Becoming a Family Nurse Practitioner: The Complete Guide

Becoming a Family Nurse Practitioner: The Complete Guide

Family nurse practitioners, also referred to as FNPs, are in high demand.

Recently ranked #7 of the 100 Best Jobs of 2019 by U.S. News & World Report, this rewarding and lucrative career offers registered nurses greater salary potential, increased autonomy and high levels of job satisfaction.

You may have questions about the FNP role, which is why we compiled this resource detailing everything you need to know about how to become a family nurse practitioner. Read on to discover information about FNP salary, roles and responsibilities, job outlook, work hours and more!

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What Is a Family Nurse Practitioner?

A family nurse practitioner is a registered nurse who has received the specialized clinical and educational training necessary to practice primary family-focused care. Like a family physician, a family nurse practitioner works with patients of all ages to diagnose medical conditions, treat illness, prescribe medications and maintain health over the lifetime.

The laws regulating family nurse practitioners differ from state to state. Certain states require FNPs to work under the supervision of a physician. In many states, however, family nurse practitioners are authorized to work independently.

What Does a Family Nurse Practitioner Do?

Think of a family nurse practitioner as a registered nurse who is licensed to perform many of the same roles as a family doctor. A family nurse practitioner sees patients of all ages for scheduled or drop-in health care appointments. Depending on state restrictions, he or she performs physical exams, orders diagnostic tests and procedures, diagnoses illnesses, prescribes and administers treatment, and educates patients on how to develop and maintain healthy lifestyles.

Family Nurse Practitioner (FNP) vs. Nurse Practitioner (NP)

What’s the difference between a family nurse practitioner (FNP) and a nurse practitioner (NP)? In short, a family nurse practitioner is a subcategory or subspecialty of the nurse practitioner role. All FNPs are NPs, but not all NPs are FNPs. While most nurse practitioners are trained to work in a particular area of health care or with a specific population, family nurse practitioners are trained to treat people of all ages and genders.

A nurse practitioner is an advanced practice nurse who holds a master’s or doctorate degree in nursing and who has completed clinical training beyond that required to become a registered nurse. He or she must undergo rigorous national certification and maintain clinical competency through continuing education. Nurse practitioners can specialize in a wide range of clinical areas, including acute care, gerontology, pediatrics, psychiatric health and women’s health.

A family nurse practitioner is a nurse practitioner who specializes in family health care. “Family” refers to a focus on health care services that revolve around the family unit, including health promotion and disease prevention for children, adolescents, adults, women and the elderly, across the entire lifespan.

History of the Nurse Practitioner Role

The nurse practitioner profession is more than 50 years old. From its inception in 1965 to today, the role of nurse practitioner has transformed health care in the United States.

In 1965, the U.S. government expanded Medicare and Medicaid coverage to include low-income women, children, the elderly and people with disabilities. With such a large influx of people qualifying for health insurance coverage, the country did not have enough physicians to meet the needs of the population. The nurse practitioner profession began in response to this physician shortage, concentrated especially in rural areas.

In 1974, the American Nurses Association (ANA) founded the Council of Primary Care Nurse Practitioners, which helped legitimize the nurse practitioner role. Three years later, it began offering NP certification exams. Another professional organization, the American Academy of Nurse Practitioners (now known as the American Association of Nurse Practitioners, or AANP), was established in 1985 and began tracking the number of NPs in a national database.

In the 1990s, the number of nurse practitioners rose from about 40,000 in 1995 to 68,000 by 1999. The Balanced Budget Act of 1997 made nurse practitioners eligible for direct reimbursement, and by 2000, nurse practitioners were able to legally practice in all 50 states.

Today, there are more than 270,000 licensed nurse practitioners in the United States, 67% of whom focus on family care. The AANP continues to advocate for increasing the number of NPs and granting them full practice authority.

Where Do FNPs Work

Where Do Family Nurse Practitioners Work?

