Family nurse practitioners (FNP) are advanced practice registered nurses (APRNs) who focus on health promotion and disease prevention, working with patients of varied ages and medical histories. According to the American Association of Nurse Practitioners (AANP), these healthcare professionals diagnose, treat, and manage illnesses by conducting lab tests; designing treatment plans (both pharmacological and non-pharmacological); and counseling patients and their families. FNPs are expected to engage in self-directed learning and continuing education (CE) hours not only to maintain credentials and licenses, but also to keep abreast of the always-evolving competencies, technologies, and procedures in the field.
Please note that the responsibilities for FNPs vary by region. The AANP (2015) reports that states in the northwest generally give their NPs more generous privileges of practice compared to southern states, although there are exceptions. Additional regional information on the scope of practice for FNPs can be ascertained through the state boards of nursing, a list of which is provided by the National Council of State Boards of Nursing (NCSBN).
The AANP (2013) reports that FNPs have at least a master’s degree and certification to practice, although current nurse practitioners with master’s degrees may pursue post-master’s certificates in new specialties or earn a doctor of nursing practice (DNP), the terminal degree of the field. The AANP (2013) recommended that the DNP be the new gold standard in preparation for nurses, noting that advanced practice nursing remains one of the few healthcare subfields which prepares its practitioners at a master’s (rather than doctoral) level.
Read on to discover how to become a FNP, including information about professional certifications, program accreditation, and family nurse practitioner schools offering on-campus and/or distance-based FNP programs.
FNP Prerequisites & Specializations
Here is a summary of how to become a family nurse practitioner (FNP):
After graduating from high school, aspiring FNPs typically enroll in a two- to four-year nursing program. Candidates are advised to seek out undergraduate nursing programs accredited by either the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN). It may be wise at this stage to pursue a bachelor of science in nursing (BSN) degree. These programs not only prepare candidates to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become registered nurses (RNs), but also cover a number of graduate nursing program prerequisites, including coursework in chemistry (inorganic, organic, and biochemistry), epidemiology, microbiology, human anatomy & physiology, statistics, and general education.
That said, some associate’s degree holders and non-nursing bachelor’s graduates may still earn entry into graduate nursing programs. These programs are sometimes referred to as accelerated (non-nursing bachelor’s to MSN), bridge (ADN-to-MSN), or alternate entry (any non-BSN entry point to MSN) programs. All of these programs still require the student to be a licensed RN. There are a few so-called direct entry programs for non-RN’s that allow non-nurses to pursue an RN, BSN, and MSN sequentially a single program. These programs are relatively rare, and always campus-based due to the heavy practical requirements.
Examples of alternate entry programs include George Washington University (GWU), which provides an RN-to-MSN program for aspiring FNPs with associate’s degrees (i.e., ADN-prepared nurses), and the University of Pennsylvania, which offers an accelerated FNP program for candidates with bachelor’s degrees in a non-nursing field. Please note, however, that a majority of graduate programs in nursing call for BSN-prepared nurses, particularly the online FNP programs.
As mentioned above, aspiring FNPs must earn at least a master of science in nursing (MSN), and some candidates—especially those interested in leadership positions—choose to pursue a doctor of nursing practice (DNP).
For FNP graduate programs, both MSN and DNP, admissions committees typically call for:
- Resume or curriculum vitae (CV)
- Official university transcripts, often with a minimum GPA (e.g., >3.0)
- A 1-2 page personal statement detailing the student’s objectives, professional or personal
- Letters of recommendation from significant mentors such as professors, clinical supervisors, and other colleagues
- Interview (in-person or video)
- Proof of registered nurse (RN) licensure in the U.S., unencumbered (i.e., nationwide) or in a specific state
- Proof of immunizations and/or drug-screening
- Graduate Record Examination (GRE) or Miller Analogies Test (MAT) scores
- Test of English as a Foreign Language (TOEFL) or International English Language Testing System (IELTS) scores for non-native speakers of English
- Application fee
Finally, once enrolled in an FNP program, some students choose to specialize. By gaining mastery in specific area, FNPs may set themselves up for better employment opportunities, especially in areas of high need such as oncology. Although not all schools offer these areas of focus, there are FNP programs such as the one at Duke University which provides four specializations: cardiology, oncology, orthopedics, and HIV.
