How to Become a Nurse Practitioner in The USA?

By ShiftMed Team//Nursing Profession
Nurse Practitioner with patient wearing a mask

Nurse practitioners provide primary and special care independently or work with other healthcare professionals. In addition, they often specialize in particular healthcare areas such as geriatric, psychiatric, and pediatric health. 

Like other nursing professions, there’s a high demand for nurse practitioners, often exceeding the supply. However, the data from the US Bureau of Labor Statistics indicates a bright future for nurse practitioners.

The employment rate will grow by up to 45% between 2020 and 2030, higher than all other occupations. With such promising opportunities, it’s essential to understand how you can become a nurse practitioner. 

Recommended Reading - What is a Nurse Practitioner in the USA?

What Are the Steps to Becoming Nurse Practitioner Without a Nursing Degree?

Nurse practitioners start as Registered Nurses (RN), then pursue specialty training to help them perform their duties.

1) First, You Need to Become a Registered Nurse.

As an aspiring nurse practitioner, you’ll start by earning an Associate's degree in Nursing (ADN). This 2-year degree is the minimum education requirement to become a registered nurse in the US.

You can become a nurse practitioner with a bachelor’s degree in a different field besides nursing. The degree gives you a head-start, unlike someone starting afresh. 

If you have a bachelor's degree, start by ensuring you have the basic requirements such as:

  • Nutrition

  • Microbiology

  • Chemistry

  • Biology

  • Anatomy & Physiology (I and II)

Some programs also require you to have a statistics or psychology course. With a bachelor's degree, you'll only need to take the above studies to meet the basic requirements.

After joining the program, you can concentrate on nursing theory and coursework. Before starting nursing school, you'll also need to acquire CPR certification called Basic Life Support (BLS) from the American Heart Association.

Once you complete your Associate's degree in Nursing, you qualify to sit for the National Council Licensure Examination (NCLEX). You’ll need to pass this exam to get a license to practice as a registered nurse.

2) Earn your Master's in Nursing Degree (MSN Degree)

There are various RN to MSN programs that offer nurse practitioner specializations. Such programs take about two or three years and can cover upper-level nursing courses before starting the MSN graduate course. 

You can enroll in bridge programs as a licensed RN with an Associate's Degree in Nursing. These programs create a pathway to your MSN without a Bachelor's Degree in Nursing (BSN).

As the name suggests, the bridge program gives you the necessary schooling equivalent to what you’d learn earning a BSN.

3) Gain Clinical Experience

Regardless of your entry approach, your MSN program will include certain hours of clinical experience. These post-graduate hours are vital to gaining your certification and license as a nurse practitioner.

You'll need a minimum of one year's experience as a professional nurse before starting the clinical experience of your post-master certificate program.

The main reason is that you need to gain hands-on experience as a nurse in the field before qualifying for an advanced nursing position. 

Although you’ll get your MSN degree after completing your master's program, you'll learn more during your first year as a nurse practitioner. You'll also gain experience collaborating with other healthcare professionals.

4) Earn your Nurse Practitioner Certificate

After finishing your MSN program, you must also take and pass a national certification exam. The exam tests your professional knowledge in the area you specialize in. 

Several national certification agencies facilitate NP certification exams. Exams from these agencies are acceptable in every state in the US:

After one year of experience under a nurse practitioner in a clinical setting, you’ll qualify to earn certification as an advanced practice nurse (APRN).

5) Apply for Nurse Practitioner Licensure

Once you get your certification, you’ll need to take and pass a national certification exam to get the APRN license. It includes practical and written sections, and you'll pay some fees for the permit.

However, this process is not straightforward since there's no national standard for licensing nurse practitioners. 

Every state has different licensing requirements, but all fifty states require a license to practice. Therefore, you may need permits from multiple state boards if you plan to practice in various states.

Some states require you to have an APRN license, while others require an advanced RN license. You'll also need additional permits to perform particular NP duties, such as prescribing medications. 

Once you get your NP license, you must abide by the renewal requirements for your license to remain active.

Various Paths to Becoming a Nurse Practitioner

You can become a nurse practitioner without a nursing background or a Bachelor of Science in Nursing (BSN). However, acquiring a license requires you to have a graduate or advanced degree and some nursing experience. 

There are three main paths you can take to become a nurse practitioner, including:

1) Direct Entry NP Programs

Direct-entry nurse practitioner (NP) programs are suitable for people with non-nursing bachelor's degrees seeking to start a career as an APRN.

Although you have no nursing background, the program includes clinical experiences to ensure you can offer advanced care in various clinical settings.

You’ll earn a Master of Nursing (MN) in the initial 15 months, qualifying you to sit for the NCLEX-RN exam to become a registered nurse. 

The Master of Nursing builds a strong foundation for the Nursing practitioner (NP) and Master of Science in Nursing (MSN) courses. You can select your specialty to become a certified NP in that field. 

The program also requires you to undergo 600 hours of clinical training before the NCLEX-RN and an additional 770 clinical hours in different primary care settings. In addition, you’ll interact with patients of all ages.

2) Bridge Programs for Nurse Practitioners

Nursing bridge programs have several primary benefits over a standard degree program. For instance, you'll save significant time, and finances since the program's flexibility allow you to work while studying.

Nursing bridge programs best suit people with a few years of experience in nursing or as nursing aides. They are available for all levels, including Associate, bachelor's, master's, and doctoral degrees, making it easier to advance your nursing career.