Family nurse practitioners work in a variety of settings. While many choose to work in private practice, others work in settings such as retail clinics, hospitals and schools.

  • Private Practice: Many FNPs work in private practice outpatient clinics, where they focus on providing primary care to their supervising physician’s patients or their own patients.
  • Retail Clinics: It is becoming common for FNPs to work in retail health clinics. Often these clinics are open during regular business hours up to seven days a week and attract a high percentage of walk-in patients.
  • Urgent Care Centers: Urgent care centers are where patients go for non-emergency urgent care such as minor fractures, sprains and allergic reactions, all of which FNPs are trained to handle.
  • Hospitals: Some FNPs choose to work in hospital settings. Because their training is in primary care, FNPs who want to work in hospitals often obtain additional certification as an acute care nurse practitioner or emergency nurse practitioner.
  • Schools: A small percentage of FNPs work in schools where they provide primary care for students.

How Much Do Family Nurse Practitioners Make?

The Bureau of Labor Statistics reports that the median annual wage for a nurse practitioner was $103,880 in May 2017. This is approximately $34,000 more than the 2017 median annual wage of a registered nurse at $70,000.

The average annual wage for a nurse practitioner is even higher at $107,480.

What Is the Job Outlook for Family Nurse Practitioners?

The job outlook for family nurse practitioners is very good. Since the United States is currently facing a shortage of primary care physicians, there is a surging demand for family nurse practitioners. The Bureau of Labor Statistics projects that more than 56,100 new nurse practitioner jobs will be created by 2026, representing an employment growth rate of 36% (much faster than the average job growth rate).

Family Nurse Practitioner Work Hours

Family nurse practitioner work hours differ depending on the setting that the FNP works in. FNPs who work in private practice often have standard 9-5 work hours, Monday to Friday. Family nurse practitioners who work in retail or urgent care clinics may work later hours and/or weekends, while those who work in hospitals may have non-traditional hours.

FNPs who work in school settings adhere to typical school hours (i.e., 8:30am to 3:30pm, Monday to Friday for elementary schools and 7:30am to 2:30pm, Monday to Friday for high schools).

Qualities of a Family Nurse Practitioner

Succeeding as a family nurse practitioner requires a unique set of skills and personal attributes. In addition to the hard skills obtained through education and certification, an FNP must possess soft skills like communication, active listening and empathy.

Common traits and skills possessed by successful FNPs include:

  • Compassion
  • Mental and physical endurance
  • Communication skills (e.g., active listening)
  • Enthusiasm
  • Optimism
  • Patience
  • Empathy
  • Confidence

Learn more about the qualities of a successful nurse practitioner.

Family Nurse Practitioner Roles and Responsibilities

A family nurse practitioner has many important roles and responsibilities. Just like a primary care physician, an FNP provides diagnosis, treatment, disease management, health education, and preventive health care services. Depending on the state they work in (see Family Nurse Practitioner Scope of Practice), FNPs have the authority to:

  • Manage chronic health conditions like hypertension and diabetes
  • Treat minor acute injuries (such as sprains and strains) and illnesses (such as flu)
  • Provide health care to people of all ages, from infants and children to adults and the elderly
  • Conduct health assessments and physical examinations
  • Oversee women’s health requirements, including preconception and prenatal care
  • Educate patients about health, wellness and disease prevention throughout the lifespan
  • Order and interpret diagnostic tests
  • Prescribe medication

FNPs work with a broad patient population including members of all genders and ages. In many parts of the country, particularly in rural areas, family nurse practitioners are the sole primary care providers in FNP-led care clinics.

Family Nurse Practitioner Scope of Practice

Each state has its own set of rules and regulations that determine to what extent a family nurse practitioner can practice primary care.

The AANP divides states into three categories based on their regulatory laws: full practice, reduced practice and restricted practice. In full practice states, FNPs have the authority to assess patients, diagnose conditions, order diagnostic exams and provide treatments. In reduced practice states, FNPs are required to collaborate with another health care provider in at least one aspect of practice. In restricted practice states, FNPs are required to be supervised or directly managed by another health care provider in at least one aspect of practice.

