Registered nurses (RNs) in Nebraska (NE) who wish to adopt a greater level of responsibility and autonomy in their profession may consider becoming nurse practitioners (NPs). Not only is this a relatively lucrative career, but also there is expected to be a wealth of future job opportunities for NPs in the Cornhusker State and beyond. In fact, the Bureau of Labor Statistics (May 2016) reported that the 21,240 RNs in Nebraska made an annual average salary of $60,370, while the 1,080 NPs in the state enjoyed a 54.5 percent higher mean salary ($94,130). Furthermore, the BLS (Dec. 2016) predicted a 36 percent explosion in job openings for NPs nationwide between 2016 and 2026, much more robust than the average growth anticipated for all occupations in the US (7 percent). While Projections Central (Dec. 2016) put the expected growth of Nebraska NP positions at a more modest 21.5 percent during that same time period, the projected addition of 44,700 fresh openings nationwide—including 220 in Nebraska—should provide a promising employment climate in the coming decade. NPs in Nebraska also enjoy a vibrant professional association—the Nebraska Nurse Practitioners—which provides online networking, educational events, job postings, and other resources.
So how does an aspiring NP in NE join this career? There are two main graduate degrees to qualify a person for all necessary national and state credentialing: a master of science in nursing (MSN) or a doctor of nursing practice (DNP). They typically take two to four years of full-time study to complete, respectively. The MSN is still the minimum academic degree to qualify for all certification and licensure, although this may change in coming years for several reasons; the American Association of Colleges of Nursing and other NP organizations have advocated for the adoption of the DNP as the preferred level of preparation for this career since 2004, when they set 2015 as their target year for the full transition. That deadline wasn’t quite met, but the motivation to make this change endures, especially since a majority of advanced healthcare professions require doctoral degrees. Additionally, DNP programs may better prepare Nebraska NPs for positions in management or academia.
Regardless of the degree desired, a growing number of prospective NPs in Nebraska and beyond are opting for online NP programs rather than traditional on-campus experiences. Particularly for Nebraska residents in more rural regions of the state or those who seek to keep their RN job while pursuing a more advanced degree, attending a distance-based NP program can prove more convenient and flexible. Also, as online graduate programs have proliferated in Nebraska and beyond, they have become more standardized and tailorable to a student’s needs. They typically combine rigorous web-based coursework with on-site clinical practicums, which are completed at healthcare facilities close to students’ homes.
This guide examines accredited online nurse practitioner programs in NE, and describes how to join this high-growth career and prepare for credentialing and advanced practice in the state.
There are varied pathways to becoming a nurse practitioner in Nebraska, but all professionals in this field must complete an undergraduate degree in nursing; achieve RN licensure; get a graduate degree in a specialized NP field; seek professional certification through a national organization; and finally get an advanced practice nursing (APRN) license from the state of Nebraska.
Here is one possible path to becoming an NP in NE:
STEP 1: Complete an Undergraduate Degree (2-4 years)
The Nebraska Nurse Practice Act states that aspiring nurses must hold at least a diploma from a Board-approved program in order to be eligible for licensure as a registered nurse, which is a prerequisite for becoming an NP. The NE Department of Health & Human Services provides a list of approved nursing programs within the state. While some nurses choose to pursue a career diploma or associate degree at this stage, it may be advisable to get a bachelor of science in nursing (BSN) instead. (It’s worth noting that the University of Nebraska Medical Center has an outstanding online RN-to-BSN program to accommodate students who completed ADN programs initially.) A BSN is a typical admissions requirement to get into online NP programs, covering core concepts of the discipline such as statistics; anatomy & physiology; human biology; and chemistry, among others. Also, these four-year programs provide hands-on clinical and laboratory experiences to prepare aspiring NPs. In addition to Nebraska’s approved list of nursing programs, aspiring NPs are strongly encouraged to seek out programs accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN). For more on the program-approval process, please see the ‘accreditation’ section below.
STEP 2: Earn RN Licensure & Gather Nursing Experience (1-2 years)
Following graduation from an undergraduate program, nursing candidates apply to take NCLEX-RN examination—the national certification exam for registered nurses—through the NE Department of Health & Human Services. The application calls for:
Additionally, those who hope to obtain a graduate NP education typically need at least one year of nursing experience to qualify for enrollment, preferably in the candidate’s intended NP specialty (e.g., family health, women’s health, etc).
