How long does it take to become a nurse practitioner?

The nurse practitioner role is one of the more influential positions in healthcare. These skilled and knowledgeable nurses are depended on to provide primary care to diverse patient populations, and can be found in hospitals, outpatient clinics, private practice, community health centers, government and even independent practices (depending on the state in which they live).

As such, many nursing students with ambitions of delivering and improving care at an advanced level strive to become a nurse practitioner. Yet the question on nearly all of their minds, and potentially yours as well, is, "How long does it take to become a nurse practitioner?"

It's a fair question to ask. As advanced practice registered nurses (APRNs), NPs must first satisfy education, experience, and state and national certification requirements before they can practice. The first essential step to becoming a nurse practitioner is to earn a graduate degree.

Completing a Master of Science in Nursing (MSN) program will have to be factored into your timeline. Read on for more information on how to become a nurse practitioner, how to become a family nurse practitioner (FNP) and the years to complete a graduate degree.

NPs at a glance

Before jumping into all of the steps necessary to become a nurse practitioner, it's important to take a look at the role and some of the core job responsibilities.

Nurse practitioners deliver primary, acute or specialty care across a range of patient populations. NPs may specialize in women's health, family care, pediatrics, gerontology or other nursing fields. They are nationally and state-certified APRNs who have completed a master's degree in nursing and have a strong grasp of concepts like evidence-based practice, advanced health assessment, leadership in nursing and other core competencies.

Given their level of education and certification, NPs perform crucial care duties autonomously or in collaboration with other care professionals. According to the American Association of Nurse Practitioners (AANP) in 2019, NPs during any given practice day might:

• Order, perform and interpret diagnostic tests (e.g. lab work and X-rays)
• Diagnose and treat acute and chronic conditions, like heart disease, diabetes, infections and injuries
• Prescribe and manage medications for multiple patients
• Help advise and guide patients in managing overall care
• Provide counseling to patients and their families, as well as relevant information or materials on conditions and care needs
• Educate patients on disease prevention and promote positive, healthy lifestyle choices

Those last couple points emphasize the importance of NPs in particular. The unique approach of the NP, according to the AANP, is the holistic focus on the well-being of the patient.

Where do NPs work?

Nurse practitioners are in high demand across America. The U.S. Bureau of Labor Statistics (BLS) estimates that nurse practitioner positions will grow 28% between 2018 and 2028, well above the national average for all occupations of 5%. According to the AANP, in 2019, there were 270,000 NPs nationwide — a number that's grown from 171,000 in 2013 and 82,000 in 2001.

Given that NPs specialize in a number of care areas, they can find employment in numerous different settings, including, but not limited to:

• Hospitals and medical clinics
• Offices of physicians
• Outpatient care centers
• Urgent care clinics
• Health departments
• Hospices and private homes
• Long-term care facilities
• Primary care private practices
• Community clinics

Overall, the median national salary for NPs in 2018, according to the BLS, was just more than $107,000. However, that figure could increase depending on the work setting, with the highest salaries for NPs available in state, local and private hospitals.

How long does it take to become a nurse practitioner?

It can be difficult to pinpoint the exact time it takes to become a nurse practitioner given the different pathways to the role, necessary degrees and the various specializations and their requisite certifications.

However, according to the AANP, as of 2019 nurse practitioners need at least six years of academic and clinical preparation. Broadly, this timeline encompasses earning accredited degrees, completing supervised clinical hours and obtaining licensures and certifications.

The AANP breaks down the process to becoming an NP like so:

1. Earn a Bachelor of Science in Nursing (BSN)
2. Become a licensed registered nurse
3. Complete a graduate nursing program
4. Secure national board certification
5. Get registered or licensed by the state you intend to practice in

It's worth noting that there is flexibility in this general outline for how to become a nurse practitioner. Some graduate programs may not require that students have a BSN. For example, Bradley has two tracks for its MSN program to become a family nurse practitioner:

• One for BSN entry that takes around three years to complete
• One for entry with an Associate Degree in Nursing (ADN), a nursing diploma or a non-nursing bachelor's degree that takes around three-and-a-half years to complete

This all underscores the importance of choosing the best possible graduate nursing program for you and your expected timeline.

What are the steps to becoming an NP?

Let's examine in greater depth those five broad steps (and the average six-plus years) it takes to become a nurse practitioner.

Earning a BSN

An undergraduate degree is the first step for many would-be nurse practitioners. Typically, these degree programs take around three to four years to complete and give nursing students the fundamental skills, knowledge and experience needed to pursue entry-level jobs in health care. Students get a mix of classroom and clinical learning where they can explore and become proficient in theories of nursing practice, concepts in pathophysiology, health promotion, disease prevention, care delivery and other core nursing subject matters.

Experiential elements may include completing clinical hours, internships or self-directed research projects. A key outcome of any BSN program is preparation for examinations to become a licensed registered nurse.

Often, accredited BSN programs are offered in both on-campus and online formats. The traditional BSN on-campus format requires in-person attendance, while online options can be completed from a personal laptop (save for clinical experiences). The latter are generally less available than traditional, on-campus BSN programs.

Becoming a licensed registered nurse

Once you've graduated with a BSN, you should be prepared to sit for the National Council Licensure Examination for Registered Nurses (NCLEX-RN), which is administered by the National Council of State Boards of Nursing (NCSBN). This is a test of the skills and knowledge gained during an undergraduate education, and whether nurses can effectively and safely apply what they learned in care settings.