As of February 2019, the following states (plus Washington, D.C.) grant full practice authority to FNPs:

  • Alaska
  • Arizona
  • Colorado
  • Connecticut
  • Hawaii
  • Idaho
  • Iowa
  • Maine
  • Maryland
  • Minnesota
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Mexico
  • North Dakota
  • Oregon
  • Rhode Island
  • South Dakota
  • Vermont
  • Washington
  • Washington, D.C.
  • Wyoming

 

The following states grant reduced practice authority to FNPs:

  • Alabama
  • Arkansas
  • Delaware
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Louisiana
  • Mississippi
  • New Jersey
  • New York
  • Ohio
  • Pennsylvania
  • Utah
  • West Virginia
  • Wisconsin

 

The following states grant restricted practice authority to FNPs:

  • California
  • Florida
  • Georgia
  • Michigan

 

  • Missouri
  • North Carolina
  • Oklahoma
  • South Carolina
  • Tennessee
  • Texas
  • Virginia

 

 

 

FNP vs Doctor

Family Nurse Practitioner vs. Doctor: What’s the Difference?

There is a lot of overlap between the roles of a family doctor and a family nurse practitioner (see "Family Nurse Practitioner Roles and Responsibilities") but the two are not equivalent.

One major difference between doctors and FNPs is the amount of schooling required. Family physicians are required to have a Doctor of Medicine (MD) degree, which takes an average of 11 years of schooling, including undergraduate education. Family nurse practitioners require a bachelor’s degree in nursing (BSN) and a master’s degree in nursing (MSN-FNP), which takes approximately five to six years of schooling.

In reduced or restricted practice states, FNPs may be required to collaborate with a physician in order to carry out certain aspects of their role, such as prescribing pharmaceuticals.

How to Become a Family Nurse Practitioner

Becoming a family nurse practitioner is a straightforward process with several steps.

To become an FNP, you must:

  • Get licensed as a registered nurse.
  • Obtain a Bachelor of Science in Nursing (BSN) degree.
  • Obtain a Master of Science in Nursing degree with an FNP specialty (MSN-FNP).
  • Become certified by passing the national FNP certification exam offered by either the ANCC or AANP.
  • Apply for state licensure as an FNP.

Get licensed as a registered nurse: The minimum requirements for obtaining RN licensure are an associate’s degree or diploma in nursing and a passing grade on the NCLEX-RN exam. Once these conditions are met, you can apply for state licensure through your state board of nursing.

Obtain a BSN degree: RNs with an associate’s degree or diploma can complete an RN to BSN degree program or fast-track their advanced education with a streamlined RN to MSN-FNP degree program.

Obtain an MSN-FNP degree: Various MSN-FNP options are available for registered nurses depending on their educational background. RNs with a bachelor’s degree can complete an MSN-FNP degree program. Registered nurses who already have an MSN degree can get a Post-Master’s FNP Certificate. All of these FNP programs include at least 500 hours of supervised clinical work to fulfill certification requirements.

Become certified by passing the national FNP certification exam: Family nurse practitioners must be certified before they can be licensed. The American Nurses Credentialing Center (ANCC) and the American Association of Nurse Practitioners (AANP) both offer national FNP certifications, which require successful completion of an exam.

Apply for state licensure as an FNP: Once you have completed your master’s degree, clinical hours, and certification exam, you can apply for licensure as an FNP through your state nursing board. To maintain your license, you must fulfill clinical practice hours and complete continuing education requirements.

How Many Years Does it Take to Become a Family Nurse Practitioner?

By choosing to earn an RN to MSN-FNP degree, a registered nurse can become an FNP in just over four years. Ultimately, though, the amount of time it takes to become a family nurse practitioner depends on your existing level of nursing and educational experience.

