Nurse Practitioner

What is a nurse practitioner?

A nurse practitioner (NP) is a nurse with a graduate-level degree of education. Additional training, skills and experience in advanced practice nursing give NPs the authority to do more than registered nurses. They can perform many of the same services that doctors provide.

NPs provide patient-centered care. They focus on disease prevention, living a healthy lifestyle and understanding your health concerns. An NP can serve as a primary care provider or as a specialty care provider focusing on a specific group of people. They work in a variety of healthcare settings, including:

• Physicians’ offices.
• Clinics.
• Hospitals.
• Emergency rooms.
• Urgent care sites.
• Nursing homes.
• Colleges.

An NP may also have the title of advanced practice registered nurse (APRN). You may also hear the term advanced registered nurse practitioner (ARNP).

What does a nurse practitioner do?

Nurse practitioners have some of the same responsibilities as registered nurses. This includes taking your medical history and administering medication. But the scope of an NP’s duties goes beyond those of an RN.

Nurse practitioners deliver advanced nursing care to their patients. They provide preventive care, diagnose health conditions and manage treatment for people in their care.

They may work independently or with doctors to provide a full range of healthcare services. Nurse practitioners:

• Take and record medical histories and symptoms.
• Perform physical examinations.
• Order diagnostic tests, such as laboratory tests or X-rays.
• Analyze test results.
• Diagnose and treat illnesses, diseases and other health conditions.
• Create patient care plans.
• Prescribe medication.
• Write referrals for specialists.
• Counsel people on how to stay healthy.

Nurse practitioner vs. doctor — what’s the difference?

A nurse practitioner isn’t a doctor, but in certain states, NPs can serve as primary care providers. In these states, they have full practice authority. That means they can work independently without a doctor’s supervision.

In the remaining states, NPs don’t have full practice authority. They need a doctor to approve certain decisions about people’s care and prescribe medication.

The education and training of doctors and NPs differ as well. Doctors must go to medical school and earn a post-graduate degree such as a doctor of medicine (MD). Doctors spend more time training than nurse practitioners.

Can a nurse practitioner prescribe medication?

In some states, nurse practitioners can prescribe medicine. But in other states, a doctor has to oversee an NP for them to prescribe medication.

Nurse practitioner vs. physician assistant — what’s the difference?

Nurse practitioners and physician assistants (PAs) provide many of the same services. However, their approach to patient care is different.

Physician assistants train and provide care using the medical model, similar to doctors. That means they focus on testing, diagnosing and treating the disease. In addition, PAs specialize in a particular area of medicine or a specific condition.

Nurse practitioners train and provide care using the nursing model. That means they focus on the patient. NPs usually specialize in a particular patient population rather than a specific type of medicine.

What are the different kinds of nurse practitioners?

Nurse practitioners can provide care for a specific group of people. For instance, they may work with adults, children or people with cancer.

Psychiatric nurse practitioners

A psychiatric nurse practitioner provides mental health care to adults, children and families. They may treat people with specific mental health disorders or conditions. They also work with people who have substance use disorders.

Family nurse practitioners

A family nurse practitioner provides healthcare to people throughout their lifetime. These practitioners develop long-term relationships with people in their care. They get to know them over time. Many people see a family nurse practitioner as their primary care provider.

Pediatric nurse practitioners

A pediatric nurse practitioner provides care to children. They see children from infancy through the time they become adults. They perform well check-ups and provide immunizations. They also diagnose and treat acute and chronic illnesses and conditions.

Neonatal nurse practitioners

A neonatal nurse practitioner provides care to sick and/or premature babies. They can diagnose illnesses and provide treatment. They may also assist in delivering babies in some hospitals and other settings.

Acute care nurse practitioners

An acute care nurse practitioner provides healthcare to adults in acute care settings. That means they provide short-term treatment for people with severe illnesses or injuries. They may also provide care after you’ve had surgery or experienced trauma.

Emergency nurse practitioners

An emergency nurse practitioner provides care to people in need of urgent care. They work in emergency departments and decide who needs the most immediate care. They make decisions about treatment and monitor people’s conditions.

Adult-gerontology nurse practitioners

An adult-gerontology nurse practitioner provides healthcare for adults of all ages. They work with people to manage their diseases and chronic health conditions.

Women’s health nurse practitioners

A women’s health nurse practitioner provides care for women and people assigned female at birth (AFAB). They provide care throughout a person’s lifetime. The care they provide may include reproductive, gynecological or obstetric services.

Orthopedic nurse practitioners

An orthopedic nurse practitioner provides healthcare for people who have musculoskeletal issues. These may include diseases and injuries involving muscles, bones, joints and connective tissue.

Aesthetic nurse practitioners

An aesthetic nurse practitioner provides care to people who are having cosmetic procedures. They examine people and counsel them on potential surgical procedures. They perform cosmetic procedures and care for people as they recover.

Oncology nurse practitioners

An oncology nurse practitioner provides complete care to people who have cancer. They work with oncologists and other providers to develop treatment plans and manage people’s care.

How do you become a nurse practitioner?

Nurse practitioners receive six to eight years of training in the medical field.

To become a nurse practitioner, you first have to become a registered nurse (RN). You can become an RN through an associate’s degree in nursing (ADN) program. You can also go through a bachelor’s degree in nursing (BSN) program. Many nurses gain a few years of working experience before continuing their education.

From there, nurse practitioner schooling varies. You must get advanced clinical training beyond the education and licensing required of RNs.

If you have your BSN, the next step to becoming a nurse practitioner is enrolling in a graduate program. This can either be a master’s degree in nursing (MSN) program or a doctor of nursing practice (DNP) program.

If you don’t yet have your BSN, you can enroll in an accelerated RN-to-BSN program. But you can also go straight from your associate’s degree to a master’s degree through an ADN-to-MSN program.

Graduate degree nurse practitioner programs include classroom education and specialized clinical experience. You’ll take courses in subjects such as:

• Pathophysiology.
• Advanced health assessment.
• Pharmacology.

You’ll also take coursework in your chosen specialty.

For some of the subspecialty NP curriculum programs, experience as an RN for at least a year or two is sometimes necessary prior to enrollment in an MSN program. For example, most Psych/Acute Care NP programs require at least one to two years as an RN (some specifically in Psych or ICU) prior to enrolling in an MSN program.

After you’ve earned your MSN or DNP, you need to get your advanced practice nursing license. Licensing occurs through a process at the state level. Nurse practitioner licensing varies by state.

Nurse practitioners must also pass a national certification exam. National nursing organizations give these exams with consistent practice standards across all states.

NPs can also complete certificate programs instead of degree curriculum to get certified in other specialties (i.e., Family NP provider can complete a 9-month certificate to become an Acute Care/ER certified NP).

A note from Cleveland Clinic

Nurse practitioners use their advanced clinical training to diagnose and treat health conditions. They share many of the same responsibilities as doctors. NPs also focus on disease prevention. In addition, they help people make healthy lifestyle choices. You may receive treatment from an NP the next time you visit a provider’s office.