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How to Become a Nurse Practitioner

Nurse Practitioner, Professional Advancement | 0 comments

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How to become a nurse practitioner is not as complicated as you might think. Like most nursing specialties, it involves additional schooling beyond that of a nurse, but it is worth the hard work. It isn’t easy – but it is possible!

Some people decide to become a nurse practitioner after they are already working as a bedside RN for years, but others have that goal from the very beginning. I fall into the latter, and I worked hard to achieve my end-goal and become a nurse practitioner fast!

This article outlines the “traditional” method of becoming a nurse practitioner – this is the route that I personally took and the one that I know best. If you’re interested in nontraditional NP routes – I have an article coming soon so be sure to subscribe to my email list to be notified when it drops!

1. BECOME AN RN

When wondering how to become a nurse practitioner, being a nurse is the logical first step. This just makes sense. A nurse practitioner is literally an “advanced practice nurse” – meaning there first is some form of nursing education. Yes, there are ways around this, but for most people this is going to be the first step. An RN license is almost always required for traditional nurse practitioner programs.

You can either obtain your BSN or your ADN to obtain your RN license. In short, a BSN is a 4-year degree that offers a bachelor’s of science in nursing. It is the recommended level of education for a nurse and required for entrance in nurse practitioner programs (aside from direct-entry programs).

No matter which RN education route you take, you will be learning how to assess your patients, all about various medical conditions, and your actions as the nurse in their assessment and treatment. You won’t be learning how to diagnose, but you will be learning which treatments are often indicated and how to administer those treatments. This may involve administering various medications, assisting with testing, communicating with other healthcare professionals, as so much more.

You will also be performing clinical within the hospital setting, learning how to become a bedside nurse. Most programs include 800-1000 hours of formal clinical experience.

Once you graduate, pass the NCLEX-RN, and become state-licensed as an RN – you can finally start working as a bedside RN.

2. OBTAIN RN WORK EXPERIENCE

Once you obtain your RN education and pass your board-certification exam (The NCLEX-RN), you will now should start working as a bedside RN! This is usually very exciting as you can finally take what you’ve learned and positively impact your patients, grow in your knowledge, and make some money!

Believe it or not, whether or not RN experience is necessary before attending a nurse practitioner program can become a heated topic. Many people believe that a certain amount of years of experience is necessary prior to matriculation into a nurse practitioner program. Some say 2 years, some say 5, and some others just say any amount of experience is beneficial.

Benefits of RN Work Experience

Obtaining work experience as a bedside RN is absolutely important in your development as a future nurse practitioner. Working as a bedside nurse offers continuous hands-on learning every day you work. The amount of learning in medicine is endless, and I can confidently say that there isn’t a shift that goes by that I don’t learn something. Working as a nurse will expose you to many common acute and chronic medical conditions, and the treatments and therapies involved. In fact – you’ll be the one administering and helping with them! Through your experience, you will improve your assessment skills, as well as your communication with your patients, and your colleagues within the hospital or clinic that you work. First-hand work experience will give you a deeper understanding of the healthcare system and just “how it all works”. This will become invaluable in your pursuit of becoming a nurse practitioner.

Is work RN experience required to get into an NP program?

Most nurse practitioner programs do not have a minimum amount of RN experience required – at least with family or adult primary care NP specialties. Some sub-specialty’s like Acute care, Pediatric, Psychiatric, and Neonatal programs will require specific nursing experience in a relevant clinical setting. This is often 1-2 years. Many program admissions pages will “recommend” but not require experience, so a lack of experience may negatively impact your admission.

So yes, you can totally become an NP without any bedside RN experience. But I do believe this will negatively impact your clinical competency as a new Nurse Practitioner when you graduate. However, I don’t believe bedside RN experience is as important as some people seem to think. A Nurse practitioner must think like a provider, using great history-taking, advanced physical assessments, and evidence-based medicine. As a nurse you will learn so much – but you will not learn how to think like a provider.

My personal recommendation is to work as a bedside RN for 1-5 years before starting an NP program and to work throughout your program if possible. The number of years of RN experience someone needs to help them become a great nurse practitioner is going to vary based on each individual. I only had 1 year of Full-time RN experience before I started my NP program. However, I worked full-time throughout most of the program and by the time I started my first nurse practitioner job – I had about 4 years of full-time RN experience, most of which were in the ER.

Are there those who will excel at Nurse practitioner school and being a new nurse practitioner without any RN experience? Maybe. But I think not obtaining any bedside RN experience would do your future patients a disservice, and you would miss out on so much hands-on learning.

