Careers for FNPs and Nurse Practitioners – Explore Your Options

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A career as a nurse practitioner (NP) is a great path to professional advancement for a registered nurse (RN), as it provides more freedom to choose a specialty and to decide what type of facility to work in. Becoming an NP or family nurse practitioner (FNP) requires either an Associate’s Degree or a Bachelor of Science in nursing, as well as a Master’s Degree in nursing. NPs generally have more specialized knowledge than RNs, and they can prescribe medication.

An NP can also provide primary care at a lower cost than physicians, and the demand for them is expected to grow in coming years, especially in inner city and rural areas, according to The U.S. Bureau of Labor Statistics (BLS). An expected 581,000 new jobs for RNs will be created by 2018, and the additional education required to become an NP will open up broader career options and the possibility of higher pay. Most NPs earn between $83,579 and $97,008 annually.

Employment Options for NPs and FNPs

An NP can decide how much independence, responsibility, and collaboration to have in their career by choosing to become a primary care provider or becoming a specialized assistant to a physician in a single or group medical practice. The chart below depicts the percentages of RNs employed in different types of facilities as of 2008:

Registered Nurse employment by facility type

In 2010, The U.S. Agency for Healthcare Research and Quality, a branch of The U.S. Department of Health and Human Services (HHS), reported that 52% of NPs were providing primary care, and 48% were providing subspecialty care.

Fields of Specialization and Certification

Nurse practitioners have a great deal of direct interaction with patients and usually perform duties such as physical exams, ordering laboratory tests, and providing referrals. However, the day-to-day activities of a nurse practitioner are largely determined by his/her specialties. Many of these specialties require a certificate that must be renewed annually. The laws governing certification of nurse practitioners vary by state. The following are some common areas of specialization chosen by nurse practitioners:

  • Geriatric care: The popularity of in-home care for aging patients with functional disabilities is expected to rise between now and 2018, creating a need for more NPs specializing in geriatric care. Additionally, The Bureau of Labor Statistics predicts job growth at medical facilities specializing in long term care for sufferers of strokes and Alzheimer’s disease, which occur more often in old age.
  • Family practice: An FNP may work with a patient for years, and since FNPs can provide primary care at lower cost than medical doctors, their popularity is rising in medically underserved areas. In 2004, a Bureau of Health Professionals survey reported that 21% of surveyed NPs were certified in family practice, making it the most common certification.
  • Women’s health: A women’s health NP may provide care and advice relating to cervical pathology, family planning, menopause and other general women’s health issues, in addition to basic primary care services.
  • Neonatal care: NPs in neonatology help care for sick newborns and provide advice to parents of infants. A neonatal NP needs clinical experience in caring for sick newborns, and a nurse with special interest in this field should also consider a career as a nurse midwife, which involves providing care to mothers throughout a pregnancy and during labor.
  • Pediatric care: Pediatric NPs work with children, usually in a hospital’s pediatric department or in the office of a private pediatrician. Similarly to women’s health and neonatal NPs, pediatric NPs may need to work with expectant mothers and provide obstetrics and gynecological services.
  • Acute care: NPs specializing in acute care must diagnose acute conditions and make treatment plans for critically ill patients. Acute care NPs often work with a patient from the time the patient is admitted to a facility until the patient is released.
  • Mental health: A mental health NP diagnoses and treats psychological and emotional issues such as personality disorders and substance abuse problems. The NP may provide this treatment in collaboration with a private psychologist or psychiatrist, in the context of a treatment facility, or as part of a primary care treatment plan.
  • Education: Teaching other nurses is another career option for NPs, though some teaching positions may require a doctoral degree in addition to a Master of Science in nursing.
  • Administration: NPs can combine clinical and administrative work in the position of unit manager or head nurse, or even move into exclusively administrative work in a nursing department, though this will likely require years of good service in lower ranking positions.

Government Programs that Help Aspiring Nurses

As a large percentage of working nurses retirement, and demand for new health professionals rises, the US government has passed legislation to help educate new nurses and build the workforce.

The Affordable Care Act (ACA)

The Affordable Care Act (ACA), a piece of health care legislation passed in March, 2010, will provide billions of dollars toward the construction and staffing of new health clinics, especially those that will provide primary care in medically underserved areas. This represents a significant opportunity for NPs, as the creation of these new clinics will result in many new jobs, especially for those interested in providing primary care and working in nurse-led facilities.

The National Health Services Corps

Some of this money from the federal government will also go to the National Health Services Corps (NHSC), which helps finance the education of NPs and other advanced-practice nurses. In exchange for two to five years of service in an underserved area, nurse practitioners can receive between $50,000 and $145,000 in loan repayment through the NHSC.

