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2019 Nurse Practitioner Career Guide

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A Nurse Practitioner is a medical professional who performs and oversees patient treatment. NPs are Registered Nurses with additional education and certification which allows them to care for patients independently, much the same way that medical doctors do.

Nurse Practitioners work in a variety of settings and either run their own private practice or work for a company or facility. NPs must have extensive medical knowledge, specific industry training, and pass exams through accredited programs and certifying bodies.

Although an NP has comparable professional capabilities to a medical doctor, most NPs fall under a more holistic treatment umbrella. NPs concentrate on the overall patient rather than aiming for a quick diagnosis and prescription cycle.

NPs also tend to focus on areas of wellness and prevention along with diagnosis and treatment. Across a variety of concentrations, NPs provide care for all ages and stages of life, including infant, family, and elderly patient care.

Nurse Practitioner Career Guide

The healthcare field is one of the most popular and potentially lucrative industries. With so many roles from general patient care to surgery to a vast range of specialties, there is a lot to learn and consider when deciding on your career path. For many, opting to become a Nurse Practitioner provides entry to multiple professional paths and allows individuals to zero in on the aspects of medicine they are most passionate about.

Here we’ll look at what Nurse Practitioners are, what they do, what their salary prospects look like, common concentrations professionals in this field choose, and how to become a Nurse Practitioner.

Special Training for a Nurse Practitioner

In general, a Nurse Practitioner will need education beyond a nursing degree and NP certification. However, most entry-level NP jobs only require certification as a Nurse Practitioner and some background knowledge in the field.

Specialized training allows NPs to work in areas such as geriatrics, family practice, acute care, psychiatry, pediatrics, obstetrics and gynecology, oncology, cardiology, and others. Advanced degrees and certifications are also available for those NPs looking to expand their skill set and move up in their careers.

Individual facilities or healthcare organizations may also have specific requirements for their employees. If you want to pursue a career within a particular company, it may help to research what specifications they have to ensure you’re earning the right degree for that role.

You may also find that not every educational program addresses the requirements of specific roles. Therefore, you might need to earn additional certification after completing an NP program to be eligible to apply for your desired job in a particular field.

Skills of a Nurse Practitioner

In addition to specialized training in the medical field, Nurse Practitioners also need a specific set of skills to help them excel in their careers:


Communicating with patients is a crucial part of becoming an effective Nurse Practitioner. Discussing symptoms, diagnoses, and treatment plans with patients is a significant part of what Nurse Practitioners do daily.

Effectively communicating with co-workers and team members is also critical in an NP role. Depending on the work environment, you may direct other employees or work underneath a supervisor or nurse team. Regardless, you will need effective communication skills in a variety of areas.

Critical Thinking

Since NPs are responsible for diagnosing patients, you will need to draw on both your training and textbook knowledge to determine a patient’s condition and medical needs. However, not every situation has a clear, textbook solution; part of being an NP is being able to think critically and survey all options before deciding on a course of action.


Working in teams will be part of your job description regardless of whether you open a private practice or work in a clinic or hospital. Nurse Practitioners work with nurses, doctors, surgeons, orderlies, and all types of other hospital, clinic, and related staff. Regardless of who you work with, functioning as a team will prove invaluable to both your patients and your workflow.

Physical Stamina

NPs often work in crises where quick thinking—and quick action—is crucial. Not only will you be on your feet most of the day, but you will also need to react quickly and often take on draining physical tasks. You must be physically active and in shape to handle the rigors of your job.

Language Abilities

All NPs must be fluent in both written and spoken English, but that is the minimum requirement for professionals. As in all industries, additional language abilities are desirable and often rewarded. If you have basic fluency in a second or subsequent language, it may help to brush up on those language skills while you work toward your NP or higher certification.

Being bilingual (or beyond) can help advance your career and even provide other opportunities that people with only English fluency may not be able to take advantage of. However, many organizations may require that you pass a fluency exam or present a degree or certification in the specified language.

Nurse Practitioner Education

NP education spans biology, chemistry, human development, and a whole host of other subjects. Here are some examples of what you can expect to study when pursuing an NP degree.

