Career as a Nurse Practitioner

How to Become a Nurse Practitioner

Nurse practitioner is a safe job choice, given that the field is projected to grow by 31% through 2024, according to the Bureau of Labor Statistics. Recent healthcare legislation, an increasing emphasis on preventive care and demand for health care services from the huge generation of baby-boomers are all fueling this growth.

There is quite a bit of education involved in becoming a nurse practitioner (though significantly less than becoming an MD). Every nurse practitioner is an Registered Nurse who holds an advanced degree. A prerequisite for NPs is either a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP).

Here’s the lowdown on how to become an NP.

Steps to Become a Nurse Practitioner

  • Become a registered nurse by earning a four-year Bachelor of Science in Nursing degree (BSN).

    Courses will usually include anatomy and physiology, patient health assessment, pharmacology and pathophysiology basics, and neonatal to geriatric nursing studies. You’ll also take part in supervised clinical rotations in a number of specialties.

  • Obtain your state license.

    Most states require NP candidates to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam administered by the National Council of State Boards of Nursing (NCSBN).

  • Choose a specialty (family practice, women’s health, mental health, anesthesia, et cetera.) and obtain experience in it before applying to graduate school.

    Many graduate programs encourage -- or require -- applicants to have at least 1-2 years of experience working as an RN in their specialty.

  • Earn your master's degree.

    Master’s programs for RNs with a bachelor’s degree may take one to three years to complete. If you have a diploma or associate degree in nursing (ADN), or a non-nursing bachelor's degree, you can enroll in a BSN-to-MSN program. These accelerated bridge programs allow you to get your RN and NP degree at the same time. Program length can be about 18 months.

    Master of Science in Nursing (MSN)2 to 3 yearsPrepares Advanced Practice Nurses, nurse administrators and nurse educators.
    Doctor of Nursing Practice (DNP)3 to 4 yearsRNs wishing to specialize; focuses on clinical practice-oriented leadership training.
  • Now that you have your MSN, you need to become certified in your specialty.

    Most states require NPs to be nationally certified by the American Nurses Credentialing Center (ANCC). Several other credentialing authorities certify nurse practitioners according to specialty. The minimum number of hours required for certification varies by specialty and generally runs between 750 and 1,400 hours.

Best Schools for Nurse Practitioners

The best school for someone else may not be the best school for you. Here is what to consider during your research to ensure a good match:

  • program structure and curriculum
  • types of clinical education and training opportunities
  • faculty composition and tenure, student demographics
  • facilities, campus setting, geographic location
  • size of the university, size of the class
  • licensure pass rate, employment rates
  • degrees awarded, program length
  • admission requirements
  • cost and financial aid opportunities
  • extracurricular activities.

Generally speaking, there is no official ranking system, but the U.S. News & World Report ranked the top master's degree programs for aspiring NPs, using a survey from academics at peer institutions to grade each on a 1-to-5, marginal-to-outstanding scale. Here are the top 10.

1Johns Hopkins UniversityBaltimore, MDThe School of Nursing has 60 full-time faculty members and a graduate nursing enrollment of 504.
2University of PennsylvaniaPhiladelphia, PAOffers one of the first PACE – Program of All-Inclusive Care for the Elderly – practices established by a school of nursing.
3University of California—​San FranciscoSan Francisco, CAOffers the UCSF online MS Healthcare Administration and Interprofessional Leadership (MS-HAIL) degree program, designed for professionals committed to improving health care systems for access, affordability, quality and safety.
4Duke UniversityDurham, NCDuke offers master’s, Ph.D. and doctor of nursing practice degrees as well as an accelerated B.S. in nursing degree to students who have previously graduated college.
5University of WashingtonSeattle, WAAmong the first universities in the U.S. to be accredited by the National Organization of Public Health Nurses.
6New York University (Meyers)New York, NYFounded in 1932, NYU offers B.S., M.S., D.N.P. and Ph.D. nursing programs.
7University of Michigan—​Ann ArborAnn Arbor, MIFaculty engage in research in areas including basic biological sciences; acute and chronic care efficacy trials in humans; health system science, health-promotion studies; investigation of care effectiveness in a variety of settings; and population-based studies.
8Case Western Reserve UniversityCleveland, OHMSN students can blend majors or pursue joint master's degree opportunities with other schools at Case Western Reserve University.
8University of MarylandBaltimore, MDIn addition to NP degrees, two specialized dual-degree options are offered: Health Services Leadership and Management: Nursing and Business Administration (MS/MBA) and Nursing and Public Health (MS/MPH).
8Columbia UniversityNew York, NYIn 1956, Columbia Nursing became the first nursing school in the U.S. to award a master's degree in a clinical nursing specialty. It is home to the nation’s oldest graduate program in nurse midwifery.
8Emory UniversityAtlanta, GAOf the respondents to a post-graduate survey, 68% were employed immediately after graduation, and 100% were employed within three months of graduation.

