Nurse Practitioner Career Overview

Nurse Practitioner Career Overview

Nurse Practitioners (NPs) are highly trained healthcare professionals with advanced nursing degrees. They specialize in various patient populations, including acute care, family healthcare, oncology, and mental health. NPs are licensed as Advanced Practice Registered Nurses (APRNs) and obtain national board certification in their specific areas of expertise. This article provides insight into the career of a Nurse Practitioner, covering their responsibilities, the advantages and disadvantages of the profession, and their compensation, with an average annual salary exceeding $100,000.

NPs are primary care providers who perform many of the same tasks as physicians. They often have more independence compared to registered nurses. Depending on state regulations, some regions grant them full practice authority, while others necessitate a collaborative agreement with a physician.

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How Long to Become

6-8 years

Job Outlook

40% growth from 2021-2031

Average Annual Salary


Source: BLS

What Does a Nurse Practitioner Do?

Nurse Practitioners (NPs) deliver clinical care to patients and possess the authority to diagnose health conditions, order medical tests, and prescribe medications. The scope of an NP’s work varies depending on their specialized area, the patient population they serve, and the state where they practice. One of their primary roles in healthcare is to address the shortage of physicians and reduce healthcare costs.

In some states, NPs must work under the supervision of a physician or collaborate with a physician, while in other states, they enjoy full practice authority, granting them professional autonomy.

NP specializations often align with specific patient populations. For instance, Pediatric Nurse Practitioners work with patients from birth to age 21, and Women’s Healthcare Nurse Practitioners focus on women’s health. Certain states allow NPs to establish private practices, although regulations vary.

Nurse practitioners may encounter challenges such as long working hours, high levels of stress, and the risk of burnout. The COVID-19 pandemic has been particularly challenging for nurses, with reported rates of burnout increasing fourfold within six months of the outbreak.

Depending on the setting, the key skills and responsibilities of an NP may encompass the following tasks:

Key Responsibilities

– Ordering medical tests
– Diagnosing medical conditions
– Prescribing treatments, including medication
– Counseling and educating patients
– Leading nursing departments or teams
– Supervising the work of other clinical staff
– Promoting community and population health

Career Traits

– Clinical knowledge
– Judgment under pressure
– Communication skills
– Integrity

Key Holistic Skills for Nurse Practitioners

Empathy and Compassion

A Nurse Practitioner understands the importance of both empathy and compassion to comprehend and build relationships with patients and their families. Nurses who approach their patients with empathy and compassion are better positioned to offer improved patient care.

Communication Skills

Nurse Practitioners dedicate a significant portion of their time to explaining medical diagnoses and treatment plans to patients and their families. Therefore, they require clear, concise, and empathetic communication skills. Effective collaboration with other healthcare professionals also necessitates strong communication skills.

Leadership Skills

Nurse Practitioners are often seen as leaders within their healthcare teams. NPs should be prepared to coach and mentor other nurses, lead problem-solving efforts, contribute to team building, and help foster a positive work environment.

Critical-Thinking Skills

Critical-thinking skills enable NPs to provide better care, enhance patient safety, and identify changes in a patient’s medical condition. They also foster innovation and improve decision-making.

Key Medical Skills for Nurse Practitioners

Basic Emergency and Urgent Care Skills

A solid understanding of basic emergency and urgent care skills enables NPs to quickly assess and address medical issues. These skills include wound dressing, suturing, and stapling, administering intravenous therapy, evaluating the respiratory system, and managing chest tubes.

Vital Sign Monitoring and Assessment

Proficiency in monitoring and assessing vital signs, such as pulse rate, body temperature, blood pressure, and respiration rate, enables NPs to detect and monitor healthcare issues.

Patient Education

Competent NPs provide health education and counseling to patients and their families. They assist patients in understanding their diagnoses and treatment plans, encourage lifestyle changes to improve health conditions, and educate them on providing at-home care.

