What You Need to Know About Becoming a Family Nurse Practitioner
Becoming a family nurse practitioner (FNP) is a rewarding endeavor—FNPs typically enjoy flexibility, high demand and competitive compensation. Completing a Master of Science – FNP online program will enable you to start your journey and provide holistic care in your local community.
Today, there's a lot of information surrounding FNPs and the process of becoming one. This guide provides essential knowledge to help as you consider becoming a family nurse practitioner.
Family Nurse Practitioner— The Basics
A nurse practitioner (NP) is an advanced practice nurse (APN) and is considered, by industry standards, to be the most highly trained of registered nurses. There are several specializations an NP can choose from including adult gerontology, neonatal care, women's health and more.
Family nurse practitioners are one type of specialization and have great flexibility in the patients they serve. FNPs can provide care across the lifespan (ages 0 and up) and work in different types of environments including private practices, outpatient clinics, hospitals, schools and more.
What Are the Duties of a Family Nurse Practitioner?
The responsibilities of an FNP vary, though they typically include evaluating patients, providing or collaborating with other health care providers on a diagnosis, and delivering treatment. FNPs tend to provide holistic care, educating patients on how to maintain a healthy lifestyle. Patient education has been linked to improved outcomes, as it not only treats but also helps in the prevention of diseases.
FNP duties can also vary based on their work environment. For instance, in urgent care and primary care, FNPs often have assistive personnel (e.g. medical assistants), to check vital signs and capture medical history. However, these tasks may be performed by the FNP if staff is lacking, or if they prefer to have more face time with the patient.
Where Do Family Nurse Practitioners Work?
FNPs can work in many different environments. Most can be found in outpatient settings, though some do work in inpatient care treating those who are admitted to the hospital.
Outpatient settings for FNPs typically include:
- Primary care practices
- Urgent care clinics
- Retail clinics
- Community health clinics and offices
- Schools and Universities
- Mobile clinics
- Specialty clinics
- Hospitals
FNPs are well-suited for primary care. However, those interested in other areas may choose a subspecialty. Subspecialties include but are not limited to:
- Dermatology
- Endocrinology
- Cardiology
- Aesthetics
- Palliative care
- Nephrology
With a variety of work settings and subspecialities to choose from, FNPs have ongoing flexibility in their careers.
What is Holistic Care?
FNPs often provide holistic care and treatment. Holistic care centers around treating the patient as a whole person, rather than focusing only on symptoms.
In holistic care, an FNP will assess internal systems including a patient's physical health, well-being and mental state. Other influences such as environment, community and family, are considered external systems. Although separate from each other, these systems are intertwined and impact the patient as a whole.
In the holistic care model, when one system is imbalanced, it affects other systems. For example, a patient who regularly suffers from debilitating migraines may find that her headaches are exacerbated by stress caused by her environment and family life. Imbalances in her external systems (environment and family) may now be causing an imbalance in her internal systems (physical health, mental state and well-being).
An FNP taking a holistic approach would treat the migraine symptoms, but also work with the patient to find ways to cope with stress.
What is the Scope of Practice?
A family nurse practitioner's scope of practice is determined by state law and the state's board of nursing. Currently, 22 states and Washington D.C. have granted nurse practitioners “full practice” authority. This means FNPs in these areas can operate without physician supervision, have the ability to diagnose, order and interpret diagnostic tests and can administer treatment, including prescribing medications.
States/regions with the right to full practice include:
- Alaska
- Arizona
- Colorado
- Connecticut
- District of Columbia
- Hawaii
- Idaho
- Iowa
- Maine
- Maryland
- Minnesota
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Mexico
- North Dakota
- Oregon
- Rhode Island
- South Dakota
- Vermont
- Washington
- Wyoming
Some states have "reduced practice," which means that at least one element of NP practice is reduced. State law requires "regulated collaborative agreement" between the NP and a physician or an outside health discipline in order for the NP to provide patient care. NPs may have limited prescriptive authority in these areas.
Reduced practice states include:
- Alabama
- Arkansas
- Delaware
- Illinois
- Indiana
- Kansas
- Kentucky
- Louisiana
- Mississippi
- New Jersey
- New York
- Ohio
- Pennsylvania
- Utah
- West Virginia
- Wisconsin
Currently, 12 states operate under "restricted practice," meaning state laws restrict some form of NP practice. These states make it necessary for the NP to undergo physician supervision, delegation or team-management. They also have limits on NP prescriptive ability, though the process varies by state.
Restricted practice states include:
- California
- Florida
- Georgia
- Massachusetts
- Michigan
- Missouri
- North Carolina
- Oklahoma
- South Carolina
- Tennessee
- Texas
- Virginia
Although NPs in Texas are under restricted practice, the state recently eliminated required on-site physician supervision. Overall, Texas is making strides to address the demand for health care services. Due to a nationwide provider shortage, more and more states are advocating for full practice, which means NP practice authority is continually evolving.
What is the Current and Future Job Outlook for FNPs?
Career prospects for all nurse practitioners, including FNPs, are bright. According to the Bureau of Labor Statistics, nurse practitioners can expect 31 percent growth between 2016 and 2026. The BLS considers this rate to be a much faster-than-average career growth rate.
Factors influencing the above-average field growth include:
A Nationwide Physician Shortage
The United States is experiencing a physician shortage, especially in the primary care setting. The American Association of Medical Colleges (AAMC) reports that by 2030, the deficiency of primary care physicians will likely fall between 14,800 and 49,300 in primary care alone.