As of July, 2010, there were 1,700 available positions for nurse practitioners in the NHSC’s clinics, according to a speech given by Mary Wakefield, administrator of the U.S. Health Resources and Services Administration (HRSA). Wakefield also said that HRSA plans to “double the size of the Corps to some 8,000 practitioners over the next seven years.” This government action to create NP jobs and lower the financial barriers to entering the field makes now an ideal time to take steps toward becoming an NP.

New government funding also creates opportunities for NPs who have been in the field for some time and want to continue their education. The Nurse Faculty Loan Program, which focuses on nurses wanting to become teachers, and the Nursing Student Loan Program both increased the maximum annual loans they would provide after receiving funding from the ACA. Increased loan availability combined with scholarships and loan repayment assistance programs can make it easier and cheaper to return to school to become an NP.

Other Considerations for Those Pursuing a Career as a Nurse Practitioner

Growing Industries

The table of data below, from the Bureau of Labor Statistics, shows the projected growth of jobs for RNs in different settings from 2008 to 2018. NPs, with their higher level of education will likely find it easier to secure jobs in the most desirable facilities:

http://www.bls.gov/oco/ocos083.htm#outlook

Licensure and Continuing Education

The American Nurses’ Association and other organizations offer national certification for nurse practitioners pursuing a specialty. Certificates must be renewed regularly, though the renewal interval and requirements vary by state.

The National Institutes of Health, a department of HHS, reports that nurses seeking recertification must show proof of continuing education. Rapid innovation in health care makes it necessary for nurses to update their knowledge every year or every few years. Scholarships may be available for nurses taking continuing education classes while already practicing.

Location

Though the general employment outlook for nurse practitioners is fantastic, the availability of desirable positions with competitive pay depends on location. The states with highest employment rates for RNs are California, Texas, New York, Florida and Pennsylvania, whereas the states with the highest pay for RNs are California, Massachusetts, Hawaii, Alaska, and Maryland, according to the United States Department of Labor’s Occupational Employment Statistics from 2010.

No specific data for NPs are available, but NPs are likely to be competitive applicants for positions available to RNs. More information on where RNs and NPs are most needed, and where they earn the most money, can be found at The Bureau of Labor Statistics’ Occupational Employment Statistics web page.

Work Hours

Nurses in general, and especially NPs with a unique specialty in their office or unit, may be expected to work long hours, and their hours may be at odd times of day. It is important to discuss the hours you will work with a potential employer before committing to a position, and to maintain a flexible schedule while also making sure your own needs are met.

Becoming a nurse practitioner requires dedication, time and money, but the rewards are rich and lasting. The availability of bachelor’s and master’s degrees in nursing through online programs puts a career as a nurse practitioner within reach for more people now than ever before. Since jobs in health care are expected to be created twice as fast as in any other field, more people than ever need to step up to the challenge and reap the benefits of a career as a nurse practitioner.

It was not always possible to earn a family nurse practitioner degree online, but shifts in education have allowed more accredited schools these programs entirely online. While online FNP programs are still relatively new, dozens of master and doctoral nurse programs are available. To see if a school offers the right program for you, use the links below to contact a school to learn more.

Georgetown University
MSN in FNP Specialization
Georgetown University — Georgetown University is one of the few schools offering an online program for student pursuing a career as a family nurse practitioner. Established in 1789, Georgetown is one of America's oldest institutions for higher education and now offers over 100 programs through its eight schools from business to medicine and healthcare.
Kaplan University
MSN to DNP in Family Nurse Practitioner
Kaplan University — In addition to its several online nursing programs, Kaplan University has a MSN to DNP in Family Nurse Practitioner. Originally the American Institute of Commerce founded in 1937, Kaplan is one of the largest online schools with 70 campuses across the country and offers almost 200 online programs at the associate, bachelor, master, and doctoral levels.
University of Cincinnati
MSN in Women's Health Nurse Practitioner
MSN in Nurse Midwifery
University of Cincinnati — If you want to advance your career in nursing, the University of Cincinnati offers online degrees for nursing professionals including an MSN in Women's Health or Nursing Midwifery. UC was founded in 1819 and while the school now has over 42,000 students, the student to faculty ratio is only 15 to one, so you get the support and attention you need as you pursue your degree.
South University
MSN in Nurse Practitioner
South University — South University has an impressive online division that is convenient for working professionals trying to earn their MSN. A Georgia-based school, South U was founded in 1889 and now offers almost 30 online programs and has schools in eight states.

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Looking for a Nurse Practitioner Degree?

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