According to the American Association of Nurse Practitioners (AANP 2015), family nurse practitioners (FNPs) make up the largest subgroup of NPs at 54.5 percent. They are qualified to treat patients across all demographic categories—children, elderly, men, women—using a holistic approach to healing in primary care settings. AANP (2015) reports that in many states of the northwest and midwest, NPs are given generous privileges of practice and can diagnose illness, manage treatments, and prescribe medications without the approval of a supervising physician. Other states, especially in the south, restrict the practice of NPs and give physicians and other healthcare providers supervising authority. In any case, FNPs provide a broad range of medical services and treatment.
So how does a person become an FNP?
According to CareerOneStop (2015)—a data group sponsored by the U.S. Department of Labor—77.8 percent of all actively working NPs have master’s degrees, and 12.7 percent boast doctoral or professional degrees. This piece focuses on master’s-prepared FNPs, but please note that the doctor of nursing practice (DNP) is now considered the terminal degree for this profession. In fact, the American Association of Colleges of Nursing (AACN 2015) recommends that the DNP be the graduate degree for advanced nursing practice training, particularly those interested in leadership positions. Prospective students are advised to consider the DNP in addition to the more traditional master’s degree, paying thought to their academic point of entry (i.e., highest degree achieved) and career objectives.
The Bureau of Labor Statistics (BLS 2014) reports that the following traits are important for anyone wishing to become an advanced practice registered nurse (APRN), a category which includes FNPs:
Read on to discover how to become an FNP, including the requisite education and certifications for the profession.
Here is one common process for becoming a family nurse practitioner (FNP):
1. Graduate from high school. Prospective FNPs generally earn high marks in classes such as anatomy, psychology, chemistry, and biology. It may also be advisable for students at this stage to volunteer in local hospitals or health clinics to garner experience and references for the nursing school application process.
2. Pursue a bachelor of science in nursing (BSN) or a related degree (4 years). There are varied academic paths to becoming an FNP. One of the most common paths, however, is to pursue a BSN which fulfills many of the prerequisites of graduate FNP degree programs. BSN programs provide hands-on clinical instruction and classes such as human behavior, pathophysiology, and nursing ethics. Also, students are urged to seek out undergraduate programs accredited by a recognized body such as the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN). This is crucial not only to ensure that the program is high quality, but also to qualify students for the NCLEX-RN exam (see below).
3. Become an registered nurse (RN) and get experience (1 – 2 years). For students in an associate or bachelor’s program in nursing, preparing for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) is typically part of the curriculum. After successfully passing the exam, RNs may choose to get some professional experience prior to enrolling in a graduate FNP program.
4. Pursue a graduate degree in nursing (1.5 – 4 years). At this stage, aspiring FNPs may enroll in a graduate FNP program. As mentioned above, there are various degree options (e.g., MSN or DNP) and academic points of entry. For example, Vanderbilt University offers an ASN-to-MSN FNP program for RNs with an associate degree. The American Association of Community Colleges (AACC) provides a list of these RN-to-MSN program options. Another possibility is exemplified by the University of Pennsylvania—U.S. News & World Report’s(2015) best FNP program—which provides an “accelerated” MSN program for applicants with non-BSN bachelor’s degrees. Generally, however, many applicants to graduate nursing programs have completed BSN degrees. Once enrolled in an MSN program for aspiring FNPs, students take classes such as advanced physiology across the lifespan, physical assessment & diagnostic reasoning, and population health in a global survey. In addition to coursework, FNPs-in-training may get clinical hours in a supervised setting such as a university hospital, clinic, or other healthcare environment. The application process for graduate FNP programs typically calls for:
5. Get certified by specialty and/or state nursing boards (timeline varies). There are two common national FNP certifications: the FNP-BC offered by the American Nurses Credentialing Center (ANCC) and the FNP certification provided by the American Academy of Nurse Practitioners (AANP). AANP (2015) notes that 96.8 percent of NPs maintain active national certification. Prerequisites for these certifications include having completed a graduate NP degree (MSN or higher) from a CCNE- or ACEN-accredited nursing program; the fulfillment of specific coursework prerequisites; having an RN license; completing at least 500 supervised clinical hours; and passing an exam. There are also state nursing boards which certify, register, or license NPs. These requirements vary by area, and the National Council of State Boards in Nursing (NCSBN) provides a helpful tool to examine procedures and contact boards of nursing by state.
6. Maintain FNP licenses, registrations, and certifications (timeline varies). The ANCC certification (FNP-BC) and the AANP FNP certification last for five years. Local or state licenses for FNPs have varying durations. In order to recertify, applicants must fulfill clinical practice hours and complete continuing education (CE) requirements.
Finally, FNPs may be interested in joining professional associations or organizations, which can provide valuable resources, networking, job boards, continuing education (CE) courses, and information on conferences. Here are some common national associations for NPs:
In addition to the online FNP programs, there is a wealth of schools across the country for those interested in joining this high-growth profession. Here are four standout options to give prospective students a flavor for what to expect from an FNP program:
The University of Michigan’s (UM) School of Nursing offers an outstanding primary care FNP program. This 59-credit MSN program includes coursework in areas such as common pediatric health problems, primary care of older adults, and advanced pharmacotherapeutics, UM’s program meets (and exceeds) the rigorous curriculum and training standards put forth by the National Organization for Nurse Practitioner Faculties (NONPF).
The University of California, San Francisco (UCSF) provides another exceptional FNP master’s program which focuses on care of individuals throughout the lifespan, particularly for underserved populations across the US. UCSF’s world-renowned nursing program is offered to BSN graduates with at least two years of experience working as RNs. In addition to core coursework in research methods, family nursing theory, and interprofessional team-based care, UCSF offers various areas of focus (i.e., minors), including HIV/AIDS and diabetes. Please note that this school also has a three-year master’s entry program in nursing (MEPN) for applicants with non-nursing bachelor’s degrees.
Vanderbilt University of Nashville, TN hosts a modified distance-based MSN program with an FNP emphasis. Depending on the student’s academic point of entry, he or she can take a majority of the coursework online, particularly for students with nursing experience. For instance, BSN-prepared candidates are given the most flexibility with course formats and have to attend campus only minimally. Those with no nursing experience or associate’s degree holders, by contrast, must complete one year of a traditional, campus-based, “pre-specialty” curricula to get a solid, hands-on grasp of the cornerstones of the discipline.
The University of Maryland provides a comprehensive DNP program—the terminal degree of the field—to prospective FNPs. Through challenging coursework and the completion of more than 700 supervised clinical hours, students are prepared in areas such as population health & promotion, evidence-based health policy, and translating evidence to practice. Also, many of the classes are offered in a hybrid format.