The total physician shortage is predicted to reach between 33,800 and 72,700 across the entire country. Nurse practitioners are needed to help bridge the gap in care. FNPs are especially valuable since they can care for patients across the lifespan.
The physician shortage is predicted to reach between 33,800 and 72,700.
Changing Care Provision Structure
Our overall health care structure is changing throughout the country. It's becoming more common for the patient care process to include nurse practitioners as well as physicians, even in the hospital setting. This shift in structure allows physicians to focus on the more complex aspects of medicine, while NPs provide direct care.
Independence
The growing independence of NPs (and the right to full practice in many states) has led to the opening of new clinics— especially primary care practices and retail clinics. Retail clinics (e.g. walk-in clinics located in retail stores), are particularly one line of business that has become increasingly utilized in states allowing independent practice of NPs.
What are the Benefits of Being a Family Nurse Practitioner?
Becoming an FNP is an enriching journey, allowing for personal and professional growth. As nurse practitioners, FNPs experience many benefits including:
High Demand
There is a growing need for nurse practitioners nationwide, especially in rural areas. By 2022, the supply of NPs in Texas alone will fall short by 5,110 positions; by 2030, that number will increase to 6,446. High demand is consistent across the country, meaning wherever you live, work should be easy to find as an FNP.
More Autonomy
Nurse practitioners have more influence over patient care than registered nurses (RNs). As discussed, NPs are completely self-governed in many states and can diagnose patients, prescribe medications and create treatment plans. Overall, NPs have a greater depth of responsibility in the realm of patient care.
Earning Potential
In 2018, the median salary of nurse practitioners was $113,930. This is quite lucrative compared to the BLS average RN salary of $71,730 that same year. More earning potential is always a benefit when deciding to advance one's career.
Career Satisfaction
Nurse practitioners enjoy high levels of career satisfaction. A PracticeMatch survey revealed that only 5 percent of nurse practitioners reported they were unsatisfied with their jobs. Since NPs are in high demand they also have job flexibility, which makes it easier to find a new job if they're unsatisfied in their current setting.
Only 5 percent of nurse practitioners reported they were unsatisfied with their jobs.
Work-Life Balance
Nurse practitioners, including FNPs, enjoy more work-life balance than they did as an RN. FNPs in particular have the opportunity to work different schedules including eight hour, ten hour, or twelve hour shifts. This grants them the flexibility to choose an arrangement that works best for them and their families.
How Do I Become a Family Nurse Practitioner?
It can be confusing to examine all the options and information on how to become an FNP. Becoming a family nurse practitioner takes dedication and practice.
Become an RN
First, you must graduate from a registered nursing program and then pass the RN licensure exam— the NCLEX, or National Council Licensure Examination.
After earning a Bachelor's in Nursing, an RN can apply for a Master of Science in Nursing - Family Nurse Practitioner program.
Many RNs choose to work as nurses for several years in order to gain experience prior to becoming nurse practitioners, however, it is not always necessary depending on the program in which you are applying.
Earn Your Master's Degree
Nurses interested in becoming FNPs can either study a Master of Science in Nursing - Nurse Practitioner program, or pursue a Master of Science in Nursing and then complete a post master's certificate program that includes clinicals and several additional courses in order to satisfy the requirements to take a nurse practitioner licensure exam.
Pass the FNP Exam
Passing a licensure exam is the final of the family nurse practitioner requirements that allow nurse practitioner graduates to practice.
Family nurse practitioner graduates have their choice between two licensure exams— the American Academy of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC).
Both exams allow you to practice as an FNP after passing, though each has a slightly different focus. The AANP exam is more geared toward those interested in clinical practice, while the ANCC may better suit those interested in research or nursing education.
Family nurse practitioner graduates have their choice between two licensure exams—the AANP or the ANCC.
How Can I Get Started?
As a leading FNP institution both locally and nationwide, Texas Woman's online Master of Science in Nursing - Family Nurse Practitioner program, offers an affordable option for those who want to advance in nursing. Our graduates have a 98 percent first-time pass rate during licensure exams, so you can feel confident as you prepared to deliver holistic care.
Learn more about Texas Woman's online MS-FNP program today.
Sources:
American Association of Medical Colleges. (2018). New research shows increasing physician shortages in both primary care and specialty care. https://news.aamc.org/press-releases/article/workforce_report_shortage_04112018/
American Association of Nurse Practitioners. (N.d.). Historical timeline. https://www.aanp.org/about/about-the-american-association-of-nurse-practitioners-aanp/historical-timeline
American Academy of Nurse Practitioners. (N.d). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment
Becker's Hospital Review. (2017). 7 statistics on NP, PA job satisfaction and salary. https://www.beckershospitalreview.com/compensation-issues/7-statistics-on-np-pa-job-satisfaction-salary.html
Brooks Carthon, M., et al. (2016). Growth in retail-based clinics after nurse practitioner scope of practice reform. Nursing Outlook, 65-2, 195-201. https://www.nursingoutlook.org/article/S0029-6554(16)30336-0/fulltext
Bureau of Labor Statistics. (2019). Nurse anesthetists, nurse midwives, and nurse practitioners. https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm
Bureau of Labor Statistics. (2019). Registered nurses: Occupational outlook handbook. https://www.bls.gov/ooh/healthcare/registered-nurses.htm
Nurse Journal. (N.d.). Family nurse practitioner role and scope of practice. https://nursejournal.org/family-practice/role-scope-of-practice-of-a-family-nurse-practitioner/
O'brien, J.M. (2003). How nurse practitioners obtained provider status: Lessons for pharmacists. Am J Health Syst Pharm. 2003;60(22). https://www.medscape.com/viewarticle/464663_1