3) Accelerated Nurse Practitioner Programs

This path is quicker than the regular program since you can simultaneously acquire a bachelor of nursing (BSN) and a master of nursing (MSN). In addition, the program allows you to combine the two into one accelerated program.

You’ll start with earning a bachelor’s degree in nursing within 12 months via the accelerated program. Then, the BSN will enable you to qualify for the NCLEX-RN exam to get your RN license. You can then proceed with your studies and the nurse practitioner specialty you choose.

Most programs best suit people with undergraduate degrees in other fields seeking to start a nursing career. Some programs are available on campus, but the majority are available online. 

Unlike the standard programs with regular semesters, accelerated programs cluster the classes in sections or quarters. They run continuously, without the long breaks in between semesters. 

Once you enroll in an online program, you can finish your clinical rotations at medical facilities nearby. 

What Positions Can You Progress to From Being a Nursing Practitioner?

As a nurse practitioner, you can advance your career by pursuing a specialty such as:

1) Neonatal Nurse Practitioner (NNP)

You’ll care for premature and ill newborns in emergency rooms, delivery rooms, and neonatal intensive care units (NICU).

2) Hospice Nurse Practitioner (HNP)

As a Hospice NP, you’ll work with patients and their families in preparation for end-of-life situations. Unfortunately, your patients will only be people who can't recover from their disease or illness, so most of your work will be on pain management. 

3) Acute Care Nurse Practitioner (ACNP)

You’ll care for adult patients with major diseases in hospitals or acute care facilities.

4) Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNPs)

As an AG-ACNP, you'll care for elderly and adult patients with critical, chronic, or acute conditions. You can work in private practices, clinics, retirement homes, hospitals, and physician offices.

5) Psychiatric Mental Health Nurse Practitioner (PMHNP)

This specialty focuses on patients with psychological disorders, mental illness, and behavioral issues.

6) Palliative Care Nurse Practitioner (PCNP)

As a Palliative care NP, you’ll deal with patients with terminal illnesses such as cancer, dementia, advanced heart diseases, and neurological disorders.

You can work in in-patient hospice facilities, medical offices, hospitals, and patient homes.

7) Family Nurse Practitioner (FNP)

You’ll care for patients and educate them on disease management and prevention. You’ll also create treatment plans and maintain medical records.

8) Surgical Nurse Practitioner (SNP)

In this specialty, your duties will be operating rooms and working with a larger medical team. In addition, you'll support the surgical staff throughout the surgery, making you an essential part of all surgical procedures.

9) Women’s Health Nurse Practitioner (WHNP)

As a WHNP, you’ll offer primary care to women and girls of all ages.

10) Dermatology Nurse Practitioner (DNP)

In this specialty, you’ll care for patients with diseases or medical conditions involving the skin's surface. You can also specialize in particular age groups or focus on some illnesses such as cancer.

11) Pediatric Nurse Practitioner (PNP)

You'll care for infants, newborns, toddlers, teenagers, and young adults. 

12) Orthopedic Nurse Practitioner (ONP)

You’ll focus on patients with musculoskeletal problems and injuries to the joints, connective tissue, bones, and muscles. You can also specialize in orthopedic oncology, metabolic disorders, and sports medicine.

13) Cardiac Nurse Practitioner (CNP)

You’ll care for patients with chronic or acute illnesses relating to the heart. You can work in outpatient clinics, in-patient hospitals, and private practices.

14) Emergency Nurse Practitioner (ENP)

You’ll focus on caring for injured and critically ill patients regardless of age. You'll be in a fast-paced environment providing immediate care in ambulances, urgent care facilities, trauma centers, and hospitals.

15) Oncology Nurse Practitioner (ONP)

You'll focus on patients who receive a cancer diagnosis and oversee their care during treatment.

The NP field is constantly evolving and often in high demand. You can advance your career as much as you wish and pursue higher professional levels, such as the Chief Nursing Officer, responsible for all nursing operations in the facility.

You can also become a Chief Nursing Executive, where you'll participate in evaluating, developing, and implementing various health policies at the state and national levels.

Do Your Nurse Practitioner Exam Qualifications Expire?

For ANP, FNP, AGPCNP, NP, or AGACNP specialties, you can acquire certification via the AANPCP or the ANCC. Remember that the board you select will remain the same throughout your career. 

AANPCB professional certification remains active for five years. You cannot use your NP license or work as a board-certified NP if it expires. You must notify the State Boards of Nursing (SBON) about your certification’s expiry. 

Recertification requires you to meet AANPCP’s current clinical practice and continuing education requirements. Alternatively, you can sit for the appropriate exam to renew your certificate.

It's best to start the recertification process about six months before your certification expires. The latest time to begin the process should be at least eight weeks before the expiration.

How Much Do Nurse Practitioners Make?

On average, NPs in the US earn $116,438.80 per year. However, the compensation rates depend on specialty, certification, education level, workplace setting, and location.

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How Long Does It Take to Become a Nurse Practitioner?

Generally, it takes six to eight years to work as a Nurse Practitioner (NP) without any formal nursing training or previous college credits.

However, the specific time depends on your chosen path and how fast you want to advance. For instance, you can choose to work as you study part-time to become an RN and NP. You can also work as an RN for several years before resuming studies to become an NP.

If you focus on studies with work in-between, it can take you about three to five years. 

Recommended Reading - How Long Is Nursing School in The USA?

Is a BSN a Requirement to Become a Nurse Practitioner?

No, you can enroll in an accelerated RN to MSN program with an associate degree on your way to your MSN.