Technology Skills

As technology plays an increasing role in healthcare, Nurse Practitioners utilize technology to aid in diagnosing, monitoring, and treating patients. They also require technical skills to accurately complete medical documentation, send prescriptions, and order laboratory tests or procedures.

History of Nurse Practitioners

The first Nurse Practitioner program commenced in Colorado in 1965. This coincided with the expansion of Medicare and Medicaid in the same year, increasing the number of Americans eligible for healthcare coverage and primary care services.

In 2018, approximately 56,000 NPs practiced in the United States. The rise of the NP profession was a response to the shortage of primary care physicians available to meet the growing need.

Nurse Practitioners play a crucial role in addressing the ongoing shortage of primary care providers, reducing healthcare costs, and enhancing patient satisfaction. NPs stand out among healthcare providers by taking a comprehensive approach to patient health and well-being.

Throughout the profession’s history, NPs have advocated for policy changes to improve healthcare and access, particularly for children, low-income individuals, and other marginalized groups.

Where Do Nurse Practitioners Work?

Physicians’ offices employ over 40% of Nurse Practitioners, followed by outpatient care centers at 23%, and hospitals and offices of other health practitioners at nearly 10% each. The remaining NPs work in settings such as home health care services.

Here are examples of specific workplaces and their job duties:

1. Hospital Outpatient

In hospital outpatient settings, NPs often serve as primary care providers or specialists. They assess and diagnose patients, prescribe treatment, provide guidance on care, and refer patients to physicians for further treatment when necessary.

2. Hospital Inpatient

In a hospital inpatient setting, NPs also assess and diagnose patients, prescribe treatment, and contribute to ongoing patient care. They may also lead nursing teams and oversee the work of other clinical staff.

3. Private Group Practices

In private group practices, NPs may work as primary care providers or specialists. They see patients, assess conditions, prescribe treatments, and escalate patient care to physicians or specialist NPs as needed.

Why Become a Nurse Practitioner?

Like any profession, there are pros and cons to becoming a Nurse Practitioner. You can compare the key qualities of an NP in the list below:

Benefits of Becoming a Nurse Practitioner

– High demand and NP salaries significantly above the national average
– Personal satisfaction from providing patient care
– Potential for career advancement in clinical or administrative roles
– Opportunities to specialize and practice with greater independence

Challenges of Becoming a Nurse Practitioner

– Rigorous education, board exams, and licensing requirements
– High potential for burnout due to demanding schedules
– Emotional stress from witnessing patient suffering
– Administrative paperwork and regulatory burdens

How to Become a Nurse Practitioner

Becoming a Nurse Practitioner is a multi-step process that begins with an undergraduate nursing degree and a Registered Nurse (RN) license. After gaining experience as an RN, aspiring NPs complete a graduate nursing program, followed by board certification and advanced practice licensing.

1. Earn an associate degree in nursing (ADN) or a BSN.

Students can obtain an ADN in two years or a BSN in four years. Some students choose to start with an ADN to determine if they enjoy the work and environment, while others prefer to begin with a BSN for higher responsibilities and pay.

2. Pass the NCLEX-RN to acquire registered nurse (RN) licensure.

Master of Science in Nursing (MSN)-NP programs typically require nursing experience. To practice as an RN, you must pass the National Council Licensure Examination for RNs (NCLEX-RN), which assesses a graduate’s readiness to start work as a registered nurse. The exam covers topics related to safety, health promotion, and the physical and psychological needs of patients.

3. Earn an MSN.

Students usually dedicate two years of full-time study to earn an MSN degree. Most MSN programs require or prefer students with at least two years of RN experience. MSN-NP programs also require a valid, unrestricted state nursing license.

4. Pass the national nurse practitioner certification board exam.

This examination, similar to the NCLEX-RN exam, evaluates a graduate’s readiness to work as an NP. It typically consists of 150 multiple-choice questions. However, different certifying bodies administer varying exams based on the NP’s specialty track within the MSN-NP program, such as Family Nurse Practitioner, Adult-Gerontology Primary Care Nurse Practitioner, and Pediatric Nurse Practitioner.

