A nurse who is truly committed to his or her education can ultimately reach the level of nurse practitioner (NP) and achieve a great deal of autonomy, particularly in the state of Washington.
Most aspiring nurse practitioners work for a number of years as registered nurses before pursuing their graduate level education to become NPs, and many desire (or even need) to continue working while attending graduate school. For such nurses, online programs often provide the requisite flexibility of schedule.
Although there are not many online nurse practitioner programs offered by universities physically based in Washington state, there are a couple, and prospective NPs may also look to online programs offered by nursing schools outside the state if there is not an in-state program to fit their needs.
Nurse practitioners have a lot of responsibility for their patients’ well-being and care, and may encounter patients with a range of life threatening illnesses and injuries. As such, their educational background is important and the training requirements are stringent. While not every nurse practitioner in Washington will follow the steps below precisely, they do provide an overview of what potential NPs can expect in their training.
STEP 1: Earn an Undergraduate Degree (duration: 2 – 4 years)The simplest path towards an NP career begins with a Bachelor of Science degree in nursing (BSN) from an accredited program. Strictly speaking, a 2-year associate degree in nursing (ADN) does make a graduate eligible to apply for RN licensure in Washington, but a registered nurse with a BS degree will have a shorter path to becoming an NP than will a nurse with an ADN. That said, while BSN-to-MSN NP programs are the norm, there are several online ADN-to-MSN NP bridge programs now available.
STEP 2: Apply for RN Licensure (duration: less than 1 year)In Washington, nursing licensure is handled through the Washington State Department of Health. After completing an undergraduate program, new nurses in Washington will have to sit for the NCLEX-RN exam as well as complete 7 hours of HIV/AIDS training. Documentation of these requirements, along with a personal data questionnaire centered around background-related questions such as criminal history, mental health history, and any previous licensure or disciplinary action in other states is also required. Once the RN license has been issued, nurses can begin to practice in Washington.
STEP 3: Earn a Graduate Degree (duration: 2 – 4 years)Most (but not all) prospective nurse practitioners choose to practice as RNs for a few years before pursuing further education. This can be a valuable time for a new nurse to learn the realities of working as a nurse and to decide what specialty might be the one they want to pursue as an NP. At this point, the nurse may apply to NP programs. Both nurses with a Master of Science in Nursing (MSN) and nurses with a Doctor of Nursing Practice (DNP) are eligible to become nurse practitioners, which in Washington fall under the umbrella of Advanced Registered Nurse Practitioners (ARNP). The ARNP title also applies to Certified Nurse Midwives (CNM) and Certified Registered Nurse Anesthetists (CRNA).
STEP 4: Obtain Specialty Certification Credential (duration: less than 1 year)After completing graduate school, nurses will be eligible to apply for certification through a national organization, such as the American Nurses Credentialing Center (ANCC). Nurses should be prepared for this certification exam during their training. Nurse practitioners can train in a number of specialties, including Adult-Gerontology, Psychiatric-Mental Health, and Family Nursing. New nurses should be sure to find a program that prepares them for the specialty in which they want to work prior to applying to graduate schools.
STEP 5: Apply for Advanced Registered Nurse Practitioner (ARNP) Licensure (duration: less than 1 year)With proof of national certification and graduate education, nurses in Washington are eligible to apply to the Washington State Department of Health for their Advanced Registered Nurse Practitioner (ARNP) license. Applicants must submit to the same personal questionnaire and HIV/AIDS training as RNs prior to receiving their license.
STEP 6: Apply for Prescriptive Authority
ARNPs in Washington are able to prescribe medications, but they must apply for prescriptive authority separately from licensure. Without prescriptive authority, NPs can still select and administer prescription medication, but they cannot write prescriptions for patients to have filled.
Admission to NP programs can be somewhat competitive, so applicants should be sure to prepare themselves as best as possible. The actual application process involves completing an online application, submitting transcripts from previous nursing education as well as proof of an RN license in good standing. At least one program in Washington requires standardized testing scores in the form of the MAT test, while most NP programs do not. Programs such as those at Gonzaga University may have minimum GPA requirements for undergraduate work as well. The GPA minimum for Gonzaga is 3.0 as of this writing, although students whose GPA falls below a 3.0 may write an explanation with their application. Applicants should also expect to submit letters of recommendation from professors or supervisors, in addition to a personal statement about why they are pursuing nursing.
Whether a school is accredited can have an impact on whether a graduate of that school is ultimately eligible for licensure. Nurse practitioner programs in Washington should be accredited by either the National League for Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE). While it is also good to check for a school’s general accreditation, here programmatic accreditation is more important.
Gonzaga University, located in Spokane, offers an online MSN with two specializations: family nurse practitioner and psychiatric mental health nurse practitioner. The MSN degree may be pursued from a BSN or a non-nursing bachelor's degree with an RN degree. Those with an RN degree and non-nursing bachelor's degree may need to take up to four nursing foundation courses in addition to the 47 credits for the MSN degree. In addition, nurses who already possess an MSN degree and wish to add a second specialization may pursue a second MSN degree through Gonzaga. These programs are mostly online with 5 campus immersions for the PMHNP track, and 6 campus immersions for the FNP track. The school is accredited by the Northwest Commission on Colleges and Universities while the nursing program is accredited by the CCNE.
At Washington State University (WSU), nurses can choose from either a DNP Family Nurse Practitioner or a DNP Psychiatric Mental Health Nurse Practitioner program. Both programs offer two tracks: a post-baccalaureate track and a post-master's track for those that have already earned a master's degree. These programs are considered hybrid. The majority of course hours are spent online, but students must be on campus for blocks at a time throughout the year for hands-on training and for some lab courses.
Dr. Sandra Carollo is a Clinical Associate Professor at the Washington State University College of Nursing, where she is also the Director of the Nursing Program at the university's Yakima campus. She has given numerous talks and written articles that largely focus on her research interests of health literacy and effective communication. Dr. Carollo is also the Family Nurse Practitioner Clinical Track Coordinator.
Dr. Ka'imi Sinclair is an Assistant Professor in the College of Nursing at Washington State University as well as a member of the Washington State Commission on Asian Pacific American Affairs. Dr. Sinclair holds both an MPH and PhD in Public Health. She has worked on many publications in the area and was a Rackham Graduate Fellow and a Doctoral Scholar at the University of Michigan during her time there.
Online nurse practitioner programs do not report their campus visitation requirements in a uniform way and in fact these requirements may change from year to year. For example Gonzaga University requires 5-6 campus immersions for their MSN degrees, whereas Washington State University touts their program as hybrid requiring some campus visits and on-campus requirements for lab courses. WSU consolidates campus visits so that requirements can be met for multiple items in 1-2 days at a time. Students should check with the admissions department of each school to verify required campus visits.
When a nurse chooses to pursue an online nurse practitioner program, it should be with the understanding that hands-on training is still a necessity. The training associated with nurse practitioner programs is known as a preceptorship. The preceptorship involves a student nurse practitioner working closely with a licensed NP and learning what it really takes to do the job. Incoming NP students should be sure to inquire about preceptorship placement assistance but also be advised that they may have find their own placement opportunities.
In Washington, graduates of NP programs are expected to have completed this training. Upon graduation and completion of the preceptorship period, new NPs are eligible to apply for licensing as an ARNP. Nurse practitioners in Washington have a tremendous amount of autonomy and are able to do more than NPs in many states, including: