How to Become a Family Nurse Practitioner

It was just 50 years ago that Dr. Loretta Ford, a public health nurse, founded the first educational program for nurse practitioners, creating an entirely new profession in the process. Prior to the inception of Ford’s program at the University of Colorado, nurses were limited in how much they could do for patients in their care; doctors handled most medical treatment.

Ford’s work changed all that. Through her program, nurses were trained to assess patients, diagnose maladies, and even create treatment plans. It wasn’t long before nurse practitioner programs were springing up all over the United States.

As a patient today, you’re just as likely to see a nurse practitioner as you are to see a physician or physician assistant for minor ailments and illnesses. Nurse practitioners’ training qualifies them to serve as independent healthcare providers, and the family nurse practitioner (FNP) designation indicates a nurse with sufficient training to provide primary care or specialty care for patients of all ages. While an FNP’s work is typically (though not always) supervised by physicians, an FNP provides many of the same services doctors do, has prescriptive authority, and may even have his own private practice.

Why you might want to become an FNP

FNPs fill some pretty crucial gaps in the healthcare system. These advanced-care nurses:

• Treat people in areas with doctor shortages
• Care for people in underserved areas and work with people of all ages
• Often develop lifelong relationships with patients and arguably deliver better care as a result
• May serve as the primary medical caregiver for an entire family (including infants and kids) — a role much like the family physician of yesteryear
• Tend to spend more time in direct patient care than does the average medical doctor

A career as a family nurse practitioner is a solution for those who might not want to be doctors but want to be a part of the medical field, help people, and work independently. It’s also a financially rewarding job, with nurse practitioner salaries among the highest in the field. According to the U.S. Bureau of Labor Statistics, the median annual wage for family nurse practitioners is $124,700, significantly higher than the annual wage for registered nurses who do not pursue an advanced degree.

What exactly does a family nurse practitioner do?

FNPs provide basic nursing care in family practice and primary care settings, of course, but they also:

• Conduct examinations
• Diagnose illnesses and assess and treat injuries
• Perform and order diagnostic tests
• Create treatment plans
• Prescribe medications
• Perform minor surgical procedures

Whether FNPs do all of the above without a supervising physician (true in about half of all states) or are required to work under the supervision of a licensed physician varies from state to state.

What is the educational commitment to become a family nurse practitioner?

Your preparations for a career as a family nurse practitioner begin at the undergraduate level. Getting your Bachelor of Science in Nursing (BSN) from an American Association of Colleges of Nursing (AACN) or National League for Nursing (NLN)-accredited university will prepare you to work as a registered nurse and to study at the master’s level (though it’s also possible to work in the field with just an Associate Degree in Nursing (ADN) after passing the certification examination).

Many people earn their ADN first before moving on to a four-year nursing degree program that combines classroom learning with clinical work. These programs include courses on public health, medical assessments, nutrition, emergency care, and anatomy. If you’re already working as a registered nurse, there are RN-to-BSN programs that last just two years, such as the online master’s programs at the University of Oklahoma and the University of West Florida.

Once you’ve earned your bachelor’s degree in nursing, you’ll be qualified to work in a range of medical and clinical settings, including doctor’s offices, hospitals, surgical centers, and long-term care facilities. Many nurses spend a few years working before pursuing the education necessary for a career in advanced-care nursing. Those who feel driven to earn their family nurse practitioner certification will then pursue a master’s in nursing.

As with most master’s-level programs, there is a lot of variation in what’s out there in terms of Master of Science in Nursing (MSN) programs accredited by the CCNE or the ACEN:

• There are online nurse practitioner programs, like Duke University’s highly ranked 49-credit program
• There are also on-campus programs, such as the prestigious nurse practitioner programs at Columbia University and Johns Hopkins University

How long does it take to become a family nurse practitioner?

It depends on where you start, and what you want to do.

• If you have no nursing experience whatsoever, you may be able to earn your MSN with five years of full-time study.
• BSN-to-MSN programs take two years, assuming the candidate has earned a bachelor’s degree in nursing and is currently working as an RN. Plan for at least 15 to 24 months of full-time study in exclusively master-level courses if that’s your trajectory, longer if you’ll be studying part-time.
• Bachelor’s-to-MSN programs allow RNs who hold bachelor’s degrees in other fields to earn an MSN without having to get a BSN first. These nurse practitioner programs take somewhat longer because they include undergraduate-level bridge courses in addition to graduate work and clinical experience components.
• RN-to-MSN programs take the longest because they let candidates pursue a BSN and an MSN at the same time, but they are faster than earning a BSN and then pursuing an MSN.
• Post-MSN certificate programs are for those who have already completed nursing school and earned a graduate degree, but would like to transition to the family nurse practitioner specialization.
• MSN to DNP programs are for nurses who want to earn the credentials necessary to take on leadership roles in nursing.

What does an MSN degree program generally look like?

No matter where you earn your MSN, the curriculum for the nurse practitioner specialization looks roughly the same. The program will include both classroom education covering a broad range of subject matter like physiology and pharmacology, health systems management, and issues related to family medical care, along with clinical training. Once a degree candidate chooses a specialization — in this case, family nursing — they’ll complete advanced courses related to that specialization, take part in workshops, and perform clinical work in a real-world setting. Online programs typically still have clinical and lab components that require students to do at least some on-campus work.

Do I need to be working as a nurse to pursue an FNP degree?

Probably. Most graduate schools require a BSN and several years of nursing experience as a prerequisite to entering an MSN program. That said, there are programs that allow degree candidates to gain the requisite RN work experience while pursuing their graduate degrees and/or to enter the program with just an associate’s degree (such as the bridge program at Adelphi University). In either case, having or gaining nursing experience is an essential part of getting an MSN.

Is an MSN enough or do I need to enroll in a DNP program?

There is definitely a growing trend toward requiring nurse practitioners to earn a Doctor of Nursing Practice (DNP) degree, but an MSN is currently the minimum degree required across states to become a certified nurse practitioner in different specialties. If you’re looking to work in healthcare administration or nursing education, you might want to look into DNP programs and pursue a Ph.D. in a related field after earning your master’s degree.

What does the licensure and accreditation for becoming a family nurse practitioner look like?

Once you’ve earned your FNP master’s degree, you’ll sit for the family nurse practitioner certification exam. There are actually two different FNP certifications — one offered by the AANP and one offered by the ANCC. They’re quite similar, and they’ll both be accepted in whatever state you choose to work in, though it’s worth checking to see which your state board of nursing prefers. Both require a number of credit and clinical hours.

It’s important to note that national certifications don’t last forever in the nursing world. Whether you have a registered nurse’s license or a license plus an FNP certification, you’ll need to renew your credentials every five years. To keep your family nurse practitioner certification, you’ll have to make sure your RN license stays current, earn at least 100 continuing education hours, and meet the minimum number of direct practice hours, which is 1,000. Requirements vary by state for renewing an RN license, so be sure to understand what will be required in the future if you decide to become a nurse practitioner.

Whether your goal is to open your own practice or to become a core member of the care team at someone else’s, don’t be afraid to pursue a nurse practitioner degree. The position offers a high degree of job security; the Bureau of Labor Statistics predicts that nursing employment will increase by 8 percent through 2031, with employment for nurse practitioners growing at a robust rate of 40 percent.

Nursing, in general, is a recession-proof field; as long as there are people who are sick or injured, there will be a need for nurses. If you’re looking at opportunities in healthcare, nursing is a great place to be.

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