5. Obtain state licensure as an NP.

Each state has its own licensing requirements, but all necessitate NPs to hold an MSN or Doctor of Nursing Practice (DNP) degree and pass the national board exam.

Nurse Practitioner Concentrations and Specializations

Popular Nurse Practitioner specializations encompass Women’s Health, Family Nurse, and Neonatal Health, among others. The licensure and national certification prerequisites differ based on the state and specialization.

Please note that the NP salary and distribution data is derived from the American Association of Nurse Practitioners’ 2020 report, unless stated otherwise.

Psychiatric Nurse Practitioner

Working in clinics, hospitals, psychiatric facilities, and substance abuse centers, these professionals concentrate on behavioral and mental health. Often specializing in patient populations, such as military/veterans or pediatrics, psychiatric NPs diagnose conditions, devise treatment plans, and educate patients and caregivers.

Median Total Salary

Distribution of NPs

Adult-Gerontology Nurse Practitioner

Adult-Gerontology NPs (AGNPs) specialize in acute or primary care and see patients in clinics, hospitals, and long-term care facilities. AGNPs perform physical exams and diagnoses for adults of all ages. Acute-care AGNPs treat existing illnesses and are more likely to work in hospitals, while primary-care AGNPs focus on preventative care.

Median Total Salary

Primary care $116,000
Acute care $131,000

Distribution of NPs

Primary care 7%
Acute care 2.9%

Family Nurse Nurse

Family nurse practitioners (FNPs) comprise the largest percentage of NPs. FNPs care for patients of all ages and life stages, providing preventative care and treatment for illnesses, conditions, and injuries. They work in clinics, hospitals, and private practice.

Median Total Salary

Distribution of NPs

Women’s Health Nurse Practitioner

Women’s health NPs provide healthcare specific to women of all ages, including gynecology and obstetrics. They find employment in hospitals, clinics, and fertility centers and often collaborate with physicians and nurse midwives.

Median Total Salary

Distribution of NPs

Neonatal Nurse Practitioner

Primarily employed in hospital neonatal intensive care units, these professionals care for infants born prematurely or with illnesses. They provide acute and critical care to newborns and administer ongoing treatments like incubation, tube feedings, IV lines, and medications.

Median Total Salary

Distribution of NPs

Emergency Room Nurse Practitioner

ERNPs collaborate with teams of healthcare providers to assist patients experiencing medical emergencies. This fast-paced career involves assessing, diagnosing, and treating patients undergoing trauma, severe injuries, and emotional crises. Other responsibilities may include supervising RNs and educating patients.

Average Base Salary
Source:, October 2022

Distribution of NPs

Pediatric Nurse Practitioner

Pediatric nurse practitioners (PNPs) specialize in the primary or acute care of infants, children, and teens. PNPs see patients in physicians’ offices, hospitals, and outpatient care centers. Acute care specialists work in emergency rooms, intensive care units, and urgent care clinics.

Median Total Salary
Primary care $119,000
Acute care $135,000

Distribution of NPs
Primary care 3.2%
Acute care 0.7%

Pain Management Nurse Practitioner

A career as a Pain Management Nurse Practitioner involves administering and monitoring medication, along with providing non-pharmaceutical options like acupuncture and chiropractic care. Common workplaces include cancer and surgical units in hospitals or rehabilitation facilities.

Average Base Salary
Source: Indeed, October 2022

How Much Do Nurse Practitioners Earn?

Nurse Practitioners (NPs) are among the highest-paid nursing professionals. According to data from the Bureau of Labor Statistics (BLS), they make an average annual salary of approximately $118,000, which translates to nearly $57 per hour. The salary of NPs can vary based on factors like their level of education, years of experience, specialized area, workplace, and location.

