A Nurse Practitioner (NP) is classified as an Advanced Practice Registered Nurse, and is one of the highest paying nursing occupations in the industry. All NPs are Registered Nurses (RNs), and they are required to have post-graduate level educations, which means they hold either Master's or Doctoral degrees in nursing. In practicality, NPs rank slightly below physicians in the type of health care that they provide to patients, and in some states NPs are also allowed to work without a physician's supervision, write prescriptions, and even open their own clinics. NPs must acquire a state-level license and receive certification from a national board in their given specialty field. Due to the high education and licensing requirements, NPs provide a quality of care that is comparable to that given by physicians, according to the Journal of the American Medical Association.
The first Nurse Practitioner training curriculum, called the Pediatric Nurse Practitioner (PNP) program (also known as tracks), was developed in 1965 at the University of Colorado by Drs. Loretta C. Ford, EdD, RN, PNP, and Henry K. Silver, MD. They created the PNP program as a response to the shortage of pediatric care services that plagued rural and urban communities in the United States. The NP profession received a major boost when President Richard Nixon signed the Comprehensive Health Manpower Training Act of 1971, which provided Federal funding for NP nursing programs. In 1974, the American Nurses Association (ANA) gave its official recognition of the profession by starting the Council of Primary Care Nurse Practitioners, an organization which helped define the NP job description. In 1977 the ANA started the Pediatric Nursing Certification Board as a certification program for NPs. In 1980, several NP-related organizations were established amidst a flourishing industry; by then there were over 200 NP programs with nearly 20,000 NPs already employed. In 1985 the American Academy of Nurse Practitioners (AANP) was formed as a professional organization for NPs in all specialties across the country, and held its first national conference in Philadelphia in 1989. To date the AANP is the only nationwide organization for the entire NP field, representing over 145,000 nurses in all NP fields. Over 9000 new NPs are certified each year at 325 nursing schools around the country.
To get started in the nurse practitioner program, one must first be a registered nurse with at least 2 years of work experience. This means going through the RN program first and then acquiring more nursing education at the graduate and post-graduate level. The AANP and the American Nurses Credentialing Center (ANCC), the two largest organizations that issue nursing credentials, require that NP candidates also hold a graduate degree, which means a Master of Science or Doctoral degree in nursing. In addition, the American Association of Colleges of Nursing (AACN) and the AANP, have proposed that entry-level NPs must earn a Doctor of Nursing Practice (DNP) degree as of 2015, with current NPs holding master's degrees being exempt from the rule. Students looking to enter the nursing career typically attend a traditional college and, in the case of NP candidates, continue their education at a four-year university. Licensing exams for NPs vary by specialty. There are also requirements for continued education, which can be fulfilled in a traditional school or through various online nursing programs.
Nurse Practitioner Responsibilities and Specialties
NPs provide services to individual patients as well as families and groups. Their responsibilities include diagnosing illnesses, and part of their primary function is to promote healthy living while providing holistic care, preventative care and education to help empower patients to take charge of their own well-being. They may order or interpret diagnostic tests; and some NPs also conduct or supervise laboratory tests. NPs may also be employed in health care research and consulting. Many NPs are also patient advocates. On any given day, a nurse practitioner typically performs physical exams, compiles family medical history, requests testing, writes and refills prescriptions, interprets test results, diagnoses patients, educates patients regarding their afflictions or the prevention of potential problems, and collaborates with doctors on more difficult issues. Pediatrics was the original profession for NPs, but since then it has grown to include other certified fields such as acute care, adult and family nursing, geriatrics, family health, psychiatry, anesthetists, obstetrics and gynecology (Women's Health, or WHNP), critical care, occupational health, and oncology(cancer). NPs can also serve as midwives.
Nurse Practitioners work in a variety of environments, depending on which field they specialize in. They can work in hospice care centers, hospitals (for nurses that specialize in neonatal and acute care), schools, research facilities, health insurance companies, correctional facilities, community health centers, or physician's offices. Some NPs also do house calls. Primarily, nurse practitioners work in family practice, pediatrics and women's health clinics. NPs can work in any area, from primary care and family practice clinics to cardiology departments and intensive care. In certain states NPs can open their own clinics and operate independently. A nurse practitioner's responsibilities and work environments vary because they may take one of several nursing career paths. Most nurse practitioners work in ambulatory care or outpatient environments. NPs may be required to work rotating shifts, and some are on-call. NPs have a greater level of autonomy compared to nurses in other professions; this, combined with the increased complexity of medical decisions they must make, makes the role of NP one of the most stressful of all nurse jobs, especially for entry-level practitioners.
On average, a nurse practitioner can earn a salary of $90,000 a year. Those working in correctional facilities can earn an annual income of $110,000, while NPs working in the psychiatry field earn an average of $61,000. Entry-level NPs with less than a year of experience start out earning between $51,000 and $87,610 per year, while nurses with over 20 years of experience as NPs can command a yearly salary as high as $119,000. Nurse practitioners in anesthesiology, also known as Certified RN Anesthetist, receive an average salary of $133,000.