● Ethical Decision-Making, as ethics is a huge component of nursing and the medical field in general
● Advanced Practice Nursing for adults/gerontology programs
● Advanced Pharmacology, to learn about how drugs affect the human body as well as how to administer medications and determine the effects of certain drugs on a patient
● Nursing Informatics, to learn how healthcare technology impacts nurses’ skills and practice
● Health Promotion and Disease Prevention to prepare for patient care at every stage of life, including pre-disease
● Management of Complications across a range of specialties

NPs must also participate in internships and practicums to gain practical experience in their respective fields. Clinical training involves hands-on learning, where prospective NPs practice assessing patients, developing care plans, and providing health services in general.

Practical experience via internships helps NPs hone the skills they need to succeed in their careers. It also allows NPs to practice what they have learned in their educational programs and expand upon their real-world knowledge.

What Does a Nurse Practitioner Do?

Certification as a Nurse Practitioner enables a professional to perform many tasks which nurses and doctors typically perform. Depending on your concentration, you may have additional responsibilities beyond the essentials as well.

Wherever NPs practice, they can work one-on-one with patients to determine a diagnosis, prescribe treatment, and offer follow-up through the course of treatment.

In many ways, an NP is equivalent to a medical doctor, or MD. For example, both MDs and NPs can diagnose and treat illnesses, including prescribing medications. NPs can also perform specific medical procedures within their scope of practice.

In most cases, NPs perform tasks such as:

  • Counseling patients on health needs and treatment plans
  • Diagnosing and treating common injuries and illnesses
  • Monitoring patients who are undergoing specified treatment
  • Completing physicals and other routine examinations
  • Prescribing medicines and other treatment
  • Overseeing general patient wellness and providing treatment accordingly
  • Ordering and interpreting lab tests

Depending on their specialty, an NP may perform other duties outside those listed here. Higher level degrees and certifications, including specializations, can also qualify NPs to provide further care to patients.

Holistic Healthcare with NPs

As NPs fall toward the more holistic side of healthcare, they are different from traditional nurses and medical doctors in many ways. A Nurse Practitioner will often include the family in treatment plans and decision making, treating the whole patient rather than a set of symptoms. Thanks to the nature of their work, NPs often develop relationships with their patients over time.

The fact that long-term NP care is growing in popularity – paired with its unique flexibility in both places of employment and areas of specialization – makes this career path more promising than ever before.

Where Does an NP Work?

NPs can work in a range of locations, including:

  • Hospitals
  • Clinics, both permanent and “pop-up”
  • Private practices
  • Community health centers
  • Colleges and schools
  • Businesses’ employee health centers
  • Managed care organizations
  • A variety of treatment facilities
  • Prisons and jails

Many NPs may accept roles as RNs while working on their education, then work their way up through an organization to become an NP once they become certified. Others may go on to open a private practice or work for a private healthcare facility.

The path you take depends on your specific interests and abilities, as well as the programs you enroll in and the certifications you earn. You may become a site administrator for a healthcare organization, oversee a team of RNs and other healthcare professionals, or begin managing a research department, depending on your chosen concentration.

How Much Does a Nurse Practitioner Make?

While salaries vary depending on each Nurse Practitioner’s specialty, the starting range for an NP is around $74,000 per year. Most NPs top out at $117,000 per year, with the median pay at around $92,000 per year, according to PayScale.

An entry-level NP can expect to begin earning around $90,000 per year in many places, but pay does depend on geographical area, type of facility/employer, and other details. NPs who earn further certification may also increase their earning power.

Some roles may result in a pay decrease, depending on the specialty.  However, most NPs report they are fully satisfied with their current roles; you may find that the salary offering is not the most essential part of selecting a career path as an NP.

Additionally, the salary of an NP is substantially higher than that of an RN. RNs may earn anywhere from $28,000 to $72,000 per year, depending on a variety of factors. Salaries vary and can increase over time, but they also depend on geographical area, type of facility, and the nurse’s level of experience. Overall, however, earning an NP certification both enhances your career prospects and allows for a large jump in potential earnings.

Common Nurse Practitioner Concentrations

Career paths, and salaries, vary for Nurse Practitioners based on the concentration each professional chooses. Here are a few common Nurse Practitioner concentrations with their associated responsibilities and salary data:

Adult-Gerontology Acute Care (AG-ACNP)

NPs who apply to and pass AG-ACNP programs, pass the required exams, and earn state certification can provide care to adult, older adult, and elderly patients with acute, chronic, and critical conditions. Educational areas include subjects such as advanced physical assessment, lab and chest X-ray interpretation, differential diagnosis, pharmacology, education and research, invasive and non-invasive procedures, and more.

