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There are many obstacles to face in becoming a nurse practitioner (NP). The quantity and rigor of the hurdles encountered vary depending on individuals’ educational backgrounds.
There are a handful of starting points from which individuals can embark on a journey to become an NP (Chaunie Brusie, BSN). Some may start from scratch without a degree or licensure of any sort. Others hold an RN license or Associate Degree in Nursing (ADN) before progressing to an NP. Then, some have a Bachelor of Science in Nursing, who are primed to enter an NP program quickly.
Non-traditional NP students are those who earn a non-nursing Master of Science Degree (MSN), and these individuals have the option to enter an accelerated Master of Science of Nursing (MSN) program. Accelerated programs enable these students to travel along a fast-track path to their new career as an NP.
Finally, students who already hold an NP degree, and some BSN students, have the option to move on to a doctorate of nurse practicing (DNP) or a Ph.D. of Nursing. After completing their doctorate degrees, these individuals can practice as an NP if they pass the National NP Certification Board Exam. In short, to become an NP, one must first obtain, at minimum, their RN license and then obtain either an MSN, a DNP, or a Ph.D. in nursing, before passing the American Association of Nurse Practitioners (AANP) exam (Family NP, Emergency NP, Gerontology NP), the American Nurses Credentialing Center (AAC) exam (General NP), or National NP Certification Board Exam (DNP or Ph.D.) (Amanda Bucceri Androus, 2022).
Non-nurses can start with an RN license or a traditional BSN and proceed as either of those degree/license holders (Chaunie Brusie, BSN). See the corresponding sections, “Registered Nurse (RN) License Holder” or “Bachelor of Science of Nursing (BSN),” for more information on this starting point.
An individual with an RN license (from a completed diploma program) can enter directly into an NP program after gaining substantial work experience (Chaunie Brusie, BSN). The amount of clinical experience varies for each program’s admission requirements. In addition to copious clinical hours, these individuals will need to complete a handful of prerequisites (see the end of the “Pathways to Becoming an NP” section for a list of core courses required). Each program’s course requirements differ from one another. Still, each prospective student has a core set that they are typically asked to complete.
Nurses who earn their ADN are commonly voyaging along the bridge program pathway to surpass their bachelor’s degree and enroll directly into a master’s program. This route involves working clinically for at least a year, participating in a year of instruction, also known as, a “bridge” year, and then pursuing a specialized ADN to MSN NP program.
Graduates with a non-nursing Bachelor of Science Degree have a few options to choose from when embarking on their journey to become a nurse practitioner. Depending on their school performance (GPA and extra-curricular), graduates might be eligible for more competitive pathways to becoming an NP. These pathways would involve enrolling in an accelerated BSN program, working for a year, and enrolling in a typical or accelerated MSN degree.
Though the programs are far and few, the option to enter directly into an MSN program also exists; however, graduates must have had outstanding marks throughout their bachelor’s degree program. In addition to a star-studded resume, students must complete the list of prerequisites each school provides (see the end of the “Pathways to Becoming an NP” section for a list of the core courses required). As stated before, in the “RN License Holders” section, course requirements vary for each program. However, the core classes mentioned below are commonly repeated across the board.
Those who hold a non-nursing Bachelor of Science Degree, and an RN license can enroll in a Post-Baccalaureate RN to MSN or Pre-MSN program. These programs prepare students to apply to MSN Degrees by offering undergraduate and graduate courses that are foundational to nursing.
Students with a BSN may enter directly into an MSN program (Chaunie Brusie, BSN). Though clinical experience is not required for enrollment, some students may also choose to participate in this hands-on work before enrolling in an MSN. Most BSN to MSN programs take approximately two years at a full-time status.
Holding a master’s degree in a non-nursing field makes individuals eligible for enrollment into accelerated MSN programs, which can be as short as two years. It is recommended that students break between the first and second half of the program to gain clinical experience. They, of course, are also eligible for typical MSN programs. Not all accelerated MSN programs offer the same array of specialization selections that standard MSNs may offer.
After completing a BSN and/or an MSN Degree, nurses may pursue a DNP. Once they complete a DNP Degree, they become eligible to take the National NP Certification Board Exam, after which they can practice as an NP. The same is true for those who obtain a Ph.D. in nursing. The subtle difference between a DNP and a Ph.D. in nursing are explained in further detail in the following section.
A DNP is a terminal degree in clinical nursing practice that enables nurses to practice as advanced NPs. DNPs have strengthened leadership skills and opportunities. One example of this includes their likelihood to serve as faculty, increasing the availability of instruction for other nurses.
