NPs are nurses, of course, but they’ve also got medical training. They might have a Master’s Degree or a Doctoral Degree. (And if they’ve got a doctoral degree, then, could they be called “Doctor Nurse?” Yikes!). It can all be really confusing (see “Why all those letters after your name???”) and that’s part of the reason so many people still don’t understand who NPs are or what they do.
Let’s try to clear up some of the confusion.
Nurse Practitioners have to complete nursing school with a Bachelor’s Degree and become Registered Nurses before they can become Nurse Practitioners.
They generally have to have a Bachelor’s Degree in Nursing (BSN, or Bachelor of Science in Nursing) before they can apply to Nurse Practitioner school. These are traditionally 4-year programs but there are accelerated programs out there, too. Requirements for a BSN differ according to university but all include classes in anatomy, physiology, chemistry, biology, and a big emphasis on nursing’s core values: altruism, autonomy, human dignity, integrity, and social justice.
(It’s no wonder that nursing remains one of the most trusted professions!)
A lot of NPs work as nurses (RNs) for years before they become NPs.
They may work in the hospital ER, for example, or in the Labor & Delivery department or in the ICU. Some may work seeing patients at home or in prisons or in a nursing home or they may take care of patients in a neighborhood clinic. There are a gillion nursing specialties.
Pretty much, wherever you find people you’ll find nurses…
Some NPs may not work much as an RN at all and will go straight into NP school.
In addition to being nurses first, all new NPs must obtain at least a Master’s Degree.
It’s generally a Master of Science in Nursing (MSN) and usually takes about 2 years of full-time work to complete. So, if you include the at least 4 years of school to become a nurse, plus the 2 years for the Master’s, a new NP has at the very minimum, 6 years of education plus hundreds, if not thousands, of hours of clinical direct-patient-contact time. Remember, that’s a mixture of nursing and nurse practitioner (diagnosing/treating/prescribing) time with the patient. It’s different than the 100% medical training of physicians (Medical Doctors, or MDs) and their thousands of hours of clinical practice in school and residency.
Once they’ve received a Master’s Degree, and completed an NP program, they can then apply for licensure with their state to practice as an NP.
Some NPs continue in school, or go back to school, to receive a doctoral degree.
Currently, there are two major doctoral degrees a nurse practitioner may attain. (There are a couple others that are less common that we don’t need to worry about here.)
The first is a PhD, or Doctor of Philosophy. This doctorate has a focus on performing research. Many disciplines can attain PhD’s other than Nurse Practitioners. These include teachers, engineers, university professors, physicians, and other nursing specialists.
The other main doctorate for nurse practitioners is the DNP, or Doctor of Nursing Practice. This is a newer degree with a focus on using the evidence compiled by PhD professionals. Another way to say this is the DNP translates the evidence, interprets it, and applies it in the clinical setting (or wherever else they’re working). PhD nurses and DNP nurses complement each other’s strengths very well.
It will take an additional two to seven years for a nurse to acquire a doctoral degree.
Yes, if a Nurse Practitioner attains his or her doctorate, then he or she has earned the privilege to be called “Doctor,” just like a professor with a PhD or a psychologist or an MD. You may hear an NP introduce herself or himself, “Hello, I am Dr. Cuevas, your nurse practitioner” or they may have you call them by their first name. But those who have earned their doctorate (be it a PhD or a DNP or other doctorate) are doctors, indeed.
NPs are trained and educated to diagnose, treat, and prescribe medicines.
This advanced training and education is what distinguishes an NP from an RN and what allows them to do a lot of what physicians do. This is the really cool aspect of the NP role: taking a nurse and training him or her to make advanced decisions about patient care.
There are many different NP specialties and NPs much choose one or more on which to focus.
These specialties include:
Acute Care (who care for patients in hospitals)
Adult (managing issues in the adult population, not in pediatrics)
Family (may be the main – or, primary care – provider for everyone in the family, from babies to elders)
Adult/Gerontological (dealing only with the elders in the population, often with those in nursing homes)
Neonatal (caring for newborn babies who have complications from birth and/or medical problems)
Pediatric (caring for infants to late teens)
Psychiatric/Mental Health (this is a growing field and these NPs focus on the care of those with mental illness)
Women’s Health (caring for the particular needs of women of all ages).
Additionally, there are other, less common NP specialties like oncology (taking care of patients with cancer), pain management (a growing field), Emergency/Trauma (working in an Emergency Room or Trauma Center), and NPs who specialize in caring for patients with HIV/AIDS or diabetes.
When an NP is in school, he or she must choose a specialty. If he or she wants to focus on more than one specialty, then it’s back to school for generally another year-and-a-half to two years.
Most states and healthcare settings require Nurse Practitioners to be nationally certified in their specialty.
In order to become nationally-certified, an NP program must be successfully completed and a national certification exam must be taken and passed. The exam is generally good for 3 to 5 years at which time, to remain certified, the NP must pass another exam or recertify based on experience and continuing education credits, or a combination of these. National certification is important and ensures that each NP specialty has an established, standardized knowledge base from which to practice.
Nurse Practitioners prefer to be called…”Nurse Practitioners” or “NPs”
You may occasionally hear the term “mid-level” or “physician extender” used to identify NPs. You may see these terms in print or hear physicians, journalists, or job recruiters use them to describe NPs. These are confusing titles and NPs prefer that they not be used.
Depending on the state, some NP’s practice independently (or autonomously), may practice collaboratively with a physician, or may work under the direct supervision of a physician.
This is changing quickly as the demand for NPs grows and more and more states are passing laws which allow NPs to practice independently. Remember “independence” doesn’t mean they practice in a bubble. They still call on other health professionals (physicians, nutritionists, physical therapists, etc.) for advice or guidance or referrals as needed.
American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author.
American Association of Nurse Practitioners. (2015). Planning Your NP Education. http://www.aanp.org/education/student-resource-center/planning-your-np-education.