If you’re researching how to become a nurse practitioner in California, you may already know that it's listed as one of the best jobs in the nation.
U.S. News & World Report ranked nurse practitioner among the top five jobs in health care and STEM. It's also the fifth-ranked occupation overall (Source).
Nurse practitioners enjoy a bright job outlook, strong salary potential and professional autonomy. They also make a meaningful difference in patients’ lives.
As a nurse practitioner in California, your career prospects are promising. The state has great demand for nurse practitioners and pays the highest average salary in America. California also is expanding the scope of nurse practitioner practice.
You can use this blog to learn how to become a nurse practitioner in California and explore the highly ranked online Family Nurse Practitioner program at Texas Woman’s University.
Step 1: Earn a Bachelor’s Degree
Completing your undergraduate nursing education is the first step in how to become a nurse practitioner in California.
Half of all new registered nurses (RNs) enter the workforce with an associate degree (Source). However, many postgraduate nurse practitioner programs, such as Texas Woman’s, require candidates to hold a bachelor’s degree in nursing.
Why? Evidence links baccalaureate and higher nursing degrees to more positive patient outcomes. Nursing organizations and other nurse leaders believe RNs should be prepared with a minimum of a Bachelor of Science in Nursing (BSN) (Source).
Earning an accredited bachelor's degree also is essential. When a program receives accreditation, it demonstrates the quality of the curriculum.
The U.S. Department of Education sanctions national accreditation agencies. For nursing education, the approved agencies are the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE) (Source).
Texas Woman’s online FNP program is accredited by CCNE. It also receives accreditation from the Southern Association of Colleges and Schools.
With an accredited BSN, you’ll be fully prepared for your post-graduate nurse practitioner education.
Step 2: Become a Registered Nurse
Earning a bachelor’s degree in nursing will qualify you to become an RN.
The process for obtaining an RN license varies by state. However, all states require applicants to pass the national nurse licensure test, called the National Council Licensure Examination (NCLEX).
In California, you must hold an active California RN license before receiving certification as a nurse practitioner.
If you already have a current RN license in California, you can continue to the third step in how to become a nurse practitioner in California.
If you’re not an RN in California, you’ll need to apply for an RN license. There are two options. You can apply by endorsement or examination:
Application by Endorsement
You qualify for endorsement into California as an RN if you (Source):
- Hold a current and active RN license in another state;
- Completed an educational program that meets California requirements; and
- Passed the NCLEX.
To apply by endorsement, you'll need to submit the Application for Licensure by Endorsement.
Application by Examination
If you don’t meet the above qualifications, you must apply for a California RN license by examination. This process involves passing the NCLEX and completing the Application for Licensure by Examination (Source).
In addition to the completed application, both licensure methods require applicants to submit other documentation. This includes official transcripts, fingerprints and a photograph.
The processing time is 10 to 12 weeks (Source).
3. Earn a Postgraduate Nurse Practitioner Degree
Nurse practitioners are advanced practice registered nurses (APRNs). All APRNs must hold a post-graduate degree in their specialty.
As you investigate how to become a nurse practitioner in California, you’ll find that completing a nurse practitioner program is a vital step.
What Are the Degree Options?
Aspiring nurse practitioners can complete a master’s, doctoral or post-master’s certificate nurse practitioner program.
Professional nursing organizations have called for the Doctorate of Nursing Practice to become the terminal degree for all APRNs, eventually replacing the master’s (Source).
However, they also agree that master's degree coursework is comparable to other clinical doctoral programs. All postgraduate nurse practitioner programs are designed to fully prepare candidates for the role of nurse practitioners (Source).
So, the type of postgraduate nurse practitioner degree you pursue is a personal choice.
BSN-prepared nurses qualify for the online Master of Science – Family Nurse Practitioner (MS-FNP) program at Texas Woman’s. Nurses who already have a master’s degree can pursue the online Post-Master’s Certificate – FNP.
What Are the Nurse Practitioner Specialty Areas?
A postgraduate nurse practitioner program will train you to serve a specific population. You’ll have several options (Source):
- Acute care
- Adult health
- Family health
- Gerontology health
- Neonatal health
- Pediatric/Child health
- Psychiatric/Mental health
- Women's health
Some of these areas allow for further specialization, such as dermatology, emergency or cardiovascular care.
As you consider the specialty areas, think about your personal preferences. What are your clinical interests? In what health care setting do you wish to work? How much do you want to earn?