"I knew I wanted to work with patients in an outpatient setting, and I knew that nurse practitioners would play a key role in our healthcare system in the future. I also had a strong interest in preventive care and wellness programs. There were many graduate programs which offered nurse practitioner programs, so furthering my education was a clear choice for me. I also knew that I loved to teach, and if I wanted to be a faculty member, an advanced degree would be very important."

Nancy Brook, MSN, RN, CFNP

Vanderbilt University School of Nursing, 1992

Applying to School

Nurse practitioner schools accept only a small number of applicants annually. Before applying, you must have your BSN and pass the rigorous National Council Licensure Exam.

Paying for School

There are numerous resources to help you pay for your advanced education.

  • The National Health Service Corps (NHSC): It may pay up to $60,000 in student loan reimbursement to NPs practicing in a medically underserved area for two years of service. (Many small towns near large metro areas qualify.)
  • Grants: You’ll often be required to work for a specific time in a particular area of nursing, but no repayment is required.
  • The NURSE Corps Scholarship Program: Students accepted or enrolled in a diploma, associate, BS, or graduate nursing programs can receive funds for tuition, fees and other educational expenses in exchange for working at an eligible NURSE Corps site after graduation.
  • Loan Repayment: When a facility pays your nursing school loan in exchange for working for it when you’ve graduated.
  • Tuition Reimbursement: When a facility reimburses your nursing school tuition while you work for it.
  • Residency Programs: Often offered by facilities that give you nursing experience.
  • Career Ladder Programs: When a facility gives you a nursing school scholarship and a job after graduation.
  • Student Loans: Research these loans carefully; the more you borrow, the higher your monthly payments after you graduate.
  • Federal Loans: Can be a great option, often offering a lower, fixed interest rate.
allNursingSchoolsA site where you can learn about financial aid for nursing school and get nursing scholarship, grant and student loan information.
DiscoverNursing.comLists national and state scholarships.
The Campaign for Nursing's FutureLists 370 nursing scholarships across the U.S.
Nurse Practitioner DegreeGuide to Nurse Practitioner scholarships and grants.
The Nurse Corps Scholarship ProgramA selective program of the U.S. Government that helps alleviate the critical shortage of nurses currently experienced by certain types of health care facilities located in Health Professional Shortage Areas (HPSAs).
Federal Student AidThe U.S. Department of Education office provides more than $150 billion in federal grants, loans and work-study funds annually to 13-plus million students.
University or College ProgramSchools and programs offer scholarships and financial aid to their students.
AmericorpsParticipating as a volunteer results in money for a student's education, no matter their major.
U.S. ArmyThe program covers a student's tuition in exchange for time spent on active duty.
Indian Health ServiceThree scholarships -- for preparatory, pre-graduate and health profession students -- are awarded annually.

"Medical school was going to cost me several hundred thousand dollars of additional debt. My graduate nurse practitioner program cost me under $50,000, which allows me more flexibility for choosing my specialty of my interest rather than choosing due to compensation."