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Featured FNP Programs
There is a wealth of FNP programs offered both on-campus and online, MSN and DNP. Here is a taste of what to expect from a graduate FNP program:
Columbia University has a prestigious FNP master’s program which prepares graduates to work in a variety of healthcare settings including outpatient clinics, hospitals, community health centers, private practice offices, and schools. Columbia challenges its students with both supervised clinical practicums in the tri-state area (permanent or rotating) and classes such as family theory in context, normal antepartum for family primary care, and diagnosis & management of illnesses in families.
Duke University offers a 49-credit online FNP master’s program with courses such as population health in a global society, physical assessment & diagnostic reasoning, and advanced physiology across the lifespan. Duke—ranked #7 among U.S. News & World Report’s (2016) top FNP schools—has exciting opportunities for nurses to complete clinical practicums at international sites. Finally, as mentioned above, this program has four distinct specializations.
The University of Washington (UW) provides a top-caliber DNP program to aspiring FNPs. The U.S. News & World Report (2016) ranked UW’s program #5 among all FNP programs in the country, boasting nationally recognized faculty; a diversity of clinical preceptor sites; and opportunities for cross-disciplinary collaboration. This 12-quarter program includes training in health politics & policy, physiology & pathophysiology across the lifespan, and a capstone research project. Graduates of UW’s prestigious NP programs have gone on to work for the Pacific Medical Center, Group Health Collective, and other various hospitals and organizations.
The University of Arizona has an online BSN-to-DNP program with an FNP specialty. This program combines 73 credits of coursework—including units in statistical inference for evidence-based practice, methods for scholarly inquiry, and molecular & clinical genetics/genomics—and 810 supervised clinical hours for hands-on experience. Please note that this program requires a five-day, on-campus residency at the outset of the program: the Resident Intensive Summer Experience (RISE).
Please visit the online NP programs page for additional distance-based FNP program options.
Following graduation from an MSN or DNP program, prospective FNPs seek national and local certification and/or licensure. In fact, the American Association of Nurse Practitioners (AANP 2015) notes that 96.8 percent of all NPs maintain some form of national certification.
There are two common organizations which offer national certification to FNPs: the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP). Prerequisites for each of these certifications include having completed a graduate NP degree (e.g., MSN, DNP) from an accredited nursing program (including specific coursework); maintaining an active RN license; completing at least 500 supervised clinical hours; and passing an exam.
Finally, there are regional nursing boards which certify or license FNPs. The prerequisites and procedures vary by state. Please see the National Council of State Boards in Nursing (NCSBN) website for a complete list of state boards of nursing and their contact information.
All of the licenses and certifications must be maintained through the completion of continuing education (CE) credits to ensure that the FNP is aware of the continually evolving treatments, methods, and technologies. For example, the FNP-BC (“board certified”) credential offered by the ANCC is valid for five years and has two options for renewal. The first option involves the completion of 1,000 practice hours in the certification role. The second option involves an exam. Both options also call for professional development (i.e., continued education [CE] hours). Check specific certification boards for details on credential renewals.
FNP Program Accreditation
Prospective FNPs are urged to enroll in programs accredited by the Accreditation Commission for Education in Nursing, Inc. (ACEN) or the Commission on Collegiate Nursing Education (CCNE), two common agencies recognized by the US Department of Education. These organizations evaluate facilities, curricula, student outcomes, and other factors to ensure that the program can prepare FNPs adequately. Also, graduating from a program accredited by ACEN or CCNE is a prerequisite for RN licensure through the National Council of State Boards in Nursing (NCSBN). Additionally, FNPs must have completed an accredited program to sit for national certification exams offered by the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP).
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