Becoming an AG-ACNP requires passing an accredited program, completing 500 clinical hours and receiving certification. AG-ACNPs must also continue their education to keep their knowledge base current and renew their certification every five years.

AG-ACNPs help assess and manage the healthcare needs of acutely ill patients. They may work in hospitals, clinics, emergency departments, intensive care, and in acute and sub-acute care wards. You will diagnose and treat medical conditions, manage patients from admission to discharge, and monitor patients through follow-up care.

An AG-ACNP can expect to earn an average salary of $100,000, according to PayScale.

As an Acute Care Nurse Practitioner, you can expect to work with young adults, older adults, and the elderly. Thanks to AG-ACNPs, patients wind up with shorter hospital stays and higher satisfaction levels, meaning this is more than just a lucrative career path.

Adult-Gerontology Primary Care (AG-PCNP)

An AG-PCNP works with culturally diverse and high-risk populations managing adult health and illnesses. AG-PCNPs can work with everyone from adolescents to older adults and often practices in a community or hospital-based primary care clinic, in patient homes, nursing facilities, or in long-term care settings.

AG-PCNP certification requires two years of full-time education. In some cases, graduates can receive certification without an examination. However, an exam is necessary for national board certification via the American Nurses’ Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP).

An AG-PCNP can expect to earn a salary of around $100,000, per PayScale.

As an AG-PCNP, you will address the needs of infants through young adults with complex acute, critical, and chronic health issues. You may work in hospital-based pediatric care areas, such as the PICU, Pediatric Cardiac ICU, Pediatric Emergency Department, and more.

You will oversee patient care from outpatient through inpatient care and beyond discharge as well.


A BSN to DNP pathway allows nursing students to complete one program and earn two degrees: an MSN and a DNP. Applicants with a nursing degree (or a current MSN degree) can go on to complete a Doctor of Nursing degree with specific educational programs.

Students must already hold a Bachelor of Science in Nursing degree. Depending on the program, this pathway may allow prospective NPs to complete an MSN and DNP in a specific specialty area.


A DNP, or Doctor of Nursing Practice, degree is the next step after earning either a nursing degree or MSN. DNP degree holders may go on to pursue facility management or executive-level nursing roles.

According to PayScale, professionals in this field can expect to earn an average of $101,000 per year.

A DNP degree focuses on clinical aspects of the disease process and includes courses of study such as advanced health policy and advocacy, advanced concepts in clinical prevention and population health, project implementation, and more.


A Family Nurse Practitioner, or FNP, cares for patients across their entire lifespan. Becoming an FPN allows professionals to work with families in a clinical setting.

FNP salaries tend to range between $105,000 and $138,000 per year, according to Glassdoor.


An MSN is a master’s degree of science in nursing. MSN programs can take anywhere from two to seven years to complete, depending on whether students attend part or full time. Regardless of the type of program you attend, it must be accredited.

MSN programs span areas such as adult-gerontology, midwifery, nurse anesthesiology, psychiatric/mental health, and neonatology.

Pediatric Primary Care (PNP)

A Pediatric Nurse Practitioner, or PNP, provides pediatric primary care to infants, children, and adolescents. Practitioners in this concentration may administer childhood immunizations, perform developmental screenings, prescribe medications, perform physicals and treat common illnesses.

Per PayScale, a PNP can expect to earn a salary between $69,000 and $109,000 per year.

Psychiatric Mental Health (PMHNP)

A PMHNP provides mental health services to patients and families across a wide variety of settings. For NPs focused on mental health, this pathway focuses on diagnosis, therapy, and medication prescription for patients dealing with mental health conditions or substance abuse, among other conditions.

Per PayScale, a Psychiatric NP makes between $80,000 and $136,000 per year.

A PMHNP provides mental health care through inpatient, emergency, and other treatment routes. They may also provide services in forensic, school, recovery program, and primary care clinic locations. Duties include everything from biopsychosocial assessment to treatment via medication and psychotherapeutic measures.

Post-Master’s Certificate

A Post-Master’s Certificate is a program between the master and doctorate levels. A Post-Master’s Certificate in nursing provides NPs with extensive training and knowledge in various areas of nursing.

Women’s Health NP

An NP concentrating on women’s health will provide ongoing healthcare for women from puberty through senior age. Women’s Health NPs can provide broad-spectrum services to women, including but not limited to gynecological and reproductive care and treatment.

