In the Aloha State and beyond, some registered nurses (RNs) are seeking greater professional independence, privileges of practice, and salary prospects. One way to meet these three objectives is to become a nurse practitioner (NP), a relatively lucrative and fast-growing occupation. As proof of point, the Bureau of Labor Statistics (May 2017) reported that the 10,800 RNs in Hawaii earned an average annual salary of $96,990, while the 410 NPs in the state enjoyed a 20.9 percent higher mean salary at $122,580 (BLS). The BLS also predicted that the growth in openings for NPs across the country would outpace the average growth of all U.S. occupations, projecting 36 percent and 7 percent increases, respectively, between 2016 and 2026. Projections Central (2018) estimated an even higher growth of NP positions in HI (37.1 percent) during that same decade, which is five times the national average expected across all jobs. In sum, the salary and job opportunities for NPs in HI look very bright on into the future.
How can someone join this promising career? Aspiring NPs may choose one of two graduate degrees in the field: a master of science in nursing (MSN) or a doctor of nursing practice (DNP). As of October 2018 the MSN was the minimum academic degree to qualify for work as a Hawaii NP, although this may change in coming years as several prominent nursing organizations—including the American Association of Colleges of Nursing—have advocated for the adoption of the DNP as the new standard.
Of course, some Hawaii NPs choose to pursue their graduate-level education in the traditional manner, attending courses on a physical campus, while others opt for a more flexible alternative: distance education. There are various online NP programs in HI available, including those at the University of Hawaii. Particularly for residents of more remote islands or those who want to keep working while pursuing an advanced degree, attending one of the online NP schools can be more convenient. Online NP programs comprise two main elements: e-classes and onsite clinical practicums completed at healthcare facilities close to a student’s home. It’s important to add that in recent years as web-based education has gained in popularity and programs have proliferated, there are now more standardized, accredited programs than ever, and the menu of online NP degrees and specializations is still expanding.
Notably, Hawaii has a thriving support network for people in nursing. In fact, the Hawaii Association of Professional Nurses provides resources for people across the gamut of nursing, including RNs, clinical nurse specialists (CNSs), and NPs. The organization offers continuing education opportunities to maintain credentialing, educational newsletters, a job board, legislative advocacy for issues affecting the industry, social events, conferences, mentorships, and various awards.
This guide explores the online NP programs in Hawaii, including a detailed discussion of how to join this high-growth and high-paying profession.
Paths to becoming a nurse practitioner in Hawaii vary, but all prospective NPs must do the following: achieve both undergraduate and graduate degrees in nursing, get RN licensure, achieve national certification, and finally apply for advanced practice (APRN) licensure in Hawaii.
Here is one possible route to become an NP in HI:
STEP 1: Complete an Undergraduate Degree (2-4 years)
Hawaii law states that a person must complete an approved nursing program in order to obtain licensure as an RN. At this stage, some people choose to pursue a diploma or associate degree in nursing (ADN), although it may be advisable to earn a four-year bachelor of science in nursing (BSN) degree instead; the BSN not only gives nurses more lab and clinical experiences, but it’s also a common prerequisite to attend an online NP school. BSN programs feature courses such as health assessment; nursing research; care of culturally diverse populations; statistics; anatomy & physiology; and college-level science courses. The Hawaii Board of Nursing provides a list of approved nursing schools, and students are strongly advised to seek out nursing programs accredited by one of two national entities: the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN). Please visit the ‘accreditation’ section below to learn about the importance of this program-approval process.
STEP 2: RN Licensure & Nursing Experience (1-2 years)
After graduating from a Board-approved nursing program, an aspiring NP must then submit an application to the Board of Nursing in order to take the NCLEX-RN, the national RN certification examination. Along with the application, individuals must also submit the following:
If the individual passes the Hawaii NCLEX-RN examination, he or she will receive licensure as an RN. At this point, aspiring NPs should gain at least a year of nursing experience as an RN—ideally in one’s intended NP specialization—as nursing experience is generally a prerequisite for admission to many graduate programs.
STEP 3: Graduate NP Education (2-4+ years)
Upon receiving licensure as an RN and working in the field, RNs must pursue a graduate degree in nursing. As mentioned in the introduction, two degree options are available: an MSN or a DNP. As with the undergraduate nursing programs, students are strongly advised to seek out CCNE- or ACEN-accredited programs. Notably, the programs at the University of Hawaii of Manoa are CCNE-accredited.
Students at this stage typically choose one of six NP specializations: neonatal care, pediatrics (primary or acute care), women’s health, family health, adult-gerontology (primary or acute care), or psychiatric-mental health. Two-year MSN programs have practice-focused coursework in areas such as nursing informatics; health promotion & disease prevention; population health; advanced pharmacology; pathophysiology; and nursing care throughout the lifespan. By comparison, three- or four-year DNP programs offer more leadership-focused classes such as organizational management; clinical decision-making; advanced research design; quantitative methods for evaluating healthcare outcomes; and the social determinants of population health. In addition to classes, graduate-level nursing students also complete supervised clinical experiences and original research projects (i.e., capstone work).
STEP 4: Achieve National NP Certification (up to 1 year)
After graduating from an accredited NP program, it’s necessary to apply for national certification in one’s specialization. This process typically involves passing a comprehensive examination in one’s field. There are varied organizations which credential NPs, including the American Association of Critical-Care Nurses (AACN); the American Nurses Credentialing Center (ANCC); the National Certification Corporation for Obstetric, Gynecologic, and Neonatal Nursing Specialties (NCC); and the American Association of Nurse Practitioners (AANP).
