Careers & Credentials Updated August 23, 2016

The Growing Demand for Nurse Practitioners

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Nurse practitioner and patientNurse practitioners (NPs) are registered nurses with advanced degrees who are clinically trained to meet a majority of a patient’s health care needs. NPs are categorized as advanced practice registered nurses (APRNs), in addition to nurse anesthetists, nurse midwives and clinical nurse specialists.

NPs are qualified to diagnose medical problems, order treatments, prescribe medications and make referrals for a wide range of acute and chronic medical conditions within their scope of practice. They may prescribe medications in all 50 states and the District of Columbia, but their scope of practice varies from state to state. In some states, NPs can practice independently.

NPs view the patient as a whole person, and focus on health promotion, disease prevention and health education and counseling, according to the American Association of Nurse Practitioners (AANP). Nurse practitioners seek to understand a patient’s concerns and lifestyle before choosing a course of action.

The idea for nurse practitioners was introduced in the mid-1960s in response to a nationwide shortage of physicians. Today, there are more than 192,000 NPs practicing in the U.S. Sixty to 80 percent of primary and preventative care can be performed by NPs, according to the American Nurses Association (ANA). The country’s growing emphasis on prevention and public health will continue to create excellent job opportunities.

Nurse practitioner at-a-glance

Minimum education required:  Master’s degree
Median annual salary:  $98,190
Number of jobs (2014):  126,900
Job outlook (2014-2024):  35% growth

Source: Bureau of Labor Statistics (BLS)

Nurse practitioner job description

NPs see three patients an hour, on average. Typical duties include:

• Diagnosing, treating and managing acute and chronic diseases
• Obtaining patient histories and conducting physical examinations
• Ordering and performing diagnostic tests
• Prescribing drugs
• Providing well-child care, including screening and immunizations
• Performing or assisting in minor surgeries and procedures (e.g., dermatological biopsies/procedures, suturing, casting, etc.)
• Counseling and educating patients on health behaviors, self-care skills, and treatment options in coordination with occupational therapists and other health care providers.

Nurse practitioners are mostly found in these specialty areas:

Family Primary Care:  49%
Adult Primary Care:  19%
Pediatric Primary Care:  8%
Acute Care:  6%
Psychiatric-Mental Health:  3%
Adult-Gerontological:  3%

 
With the right education and experience, NPs may also specialize in areas such as cardiology, dermatology, oncology, pain management, surgical services, orthopedics and women’s health.

Where nurse practitioners work

A majority of NPs work in physician’s offices. It makes business sense for doctors to add a nurse practitioner to their practice because it allows the doctor to see more patients overall. The nurse practitioner can attend to the more routine visits while the physician can focus on the complex cases.

In addition to physicians’ offices, NPs typically practice in hospitals, outpatient care centers and in home health care as well as teach in schools and universities.

Doctor’s Offices:  62,550
Hospitals:  35,220
Outpatient Care:  11,610
Education:  3,970
Other Health Care Offices:  3,760

 
Nurse practitioners also deliver care in rural areas, community health centers, worksite employee health centers and government health departments. About 15 percent of NPs have their own private practices.

Nurse-led clinics (also known as nurse-managed care centers) are a lower-cost alternative to delivering health care, and are becoming increasingly popular as a result. There are approximately 150 of these clinics currently in the U.S., according to the National Nursing Centers Consortium. Nurse-led clinics typically focus on managing chronic diseases such as diabetes and hypertension.

Who makes a good nurse practitioner?

Someone who:
• Demonstrates compassion
• Is detail-oriented
• Is resourceful
• Thinks critically
• Makes sound decisions
• Has good interpersonal skills

Nurse practitioner education requirements

Registered nurses need to complete a master’s degree in order to become a nurse practitioner. The typical curriculum includes courses in epidemiology, health promotion, physical assessment and diagnostic reasoning, advanced pharmacology, laboratory/radiography diagnostics statistics and research methods, health policy, acute and chronic disease management and clinical rotations.

Most master’s programs prefer candidates who have a bachelor’s degree in nursing. However, some schools offer bridge programs for registered nurses with an associate’s degree or diploma in nursing. Many NPs choose to further their education and earn a Doctor of Nursing Practice (DNP) or a Ph.D., and there is currently an initiative to require the DNP as the entry-level degree for nurse practitioners.

NP Education Level

Associate’s degree:  2%
Bachelor’s degree:  6%
Master’s degree:  78%
Doctorate:  13%

Nurse practitioner certification

Nurse practitioners are required to pass a national board exam that certifies them in a specific area: acute care, family practice, women’s health, pediatrics, adult-geronotology, neonatal or psychiatric-mental health. After achieving board certification, NPs must apply for additional credentials (e.g., APRN license, prescriptive authority, DEA registration number, etc.) at the state and federal level.

NPs are also required to achieve a certain amount of continuing medical education (CME) credits and clinical practice hours in order to maintain certification and licensure. NPs are licensed through state boards of nursing.

Nurse practitioner salary

The median annual salary for nurse practitioners is $98,190, according to the Bureau of Labor Statistics (BLS). Wages vary slightly according to the workplace, with hospitals topping out at $111,080, followed by doctor’s offices at $104,150, outpatient care at $102,810, other health practitioners at $98,660 and lastly education at $95,720 annually.

The top paying states for NPs are New York, California, Florida, Texas and Ohio.

Employment outlook for nurse practitioners

The employment outlook for NPs is bright, due to a number of factors, including a shortage of primary care physicians, increased access to health care and an aging population. The BLS estimates a 35 percent growth rate for nurse practitioners through 2024.

As baby boomers age, they will experience ailments and complex conditions that require medical care. Nurse practitioners will be needed to keep these patients healthy and to treat the growing number of patients with chronic and acute conditions.

NPs will be in high demand in medically underserved areas such as inner cities and rural areas as well as outpatient centers. The increasing number of procedures that were once only possible in hospitals can now be performed in outpatient facilities. Nurse practitioners will also be needed where people have long-term illnesses such as dementia or in cases where patients need extensive rehabilitation.

Difference between nurse practitioners and physician assistants

Physician assistants (PAs) perform tasks similar to nurse practitioners. They examine, diagnose and treat patients, and can prescribe medications. The big difference is that physician assistants practice medicine directly under a supervising physician, and nurse practitioners do not have this requirement and have more autonomy.

Like nurse practitioners, physician assistants are required to have a master’s degree. PAs then must take a national certification exam and practice under a trained physician. Physician assistants are also required to have state licensure and pursue continued education units.

PAs are not required to complete a residency and do not have to take an exam with a more specific focus on a particular population, such as children or seniors, as nurse practitioners are required to do.

NPs typically have more experience than physician assistants because they are required to be RNs before pursing education to be an NP.

Professional associations for nurse practitioners

American Association of Nurse Practitioners
American College for Nurse Practitioners
National Association of Pediatric Nurse Practitioners
Nurse Practitioners in Women’s Health

Publications for nurse practitioners

Nurse Practitioner Perspective
The Clinical Advisor
The Journal for Nurse Practitioners
The Journal of the American Association of Nurse Practitioners
The Nurse Practitioner

Learn More: Click to view related resources.

Back to: Careers & Credentials Updated August 23, 2016