STEP 3: Complete a Graduate NP Education (2-4+ years)
As mentioned in the introduction, aspiring NPs generally have two post-BSN degree choices: a two-year master of science in nursing (MSN) or a four-year doctor of nursing practice (DNP). It’s important to note that a select few online NP schools provide ‘bridge’ or ‘direct entry’ programs. The former refers to admissions for a post-ADN students, and the latter refers to admissions for RNs who hold non-nursing bachelor’s degrees. Regardless the point of academic entry and degree desired, NPs at this stage must choose a specialization. There are six main foci in this discipline: family health, adult-gerontology (acute or primary care), pediatrics (acute or primary care), women’s health, psychiatric-mental health, and neonatal care. MSN programs typically feature more specialty-focused coursework and advanced nursing fundamentals such as pathophysiology; advanced pharmacology; health promotion; disease prevention; and nursing care throughout the lifespan, among others. DNP programs, by contrast, generally have more leadership-oriented coursework in areas including interprofessional collaboration; organizational & systems leadership; and improvement of healthcare outcomes.
Also, eligibility for licensure as an NP in the state requires the completion of a Board-approved program, ‘which included both a didactic component and a preceptorship of 500 contact hours,’ as described by the NE DHHS regulations. Most online MSN programs will fulfill this requirement, and DNPs typically involve at least 1,000 clinical practicum hours.
STEP 4: Achieve National NP Certification (up to 1 year)
Following graduation from an accredited NP program, candidates must apply to a national credentialing agency to take a comprehensive examination in their specialty. Certification organizations include the American Association of Critical-Care Nurses (AACN), the American Nurses Credentialing Center (ANCC), the American Association of Nurse Practitioners (AANP), the National Certification Corporation (NCC), and the Pediatric Nursing Certification Board (PNCB).
STEP 5: Obtain NE Licensure as a Nurse Practitioner (up to 1 year)
Finally, upon receiving certification as an NP from one of the national credentialing bodies, NPs must pursue APRN licensure in Nebraska by submitting an application to the NE DHHS. This requires the following: proof of RN licensure, proof of citizenship, official transcripts from an accredited NP school with specific coursework (e.g., pharmacotherapeutics, pathophysiology, health assessment), proof of national certification, a fee (varies), and proof of professional liability insurance. It’s important to note that applicants for NP licensure must have at least 2,080 hours of practical experience in their specialty over the previous five years before they will be deemed eligible for this advanced nursing role. In the interim, they can apply for a ‘Transition to Practice’ or temporary permit to complete the necessary hours.
While application procedures and materials vary among online NP programs in Nebraska, they generally involve the following:
As mentioned above, the vast majority of online NP programs—including most of the ones in NE—require candidates to have at least a bachelor of science in nursing (BSN) degree with proof of specific coursework in chemistry, biology, statistics, and anatomy. Some Nebraska institutions provide an on-campus ‘accelerated BSN’ program for RNs seeking to complete their bachelor’s degree, and the aforementioned University of Nebraska Medical Center offers an online RN-to-BSN program.
The UNMC requires NP program applicants to have an undergraduate GPA of at least 3.0, a typical requirement of online NP programs. Generally, DNP admissions standards may be even higher, as many schools call for at least a 3.2 GPA to qualify. That said, some institutions may provide alternative evaluation methods for applicants just under GPA requirement such as clinical portfolio evaluations. Please note that online NP programs don’t generally ask for MAT or GRE scores, although it may be advisable to send them if the candidate believes they will enhance his or her candidacy.
Finally, applicants to graduate nursing programs may be asked to submit additional documents and information, including a statement of purpose (500-600 words), a CV or resume with at least one year of experience, proof of health insurance or immunizations, a background check, a drug test, proof of citizenship, and letters of recommendation from professors or supervisors or employers. Some students may be asked to participate in an in-person or online interview, although this is not always required.
While the Nebraska DHHS provides a list of approved nursing programs offering undergraduate degrees, no such list is available for graduate programs. That said, prospective NPs in NE are strongly advised to seek out nursing programs at all levels accredited by one of two institutions: the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN). This program-approval process weighs various factors in its evaluation, including the quality of program facilities; resources for enrollees; management of program & institutional finances; and student outcomes, among other measures. To learn in-depth about how programs are evaluated, please visit the accreditation entity websites or the appropriate section of the main online NP schools page.
Dr. Pozehl is a professor of nursing at the University of Nebraska Medical Center, where she teaches advanced practice clinical courses in the adult gerontology graduate program, among others. She received funding from 2012 through 2017 as the principal investigator of the ‘HEART Camp: Promoting Adherence to Exercise in Heart Failure Patients’ project, and has received numerous awards and recognition over the years; she was a Fellow in the American Academy of Nursing (2013) and the American Heart Association (2010), as well as the recipient of the 2013 Distinguished Scientist Award at the University of Nebraska Medical Center.
