Career Information for HPAG Students: Nurse Practitioner

A nurse practitioner (NP) is a registered nurse (RN) who has completed advanced education and training in the diagnosis and management of common medical conditions, including chronic illnesses. Nurse practitioners provide a broad range of health care services. They provide some of the same care provided by physicians and maintain close working relationships with physicians. An NP can serve as a patient’s regular health care provider.

What's the difference between a Physician Assistant (PA) and an NP? Nurse practitioners are educated in the "nursing model” rather than the “medical model”. The core philosophy of the field is individualized care. Nurse practitioners focus on patients' conditions as well as the effects of illness on the lives of the patients and their families. NPs make prevention, wellness, and patient education priorities. This can mean fewer prescriptions and less expensive treatments. Informing patients about their health care and encouraging them to participate in decisions are central to the care provided by NPs. In addition to health care services, NPs conduct research and are often active in patient advocacy activities.

The Work:  Because the profession is state regulated, care provided by NPs varies. A nurse practitioner's duties include the following:

  • Collaborating with physicians and other health professionals as needed, including providing referrals
  • Counseling and educating patients on health behaviors, self-care skills, and treatment options
  • Diagnosing and treating acute illnesses, infections, and injuries
  • Diagnosing, treating, and monitoring chronic diseases (e.g., diabetes, high blood pressure)
  • Obtaining medical histories and conducting physical examinations
  • Ordering, performing, and interpreting diagnostic studies (e.g., lab tests, x-rays, EKGs)
  • Prescribing medications
  • Prescribing physical therapy and other rehabilitation treatments
  • Providing prenatal care and family planning services
  • Providing well-child care, including screening and immunizations
  • Providing health maintenance care for adults, including annual physicals

The Work Setting: NPs practice in all states. The institutions in which they work include community clinics and health centers, health departments, health maintenance organizations (HMOs), home health care agencies, hospitals and hospital clinics, hospice centers, nurse practitioner offices, nursing homes, nursing schools, physician offices, private offices, public health departments, school/college clinics, Veterans Administration facilities, walk-in clinics. Most NPs specialize in a particular field of medical care, and there are as many types of NPs as there are medical specialties.

Entry Into Field:  To be licensed as a nurse practitioner, the candidate must first complete the education and training necessary to be a registered nurse (RN). Entry-level preparation for NP practice is a master’s degree.  Licensure and certification are regulated at the state level. The State Boards of Nursing regulate nurse practitioners and each state has its own licensing and certification criteria. In general, the criteria include completion of a nursing program and clinical experience. Because state board requirements differ, nurse practitioners may have to fulfill additional requirements, such as certification by the American Nurses Credentialing Center (ANCC) or a specialty nursing organization. The license period varies by state; some require biennial re-licensing, others require triennial.
After receiving state licensing, a nurse practitioner can apply for national certification from the ANA or other professional nursing boards such as the American Academy of Nurse Practitioners (AANP). Some NPs pursue certification in a specialty.

Education: There are a variety of educational paths for NPs as a result of the history of the field. In 1965, the profession of nurse practitioner was instituted and required a master's degree. In the late 1960s into the 1970s, predictions of a physician shortage increased funding and attendance in nurse practitioner programs. During the 1970s, the NP requirements relaxed to include continuing education programs, which helped accommodate the demand for NPs.

Nurse practitioners are educated through programs that grant either a certificate or a master's degree. A registered nurse is recommended to have extensive clinical experience before applying to a nurse practitioner program. An intensive preceptorship under the direct supervision of a physician or an experienced nurse practitioner, as well as instruction in nursing theory, are key components to most NP programs.

NP education provides theoretical and empirical knowledge in addition to clinical, technical and ethical learning experiences for delivery of care and role development in advanced nursing practice. The emphasis in a master’s program preparing NPs is on the development of clinical and professional expertise necessary for comprehensive primary care and specialty care practice in a variety of settings. The curriculum should be designed to prepare graduates to qualify for certification in their anticipated area of practice. NP programs also cultivate advanced skills in the roles of educator, counselor, advocate, consultant, manager, researcher, and mentor.

The Career:
 Median annual earnings of nurse practitioner’s were $68,083 - $78,726 in 2004.
 
Job Outlook: Job opportunities for NPs and other advanced RNs are expected to be very good. Employment of registered nurses is expected to grow faster than the average for all occupations through 2012, and because the occupation is very large, many new jobs will result. In fact, more new jobs are expected be created for NPs and RNs than for any other occupation. Thousands of job openings also will result from the need to replace experienced nurses who leave the occupation, especially as the median age of the registered nurse population continues to rise.

Faster-than-average growth will be driven by technological advances in patient care, which permit a greater number of medical problems to be treated, and an increasing emphasis on preventive care. In addition, the number of older people, who are much more likely than younger people to need nursing care, is projected to grow rapidly.

Web sites of interest:
All Nursing Schools
Virginia Board of Nursing

Virginia Council of Nurse Practitioner
Women's Health Channel
Nursing Masters Degree

NP Schools in Virginia.
Marymount University
School of Health Professions - Department of Nursing
2807 North Glebe Road
Arlington, VA 22207-4299

Shenandoah University
Division of Nursing
1460 University Drive
Winchester, VA 22601

University of Virginia
School of Nursing
McLeod Hall
PO Box 800782
Charlottesville, VA 22908-0782