  • Someone with no background in nursing would take approximately six years to become an FNP (two years to get an associate’s degree or diploma and become an RN, then another four years to complete an RN to MSN-FNP degree program and become licensed as a family nurse practitioner).
  • A registered nurse with an associate’s degree or diploma would take just over four years to become an FNP (the length of an RN to MSN-FNP degree program plus time for certification and licensure).
  • A registered nurse with a Bachelor of Science in Nursing degree would take approximately three years to become an FNP (the length of an MSN-FNP degree program plus time for certification and licensure).
  • A registered nurse with a Master of Science in Nursing degree would take two years or less to become an FNP (the length of a Post-Master’s FNP certificate program plus time for certification and licensure).

FNP Practicum

Family Nurse Practitioner Practicum Requirement

To become certified and licensed as a family nurse practitioner, you must complete a minimum of 500 hours of supervised clinical hours in a relevant health care setting, such as a family practice clinic.

FNP degree and certificate programs include these clinical hours as part of the course requirements. At Carson-Newman Online, we help our online nursing students in master degree level courses by providing them with clinical placement sites and preceptors (supervisors) in their local area, so they can get the clinical experience they need to feel confident and become certified as an FNP.

Family Nurse Practitioner Preceptors

A preceptor is a mentor who supervises you while you complete your minimum 500 hours of practicum clinical hours. Your preceptor will act as a role model who guides your professional development and monitors your progress while you complete your FNP program.

Preceptors must be board-certified nurse practitioners, physicians or physician’s assistants who hold an active practice license. At Carson-Newman Online, we place you with a suitable preceptor in your local area to fulfill your clinical hours requirement for your MSN level courses.

Family Nurse Practitioner Certification

Certification is required to become a family nurse practitioner. Most FNPs opt for certification through one of two national nursing boards – the American Nurses Credentialing Center (ANCC) and the American Association of Nurse Practitioners (AANP).

Both the ANCC and AANP require you to pass an exam in order to become FNP certified. The ANCC exam consists of 175-200 questions and takes around four hours to complete. The AANP exam consists of 150 questions and takes around three hours to complete. Both exams draw from material covered in an FNP degree or certificate program.

Upon achieving a passing grade on either exam, you can apply for state licensure as an FNP with your state nursing board.

Why Choose to Become a Family Nurse Practitioner?

There are numerous personal and professional reasons to consider becoming a family nurse practitioner. Many FNPs enter the profession because they feel a calling to provide primary care, while others are attracted to the high salary potential and increased autonomy available to family nurse practitioners.

Here are just a few reasons why you may want to choose an FNP career track:

  • Family nurse practitioners are in high demand: The Bureau of Labor Statistics (BLS) predicts that more than 56,000 new nurse practitioner jobs will be created by 2026, representing a growth rate of 36%.

  • Family nurse practitioners enjoy a low unemployment rate: The unemployment rate for FNPs is 0.7%, five times lower than the national average.

  • Family nurse practitioners earn high wages: The median annual wage for a nurse practitioner is $103,880 according to the BLS, significantly higher than the median annual wage of a registered nurse.

  • Family nurse practitioners have more autonomy than registered nurses: In many states, FNPs have full practice authority, meaning they can run their own clinics, prescribe medications, and choose their own schedules.

  • Family nurse practitioners report high levels of job satisfaction: Relatively low stress and a great work-life balance means there is high job satisfaction among FNPs. According to the American Association of Nurse Practitioners (AANP), 77% of NPs reported they were satisfied or very satisfied with their employment in 2018.

  • Families and communities depend on FNPs: The Health Resources and Services Administration (HRSA) predicts a shortage of more than 20,000 primary care physicians by 2020. Family nurse practitioners are needed to fill the gap left by physicians, especially in underserved communities and rural areas across the United States.

Learn more about the benefits of a career as a family nurse practitioner.

Family Nurse Practitioner Residency Programs

The term “residency” refers to on-the-job, paid post-graduate training. Unlike a physician, a family nurse practitioner does not have to complete a residency in order to become licensed. Instead, an FNP’s training is provided over the course of the minimum 500 hours of clinical work obtained during the MSN-FNP degree or post-graduate FNP certificate program.