Dr. Costanzo is a senior associate dean at Creighton University’s School of Nursing, where she also serves as the MSN program chair. She has many distinguished author and co-author credits to her name, including the groundbreaking ‘Development of a Guideline for Treatment of Deep and Superficial Venous Thrombosis in the Emergency Department’ (Advanced Emergency Nursing Journal 2012) and ‘Increasing Self-Efficacy and Support for Physical Activity in Older Women’ (Women and Health 2008).
The University of Nebraska Medical Center of Omaha boasts one of the largest collections of online NP programs in the country. The website states: ‘From the beginnings of the digital age, our mission was to reach all Nebraska—a large, primarily rural state in which students often don't live within an easy commute of our five border-to-border nursing campuses.’ It has MSN, post-master’s certificate, and DNP programs across six specializations: adult-gerontology (primary care), adult-gerontology (acute care), family health, pediatrics, psychiatric-mental health, and women’s health. The MSN programs require between 45 and 48 credit hours of coursework, depending on the specialty, including instruction in graduate statistics; nursing scholarship; health systems innovation & improvement; and applied pharmacology, among others. Part-time schedules and post-master’s certificate options are available as well, and students may take up to five years to complete the MSN degrees. The three-year online BSN-to-DNP programs feature classes such as changing complex systems to improve healthcare; healthcare economics & financial management; and methods for assessing clinical practice outcomes. Tuition for the graduate nursing programs costs $458.50 per credit hour for NE residents and $956.50 for non-residents.
At Clarkson College of Omaha, students may pursue an online MSN, post-master’s certificate, or a DNP with limited campus visits. Furthermore, Clarkson College also offers an online RN-to-MSN option wherein licensed RNs who do not possess a BSN can still pursue a graduate degree in nursing. This pathway requires four campus visits total. The two NP specializations available are family health and adult-gerontology (primary care), and MSN students must complete an evidence-based journal article and poster presentation, as well as courses such as health law ethics; evaluation strategies; pharmacology, pathophysiology & health assessment; and behavioral healthcare. The seven-semester, online MSN-to-DNP features courses such as outcomes of healthcare in a global society; healthcare organizational systems; biostatistics & epidemiology; and designing theory for advanced practice nursing.
In its 2017 ratings, U.S. News & World Report ranked Clarkson College 39th out of 147 eligible institutions in the nation in the category of 2017 Best Online Graduate Nursing Programs, making it the top ranked program of its kind in Nebraska. This is the sixth year U.S. News released a Best Online Graduate Nursing Programs list and the sixth time Clarkson College achieved a high-ranking status in the category, this year earning 77 out of 100 possible points.
NMC, also of Omaha, provides an online DNP program requiring only two campus visits. It’s important to note that the NP option is only open to post-MSN candidates, comprising 31 credits of coursework in population-based healthcare; clinical inquiry; community health program planning; and rural nursing, among other classes. This program costs $793 per credit hour.
Lastly, there is a wealth of programs at all degree levels and specializations which are available through distance-based programs located in other states. Prior to applying, all NE residents are advised to verify the ‘state authorization’ status of non-NE programs, as laws governing the delivery of online education differ between states. For an overview of the programs available, check out the online NP programs page.
Purdue University Global offers 100 percent online MSN and post-master's certificate degrees in family nursing and adult gerontology primary care. In addition, Purdue Global offers an MSN in adult gerontology acute care which is almost completely online, and requires one campus intensive at the Indianapolis, IN, campus. Purdue Global has student services campuses located in Lincoln and Omaha, NE, at which students have access to financial aid services, tutoring, admissions counseling, a lounge, and other services. No classes for the advanced nurse practitioner degrees take place here. Students must complete clinicals at an approved facility near them. Purdue Global seeks to serve busy, working adults with an excellent online education at an affordable price.
Nebraska, like many other states, requires nurse practitioners to have completed a specific number of preceptorship hours before they are eligible to practice in this field. Specifically, all NPs must have at least 2,080 practice hours in their specialty to qualify for APRN licensure. For a full breakdown of the requirements, please check out the Nebraska DHHS APRN application.
As a final note, Nebraska is considered a ‘full practice’ state, according to the American Association of Nurse Practitioners (AANP). This means that ‘state practice and licensure law provides for all nurse practitioners to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments—including prescribe medications—under the exclusive licensure authority of the state board of nursing.’ This legal environment provides Nebraska NPs with relative autonomy and privileges of practice compared to states under ‘reduced’ or ‘restricted’ conditions.