3. ATTEND A NURSE PRACTITIONER PROGRAM

How to become a Nurse practitioner: NP specialties

When you are ready to start your NP education, you can apply and get into a nurse practitioner program of your desired specialty. Unlike PA programs that train generalists, NP programs are population-specific. This means that you have to apply to a specific patient-population specialty. This helps your education be tailored to the patients that you will be seeing in your future NP job. Nurse practitioner specialties include:

  • Family Nurse Practitioner (FNP)
  • Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)
  • Adult-Gerontology Acute Care Nurse Practitioner (AGACNP)
  • Emergency Nurse Practitioner (ENP)
  • Psychiatric Mental health Nurse Practitioner (PMHNP)
  • Women’s Health Nurse Practitioner (WHNP)
  • Pediatric Nurse Practitioner (PNP)
  • Neonatal Nurse Practitioner (NNP)

The difference between each specialty is an entirely different article, but which one you choose will depend on which clinical setting you plan to practice in one day. If you want to work with adults within the hospital – obtain your AGACNP. If you want to work in a primary care office – get your FNP or AGACNP depending on which ages you want to see. Understand that some specialties are somewhat flexible, and many facilities will hire an FNP or AGPCNP for both inpatient and outpatient roles, as well as within the ED.

How Long will it take?

The amount of time a nurse practitioner program will take will depend on which degree you choose to obtain. There is the more traditional Master of Science in Nursing (MSN) degree, as well as the newer Doctorate of Nursing Practice (DNP) option. MSN programs will take about 2-3 years to complete, and DNP programs will take 3-4 years. To currently work in a clinical setting, there isn’t much difference in terms of clinical education, job role, or salary at this current time – although that may change in the future.

Nurse Practitioner Program Curriculum

The courses you take will depend on your selected specialty. All NP programs will include some basic fundamental classes such as advanced pathophysiology, advanced pharmacology, and advanced health assessment. Then depending on your specialty, you will have various classes specific to each population which outlines various medical conditions and diseases that will present in that population, along with the assessment, diagnosis, and treatment of each one.

Just like as an RN, you will also obtain clinical experience during your NP program. The number depends on the program, but most NP programs will require 600-800 hours. Again, this ended up being about 16 hours per week for me. A common misunderstanding is that NP students are just observing during clinical – however, this could not be further from the truth.

During clinical, it is expected that you are seeing the patient alone, conducting a thorough history, performing your physical assessment, and then presenting the patient to your preceptor (an experienced NP or physician). You will recommend a plan of care, and you and your preceptor will formulate a plan together. This is essential in connecting the dots and preparing you to become a great nurse practitioner.

Full-time and part-time program options

Many programs will offer both full-time and part-time tracks which you can use to fit into your lifestyle. Nurse practitioner programs can be intense and most people cannot work full-time and complete a full-time NP program simultaneously. I myself attended a part-time 24-month program which helped me work throughout most of my program, continuing to financially support myself.

As mentioned above, continuing to work also helps in your learning. You can see firsthand everything you are learning about in your NP education. You might not be formulating the plan of care, but this piece was essential in my development as a competent new NP graduate.

4. Pass Your Board Certification Exam

Once you successfully graduate from your NP program, you are eligible for national certification as a nurse practitioner. To be certified, you must first pass a board-certification exam. Depending on your specialty, these are offered through the AANP or the ANCC.

Once you take your exam and pass, you are officially a nationally board-certified nurse practitioner. BUT you can’t start working yet.

5. Nurse Practitioner Licensing and Credentialing

After being certified either through the ANCC or the AANP, you can apply for state licensure within your specific states in which you intend to practice. The steps involved here are state-dependent, but a quick “Nurse practitioner license in (insert your state here)” should be able to illuminate the next steps.

Even so, this process can be confusing so I have another article outlining these steps which outlines your license, as well as additional necessities like an NPI number or your DEA. Once licensed, you need to get a job within your scope of practice. Once hired, your job will need to credential you. This basically involves background checks and a lot of paperwork being filed with insurance companies. This must be done before you can start practicing as an NP at their clinical site. Be warned – this can take 3-6 months! In 2018 I was hired in February and wasn’t able to start until July for my first NP job.

On average, the Nurse Practitioner education and training can take a minimum of 6 years to complete, although most will take longer if they obtain more RN experience first or if they attend a part-time track. And just like that – you can be a nurse practitioner too! It’s a long and difficult road, but definitely doable. And I can personally tell you that it is 1000% worth it. If you find yourself wondering how to become a nurse practitioner – this might just be the perfect career for you!

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