Working nurses in New Hampshire (NH) seeking a more autonomous role and heightened earning potential might consider becoming nurse practitioners. Not to be confused with a registered nursing (RN) career, nurse practitioners (NPs) are advanced practice nurses who have training in areas such as evidence-based practice, health promotion & disease prevention, advanced pathophysiology, health assessment, and pharmacotherapeutics, among other subjects.
NP programs can be completed at various levels, including a master’s of science in nursing (MSN) degree, a post-master’s certificate, or a doctor of nursing practice (DNP) degree, the terminal academic credential in the discipline. It’s important to note that the American Association of Colleges of Nursing (AACN) and the American Association of Nurse Practitioners (AANP), among others, have called for the widespread adoption of the DNP as the new standard in preparation for a career in advanced practice nursing. That said, as of 2018, a master’s degree in nursing is still sufficient to pursue national and regional NP credentialing.
Nurse practitioner programs in New Hampshire, both on-campus and online, are typically completed in a specialty such as adult-gerontology, psychiatric-mental health, neonatal care, pediatrics, family, or women’s health. In addition to advanced coursework, aspiring NPs need to complete practicum hours in their chosen field of expertise. Following graduation, these healthcare professionals generally seek national certification through an agency that offers an examination in their chosen field. There are plenty of on-campus NP programs available in NH and nationwide, but for some working nurses or those living in more rural regions, attending a traditional NP program can prove difficult. Fortunately, there are many accredited schools offering online MSN degrees and other graduate-level NP programs, allowing people to complete coursework their own time, from the comfort of their own homes.
NPs are in high demand across the country. According to the U.S. Bureau of Labor Statistics (BLS May 2016), openings for nurse practitioners are expected to increase 36 percent between 2016 and 2026, much more robust than the average growth projected across all occupations during that time (7 percent). In fact, advanced practice nurses of all types are expected to be in demand to serve the healthcare needs of an aging Baby Boomer population, as well as the record number of Americans insured due to the Affordable Care Act (ACA). In New Hampshire specifically, the 10-year job growth rate is expected to match the national projections, at 35.7 percent, according to Projections Central. With the expected addition of 280 fresh NP openings in New Hampshire, the employment prospects are expected to be bright in the years to come.
Additionally, there’s a thriving support community for NPs within the state. Organizations such as the New Hampshire Nurse Practitioner Association—non-profit professional advocacy group—provide community outreach, continuing education (CE) opportunities, conferences, and other valuable resources.
It’s true that becoming an NP in New Hampshire or elsewhere is a significant commitment—a minimum of two years of full-time study for many MSN programs—but the payoffs can include more autonomy on the job, better pay, and the opportunity to work with a unique clinical population. Read on to discover the array of online NPs programs available to students in NH.
Becoming a licensed NP in New Hampshire typically requires having a graduate degree and achieving a national certification in one’s area of expertise. Some candidates choose to pursue an associate degree in nursing (ADN), although a bachelor of science in nursing (BSN) degree may be preferable since most online NP programs require at least a BSN to qualify. Here is one pathway to becoming an NP in NH as outlined by the New Hampshire Board of Nursing:
STEP 1: Undergraduate Education (4 years)
Complete a four-year BSN degree, comprising courses such as leadership in nursing practice; community health nursing; and ethics in nursing, as well as clinical practicum hours to give students hands-on experience in a healthcare setting. Please note that at least an associate degree is required to sit for the NCLEX-RN test, the main credentialing exam for RNs nationwide. Also, an RN license is required to qualify for most graduate-level NP programs.
STEP 2: RN Licensure (Less than 1 year)
The New Hampshire State Board of Nursing manages the RN licensure process in New Hampshire. Steps for licensure include:
Applications can be found online. Candidates have 180 days to complete their application.
STEP 3: Graduate Nursing Education (2 – 4 years)
There are some online MSN and DNP programs which allow nurses to ‘bridge’ from an associate degree, but these can be harder to find. The more common pathway is for post-BSN students to gain entry into a specialized NP program at the master’s or doctoral level, focusing on one field such as women’s health, psychiatric-mental health, or family care. Graduate-level NP courses include evidence-based practice; clinical pharmacology; population health; and advanced physiology across the lifespan. Additionally, distance-based NP students must complete clinical hours at local preceptor sites, and may also be required to complete a research-based capstone project.
STEP 4: Obtain National Nurse Practitioner Certification (Less than 1 year)
To qualify for state NP licensure, most local governments require candidates to have achieved a specialty NP certification through the American Nurses Credentialing Center (ANCC), the American Academy of Nurse Practitioners (AANP), the American Association of Critical-Care Nurses (AACN), or the National Certification Corporation (NCC). To qualify, candidates typically need to submit official transcripts from a graduate-level NP program and pass a comprehensive examination. For the full details on credentialing, please check out the specialization section of the main online NP programs page. The page features an in-depth look at how to become an adult-gerontology NP, pediatric NP, neonatal NP, family NP, psychiatric-mental health NP, or women’s health NP.
STEP 5: Obtain Nurse Practitioner State License (Less than 1 year)
To apply for advanced practice nursing licensure in New Hampshire through the State Board of Nursing, applicants must have:
Please note that there are slightly different requirements for nurses who graduated from an APRN program two or more years before seeking state licensure.
While admission requirements for online NP programs vary from school to application procedures for online NP programs in New Hampshire:
Some online NP programs require an application to both the school of nursing as well as to the school’s graduate studies program. Often these applications can be found online. For example, Rivier University of Nashua, NH has both paper and online applications for its graduate studies. As of Nov. 2016, there was a $25 fee for submission of a paper application, but no fee required for submitting online.