For instance, NPs working in home health care services earn an average salary of $133,170, while those in outpatient care centers earn around $129,190. In the state of California, NPs earn higher salaries compared to their counterparts in other states. Interestingly, the top ten highest-paying metropolitan areas for NPs are all in California.

The job outlook for NPs is very promising. The BLS projects a 46% increase in NP employment from 2021 to 2031, making it the fastest-growing occupation in the country.

Here is a list of the top five states with the highest NP salaries and their respective average annual wages:

Top-Paying States for Nurse Practitioners
State Average Annual Salary
California $151,830
New Jersey $137,010
New York $133,940
Washington $130,840
Massachusetts $129,540

Source: BLS Occupational Employment Statistics (OES), 2021

Nurse Practitioners’ salaries also vary depending on the workplace setting. Interestingly, the most common industries that employ NPs, such as physicians’ offices, hospitals, and educational institutions, may not necessarily offer the highest salaries. Job seekers looking to maximize their earnings may want to consider the following workplaces:

Highest Paying Work Settings for Nurse Practitioners
Workplace Setting Median Total Salary
Hospital Inpatient Unit $125,000
Urgent Care $120,000
Private NP Practice $120,000
Employer/Corporate Clinic $120,000
Hospital Outpatient Clinic $117,000

Frequently Asked Questions about Nurse Practitioners

1. How long does it take to become a nurse practitioner?

Becoming a Nurse Practitioner (NP) requires at least six years of education, along with prior experience working as a Registered Nurse (RN). Most full-time students spend four years earning a Bachelor of Science in Nursing (BSN) degree, followed by two years to obtain a master’s degree in nursing. Many educational institutions also recommend at least two years of RN work before applying to an MSN-NP program.

2. Can nurse practitioners prescribe medication?

NPs have the authority to prescribe medications, including controlled substances. The specific requirements may vary by state, with some states mandating a certain number of credit hours in pharmacology, while others require NPs to collaborate with a physician. In contrast, some states grant NPs full practice authority, meaning they do not need physician collaboration or supervision.

3. What are the most popular nurse practitioner specialties?

According to the American Association of Nurse Practitioners, in 2020, Family Nurse Practitioners were the most preferred specialization, accounting for nearly 70% of NPs. The second most popular specialization was adult care at 10.8%, followed by adult-gerontology primary care at 7%.

4. What is the difference between an RN and NP?

Registered Nurses (RNs) typically hold a two- or four-year nursing degree or a nursing diploma, whereas Nurse Practitioners (NPs) have at least a Master of Science in Nursing (MSN) and board certification as NPs. It’s worth noting that all NPs are RNs, but not all RNs are NPs.

Professional Organizations for Nurse Practitioners:

– American Association of Nurse Practitioners (AANP): This organization, with 118,000 members, is the largest professional NP association in the United States. AANP is involved in certifying NPs, conducting research on the profession, offering continuing education to members, advocating for the NP profession, and hosting an annual conference. Membership is open to various categories, including students and retirees.

– National Organization of Nurse Practitioner Faculties (NONPF): NONPF is the national membership association for nurse practitioner education. It advises on NP program curricula and effective NP education. Membership is available to nursing schools, students, retired faculty members, and current NP school faculty members.

– National Association of Nurse Practitioners in Women’s Health (NPWH): NPWH is dedicated to ensuring high-quality care from NPs specializing in women’s health. The association is involved in education, research, and advocacy for policies that promote the profession. Membership is open to NPs, students, and those working in women’s health.

– National Black Nurses Practitioner Association (NBNPA): NBNPA, located in Houston, Texas, was established in 2010 to create a professional community and support Black NPs. The association advocates for health equity in underserved communities, provides scholarships, and offers philanthropic support.

– American Academy of Emergency Nurse Practitioners (AAENP): AAENP, based in Scottsdale, Arizona, focuses on providing continuing education, setting guidelines for emergency care nursing, and advocating for emergency nurse practitioners. Membership is open to any emergency care provider or student in this field, with certain leadership roles reserved for NPs.

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