Nurse Practitioner (NP)

Nurse Practitioner (NP) Career Overview

Amanda Gamboa, RN, BSN

Updated

Reviewed by NursingEducation Staff

What is a Nurse Practitioner (NP)?

A nurse practitioner (NP) or certified nurse practitioner (CNP) is a type of advanced practice registered nurse (APRN). An NP assesses patients, orders tests, reviews test results, diagnoses, and prescribes treatments in clinics, hospitals, and other healthcare settings. The scope of practice for an NP, or what an NP is legally allowed to do, varies by state.

Nurse practitioners (NPs) often focus on caring for a specific patient population. NPs can become certified, or board certified, and work in roles such as:

What Does a Nurse Practitioner Do?

A nurse practitioner blends patient-focused nursing care and the responsibilities of a physician. In many states, the scope of practice allows NPs to act as primary care providers with varying degrees of physician oversight. Daily responsibilities of an NP depend on the setting, but will include some or all of the following:

Nurse practitioners working with patients rely on their assessment and diagnostic skills to provide care to patients. Thorough and detail-oriented physical exams are a critical component of caring for patients. Gathering information about patients’ medical and even personal histories is part of the NP’s role. Asking patients questions that lead to further relevant information, while also listening to what patients want to share, is a skill NPs must learn in order to be effective. And in order for patients to share this personal information, they must feel comfortable and confident with the NP. Compassion, excellent listening skills, and critical thinking are all key characteristics of NPs.

Collaborating and communicating with other providers, either as required by law or to make a referral on behalf of a patient, are also an essential part of performing this job successfully. NPs who work under the supervision of physicians have defined contracts and communication requirements that must be met. A nurse practitioner’s level of autonomy varies by state law, so practice location may be a key factor for nurses pursuing NP certification.

An NP is also required to complete ongoing education throughout their career. In-person classes, online lectures, skill demonstrations, and computerized testing are all possible examples of continuing education. Each state has its own requirements for the number of hours of continuing education per year. Failure to complete certain classes or failure to obtain enough hours would make an NP ineligible to practice. NPs may be responsible for registering for and reporting their own continuing education hours.

How Much Does a Nurse Practitioner Make Per Year?

The median pay for nurse practitioners, including certified nurse practitioners (CNPs), is $124,680 per year in the United States. The median hourly wage is $59.94 for NPs. The median pay represents the middle: half of NPs earned more than that amount, and half earned less. NPs and other advanced practice nurses were paid the most in positions within hospitals, home health care services, and outpatient care centers.

NPs are paid hourly, with an annual salary, or based on productivity. Some employers may use a blended contract, offering a base salary and paying more for increased productivity. Pay will vary by location, employer, experience, and specialization. The annual mean wage of NPs varies by over $100,000 across the United States. In the lowest-paying rural areas of the U.S., NPs make $94,480 compared to $199,630 in the highest-paying area of California.

Annual Mean Wage of Registered Nurses, by State

  • $68,000 - $73,000
  • $74,000 - $78,000
  • $78,000 - $81,000
  • $81,125 - $104,000

Blank areas indicate data not available


Source: BLS

The U.S. Bureau of Labor Statistics predicts that the employment of NPs will increase by 38% from 2020 – 2030, which is much faster than the average for all occupations. NPs are gaining recognition from the public as primary care providers, and changing state laws are allowing NPs to perform more services. These trends, in addition to the increasing need to care for the aging population, provide excellent job security for NPs.

Where and When Do Nurse Practitioners Work?

Nurse practitioners can work in clinics, hospitals, surgery centers, outpatient care centers such as birth centers, long-term care facilities, private homes, schools, and in public health positions. Most NPs work in private clinics or physicians’ offices and thus work traditional office hours. NPs working in hospitals or other facilities that are always open can expect to work evenings, nights, weekends, and holidays at some point in their careers. NPs responsible for critically ill patients or delivering newborns may also be expected to have on-call hours as well.

The scope of practice does vary by state for NPs, so it is important to research where you plan to practice and decide if that scope aligns with your goals. For example, nurse practitioners in California are not currently able to practice independently. However, new legislation will allow them to practice independently after three years or 4,600 hours of experience. The ability to practice independently, or Full Practice Authority (FPA), is granted in some states and does not require partnership or oversight by a physician. This map illustrates which states allow independent practice, utilize a transition phase, or require an ongoing contract with a physician.


Source: NCSL

How Do I Become a Nurse Practitioner?

The first step to becoming a nurse practitioner is to become an RN (registered nurse) by taking the NCLEX-RN after graduating from a Bachelor of Science in Nursing (BSN) program. NP programs are at the master’s or doctoral level, so nurses with an Associate Degree in Nursing (ADN) will need to complete their BSN first or only apply to ADN-to-MSN bridge programs. Gaining experience as an RN is not a requirement for applying to NP school, and some schools even help students prepare for the NCLEX while earning their master’s degree (or doctorate).

There are also NP programs that accept students with bachelor’s degrees in other fields, so long as all prerequisite courses have been completed. Prerequisites often include anatomy, physiology, microbiology, psychology, and chemistry. Most NP programs are two to four years long and can be pursued by full-time or part-time students. NP programs often have different focus areas, such as family, mental, or neonatal health. Students will be expected to choose a focus area when applying. Studying within one focus area best prepares students for NP certification after graduation. Requirements vary by state, but most states do require certification by exam. There are many certificates available from at least five different testing organizations. The American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP) are two such organizations. NPs will then need to apply to the nursing licensure board in the state they wish to practice. Applications generally require a fee, background check, and proof of active RN license in good standing.

What Are the Benefits of Being a Nurse Practitioner?

Many NPs value the ability to practice at the highest level of nursing in a healthcare setting of their choosing. The job security for this position is one of the highest in healthcare due to changes in practice laws and the increasing number of aging adults needing more complex care. Experienced NPs have the freedom to choose between several types of healthcare institutions and geographical locations. The option to work in private practice enables an NP to cultivate long-term patient relationships while still having time off on evenings and weekends. The independence NPs can experience in some states can be attractive, but that level of responsibility also comes with an increased risk of stress and burnout. Successful NPs, like all healthcare providers, develop resources and relationships that improve patient outcomes.

What Are Other Advanced Practice Registered Nurse (APRN) Careers?

In addition to NPs, there are three additional APRN providers. Nurses in these roles have earned at least a master’s degree and have specialized to care for specific patient populations. They are certified to assess, diagnose, prescribe, and treat patients at various levels based on state regulations.

Other APRN roles in the United States include: