How do I become a Nurse Practitioner in the U.S.?

October 5, 2023 Victoria Sanderson

(in 2024)

The path to becoming a nurse practitioner is a unique and non-linear journey. For those of you thinking of pursing a career as an NP, I hope to provide some guidance. In a series of posts I will review basic steps from point A (applying to programs) to point B (getting your licence). In a previous post, we reviewed how to become an NP in Canada, now we will move our focus to the U.S.

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What is a Nurse Practitioner?

NPs are registered nurses who have additional education, nursing experience, and expanded scope to autonomously diagnose and treat, order and interpret tests, prescribe medications, refer to specialists, and perform medical procedures (1). Scope of practice varies from state to state. In the U.S., NPs are classified as Advanced Practice Registered Nurses (APRNs) with a speciality focus. According to the American Association of Nurse Practitioners (AANP), there are approximately 400 academic institutions with NP programs in the U.S (2). There are several things to consider when choosing a program. What speciality focus are you interested in pursuing? Do you prefer online learning versus in-person? What programs do you qualify for based on your previous education and degree(s)?

How long does it take to be a nurse practitioner?

Step 1: You need to obtain your Bachelor of Science in nursing and your Registered Nurse licence. All U.S. boards of nursing use the NCLEX-RN, which is the examination required for nursing graduates to be licensed as a Registered Nurse in the U.S (3). There are hundreds of nursing programs to choose from in the U.S.

Step 2: Gain nursing experience as an RN in the field. Most graduate NP programs require 1-2 years of clinical experience. This experience is crucial to determine what clinical areas spark your interest. Can you see yourself working in family medicine? Pediatrics? Adult gerontology? Women’s health? Mental health? The best way to find out is to work in the field. This will help inform what NP specialty you want to pursue in the future.

Step 3: Obtain a master’s degree.

Option 1: you can complete an NP-focused master’s degree, either a Master of Science in Nursing (MSN) NP speciality focus or a Doctoral of Nursing Practice (DNP) with an NP speciality focus. The MSN degree is ideal for you if your main goal is to work in a clinical setting as an NP. The DNP is ideal for you if you are interested in clinical practice plus research, education and/or leadership roles in the field. Both degree tracks require you to choose a specialty. There are different specialty options depending on the academic institution. Typically, course work is completed first, followed by speciality courses and clinical hours pertaining to your speciality. For example, one could choose the MSN-Family Nurse Practitioner (FNP) option, whereby you complete a Master of Science in nursing with a family nurse practitioner focus.

Option 2: you can complete a master of science in nursing degree or a doctoral degree in nursing first, then go on to complete a post-master’s nurse practitioner certificate. For example, if you already completed a course-based or thesis-based masters or doctoral program, this option is available to you. For the post-master’s certificate, you also choose your NP speciality focus.

Most programs will offer either full or part-time study options, so program length will vary.

Practical tip: When in doubt, contact the program’s academic advisor or other contact personnel to gain clarity on which program will suit your interests and career path. Ask around - do you know anybody who completed the MSN versus DNP versus post-master’s certificate? What was their experience like?

Step 4: once you have completed your respective program’s course work, clinical hours, and passed all classes, you will be eligible to write an NP board certification speciality exam (licensing criteria vary by state, but all require a passing score on a national board certification exam). For example, if you completed an MSN-FNP program, you would be eligible to write the FNP specialty exam.

National board exam options: American Academy of Nurse Practitioners (AANP) Certification Board, the National Certification Corporation (NCC) or the American Nurses Credentialing Center (ANCC) – each board offers different certifications, so do your research to determine which is the best fit for you and your specialty.

Stay tuned for a future post on certification exam prep.

Everyone’s NP journey is unique. Get as much experience as you can and ask lots of questions!

*Common nurse practitioner specialties:

Adult-Gerontology Acute Care NP
Adult-Gerontology Primary Care NP
Family NP
Neonatal NP
Pediatric NP
Psychiatric Mental Health NP
Women’s health NP
Emergency NP
And more depending on your academic institution of interest

Key Take Home Point: There are different paths to becoming an NP. Investigate what programs and NP specialties your academic institution offers and check the pre-requisites to see whether you qualify.

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