Each type of nurse practitioner role comes with a different set of circumstances.
- Acute care nurse practitioners typically work in emergency departments and intensive care units, while medical offices often employ pediatric nurse practitioners.
- FNPs are in particularly high demand due to the shortage of primary care doctors.
- Nurse practitioners who specialize in adult gerontology acute care and psychiatric mental health are among the highest-paid (Source).
Whichever area you choose, a nurse practitioner program like the one at TWU will prepare you to provide a variety of health care services. You'll learn to diagnose and treat health conditions, prevent disease and manage patients' overall well-being (Source).
What’s the Length of Nurse Practitioner Programs?
You can complete a postgraduate nurse practitioner program in two to four years. During this time, you’ll engage in coursework and clinical experiences embedded in the curriculum.
At Texas Woman’s, students can earn a postgraduate nurse practitioner degree in under three years. The curriculum includes three to seven courses, depending on whether you choose the online MS - FNP or online Post-Master’s Certificate - FNP.
Both programs include almost 600 hours of clinical experience. Students participate in specialty and preceptorship courses, plus one residency on Texas Woman's campus.
The university also provides every student with clinical placement support.
What's the Focus of Texas Woman’s Nurse Practitioner Programs?
If you’re wondering how to become a nurse practitioner in California, Texas Woman’s can help you get there.
The online MS – FNP and online Post-Master’s Certificate – FNP are authorized in Texas and 30 other states, including California.
Both programs provide graduates with the educational foundation to fulfill the significant demand for FNPs.
By 2032, there will be a deficit of up to 55,000 primary care doctors in the U.S. (Source). FNPs are equipped to fill the gap because they provide a range of primary care services to patients of all ages.
Texas Woman’s online FNP programs are well-regarded and highly ranked. They’re also one of the more affordable options for aspiring nurse practitioners.
Between 2010 and 2018, 98% of TWU graduates passed the FNP licensure exam on their first attempt.
4. Obtain National Nurse Practitioner Certification
Graduates of accredited nurse practitioner programs are eligible to become nationally certified nurse practitioners. To obtain certification, you’ll need to sit for an exam.
The American Nurses Credentialing Center (ANCC) and the American Association of Nurse Practitioners (AANP) offer nurse practitioner certification exams.
Both organizations ask candidates to apply for the exam. If your application meets the eligibility requirements, you can take the exam at a testing site near you.
Exam content differs by the provider but will test your clinical knowledge of your nurse practitioner specialty area. For example, graduates of Texas Woman’s online FNP programs sit for the Family Nurse Practitioner Certification, which is available through ANCC and AANP.
Once you pass the exam, your national board certification is valid for five years. Then, you’ll need to renew it. Recertification is crucial in health care because it ensures practitioners are competent in their discipline.
AANP requires recertification applicants to pass an exam or complete a combination of clinical hours and advanced continuing education (Source). ANCC requires the completion of clinical hours and at least one other professional development activity, such as passing an examination or performing volunteer service (Source).
5. Obtain Nurse Practitioner Certification in California
Now, you’re ready to become a nurse practitioner in California.
The California Board of Registered Nursing (BRN) certifies APRNs. To practice in the state, nurse practitioners must obtain certification and an optional credential to prescribe drugs.
California Nurse Practitioner Certification
To apply, submit the following documents directly to BRN (Source).
- Application for Nurse Practitioner Certification:
You'll provide details about your RN license and education, nurse practitioner education and national nurse practitioner certification. You’ll also answer questions about your history of professional disciplinary action and any criminal convictions beyond minor traffic violations.
- Verification of Nurse Practitioner Academic Program Form:
This document confirms when and where you earned your postgraduate nurse practitioner degree.
- Official Transcripts:
Sent by the nurse practitioner education program you attended, the transcripts outline the coursework and degree you completed.
- Verification of Nurse Practitioner Certification by National Organization/Association Form:
Graduates of nurse practitioner education programs based outside of California, like Texas Woman’s, also need to submit this document. It confirms when you became nationally certified as a nurse practitioner.
Once you submit these documents, BRN will process them and issue your certification in 12 to 14 weeks (Source).
Prescriptive Privileges Credential
In California, a “furnishing number” authorizes nurse practitioners to prescribe drugs and devices to patients. You can obtain a furnishing number from BRN at the same time as you apply for the nurse practitioner certification.
If you graduated from a nurse practitioner program outside of California, like Texas Woman’s, the required documentation depends on when you completed an advanced pharmacology course (Source).
