A nurse practitioner (NP) is essentially a registered nurse (RN), who has completed advanced education and training in the diagnosis and management of common medical conditions, including chronic illnesses. Nurse practitioners provide a broad range of healthcare services. They provide some of the same care provided by physicians and in addition, maintain close working relationships with physicians. An NP can serve as a patient's regular healthcare provider.

Nature of the Work

Nurse practitioners take health histories and provide complete physical examinations, diagnose and treat many common acute and chronic problems, interpret laboratory results and X-rays, prescribe and manage medications and other therapies, provide health teaching and supportive counseling with an emphasis on prevention of illness and health maintenance, and finally refer patients to other health professionals as the situation warrants.

Working Conditions

The working conditions will vary based on the type of specialty that the nurse practitioner is engaged in. Usually, nurse practitioners involved in acute care and neonatal departments, which are largely hospital-based, are required to attend rotating shifts to provide coverage in the hospital during days, evenings and nights, and also remain prepared to go to hospital on call. Other than Acute Care NP and Neonatal NP, most other nurse practitioners work in ambulatory care positions, where they serve in outpatient settings seeing patients. The settings however, can be quite varied, and may include proceeding on house calls in rural areas, or working in standard pediatric or family practice office.

In general, being an NP is not considered a 9 to 5 job. There may be frequent requirement to attend call after normal business hours in order to take care of patients who require care and consultation. Time is also spent attending conferences, reading research in journals, and doing such things as necessary to remain in touch with the changes in the field.

Being a nurse practitioner requires a great deal of autonomy, decision-making ability, logical reasoning, and the ability to reach a conclusion on what to do in seemingly difficult circumstances.

Employment

Nurse practitioners largely find employment in health maintenance, disease prevention, counseling and patient education in a wide variety of settings. With a strong emphasis on primary care, nurse practitioners are employed within several specialties, including neonatology, nurse-midwifery, pediatrics, school health, family and adult health, women's health, mental health, home care, geriatrics and acute care.

NPs are also authorized to practice across the nation and have prescriptive privileges, of varying degrees, in 49 states. Nurse practitioners perform services as authorized by a state's nurse practice act or similar regulation. The nurse practice acts vary from one state to another, with some states having independent practice for NPs (not requiring any physician involvement), while others requiring collaborative agreement with a physician.

Training, Other Qualifications, and Advancement

To be licensed as a nurse practitioner, the candidate must first complete the education and training necessary to be a registered nurse (RN). The NP program itself will vary in length from 1-2 academic years, depending on the nature of the program and the school chosen for studying.

Requirements for a registered nurse include an associate degree in nursing (ADN), a bachelor-of-science degree in nursing (BSN), or completion of a diploma program, as well as direct patient care for acutely or chronically ill patients. Associate degree in nursing programs, which are offered by community and junior colleges, usually take 2-3 years. BSN programs are offered by colleges and universities and take 4-5 years, while diploma programs are administered in hospitals and may take 2-3 years. Depending on the program attended, the candidate may fulfill some requirements of nurse practitioner even while completing the RN degree.

In most cases, professionals and employers in the field strongly recommend BSN as the minimal requirement for nurse practitioners, and in fact some states do require this. To become nurse practitioners, most nurses with an ADN or diploma enter a bachelor-of-science program. They may be able to get for themselves staff nursing positions, thereby taking advantage of tuition reimbursement programs to study for BSN.

There are some programs available for individuals who have completed a Baccalaureate degree, but who are not registered nurses. These programs are longer in length than the standard Master's program and result in eligibility for licensure as a registered nurse, and also for eligibility in sitting for the certification boards as a nurse practitioner. Generally these programs are very selective in which candidates they will take for entry into their programs.

Job Outlook

According to the "National Sample Survey of Registered Nurses March 2004:Preliminary Findings" (Health Resources Services Administration, 2005), in March 2004, there are an estimated 141,209 nurse practitioners with credentials as NPs in the United States, an estimated increase of 38,560 from 2000. The actual number of nurse practitioners in 2006 is estimated to be at least 145,000.About 65.5 percent of NPs have completed a master’s degree program and an additional 10.5 percent have a post-masters certificate as their NP preparation. An estimated 87.7 percent of NPs are employed in nursing, with 65.7 percent of NPs employed in nursing, reporting the position title as “Nurse Practitioner".

Earnings

2004 NP Salary Survey, updated in August, 2005, presents the following full-time annual earnings estimation:

2002
Average Salary (all specialties) : $ 66,125 Average Salary (primary care specialties) : $ 65,050Median Salary (all specialties) : $ 64,000Median Salary (primary care specialties) : $ 64,000

2003
Average Salary (all specialties) : $ 71,140

Average Salary (primary care specialties) : $ 70,149

Median Salary (all specialties) : $ 68,000

Median Salary (primary care specialties) : $ 67,200

2004
Average Salary (all specialties) : $ 73,235

Average Salary (primary care specialties) : $ 72,655

Median Salary (all specialties) : $ 70,000

Median Salary (primary care specialties) : $ 70,000