What Is a Nurse Practitioner?
If you are considering a career in nursing or looking to advance your current one you may have heard the term "nurse practitioner" and wondered what it truly means. A nurse practitioner (NP) is a nurse with a graduate degree in advanced practice nursing, sometimes referred to as an Advanced Registered Nurse Practitioner (ARNP) or Advanced Practice Registered Nurse (APRN) . This is not simply a nurse with more experience it is a completely different level of practice with its own education, certification, and scope of authority.
In short, a nurse practitioner is a clinician trained in the assessment, diagnosis, management, and treatment of patients with acute, chronic, and critical illness, as well as health promotion and disease prevention . They are qualified to meet the majority of patients' healthcare needs; in fact, 60 to 80 percent of primary and preventive care can be performed by nurse practitioners according to the American Nurses Association . This role was originally created in response to a nationwide shortage of doctors, and it has since become a vital part of modern healthcare delivery.
What Does a Nurse Practitioner Do?
Nurse practitioners provide a broad range of health care services that go far beyond what a registered nurse typically performs . Their responsibilities include:
- Taking the person's history, performing a physical exam, and ordering laboratory tests and procedures
- Diagnosing, treating, and managing diseases
- Prescribing medicines and writing prescriptions
- Coordinating referrals to other health professionals
- Providing education on disease prevention and healthy lifestyles
- Performing certain procedures, such as a bone marrow biopsy or lumbar puncture
The scope of practice for NPs varies significantly from state to state. Some nurse practitioners may work independently in clinics or hospitals without a doctor's supervision. Others work together with doctors as part of a joint healthcare team, sometimes requiring physician oversight for prescriptive practice or specific procedures . This is known as "full practice authority" and it is a key differentiator between states.
How Does an NP Differ from an RN and a Doctor?
Understanding the distinctions between an NP, an RN, and a physician is crucial for anyone exploring this career path.
Nurse Practitioner vs. Registered Nurse
The primary distinction is scope of practice and level of autonomy. Registered nurses provide fundamental patient care, such as medication administration, treatment, and patient monitoring, typically under the supervision of physicians or nurse practitioners . They work under a healthcare provider who determines patient care, diagnoses, and follow-up .
Nurse practitioners, on the other hand, have received advanced education and training often earning a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) . This advanced training gives nurse practitioners more authority. They can order tests, prescribe treatments, and diagnose patients tasks that RNs cannot perform . They also have the option to work independently in states that grant full practice authority, effectively serving as primary care providers .
Nurse Practitioner vs. Physician
The most significant difference between a nurse practitioner and a doctor is the amount of schooling. Physicians attend four years of medical school and complete an accredited residency training program, which typically lasts three to seven years, plus additional years for sub-specialization . They are licensed differently than NPs and have a broader scope of practice, including complex surgical procedures .
Nurse practitioners are educated in an advanced nursing role, following a patient-centered model of education and practice . They typically select a primary specialty before beginning their graduate program and subsequently work with that specific patient population. Physician assistants (PAs), by contrast, are educated in general medicine and trained using a disease-centered curriculum model . This difference in philosophy and training shapes how each profession approaches patient care.
Educational Path to Becoming an NP
The minimum educational preparation to become a nurse practitioner is a Master of Science in Nursing (MSN) , but you can also choose to pursue a Doctor of Nursing Practice (DNP) . Both degree programs must contain the "three Ps" —pathophysiology, pharmacology, and physical exam—as well as a minimum number of clinical hours as set forth by the American Association of the Colleges for Nursing standards . Here is the typical step-by-step path:
Step 1: Earn a Bachelor of Science in Nursing (BSN)
Most NP programs require a BSN as a prerequisite for applying for an MSN graduate program. However, individuals with an associate degree in nursing (ADN) or a bachelor's degree in another field can choose from a few "bridge" programs to obtain a BSN .
Step 2: Pass the NCLEX-RN and Obtain Licensure
You must pass the National Council Licensure Examination (NCLEX) to become a registered nurse. This is a mandatory first step before applying to any NP program .
Step 3: Gain Clinical Experience
Most NP programs require applicants to have at least one, if not two, years of clinical experience as registered nurses . This experience is vital for developing the clinical judgment and confidence needed for advanced practice.
Step 4: Pursue a Master of Science in Nursing (MSN)
There are several pathways to complete an MSN:
RN-to-MSN programs are ideal for RNs with experience but no BSN or for individuals with an undergraduate degree unrelated to nursing.
