How To Become a Nurse Practitioner

Nurse practitioners are healthcare professionals trained to provide a full range of services either independently or as part of a healthcare team. Millions of Americans see nurse practitioners to manage acute and chronic illness and injury. The American Association of Nurse Practitioners (AANP) reported that more than 1.06 billion visits are made to nurse practitioners each year. Because demand for these healthcare professionals is rising, a career as a nurse practitioner is a smart choice for those interested in making a difference in their community while earning a great salary.

Understand a Nurse Practitioner’s Approach

Most nurse practitioners have experience working as nurses, so they are uniquely suited to a holistic approach to treatment. They treat each patient by considering all of their physical, mental and environmental conditions in addition to any symptoms that may be present. Nurse practitioners rely on this comprehensive approach to build trust and confidence, leading to stronger patient relationships and better outcomes. Patients who see nurse practitioners can also lower their healthcare costs by maintaining preventative care.

Nurse practitioners are trained to educate patients on disease prevention and lifestyle choices to promote good health, which could mean fewer office visits and treatments. According to the AANP, “Patients who see nurse practitioners as their primary care providers often have fewer emergency room visits, shorter hospital stays and lower medication costs.” Plus, nurse practitioners can relieve some of the workloads from physicians who need to perform surgery, review test results and maintain complex documentation.

Because they have advanced qualifications in their specialty, nurse practitioners can prescribe medication and carry out most of the same testing as physicians. But nurse practitioners can be found in a much wider variety of settings than physicians. Nurse practitioners work in primary care, acute care and long-term healthcare settings, including:

To pursue their ideal careers, most nurse practitioners add onto their advanced education with a license in one of several specialties.

Choose a Specialty

Although it is possible to become a general nurse practitioner, nurse practitioners typically specialize in healthcare for a specific population or community. This requires them to pass a national certification exam as part of their boards. The AANP described national certification boards as “rigorous, psychometrically-sound evidence-based exams that verify entry-level to clinical practice. These exams test both general advanced practice knowledge and population-specific competencies.” Nurse practitioners can only sit for an exam that aligns with their graduate education, so students need to know which specialty they would like to target as they enter their program. Five of the most common nurse practitioner specialties are described below.

Family Nurse Practitioner

Family nurse practitioners, or FNPs, treat individuals and families throughout their lives. As long-term primary care providers, family nurse practitioners often enjoy building relationships with patients and helping them through any healthcare issues. Many family nurse practitioners work in doctor’s offices or clinics, and others work in community health centers or public health departments. The most recent statistics from AANP showed that 69.7% of nurse practitioners specialized in family practice.

Emergency Nurse Practitioner

Emergency nurse practitioners are trained to work in an emergency room at a hospital or urgent care center. They diagnose, assess and treat acute injuries and illnesses with the help of an emergency healthcare team. Emergency rooms are usually crowded, so emergency nurse practitioners use their specialized skills to triage patients and decide who needs care first. The AANP reported that 4.1% of nurse practitioners specialized in acute care in 2020.

Pediatric Nurse Practitioner

Becoming a pediatric nurse practitioner is a good choice for those who want to help kids. These nurse practitioners work in clinics, hospitals, schools, colleges and other settings. They must understand how illnesses and injuries impact children and adolescents, and a large part of their knowledge base is preventative care. In 2020, the AANP determined that 3.2% of nurse practitioners specialized in pediatrics for primary care, while 0.7% specialized in pediatric acute care.

Psychiatric Nurse Practitioner

Psychiatric nurse practitioners help diagnose and manage the treatment of common mental health issues, substance abuse disorders and more. Like psychiatrists, they can prescribe medication and perform therapy. Unlike psychiatrists, psychiatric nurse practitioners don’t need to go to medical school or complete rotations, and psychiatric nurse practitioners are not equipped to treat less common mental health illnesses. 4.7% of nurse practitioners specialized in psychiatric or mental health in 2020, according to the AANP.

