner
In acute care, HCPs work with patients with serious conditions. As the name implies, Acute Care NPs solely specialize in caring for adults with complex conditions. This includes patients who are unstable physiologically, technologically dependent, critically ill, incredibly vulnerable, rapidly changing in condition, or saddled with complex chronic illnesses.
According to Glassdoor, their annual median salary is around $110,076.
7. Orthopedic Nurse Practitioner
Orthopedic Nurse Practitioners provide treatment and care to patients with musculoskeletal problems. Diseases and injuries of bones, connective tissue, muscles, and joints all fall under this scope. Examples include hernias, sprains, carpal tunnel syndrome, back pains, and more.
Per Payscale, the median salary is around $100,035 per year.
8. Women's Health Nurse Practitioner
As the name implies, Women’s Health Nurse Practitioners offer comprehensive and continuous care for women of all ages. Over the course of their lives, girls can consult these NPs to resolve reproductive, gynecological, and obstetric health concerns.
Glassdoor estimates the annual income for WHNPs at around $130,094 per year, on average. Payscale has a lower estimate of $96,480.
9. Adult-Gerontology Nurse Practitioner
An Acute Care Nurse Practitioner: Adult-Gerontology (ACNP-AG) is responsible for providing care to adult and elderly patients with serious health issues. Your most common patients will be the elderly, who come for routine checkups or to treat minor or chronic illnesses. You can find these NPs in collaborative settings like hospital emergency rooms and ICUs. They can also be found providing primary care in clinics and outpatient settings.
Currently, Glassdoor estimates that ACNP-AGs make around $117,577 in annual salary. Meanwhile, Payscale places their estimates at $89,521.
10. Neonatal Nurse Practitioner
Neonatal NPs provide care to premature or sick newborn babies. Among other responsibilities, they prescribe treatment, draft medical plans and diagnose infant children. You can commonly find NNPs in ICU settings, but they can find work in a variety of settings.
Their median annual salary as of February 2022 sits at $129,309, according to Salary.com.
11. Oncology Nurse Practitioner
Oncology NPs apply ongoing treatment and care to patients going through cancer treatment. With close collaboration from physicians and other healthcare providers, they plan out treatment plans for individuals afflicted with unfortunate condition.
At the moment, Salary.com marks the average US salary for Oncology NPs at around $105,427 per year.
Go out there!
All these salaries are subject to change, as the years pass. That being said, you cannot go wrong with any of the eleven NP specializations listed. They are all in-demand niches in the healthcare industry and they compensate their HCPs extremely well. The future for specialized NPs remains bright.