There are many different paths to becoming a nurse practitioner (NP), no one better than another. Nurse practitioners can begin their careers as registered nurses, vocational nurses, or nursing assistants, or they can even start off as graphic designers, engineers, health administrators, or lawyers. A common misconception is that you must study nursing and practice as a nurse before going to nurse practitioner school. This is not true at all!
Just like physicians, nurse practitioners can study anything in their undergraduate programs. Most often, nurse practitioners study a natural science like biology or chemistry, or they study nursing. A Bachelor of Science in Nursing (BSN) provides a solid foundation to become a nurse practitioner by requiring students to take a mixture of natural sciences, social sciences, research, and nursing courses. A BSN also requires hundreds of clinical hours in a variety of specialities: medical-surgical, intensive care, obstetrics, pediatrics, geriatrics, psychiatry, home health, public health, and more. This diversity of clinical experience allows you to sample different areas of medicine before picking your nurse practitioner specialty.
What all nurse practitioners have in common is they must pass the National Council Licensure Examination (NCLEX) before starting nurse practitioner school. The NCLEX is to nurse practitioners as the MCAT is to physicians and the LSAT is to lawyers. The NCLEX exam tests an individual's knowledge on a variety of topics such as infection control, pharmacology, patient care, patient rights, emergency response, health screening, nutrition, hygiene, hemodynamics, and pathophysiology.
After passing the NCLEX and earning a RN license, a nurse often practices for a year or two (many NP programs require this) before applying to a graduate nursing degree program with an NP specialization, otherwise known as a nurse practitioner program. NP programs include clinical hours, and culminate in a Master of Science in Nursing (MSN) degree, Doctor of Nursing Practice (DNP) degree, or post-master’s certificate with a nurse practitioner specialization. Upon completing an NP program, and passing a national board certification exam in a chosen specialty area, a nurse practitioner may begin to practice.
But stepping back to the start of the process, the path you take to becoming a nurse practitioner usually depends on two things: your current education, and whether or not you are a nurse.
Start by answering these two questions for yourself:
Based on your answers, continue reading to learn more about your ideal path for becoming a nurse practitioner.
Nurse practitioner programs designed for licensed practical nurses (LPN) or licensed vocational nurses (LVN) are extremely limited and require intensive on-campus courses. It is often beneficial for LPNs and LVNs to first become an RN before applying to NP school so they have more options.
Nurse practitioner programs for ADNs are typically highly competitive because there are few programs and many applicants. Requirements include having an RN license and a diploma (in some cases) or associate degree in nursing (ADN). Usually, these schools require a previous grade point average of at least a 3.0 on a 4.0 scale and above average Graduate Record Exam (GRE) test scores. Additional admission requirements include letters of reference, curriculum vitae, interview, and statement of professional goals. Sometimes referred to as RN-to-NP bridge programs, or ADN-to-NP bridge programs, these programs are often offered in-person or via a hybrid format that combines online and on-campus education. Licensed RNs with an ADN degree may find some primarily online programs as well, although it is important to check the campus visitation requirements of such programs, as many will require at least one campus visit for orientation or a multiple-day intensive.
ADN-to-NP students can usually choose whether they wish to earn a Master of Science (MSN) in Nursing or a Doctor of Nursing Practice (DNP). Currently, the American Association of Colleges of Nursing (AACN) recommends that all NPs earn a DNP; however, it is not officially a requirement yet. Students who choose an MSN will take fewer courses and graduate sooner. These DNP programs are usually completed in four to six years and range from 80 to 100 credit hours.
To be accepted into a BSN-to-NP program, you need an RN license and a BSN. Some schools recommend that applicants have at least one year of previous nursing experience; however, this is rarely a requirement. As a result, many BSN-graduates are opting to go directly to NP school without practicing as an RN first. These schools require an undergraduate grade point average of at least a 3.0 on a 4.0 scale, three letters of reference, curriculum vitae, interview, and statement of professional goals. These programs can often be completed online, with most schools allowing the clinical hours (in the form of a preceptorship) to be completed at a facility located conveniently close to where the student lives or works.
Students in these programs can choose between earning an MSN or DNP. Today, the AACN recommends that all NPs have a DNP in order to practice; however, this requirement is still up for debate and many NPs continue to earn MSN degrees instead. Students who complete the recommended DNP usually spend three to four years in school and take 70 to 100 credit hours.
So-called accelerated nurse practitioner programs enable RNs with a bachelor’s degree in another area to complete the requirements for their BSN before proceeding into their NP education. These programs require an undergraduate grade point average of at least a 3.0 on a 4.0 scale and above average Graduate Record Exam (GRE) score. Other admission requirements include letters of reference, curriculum vitae, interview, and statement of professional goals. Prerequisite courses often include a variety of science courses such as human anatomy and nutrition.