Women’s Health Nurse Practitioner

Women’s health nurse practitioners typically work in primary care or private practice settings, including obstetrics, gynecology and reproductive health. They are trained to give annual checkups, test for pregnancy, treat pregnancy-related conditions and educate patients about contraception. When it comes to labor and delivery, a women’s health nurse practitioner can assist as an obstetrician delivers the baby. The AANP reported that this specialty accounted for 2.9% of nurse practitioner specialties in 2020.

Other nurse practitioner specialties include dermatology, gerontology, hospice, neonatal care, nurse anesthetist, nurse midwife, oncology, orthopedics and surgery. While it can be challenging to assess the career outlook for different specialties, the overall career outlook for nurse practitioners is promising.

Review the Career Outlook

A career as a nurse practitioner is not only rewarding, it is sustainable. The U.S. Bureau of Labor Statistics (BLS) reported that available positions for nurse practitioners will grow 52% from 2020 to 2030, adding over 114,900 jobs. Several factors will contribute to the need for more nurse practitioners, such as replacing those who retire, providing more preventive care and increasing healthcare services for the aging population.

As the U.S. baby boom generation retires, they are moving to warmer areas, like Florida. The most recent U.S. Census revealed over 20% of Floridians are 65 and older, a number that has grown alongside over 3 million people that have been born in Florida or moved to Florida since 2010. According to the New York Times, this growth was “fueled in large part by a steady stream of retirees lured by Florida’s year-round balmy weather, beaches and endless golfing.” In fact, Florida’s growing number of retirees was partly responsible for its additional Congressional seat in 2021.

The increase in Florida’s older population has led to greater demand for nurse practitioners. The BLS identified Florida as one of the states with the highest employment of nurse practitioners—over 13,000 nurse practitioners worked in Florida as of May 2020. The highest concentration of nurse practitioners, 3,620, worked in the Miami, Fort Lauderdale and West Palm Beach areas.

No matter where they work, nurse practitioners enjoy a salary commensurate with their background. Because of their advanced education and experience, nurse practitioners can earn a higher salary than other nurses, such as registered nurses, travel nurses and LPNs. Gaining additional specialties can raise the salary potential for nurse practitioners, as well as working for larger, more established healthcare providers.

According to 2020 data from the U.S. Bureau of Labor Statistics:

• Licensed practical and licensed vocational nurses made a median salary of $48,820.
• Registered nurses made a median salary of $75,330.
• Nurse practitioners earned a median salary of $111,680.

The BLS reported that Florida’s nurse practitioners earned a mean annual salary of $101,060 in 2020. Pay can increase for nurse practitioners based on skill level, specialties, location and years of experience. According to ZipRecruiter, the top 90th percentile of nurse practitioners in Florida made $117,429 annually. ZipRecruiter also provided the top ten cities where the typical salary for a nurse practitioner is above average:

1. Cape Canaveral
2. Bonita Springs
3. West Palm Beach
4. Venice
5. Lake City
6. Pembroke Pines
7. St. Petersburg
8. Miami Beach
9. DeLand
10. Sarasota

Along with their specialties, career outlook and location, nurse practitioners should familiarize themselves with their scope of practice.

Consider the Scope of Practice

For nurse practitioners, the scope of practice has three major categories. These categories refer to the legal ability to prescribe medication, practice with or without oversight, and define the nurse practitioner’s role as a primary care provider. Each state determines the scope of practice for nurse practitioners, so it’s important for job seekers to know what they’ll be allowed to do.

Prescriptive Authority

For nurse practitioners, having prescriptive authority means prescribing medications to patients. In some states, nurse practitioners can prescribe without any oversight, but other states require a physician or doctor to review and approve prescriptions. Sometimes, a nurse practitioner can transition from supervised prescribing to independent prescribing after a period of time.