The majority of online NP programs require a minimum undergraduate GPA of 3.0 to be considered for acceptance. This is true of Rivier University, which offers a distance-based family nurse practitioner program. However, Rivier University master’s-level degrees do not require submitting scores from the GRE or MAT as part of the admissions process. Please note that some schools require GRE, TOEFL, or other test scores.
Additional requirements will vary from school to school. At Rivier University, other application materials include a resume or curriculum vitae, a copy of one’s RN license, completion of an undergraduate course in statistics, and a course of study form indicating part- or full-time status in one’s intended field of study. Additionally, RNs without a bachelor’s degree in nursing need to submit a professional nursing portfolio for acceptance into the school’s on-campus ‘bridge’ program. Keep in mind that these requirements are specific to Rivier. Other online programs that are based out of state but still offer study options to New Hampshire nursing students could have different requirements including writing a personal statement (500-600 words), submitting letters of recommendation, showing proof of health insurance, or having a candidate interview.
Program accreditation is important for numerous reasons. One, it is typically necessary to have completed an accredited program prior to seeking national certification; two, it also necessary for state licensure. Furthermore, for those interested in a doctor of nursing practice (DNP) program or even a PhD, having graduated from an accredited program is generally required.
What does accreditation mean? It means that an outside agency has come in and rigorously evaluated the school’s program, examining the teaching standards, curriculum, and quality of facilities (among other variables) to ensure they meet current expectations for the NP field. The accreditation process can be lengthy and all schools do have to undergo reaccreditation at regular intervals. There are two main commissions carrying out accreditation of nursing programs. These are:
Students are strongly encouraged to verify a program’s accreditation status prior to seeking admission and enrollment. Rivier University’s program is accredited through ACEN.
Lynn E. Andersen, MS, RN, CAGS is an assistant professor at Rivier University who teaches courses in pediatric care, care of the adult, and a capstone course, among others. Her areas of interest include medical-surgical nursing and FNP care. Before teaching at Rivier, she was a medical-surgical nursing instructor at Boston University. She notes on her profile that, “as an educator, I stress compassion, personal ethics, dedication to learning and personal well-being, and balance.”
Tracy Hardy, MS, APRN-BC is an instructor in the FNP program at Rivier University. She completed her own MSN degree to become a FNP at the school and obtained her BSN degree from the University of New Brunswick in Canada. Her areas of interest include family practice, internal medicine and college health services. She has taught in the FNP program for the past seven years.
There is one school in the state of New Hampshire that offers online nurse practitioner education: Rivier University. Additionally, students in New Hampshire can enroll in non-NP online advanced nursing programs at two other New Hampshire universities (UNH and SNHU), which are not profiled here, or in an online NP program based out of state.
This Nashua-based university offers a 43-credit online MSN program in the family NP subfield with classes such as advanced pathophysiology; family nursing theory; quality healthcare improvement; and biostatistics for health sciences. This program costs $970 per credit hour. Some practicum courses require an on-campus intensive session lasting from two to five days. Impressively, 100 percent of Rivier’s FNP program graduates passed a national certification exam in this field. This program is also offered an an online post-MSN certificate. Please note that this school has several on-campus programs as well, including an MSN (or post-master’s certificate) in the psychiatric mental health field; a ‘bridge’ program for candidates with non-nursing bachelor’s degrees; and an RN-to-MSN pathway for registered nurses with an associate degree in nursing (ADN).
Perhaps most impressive about the nursing school at Rivier is that 100 percent of Rivier’s FNP program graduates passed a national certification exam in this field. Overall, Rivier was ranked by U.S. News & World Report as among the top 200 schools in the Regional Universities North category, and College Factual considers Rivier to house the best nursing school in New Hampshire for veterans of the armed forces.
On-campus requirements vary from school to school. At Rivier University, the distance-based MSN-FNP program can be completed almost entirely online, except for three classes (FNP practicum I, II and III), which require on-campus intensives (OCIs) lasting from two to five days each. Frontier Nursing University requires just one to three campus visits total, depending on the online NP program. The Maryville Online page indicates there are no campus requirements and that preceptorships and clinicals can be completed locally. Interested students should reach out to program coordinators to verify the number of campus visits required, which may vary by point of academic entry and prior coursework completed.
To become licensed as an advanced practice nurse in New Hampshire, a person must have completed more than 225 hours of theoretical nursing content and achieved 480 hours of clinical nursing practice, which includes a precepted experience in pharmacological interventions (New Hampshire Board of Nursing). Many schools allow these experiences to be completed locally, but APN candidates still need to get approval for their preceptor sites in advance.
In New Hampshire, NPs are granted ‘full practice’ authority, according to the American Association of Nurse Practitioners (AANP 2017). This means that not only can they evaluate, diagnose, and interpret diagnostic tests, they also can prescribe medication given that they have met all of the requirements of the state board of nursing. Not all NPs are given full practice authority. Some states operate under ‘reduced’ or ‘restricted practice’ standards. NPs in NH and other full practice environments can work more autonomously and independently than those in other states. Notably, the full practice model is the one recommended by the Institute of Medicine and National Council of State Boards of Nursing.
In sum, before registering for any online NP program in New Hampshire or elsewhere, aspiring NPs are encouraged to verify local credentialing and preceptor requirements to carve out their own path to joining this high-growth career.