Christopher Caulfield, FNP, MSN

Frontier Nursing University, 2016

Getting Licensed

AANPCP examinations are entry-level, competency-based exams for NPs that reflect expertise for the following specialties:

  • Adult Nurse Practitioner*
  • Family Nurse Practitioner
  • Adult-Gerontology Primary Care Nurse Practitioner
  • Emergency Nurse Practitioner Specialty for Family Nurse Practitioners (Launch January 2017)

*Exam will be retired December 2016, and will not be replaced. But as long as NPs maintain current certification with AANPCP through continuing ed and clinical practice hours, and don’t allow their certification to expire, their credential will not be affected.

Certification is granted for five-year periods. Candidates must complete requirements for certification renewal before expiration.

A second national certification program, the American Nurses Credentialing Center (ANCC) Certification Program, offers certifications for the specialities of...

  • Acute Care NP
  • Adult Nurse NP
  • Adult-Gerontology Acute Care NP
  • Adult-Gerontology Primary Care NP
  • Adult Psychiatric–Mental Health NP
  • Family NP
  • Gerontological NP
  • Pediatric Primary Care NP
  • Psychiatric–Mental Health NP
  • School NP
  • Diabetes Management—Advanced
  • Emergency NP

NPs must then be licensed through their state boards of nursing.

"Obtain clinical experience prior to starting NP school. Too many new grads are entering Direct Entry MSN programs without clinical experience. I obtained my RN through a local community college and gained valuable experience as an RN prior to NP school, which allowed me to develop my clinical knowledge tremendously before starting as a NP."

Christopher Caulfield, FNP, MSN

Frontier Nursing University, 2016

Getting Experience

To become a nurse practitioner, you’ll need hands-on nursing experience before you apply to graduate school. This can be in the form of an internship or a “real” job. Below are some options for getting the experience you need under your belt.

  • Look for internship information on health care facility websites
  • Seek out per diem nursing (PRN) jobs
  • Speak with your school’s career counselor or career placement office
  • Take a job in a large teaching hospital as a new grad
  • Look into NP residency programs
  • Take a no-pay opportunity to learn
  • Approach a practice and offer to intern with it for a few months

Poll: Why Did You Become a Nurse Practitioner?

So we have answered the question of how one becomes an NP. But... why become an NP at all? That's the question we posed to working professionals, who are listed by their undergraduate year and alma mater.

Temeka Gillespie, FNP-C (Hampton University, 2006): "As a bedside Critical Care RN for 16 years, I was at a crossroad in my career. I was mentally and physically exhausted in the bedside role, but knew I couldn’t abandon my foundation and desire to provide quality, compassionate care. I felt it was natural to expand into an advanced practice role as an FNP, where my nursing foundation could be beneficial. It occurred to me that I could be the necessary change agent, advocate and educator needed to help patients recognize the need to acknowledge or own their medical issues and conditions with the overall goal or intention to work on changing behaviors, lifestyle to prevent the associated complications and improve overall health. I feel that patients respond better to instructions from NPs because we take the time to provide the appropriate teaching, education they can understand and therefore be made to feel that they can successfully make gradual, effective changes with our attention and guidance as compassionate caregivers."

Nancy Brook, MSN, RN, CFNP (Vanderbilt University School of Nursing, 1992): "I knew I wanted to work with patients in an outpatient setting, and I knew that nurse practitioners would play a key role in our healthcare system in the future. I also had a strong interest in preventive care and wellness programs. There were many graduate programs which offered nurse practitioner programs, so furthering my education was a clear choice for me. I also knew that I loved to teach, and if I wanted to be a faculty member, an advanced degree would be very important."

Margaret (Peg) O’Donnell, DNP, FNP, ANP, B-C, FAANP (SUNY Stonybrook, 2016): "I was an RN for 16 years, and Nurse Practitioning seemed like a natural progression for me. I always loved medicine and caring for patients, and this just took my skills to a higher level."

Shamika Brooks, RN-BSN, MSN-FNP-C (Maryland University, 2014): "I knew that I wanted to be a nurse practitioner my junior year in high school. I took a health professions class and my instructor introduced us to the role. I felt that it was the best of both worlds because I could work as a registered nurse and get an advanced degree to manage a patient's care similar to a physician, but without all the years of school."

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