STEP 5: Obtain Hawaii APRN Licensure (up to 1 year)
Upon receiving certification through a national organization, an aspiring NP must finally submit an application through the Hawaii BoN. In addition to identifying information and work experience requested in the application, aspiring NPs must send the following:
It’s important to note that in order to have prescriptive authority, NPs in HI must show proof of at least 30 hours of qualifying education or experience in the realm of pharmacotherapeutics. Please visit the application instructions for details.
There’s only one institution in Hawaii that has online NP programs—the University of Hawaii at Manoa—and the following is a brief overview of admissions requirements to this school, as well as a discussion of common application materials requested by other online NP programs.
Undergraduate RequirementsThe UH of Manoa specifies that a bachelor’s degree is necessary to be considered for admission, and most online NP programs take it one step further, requiring a bachelor of science in nursing (BSN). There are some distance-based NP schools with ‘bridge’ or ‘direct entry’ programs, admitting RNs with ADN or non-nursing bachelor’s degrees, respectively.
GPAA majority of MSN programs—including the one at UH—require at least a 3.0 GPA to be considered for admission, while DNP programs often require a 3.2 GPA or higher.
Other Admissions RequirementsIn addition to proof of an undergraduate degree and an acceptable GPA, applicants must also typically send verification of licensure as an RN; a personal statement or writing sample; a resume or CV with at least one year of nursing experience; copies of any national certifications; proof of immunizations or health insurance; proof of completion of specific coursework (e.g., statistics, anatomy, chemistry, biology, etc.); and English language proficiency scores (e.g., TOEFL test), if applicable.
Because the Hawaii Board of Nursing requires aspiring NPs to possess a graduate degree from an accredited program in order to be considered for licensure, all individuals interested in working in this capacity should highly consider applying to a program that has received accreditation. Fortunately for those hoping to pursue their degree online in Hawaii, the University of Hawaii at Manoa has received accreditation from the Commission on Collegiate Nursing Education (CCNE), one of the two main program-approval entities nationwide. The other is the Accreditation Commission for Education in Nursing, Inc. (ACEN), and these two organizations weigh factors such as the quality of program curricula, facilities, faculty, and student outcomes to ensure that a given NP school is meeting baseline standards of excellence. For a thorough examination of how programs and schools are evaluated, check out the accreditation websites or the relevant section of the main online nurse practitioner schools page.
Dr. Gandall-Yamamoto is an assistant professor of nursing at the University of Hawaii at Manoa, where she also serves as the director of the DNP program. Prior to her position at the university, she was a primary care provider at the Waikiki Health Center, and was the medical director at the Lana’i Community Health Center. She received the Hawaii State Award for Excellence in 2010 from the American Association of Nurse Practitioners, as well as the Faces of Nursing Award from the University of Hawaii.
Dr. Kataoka-Yahiro is an associate professor in the school of nursing at the University of Hawaii at Manoa, where she also served as graduate chair and assisted the curriculum audit of the master’s graduate core in preparation for accreditation from the CCNE. She is currently a nurse researcher and an educational consultant with the National Kidney Foundation of Hawaii, as well as a member of several organizations, including the Society of Pediatric Nurses; the Western Institute of Nursing; and the Asian American Pacific Islander Nurses Association, among others. She has an array of authorship credits to her name, including the 2011 ‘Randomized Clinical Trials of Self-Management with Asian/Pacific Islanders’ in Clinical Nursing Research, and the 2010 ‘Filipino American Grandparent Caregivers’ Roles, Acculturation, and Perceived Health Status’ in the Journal of Cultural Diversity.
The CCNE-accredited University of Hawaii at Manoa offers two DNP options for students interested in pursuing an online graduate degree in nursing. Specifically, programs are available for students with either a BSN or non-nursing bachelor's degree. DNP specializations include family nursing and adult gerontology primary care. The DNP consists of 77 credits and 1,000 hours of clinical practicum and is a 3-year, full-time cohort program. Classes in the online DNP programs include Pathophysiology for Advanced Practice; Introduction to Leadership & Acute and Episodic Care Management; Advanced Assessment & Clinical Reasoning; Chronic Illness Management; Translational Science; Evidence-Based Practice & Statistics; and a final scholarly project. It’s important to note that students must attend two on-campus mandatory summer intensives. The University of Hawaii at Manoa also offers an MSN to DNP track, however this program does not specialize in family nursing or adult gerontology primary care.
While the University of Hawaii is currently the only Hawaii-based nursing school providing online NP education, there is a wealth of other institutions across the US which enroll students from the Aloha State. To discover the distance-based degrees and specializations, please visit the online NP programs page.
Because the nursing graduate program at the University of Hawaii at Manoa only requires students to attend two on-campus summer intensives, the program is considered an online program. For those interested in 100% online programs, these are covered in the aforementioned online nurse practitioner programs page.
Many states require aspiring NPs to complete preceptorship hours before they may achieve licensure. Hawaii does not have this requirement, but students pursuing a graduate degree in the state will inevitably complete clinical hours during the course of their study. Furthermore, national NP certification typically requires at least 500 qualifying practice hours in addition to other requirements.
Lastly, it’s worth noting that Hawaii NPs enjoy a ‘full practice’ environment with respect to their professional privileges and autonomy in the state (AANP 2016). In sum, this means that state laws and regulations allow NPs to evaluate patients and perform other tasks within their expertise under the exclusive licensure of the Hawaii Board of Nursing; this is a direct contrast to states operating under ‘reduced’ or ‘restricted’ practice environments.