However, it is becoming more common for organizations to offer residency programs for FNPs who want to obtain additional paid training before going into practice. The term “fellowship” is also often used to describe such programs. These programs can be a great way to enhance your skills, build your resume, or learn a new subspecialty.

Nurse Practitioner Professional Organizations

Once you have become a certified nurse practitioner, you can join national, international and state organizations that provide support, education and advocacy for NPs. These organizations are also a great way to access networking and continuing education opportunities.

National nurse practitioner organizations include:

International nurse practitioner organizations include:

Almost all states also have their own nurse practitioner organizations.

Family Nurse Practitioner Conferences

Several organizations hold annual conferences relevant to family nurse practitioners or to nurse practitioners more broadly. Attending one of these conferences can be a great way to network and to learn more about issues that are being faced by FNPs and NPs today.

The website www.nursepractitionerconferences.com maintains an extensive list of nurse practitioner conferences happening all across the country. The American Association of Nurse Practitioners also keeps a list of its own upcoming conferences and events.

Carson-Newman’s Family Nurse Practitioner Programs

If you are a registered nurse interested in becoming a family nurse practitioner, Carson-Newman University can set you on the path to your career goals, regardless of your current level of education.

If you are an RN with an associate’s degree or diploma, choose the online RN to MSN-FNP degree option and graduate in just over four years.

If you are an RN with a BSN degree, choose the online MSN-FNP degree option and graduate in as few as 32 months.

If you are an RN with an MSN degree, choose the online post-master’s FNP certificate option and graduate in less than 24 months (on average).

 

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Sources:

2017 AANP National NP Compensation Survey. Purchased from the American Association of Nurse Practitioners website at https://my.aanp.org/ProductCatalog/ProductCategory.aspx?ID=14.

About the American Association of Nurse Practitioners: Historical Timeline. Retrieved from the American Association of Nurse Practitioners website at https://www.aanp.org/about/about-the-american-association-of-nurse-practitioners-aanp/historical-timeline.

ANCC vs. AANP: Which FNP Exam Should I Take? (Nov 2018). Retrieved from the Board Vitals website at https://www.boardvitals.com/blog/ancc-aanp-fnp-exam/.

How Long Should it Take to Train a Family Physician? (June 2015). Retrieved from the American Academy of Family Physicians website at https://www.aafp.org/news/blogs/freshperspectives/entry/how_long_should_it_take.html.

NP Fact Sheet (Jan 2019). Retrieved from the American Association of Nurse Practitioners website at https://www.aanp.org/about/all-about-nps/np-fact-sheet.

Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners: Job Outlook (Apr 2018). Retrieved from the Bureau of Labor Statistics Occupational Handbook at https://www.bls.gov/ooh/health care/registered-nurses.htm.

Occupational Employment and Wages, May 2017: 29-1141 Registered Nurses. Retrieved from https://www.bls.gov/oes/2017/may/oes291141.htm.

Occupational Employment and Wages, May 2017: 29-1171 Nurse Practitioners. Retrieved from https://www.bls.gov/oes/2017/may/oes291171.htm.

Projecting the Supply and Demand for Primary Care Practitioners Through 2020 (Nov 2013). Retrieved from the Health Resources & Services Administration website at https://bhw.hrsa.gov/health-workforce-analysis/primary-care-2020.

State Practice Environment (Dec 2018). Retrieved from the American Association of Nurse Practitioners website at https://www.aanp.org/advocacy/state/state-practice-environment.

The 100 Best Jobs (2019). U.S. News & World Report. Retrieved from https://money.usnews.com/careers/best-jobs/rankings/the-100-best-jobs.

Unemployment Rates Are at an All Time Low for Nurse Practitioners (July 2018). Retrieved from https://www.npnow.com/unemployment-rates-are-at-an-all-time-low-for-nurse-practitioners/.