Where Can a Family Nurse Practitioner Work?

The healthcare industry is suffering a physician shortage that has left many patients—especially those in underserved low-income and rural areas—without adequate service. An aging population and healthcare advances that improve longevity and quality of life but also require increased service have exacerbated the situation considerably.

While patients have traditionally relied on primary care physicians for their health care needs, MDs in today’s environment simply don’t have the bandwidth. Fortunately, a new class of health care providers has emerged to fill the gap. Physician assistants (PAs) and nurse practitioners (NPs) capably perform most of the same tasks as MDs. In many states, they can diagnose and treat patients, order labs, and prescribe medications—all without a doctor’s sign-off.

According to the American Association of Nurse Practitioners, family nurse practitioners constitute the majority of practicing NPs in the US: just over 70 percent, to be precise. And their ranks are increasing; according to the Bureau of Labor Statistics, the profession should grow at a robust 40 percent rate between 2021 and 2031. Perhaps you’re considering joining them.

If so, you likely have a lot of questions. What does a family nurse practitioner do? How do you become a family nurse practitioner? How much will you earn? Where can a family nurse practitioner work? This article discusses all those questions.

What is a family nurse practitioner?

Family nurse practitioners belong the advanced practice registered nurse (APRN) class of health care professionals. Their graduate-level education and extensive training qualify them to provide high-level primary and preventive care.

FNPs see and treat patients. In the course of their duties, they typically:

• Perform medical examinations
• Diagnose conditions and illnesses
• Treat injuries
• Order and perform diagnostic tests
• Formulate treatment plans
• Prescribe medications
• Perform minor surgery
• Offer guidance and counseling

According to the American Association of Nurse Practitioners, nurse practitioners can prescribe medications in all 50 states and in the District of Columbia. NPs enjoy full practice privileges (no restrictions) in 25 states, primarily in the Pacific Northwest, Great Plains, and New England. They operate under reduced practice standards in 11 states, primarily in the Midwest and Deep South. The remaining states are “restricted practice” states. These restrictions often take the form of a collaborative practice agreement, which requires that a physician be available for immediate consultation as necessary. The physician need not practice on premises with the PA in most cases.

Where do family nurse practitioners work?

FNPs practice in a broad range of health care settings. The flexibility and breadth of their practice allow them to contribute in diverse circumstances.

As an FNP, you may find employment in:

Primary care clinics

These are what most people think of as “the doctor’s office.” Located in medical centers, office complexes, strip malls, and occasionally even private residences, primary care clinics provide routine care, including annual checkups, virus and infection diagnosis, and injury treatment. Primary care clinics also practice preventative care and provide referrals to specialists.

Hospitals

FNPs in hospitals may provide outpatient care, emergency services, or specialized treatment. According to Johnson & Johnson, hospital FNPs are most frequently utilized to provide acute care.

Urgent care centers

Emergency rooms are crowded and expensive. A growing need for urgent medical treatment has given rise to urgent care centers to treat minor injuries, infections, and other common illnesses. FNPs are optimally trained to deal with the variety of cases urgent care centers see as part of their daily operations.

Community health centers

Treating underserved communities, community health centers provide primary care, preventive care, chronic disease management, and health screenings to those who might otherwise have to go without. As generalists, FNPs are well-suited to this practice.

Occupational health clinics

Occupational health clinics focus on work-related health care. FNPs in these facilities may assess patients’ fitness to begin or return to work, treat work-related injuries and conditions, and promote workplace safety and wellness.

Specialty practices

FNPs are generalists, but that does not prevent them from developing and working in specialized areas. You’ll find FNPs at work in practices focused on cardiology, critical care, dermatology, oncology, orthopedics, women’s health, and other areas.

Private practice

FNPs may open private practices only in states that allow them unrestricted practice privileges. Duquesne University warns that setting up a private practice requires a business plan, legal complications, and perhaps outside financial backing. You’ll need business acumen as well as medical expertise to make this work but it can be an excellent option for independent-minded practitioners.

How much does a family nurse practitioner make?

Family nurse practitioners work in various settings. Where they work can impact their earning potential. So too can their work experience, geographic location, and any certifications or specializations they have developed.

According to the Bureau of Labor Statistics, the average annual income for nurse practitioners was just under $125,000 in 2021. Pay was higher in hospitals (about $129,000), outpatient care centers ($134,000), and home health care services ($146,000). NPs working in physicians’ offices earned, on average, about $122,000 annually.

Salary.com sets the median FNP salary at $121,000. The site reports a 25th-to-75th percentile salary range of $112,000 to $131,000. The top 10 percent in this field earn more than $141,000 annually.

How to become a family nurse practitioner

Becoming a family nurse practitioner is a multistep process involving rigorous education, training, and testing. Here’s how to do it.

Earn a Bachelor of Science in Nursing (BSN)

The Bachelor of Science in Nursing is the most common precursor degree for a Master of Science in Nursing. Alternatively, nurses who earned an Associate Degree in Nursing (ADN) and subsequently became registered nurses may qualify for a direct-entry MSN program.

Get your RN license

After earning your BSN or ADN, you’ll need to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to earn your RN credentials. Each state sets its own licensure requirements so check to see what additional hoops you must leap through to earn this essential license.

Work as a nurse

It is technically possible to advance from RN licensure directly to an MSN, but most MSN programs require candidates to work in the field first. They want you to acquire the type of hands-on experience that will augment your advanced learning experience.

Earn an MSN

The Master of Science in Nursing is the primary gateway degree to advanced practice nursing. You could also pursue a Doctor of Nursing Practice (DNP). There may come a point in the future when a DNP will be required to become an APRN, but for now either the MSN or DNP is sufficient. Should the DNP become the minimum standard, all practicing NPs with an MSN will almost certainly be grandfathered in.

Many MSN and DNP programs offer specializations in family nursing; it is, after all, far and away the most popular NP practice area. You can even pursue the degree online. Yale University will soon launch an online FNP MSN program, in fact.

Earn FNP certification

In the United States, you can obtain FNP certification from one of two certifying bodies: The American Association of Nurse Practitioners (AANP) and the American Nurses Credentialing Center (ANCC). You’ll need to pass a rigorous exam and meet academic credit and clinical hours requirements. Credentials must be renewed every five years, a process that typically involves continuing education.

Get your license

Once certified, you can apply for your state license as an advanced practice registered nurse (APRN). Requirements vary by state.

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