A nurse practitioner (NP) is a highly qualified nurse with years of training and an advanced degree. NPs can specialize in a number of areas, with the most popular option being family nurse practitioner (FNP).
What separates an FNP specialty from the rest, and what other options do you have if you want to pursue a career as an NP? Learn more about becoming an NP and choosing a specialty below.
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What is an NP?
An NP is an advanced practice nurse with a graduate degree who is trained and qualified to provide a number of services, including diagnosing, managing, and treating diseases, prescribing medications, and performing procedures.
NPs can be certified in a number of specialties, but each specialty is regulated by a state board and certified through a national organization.
Licensing laws vary from state to state, and each state also has its own scope of practice for NPs. In many states, NPs can practice independently, but many states require them to work under cooperative agreements with or under the direct supervision of a physician.
What is an FNP?
An FNP is an NP who is trained to provide care for individuals and families across the lifespan, from infants to seniors and every age in between.
FNPs generally work in patient-facing roles, treating illnesses and injuries, managing preventative care, and teaching patients about healthy habits. The responsibilities of this role can include conducting routine checkups, developing and managing treatment plans for acute and chronic illnesses, ordering labs and other tests, interpreting their results, and prescribing medication.
To become certified to practice, nurses must pass the Family Nurse Practitioner (FNP) board certification exam from the American Nurses Credentialing Center or the FNP certification examination from the American Academy of Nurse Practitioners Certification Board.
How to become an NP
There are multiple pathways to becoming an NP, but there are several milestones that nurses must reach on their journey to this profession, regardless of what path they take. Here are the basic steps to becoming an NP.
Obtain a nursing degree
BSN programs are the most popular option, but diploma and associate’s programs are also available. If you plan to pursue an NP degree, keep in mind that most MSN programs require a BSN for admission, though some schools offer RN-to-MSN programs for diploma or associate-prepared nurses or second-degree programs for those with a bachelor’s in another specialty.
Pass the NCLEX exam
To practice as an RN, you must pass the National Council Licensure Examination (NCLEX). This test is required for RN licensure in all fifty states and tests your nursing knowledge and critical thinking skills. You will need an RN license to practice as a registered nurse and complete clinical requirements for your NP program.
Apply to an MSN or DNP program
To become an NP, the next step is to apply to an MSN or DNP program in your chosen specialty. As mentioned, most of these programs require a BSN for entry, but there are options for RNs, RNs with a bachelor’s in another field, and nurses with an MSN in another specialty.
(While the AACN has endorsed the position that all entry-level NPs should have a DNP degree and not an MSN, this is not currently the law in any state, so you can still be licensed as an NP with an MSN degree. Note that this may change in the future if there is a big push for all entry-level NPs to have a doctorate.)
Get certified and licensed
Once you complete your NP program, you must get certified by taking the appropriate exam. After you pass, you can apply for state licensure. NPs must renew their licenses, complete continuing education credits, and meet the criteria to maintain their certification. Every state and certifying body is different, so make sure you understand what is required by your state and certifying organization.
Other NP specializations
FNP is just one of the certifications available for nurses who wish to pursue careers as NPs. Other NP specialties include:
Adult-Gerontology Nurse Practitioner (ACNP)
These NPs work with teenagers and adult patients in a variety of settings. Primary care AGNPs offer more comprehensive care in doctors’ offices and clinics, while acute care AGNPs can work in hospital settings, including ICUs, ERs, and nursing homes.
Neonatal Nurse Practitioner (NNP)
NNPs specialize in caring for patients under two years old. In many cases, their patients may have been born prematurely or with congenital challenges, illnesses, or other conditions. They typically work in neonatal ICUs.
Pediatric Nurse Practitioner (PNP)
Nurses interested in the PNP specialty can choose between primary and acute care. While nurses in both areas work with children of all ages, primary care PNPs work in settings like doctors’ offices, clinics, and public health centers, while acute care PNPs care for patients with more critical health needs in hospitals, emergency rooms, and specialty clinics.
Psychiatric/Mental Health Nurse Practitioner (PMHNP)
NPs in this specialty work in mental health care. In some states, they can prescribe medication and work independently; in others, they have to work under the supervision of a psychiatrist. PMHNPs can work in a number of settings, including therapy centers, psychiatric practices, and schools.
Women’s Health Nurse Practitioner (WHNP)
WHNPs specialize in women’s health, providing reproductive and sexual health services and gynecological care. They typically work in OBGYN offices, but they can also work in hospitals and fertility clinics. (Note that WHNPs are not qualified to deliver babies. Nurses who are interested in caring for pregnant women and tending to them during labor should seek certification as a Nurse Midwife.)
What sets an FNP apart?
As you can see, there are several options for nurses who wish to pursue careers as NPs; so, what sets an FNP apart?
One of the things that makes a career as an FNP special is that you will care for patients across the entire lifespan. Depending on where you work, you may care for an infant, a teenager, and a senior citizen, all on the same day. This specialty is the only one that prepares an NP to deliver this breadth of care.
I want to be an NP—what should I specialize in?
There are many factors to consider when choosing an NP specialty. If you’re not sure which path is right for you, here are some things to consider:
- What is your previous nursing experience? Many PNPs start as pediatric nurses, and a lot of NNPs may begin their careers as NICU nurses. What experience do you already have that can help prepare you for your next role?
- Consider the practical things. Is there a high demand for a particular specialty in your area? Will your nursing job reimburse you for a specific program? How much does each program cost? What speciality has an earnings potential that suits your lifestyle?
- What type of environment do you like to work in? For example, if you don’t want to work in a hospital, it may be best to avoid acute care specialties.
- What patient population are you interested in? If you prefer to work with kids, an AGNP may not be the right path, and if you want to work with adults, a PNP may not be the right choice.
- What are you passionate about? Mental health? Women’s health? Caring for seniors? Let what you’re naturally interested in help guide you to your path.