The National Conference of State Legislatures (NCSL) showed that nurse practitioners in 23 states have full prescriptive authority, meaning that they can prescribe medications without oversight. Alternatively, 23 states require a physician to approve any prescriptions by a nurse practitioner. In four other states (Colorado, Arkansas, West Virginia and Connecticut), nurse practitioners can only prescribe independently after a period of oversight. Florida grants nurse practitioners independent prescriptive authority.

Full Practice Authority

Similar to prescriptive authority, gaining full practice authority means that nurse practitioners can perform their job duties independently. Without full practice authority, nurse practitioners must consult with their supervising physician to outline which procedures can be done independently and which procedures require approval.

Nurse practitioners have full practice authority in 15 states and the District of Columbia, according to the American Academy of Family Physicians (AAFP). In 17 other states, nurse practitioners can transition to independent practice after a period of supervision by a physician. Nurse practitioners do not have full practice authority in the 18 other states.

In Florida, nurse practitioners were given full practice authority after several years of indecision by the Florida Medical Association. DailyNurse® reported that as of July 2020, “advanced nurse practitioners who have accumulated at least 3,000 hours of experience under physician supervision will have the right to independently operate primary care practices in Florida without an attending doctor.” Nurse practitioners in Florida who would like to practice independently will also need graduate coursework in differential diagnoses and pharmacology.

Primary Care Provider

In some states, nurse practitioners can officially be named primary care providers. In other states, nurse practitioners are identified as a separate entity from primary care providers. The NCSL identified 11 states where nurse practitioners are not recognized as primary care providers: South Dakota, Nebraska, Kansas, Missouri, Wisconsin, Michigan, Indiana, Alabama, Georgia, Virginia and the District of Columbia. In all the other states, nurse practitioners can work as primary care providers for the population they specialize in.

Nurse practitioners in Florida are able to independently practice family medicine, general pediatrics and general internal medicine, according to DailyNurse®. This allows nurse practitioners to help patients while using the full extent of their education and training.

Becoming a qualified, independent nurse practitioner can seem complicated, but it starts with the right education.

Map an Educational Path

For those interested in becoming a nurse practitioner, the first steps are to earn a Bachelor of Science in Nursing (BSN) and hold an active RN license. Securing an RN license will mean passing the National Council Licensure Examination (NCLEX). Guidance from the AANP explained that the NCLEX “tests your knowledge and critical thinking skills related to nursing,” and RNs who pass the exam are eligible to apply for a state license.

All nurse practitioners must also complete a graduate program, most commonly a Master of Science in Nursing (MSN), although some also choose to complete a doctoral degree program. The goal of graduate school for nurse practitioners, according to the AANP, is to provide advanced clinical knowledge and skills needed to diagnose, manage, treat and prescribe medications for patients.

In their graduate program, aspiring nurse practitioners will decide which of the various specialties they would like to pursue and take the appropriate courses. Upon completion of a graduate degree, nurse practitioners must pass a national board certification exam that aligns with their specialty. After passing the exam, the final step is to apply for state licensure as a nurse practitioner.

Once licensed, nurse practitioners nationwide need to fulfill continuing education requirements to ensure that their practice remains up to date. Continuing education is necessary for anyone who works in healthcare, but it’s especially important for nurse practitioners because they work so closely with their patients.

For working nurses considering a graduate program, a convenient option is to study online. Taught by nurse educators with years of experience in nursing and healthcare, the fully online Master of Science in Nursing from the University of West Florida includes a focus on becoming a Family Nurse Practitioner. Graduates of UWF’s accredited online MSN can complete the national certification exam and pursue nurse practitioner licensure in their state.*

*UWF cannot confirm whether a particular program meets requirements for professional licensure outside of the State of Florida. Please contact the applicable licensure board(s) in any state you may want to pursue licensure prior to beginning the academic program to determine whether the program meets licensure requirements. It is the student’s responsibility to confirm program eligibility for licensure in any state outside Florida.