What is a nurse practitioner (NP) and how is it different from your role as a nurse? According to the American Association of Nurse Practitioners, an NP is a master’s or doctorate-prepared nurse with the knowledge and clinical competence to practice as a clinician in acute or primary care settings. Becoming an NP is highly rewarding and requires effort, time, money, and managing more licenses and certifications.

So you are comfortable with your role as a bedside nurse, but you feel like you want or need something different. You can hold various nursing positions with a bachelor’s of science in nursing (BSN) if you aren’t interested in pursuing additional education. But, if you want more of a challenge, more responsibility, more independence, and higher education, then becoming a nurse practitioner may be the right pathway for you. Read on to see what it takes to become a successful nurse practitioner.


5 Necessities to Becoming a Successful Nurse Practitioner


1. Registered Nurse Licensure

The first step to becoming a successful NP is to become a successful registered nurse (RN). If you aren’t an RN already, there are options for second-degree BSN programs available. If you are an associate-prepared registered nurse, RN to MSN programs are available for you to earn your MSN and your BSN. If you are a bachelor-prepared RN, there are numerous NP programs online and in-person all over the country. 

2. Know Your Specialty

Unlike physician assistant programs, nurse practitioners must decide on what specialty they would like to study before applying to their program. Most nurses will utilize their bedside experience to help decipher which focus they would like to pursue. Although this is not necessarily a requirement of an NP program, it is challenging to acquire advanced knowledge and skills in a field without that specific experience. NPs can decide later on a subspecialty if they choose to go down that path. NP specialties include:

  • Adult-Gerontology Acute or Primary Care
  • Family Acute or Primary Care
  • Neonatal Acute Care
  • Pediatric Acute or Primary Care
  • Psychiatric/Mental Health
  • Women’s Health Acute or Primary Care
3. Consider Interests as Subspecialties

NPs can decide later on a subspecialty if they wish to focus on an even more niche area of care. Not all NPs subspecialize, but if a nurse has experience or interest in a subspecialty and they would like to practice as an advanced practice provider in that field, they can do so after graduation. Additionally, NPs can get post-graduate certifications to further their subspecialty education. Subspecialties include, but are not limited to:

  • Allergy/Immunology
  • Cardiovascular
  • Critical Care
  • Dermatology
  • Emergency
  • Endocrinology
  • Gastroenterology
  • Hematology/Oncology
  • Infectious Disease
  • Neurology
  • Occupational Health
  • Orthopedics
  • Pulmonology
  • Sports Medicine
  • Urology

A nurse practitioner can even choose to switch their speciality if considering a career move. 

4. Independent Practice

NPs have varying levels of independence depending on their state of practice. In some states, overseeing physicians need to approve all decisions made by an NP. This style of collaboration is suitable for new graduates, but it can become tedious for more experienced NPs. In other states, NPs have what’s called Full Practice Authority (FPA) to order and prescribe as they see fit; this type of autonomy is excellent for more experienced NPs. However, it is still essential to know when to consult additional providers due to patient complexity. Regardless of their scope, NPs need to be effective autonomous providers with an increased level of accountability. It is crucial that an NP doesn’t rely solely on their overseeing physician to correct any potential mistakes made. 

5. Clinical Decision-Making

NPs have a more in-depth scope of clinical decision-making than their RN counterparts. Not only do NPs need the knowledge base to make clinical decisions, but they also need the confidence to make those decisions. The increased responsibilities include, but are not limited to:

  • Managing acute, chronic, and preventative care
  • Counseling, planning/implementing treatment plans and palliative care
  • Understanding and utilizing appropriate diagnostic and screening protocols
  • Distinguishing between normal and abnormal findings
  • Prescribing medications within the state’s scope of practice
  • Delivering patient-centered, culturally competent care and empathetic relationships with parents and caregivers

As you can see, there is a significant difference in the role of a nurse and a nurse practitioner. Deciding whether or not you have what it takes to leap into a more autonomous medical role isn’t a decision to take lightly. It is important to remember that to be a successful nurse practitioner, you must be a successful nurse first. There is more required to being a good nurse or NP than simply having the foundational knowledge. Nurses must have the personal qualities and characteristics that are necessary for creating a career as a competent nurse practitioner. 

Andrea Mosher, CPNP, PMHS
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