Applicants who completed the course within five years of applying must submit the:
- Nurse Practitioner Furnishing Number Application
- Advanced Pharmacology Course Verification Form
Applicants who took the course more than five years before applying must submit the items above, plus:
- At least five years of employment history working as a nurse practitioner and prescribing medication
- A copy of your state license that allows you to prescribe medication as a nurse practitioner
- A copy of your Drug Enforcement Agency identification card
- A copy of your state’s rules for prescriptive authority for nurse practitioners
- If applicable, a copy of the agreement set in place by the supervising physician that allowed you to prescribe drugs in the state where you’re a licensed nurse practitioner
6. Understand the Practice Environment of California
Nurse practitioners can work in all 50 states and Washington, D.C., but each state has regulations that define their scope of practice.
AANP has categorized these regulations into three practice environments. From least to most restrictive, they are:
- Full Practice
- Reduced Practice
- Restricted Practice
California is one of 12 states that has a restricted practice environment (Source). While the Golden State recognizes nurse practitioners as primary care providers, they must work under the supervision of a physician (Source | Source).
California nurse practitioners carry out their roles by following Standardized Procedures. Standardized Procedures allow nurse practitioners to perform duties otherwise regulated for doctors (Source). A nurse practitioner's supervising physician develops and approves the Standardized Procedures.
For example, a nurse practitioner can prescribe drugs but only according to the protocol in their Standardized Procedures.
Will California’s Practice Environment Change?
Twenty-three states grant nurse practitioners full practice authority. That means nurse practitioners can practice to the full extent of their training and without physician oversight.
AANP and other health care authorities, including the National Academy of Medicine, believe all states should adopt the full practice model (Source).
The good news is California has taken steps to expand the scope of nurse practitioner practice.
In 2017, the Veterans Affairs (VA) Long Beach Health Care System became the first California facility to apply a new federal law that gives nurse practitioners more autonomy (Source).
The U.S. Department of VA announced in 2016 it would permit full practice authority to three types of APRNs at VA health care centers. A nurse practitioner is one. With VA patients facing long wait times, the VA decided this change would provide them more timely, efficient, effective and safe primary care (Source).
As a result, every VA hospital in the country can allow its nurse practitioners to become credentialed for full practice.
Broader progress is also evident. As of January 2020, the California Legislature is considering a bill that would allow nurse practitioners to carry out certain functions without Standardized Procedures.
Specifically, the bill mentions ordering, performing, and interpreting diagnostic procedures; certifying disability; and prescribing, administering, dispensing and furnishing controlled substances.
The California Assembly passed the measure by a vote of 61-1. Now, it's under review by the Senate (Source).
Nursing advocates are hopeful that California will continue to make progress toward a less restricted practice environment.
Regardless, you can still create a rewarding career as a nurse practitioner in California. In fact, the state is one of the best places to work as a nurse practitioner.
7. Find Employment
The final step in how to become a nurse practitioner in California is to find employment.
Thanks to an active job market, California is a terrific place to work as a nurse practitioner. Between 2012 and 2018, the employment of nurse practitioners in California grew by 38%, adding 3,700 jobs (Source).
The need for primary care nurse practitioners is especially pressing. By 2030, the supply of physicians will meet less than half of the demand for primary care in California (Source). As independent primary care providers, FNPs – such as Texas Woman’s graduates – are equipped to address the shortage.
California nurse practitioners also receive the highest salaries in the country. On average, they take home $133,780 per year (Source).
Certain metropolitan areas pay even more (Source). Nurse practitioners in the San Francisco-Oakland-Hayward area earn an average of $150,790, while Vallejo-Fairfield pays an average of $145,400.
Nurse practitioner employment is also flexible. You can work in a variety of health care settings, including (Source):
- Emergency rooms
- Urgent care sites
- Private practice
- Nursing homes
- Academic institutions
- Public health departments
The most common practice setting among FNPs is a hospital outpatient clinic (Source).
To find nurse practitioner openings, check out the online job boards provided by nursing authorities. AANP, the California Association of Nurse Practitioners and the American Nurses Association all offer robust employment websites.
Get More Information
Now that you know how to become a nurse practitioner in California, are you ready to begin the process?
As one of the top graduate nursing programs in the country, Texas Woman’s helps its graduates become holistic primary care providers. You’ll develop advanced health care knowledge, research skills and clinical capabilities while gaining a multifaceted perspective of wellness. >Learn more about Texas Woman's online FNP program.