BSN-to-MSN programs are for RNs with a BSN and take about two years.
Direct-Entry MSN programs are for nurses with a bachelor's degree in another field. These are intensive, full-time curricula with a strong focus on hands-on experience .
Step 5: Choose a Population Focus
During your graduate program, you must select a specialty. Common NP specialties include:
- Family
- Adult-Gerontology (Acute or Primary Care)
- Pediatric (Acute or Primary Care)
- Neonatal
- Psychiatric-Mental Health
- Women's Health
Step 6: Pass a National Certification Exam
After graduating from an accredited program, you must pass a national NP certification exam in your chosen specialty . This is required to be board-certified and to practice as an NP. The two primary certifying bodies are the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners Certification Board (AANPCB). Both organizations offer certification exams for various specialties, such as Family Nurse Practitioner (FNP) and Psychiatric-Mental Health Nurse Practitioner (PMHNP) . The exams typically consist of 150 to 175 questions, covering topics such as assessment, diagnosis, planning, and implementation .
Step 7: Apply for State Licensure
Once you are certified, you apply for licensure as an NP through your state's Board of Nursing. This authorizes you to practice in your state and gives you the authority to prescribe medications and perform other duties within your scope of practice .
Alternative Pathways for Non-Nursing Degree Holders
It is possible to become an NP without an undergraduate nursing degree. For individuals who already hold a bachelor's degree in another field, there are Master's Entry Programs in Nursing (MEPN) . These are graduate-level programs designed specifically for students without a nursing background. They provide a streamlined path to RN licensure (via the NCLEX) without the need to earn a second bachelor's degree . After becoming a licensed RN through this program, graduates can pursue additional education and certification to become a nurse practitioner.
NP Career Outlook and Salary
The future for nurse practitioners is exceptionally bright. The Bureau of Labor Statistics (BLS) estimates that demand for nurse practitioners will increase by 40% between 2021 and 2031 . This rapid growth, significantly faster than the average for all occupations, is driven by an aging population, increased focus on preventive care, and the ongoing shortage of primary care physicians.
Nurse practitioners enjoy competitive salaries that reflect their advanced education and responsibilities. According to recent data, the average annual pay for a Nurse Practitioner in the United States is $130,295, which translates to approximately $62.64 per hour . ZipRecruiter reports that while salaries vary, the majority of NPs currently earn between $108,000 (25th percentile) and $150,000 (75th percentile), with top earners (90th percentile) making $180,000 annually . Indeed data shows a similar figure, with a national average salary of $128,511 per year plus $18,750 in overtime pay .
Certain NP specialties command higher salaries. For example:
- Certified Registered Nurse Anesthetists (CRNAs) have an average salary of $260,699 per year .
- Pediatric Nurse Practitioners earn approximately $160,254 per year .
- Cardiac Nurse Practitioners have a national average salary of $159,781 per year .
- Hospice Nurse Practitioners average $158,867 per year .
Frequently Asked Questions
Is nurse practitioner a doctor?
No. A nurse practitioner is not a doctor, though they share many clinical responsibilities with physicians. Doctors attend medical school and residency, while NPs receive graduate-level nursing education and clinical training.
What is the difference between an RN and an NP?
RNs provide fundamental patient care under supervision, while NPs have advanced education and authority to diagnose, prescribe medications, and order and interpret diagnostic tests .
Can nurse practitioners practice independently?
It depends on the state. Some states grant NPs "full practice authority," allowing them to practice independently without physician oversight. Other states require NPs to work under a physician's supervision or have collaborative agreements.
What are the highest-paying NP specialties?
The highest-paying NP specialties include Certified Registered Nurse Anesthetist (CRNA), Pediatric Nurse Practitioner, Cardiac Nurse Practitioner, and Hospice Nurse Practitioner .
Conclusion
A nurse practitioner is a highly trained, advanced practice registered nurse who provides comprehensive healthcare services, including diagnosing and treating illnesses, prescribing medications, and managing patient care. The role requires a master's or doctoral degree and offers significant autonomy, especially in states with full practice authority. With a career outlook that is growing at 40%, exceptional job satisfaction, and an average salary of $130,295 per year, becoming a nurse practitioner is a highly rewarding career path for motivated registered nurses . It is a role that allows you to practice at the top of your license, making a profound difference in patients' lives while enjoying professional and financial growth.
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