Typically, applicants have worked as a registered nurse for a few years prior to admission and possess a strong academic record. These programs generally last two to four years and require 45 to 55 credit hours of coursework. These students also have the option of earning either an MSN or a DNP. The program is normally presented in a face-to-face format, or hybrid format, with some courses completed online and some courses in person. There are some accelerated online nurse practitioner programs, but be sure to check their campus visitation requirements to understand when campus appearances will be required.
Nurse practitioner programs that accept students without an RN license, and with a bachelor’s degree in something other than nursing, are commonly called direct entry nurse practitioner programs, graduate entry NP programs, or master’s entry NP programs. Confusing matters somewhat, some schools will call these programs accelerated NP programs, but to avoid confusion we will use the term “accelerated” to mean programs for RNs with non-nursing bachelor’s degrees (see above).
Students accepted into direct entry NP programs often have a degree in a health or science-related field such as biology, chemistry, or kinesiology, which may be helpful since these programs require the successful completion of many prerequisite courses such as anatomy and physiology, abnormal psychology, microbiology, and pathophysiology. As is the case with other types of NP program applicants, direct entry NP program applicants must have a high grade point average and submit letters of reference.
Admission into graduate entry nurse practitioner programs is highly competitive due to the limited number of spots and a large number of applicants. Direct entry students also have the option of earning either an MSN or a DNP, and the programs typically last three to six years and require 85 to 110 credit hours. Usually, parts of the program can be completed online and at a distance, while other parts must be completed on campus. Often, the initial semesters of the program must be completed entirely on campus, in face-to-face format.
Some RNs and advanced practice nurses have earned a Master of Science in Nursing (MSN), but not in a nurse practitioner specialty. These applicants can apply to special programs designed specifically for them. Such programs are usually tailored to the need of the individual and involve a transcript review to determine which courses can and cannot transfer. Applicants may have to complete additional didactic courses and clinical hours to qualify for the program, which will most typically culminate in a post-master’s NP certificate or a DNP degree. Applicants should have a grade point average of at least a 3.0 on a 4.0 scale, and they must submit letters of reference, a resume, and a statement of professional goals. The GRE requirement is typically waived for these programs.
Nurse practitioners who wish to earn another NP credential may apply to a post-master’s NP certificate program, sometimes called a post-graduate NP certificate program. These programs are shorter in duration and enable currently practicing NPs to take additional classes and become certified in an additional medical specialty. Admission requirements are similar to all other programs, including previous grade point average of at least a 3.0 on a 4.0 scale, letters of reference, resume, interview, and goal statement. Many times these programs can be completed online in 10 to 20 credit hours and an additional 600 precepted clinical hours.
These programs are designed for currently practicing NPs who want to earn their DNP as recommended by the AACN. The final step toward completing the DNP may just be 36 to 47 credit hours. These courses are usually completed in two years. MSN-to-DNP programs require up to 1,000 clinical hours, but some of these can be transferred from a previous MSN degree. Admission requirements for these programs include an RN license, NP license, and certification in your medical specialty. Most schools require a graduate grade point average of at least a 3.0 on a 4.0 scale, three letters of reference, curriculum vitae, interview, and statement of professional goals.
Just like physicians, nurse practitioners maintain a national board certification in their specialty. The certifying board varies depending on the medical specialty. For dually certified nurse practitioners, this may mean maintaining certifications through two separate boards.
In the United States, there are four different nurse practitioner certification boards:
These organizations differ in the specialities they certify, the renewal cycle, costs, and certification requirements. Some of this information is summarized in the table below, but you should always check each organization’s website to stay up-to-date.
|Maintaining National Board Certification for Nurse Practitioners|
|Certifying Board||Specialties||Renewal Cycle||Requirements|
|American Nurses Credentialing Center (ANCC)||
Either 1,000 clinical hours in medical specialty or retaking the certification exam AND about 150 continuing medical education hours with 25 of those on the topic of advanced pharmacology
Please see explicit details in the ANCC 2015 Certification Renewal Requirements booklet.
|Pediatric Nursing Certification Board(PNCB)||
Documentation of 30 continuing medical education every year for the past seven years with 50% of those related to pharmacology AND successful completion of the PNCB Pediatric Updates. These are accessed by logging on the PNCB website.
|National Certification Corporation(NCC)||
Successful completion of a specialty assessment through the NCC website (access by logging int your NCCwebsite.org account) AND around 50 hours of continuing medical education.
Please see explicit details in the the NCC Core Maintenance Certification Manual on pages 7-9.
|American Academy of Nurse Practitioners Certification Program(AANPCP)||
Either retaking the national certification exam OR completing 1,000 clinical hours and 100 continuing medical education hours with 25 of these in advanced pharmacology.