According to PayScale, a Women’s Health NP can make anywhere from $70,000 to $107,000 per year.

A Women’s Health NP program includes advanced health assessment, nurse-midwifery management process education, training in the management of antepartum, intrapartum, and postpartum periods, and GYN and family planning care, among others. Women’s Health NPs also complete courses in advocacy and policy, professional practice, clinical pharmacology, and other areas.

How to Become a Nurse Practitioner

While there are multiple avenues toward becoming a Nurse Practitioner, there are also specific requirements for pursuing this career path, including:

High School Education/GED

To earn admittance into a Registered Nurse program, you must first earn a high school diploma or GED. A diploma or GED is the minimum requirement for nursing programs, although your specific GPA or grade details may not be relevant, depending on the school and program you select.

Many programs require you to complete prerequisites before applying to an RN program, however, so it’s worth investigating the requirements before committing to a program. Some programs may also offer enrollment at specific times of the year or based on your concentration, which is a detail to keep in mind for planning your degree and career path.

Registered Nurse Education

To become a Nurse Practitioner, professionals must first obtain a Registered Nurse certification. There are three primary educational paths toward RN certification. Regardless of which path you choose, once you complete the program, you must take the National Council Licensure Examination – Registered Nurse (NCLEX-RN) to become licensed to practice.

Bachelor’s degree in nursing (BSN)

Applicants must attend a college or university and pass a nursing program. These programs typically require four years of study and encompass subjects such as biology, human development, chemistry, clinical practice, and more.

Associate degree in nursing (ADN)

An associate degree in nursing requires a two-year program of study at the community college level. An ADN often allows applicants to work in some capacity as a nurse while they pursue a BSN at a higher level. Plus, many employers offer tuition assistance for employees who continue to pursue higher education while in a specific role.

Nursing program diploma

The third option for becoming an RN involves participation and graduation from an accredited nursing program. Similarly, a vocational nursing program is another option which promises a certificate after you complete the required course of study.

Hospitals often oversee these programs, and attendance can span from one to three years. However, this is the least common RN path as many hospitals place a cap on how many nursing program graduates they can hire.

Post-Graduate Work

After completing your RN prerequisites, you will need to pursue higher education at a facility with accreditation via either the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC).

Completing a master’s degree of science in nursing (MSN) prepares you for the next step of your career path, which is focusing on a specific concentration or specialty. You may also continue your education and achieve a Doctor of Nursing Practice (DNP) degree, which is becoming the industry standard for NPs. The DNP degree requires anywhere from three to four years of study following your RN license.

To become an NP after finishing your education, whether with an MSN or another degree, you must also take the certification examination by the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners (AANP).

You can also continue to take specialty examinations for certification in other areas such as forensic nursing, pediatrics, cardiac rehabilitation, and more.

Job Opportunities for Nurse Practitioners

Job opportunities exist for Nurse Practitioners all over the country. Depending on your background and degree type, you may find that your specific qualifications are in high demand. Nursing is a stable industry, as there is always a demand for knowledgeable healthcare professionals, but some areas are in higher demand than others.

Job Outlook for NPs

As the healthcare industry grows and changes, NPs are expected to be in higher demand, with NP occupations growing as much as 31 percent by 2026. Because a Nurse Practitioner can stand in for an MD in many instances, plenty of patients are turning to NPs for their regular care.

At the same time, healthcare facilities and agencies are recognizing the benefits of having NPs on staff. Because of their commitment to patients’ health, along with their strategic and holistic care standards, NPs have earned a reputation for providing exceptional care.

Benefits of an NP Degree

Because the healthcare field remains stable, NPs can expect their earning potential to stay the same or even increase. And because there is always a need for every type of NP specialty, from pediatrics to gerontology, NPs can stay with patients for a lifetime.

Of course, the nature of healthcare means there are always new patients to see, but that’s also a benefit for those looking to become Nurse Practitioners.

Career Advancement

Although many positions in the NP field require specific degrees and certifications, all professionals must maintain their education throughout their careers. Continuing education is a crucial part of the healthcare industry and keeping up on the latest changes and methods will not only help round out your knowledge, but it could also help advance your career even further.

Taking additional courses and classes may also help you further define your desired field of practice, enhancing what you have to offer patients in whichever concentration you decide to pursue.

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