Furthermore, the unfulfilled needs of complex healthcare issues that can only be addressed by expert faculty are more sufficiently met through the effort and leadership of DNPs. DNPs have a range of facilities in which they practice, including universities, public health offices, hospitals, specialty practices, autonomous practices, health care administration settings, and health care policy advocacy organizations (Kathleen Gaines, MSN).
A Ph.D. in Nursing is a terminal degree in nursing wherein individuals center their time around research and education; however, they also qualify to perform clinical practice if they pass the National NP Certification Board Exam.
The significant benefit of earning a Ph.D. in nursing is an increased salary and a greater semblance of work-life balance than that of a typical NP. Some research schedules can be maintained at regular working hours (no weekends or holidays).
Ph.D.’s in this field can enact change in nursing practice through the influence of policy. Suppose prospective students have a thirst for prestige. In this case, a Ph.D. will suit them well. In gaining mastery in nursing via one of the highest offered degrees, they will have senior status job titles, be regarded as experts in their field of research, and have opportunities to serve as Chief Nursing Officer (CNO) or VP of Nursing.
The role of CNO and VP roles require versatility in skill as they responsible for financial management, oversight of patient treatment plans, administration of scheduling, training of new employees, enactment of new policies, the institution of policy change, and the integrating of new high-tech medical systems into routine medical care. A Ph.D. typically works at a college or university, research facility, hospital, medical laboratory, or government agency.
Most NP specializations require either a license (“sanction for a nurse practitioner to practice in their state legally”) or a certification (“requirement for the nurse practitioner to demonstrate that they are competent to practice in a particular setting”). Certification processes can also vary depending on what specialization one already holds. For example, an NP with a family nurse practitioner (FNP) subspecialty can more easily certify for specialties like cardiology or dermatology via a certification, than an NP who is not specialized (Toerner, 2021). Multiple organizations offer credentials for NP licensing (the American Nurses’ Credentialing Center, Pediatric Nursing Certification Board, and more). Once the exam is successfully passed, there are many specialty options from which to choose.
The population(s) with which an NP works generally correlates with their specialty. An NP concentrating in emergency medicine will have a more diverse population than a palliative care NP. By focusing on which population is most desired to work with, narrowing down choices in specialties may become easier (US National Library of Medicine). In addition to population, potential NPs should consider setting. The specialty will determine the environment of work. For example, a neonatal NP will spend most days in the neonatal intensive care unit. Contrastingly, a primary care FNP will perform work in an outpatient setting, and a geriatric care NP will work in a long-term care facilitie or community-based setting (US National Library of Medicine).
AANC has pushed toward understanding the differences between RN degrees and ADNs since the early 2000s, initially finding little differentiation between the two (Regulations, Standards, Policies, Procedures, and Protocols). More recently, the organization stated that the higher the degree of nursing education, the more significant the positive patient care outcomes.
Once these findings were elucidated, the AANC rapidly moved toward filling the gaps in the nursing field that prevent nurses from performing to their most successful capacity. This effort led to the development of a new certification; a clinical nurse leader (CNL). CNLs, a role usually held by an NP, enable an overall increase in efficacy of the workforce, producing improved outcomes, lowered costs, and a betterment of patient satisfaction. Similarly, Advanced Practice Registered Nurses (APRNs) have changed the healthcare field’s effectiveness. After establishing uniformity in certification through the “Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education,” AANC consistent puts regulatory practices in place and, thus, results in more positive workforce trends.
Chaunie Brusie BSN. (n.d.). How to go from registered nurse to nurse practitioner (RN to NP).
Amanda Bucceri Androus, R. N. (2022, January 25). How to choose between AANP vs ANCC nurse practitioner certification exams. How to Choose Between AANP vs ANCC Nurse
Kathleen Gaines MSN. (n.d.). DNP vs Ph.D. in nursing – what is the difference? Nurse.org. Retrieved March 8, 2022, from https://nurse.org/education/dnp-or-phd-in-nursing-difference/
Toerner, L. (2021, February 22). How to choose your nurse practitioner specialty. UC News. Retrieved March 8, 2022, from https://www.uc.edu/news/articles/2021/02/how-to-choose-your-np-specialty.html
US National Library of Medicine. (n.d.). Nurse practitioner (NP) : MedlinePlus Medical
Regulations, Standards, Policies, Procedures, and Protocols. (n.d.). Retrieved March 8, 2022, from https://www.ncchc.org/cnp-regulations