If you hold a BSN (or ADN) from an accredited nursing program, you'll likely be eligible to sit for the exam. Other degrees may not meet eligibility criteria, so be sure to check with your state board. The exam consists of a minimum of 75 questions and a maximum of 265 questions that assess four areas of practice:

1. Physiological Integrity
2. Safe and Effective Care Environment
3. Health Promotion and Maintenance
4. Psychosocial

Test questions may cover a range of topics, including abnormalities in vital signs, mental health concepts, informed consent and health promotion, among many other concepts. Physiological integrity makes up the bulk of the examination, accounting for up to two-thirds of all questions. The NCLEX-RN is administered in-person and electronically. Individuals have up to six hours to complete as much of the examination as they can. If you fail, you must wait 45 days until the next attempt. Nurses get eight attempts per year and there is no maximum lifetime number of attempts, although varying state regulations may apply. It costs $200 to sit for each instance of the NCLEX-RX.

As noted, there are alternative pathways to becoming a nurse practitioner. If you are a licensed registered nurse, an accelerated bachelor's program may be available to you. These degree programs, offered both on-campus and online, typically take two years to complete.

Completing a graduate nursing program

A graduate degree is necessary to become an NP, as it is a minimum requirement for licensure as an APRN. In 2018, 99.1% of NPs held a graduate degree, according to the AANP. Typically, professionals who want to become a nurse practitioner pursue a Master of Science in Nursing. MSN programs are designed to refine skills and knowledge in areas of undergraduate education, while also expanding expertise in advanced nursing principles, evidence-based practice, statistical procedures, advanced health assessment, health care informatics and health care organizational management.

Generally, MSN programs are offered on a part-time or full-time basis and take between two and four years to complete. However, the years required to complete an MSN program depend on the track and NP specialization. For instance, Bradley offers a graduate nursing program that prepares students to become a family nurse practitioner. According to 2018 AANP statistics, more than two-thirds (66.9%) of NPs were certified in family care. Bradley MSN programs are offered on two tracks with differing lengths:

• The BSN-entry program can be completed in three years (nine semesters) and requires 750 clinical hours
• The RN-MSN-FNP program (which allows entry with an ADN, nursing diploma or non-nursing bachelor's) takes 3.6 years (11 semesters), includes bridge courses and requires 800 clinical hours

However, the MSN is not the only graduate degree that can be used for licensure as an APRN. The Doctor of Nursing Practice (DNP) is the terminal degree for clinically focused nurses — as opposed to those interested in research, education or academia — and provides students with the skills, knowledge and experience needed to become a nurse practitioner. DNP programs generally take between three and four years to complete.

Overall, DNP degree programs build on fundamentals established in an MSN education, like evidence-based practice, principles of advanced nursing practice, leadership in health care and quality improvement. They also broach topics like data management, health policy, nurse advocacy, advanced pharmacology and health care organizational finance. Often, DNP programs have more intensive experiential elements, sometimes requiring multiple internships, practicums or a capstone project. Hundreds of clinical hours must also be amassed.

An important factor to consider is that the DNP may eventually become the standard education requirement for becoming an APRN. While a master's degree is the minimum needed at this time, the American Association of Colleges of Nursing (AACN), which establishes and implements quality standards for nursing education, made a recommendation that the DNP be considered as a requirement for practice as an APRN. While that shift has not yet been initiated — the AACN most recently updated its recommendation in 2013 — some professionals have pursued a DNP to become a nurse practitioner regardless.

The timeline to completion for a DNP, just like with any other degree program, depends on the entry degree and the specialization track. Considering Bradley's two DNP programs helps illustrate these differences:

• The DNP-FNP program is designed for entry with a BSN. The program takes four years to complete (12 semesters), is offered 100% online and includes 1,050 clinical hours
• The DNP leadership program is structured for entry with an MSN. The program takes three years (9 semesters), is offered 100% online and includes 1,000 clinical hours; it prepares nurses for roles like nurse executive, health care administrator, nurse director or nurse manager

Securing national board certification

The penultimate step to becoming a nurse practitioner is being certified by a national board. Certification is the process by which a non-governmental body attests to a nurse's ability to meet qualification standards for practice. There are multiple certifications for NPs, as well as multiple certifying boards, which can make the overall process difficult to understand.

As identified by the AANP, the most-recognized NP types of certification are (ranked by percentage of current certified NPs):

• Family (66.9%)
• Adult (12%)
• Adult-Gerontology Primary Care (6%)
• Acute Care (4.8%)
• Women's Health (2.7%)
• Psychiatric/Mental Health-Family (2.1%)
• Psychiatric/Mental Health (2%)
• Gerontology (1.8%)

The major certifying bodies (and the NP specialities they credential) are listed below:

• The American Academy of Nurse Practitioners National Certification Board (AANPCB): Family Nurse Practitioner Certification (FNP), Adult-Gerontology Primary Care Nurse Practitioner Certification (A-GNP) and Emergency Nurse Practitioner Certification (ENP)
• The American Nurses Credentialing Center (ANCC) Certification Program: Acute Care Nurse Practitioner Certification (ACNP-BC), Adult Nurse Practitioner Certification (ANP-BC), Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP-BC), Adult-Gerontology Primary Care Nurse Practitioner Certification (AGPCNP-BC), Adult Psychiatric-Mental Health Nurse Practitioner Certification (PMHNP-BC), Advanced Diabetes Management Certification (ADM-BC), Emergency Nurse Practitioner Certification (ENP-BC), Family Nurse Practitioner Certification (FNP-BC), Gerontological Nurse Practitioner Certification (GNP-BC), Pediatric Primary Care Nurse Practitioner Certification (PPCNP-BC), Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC), School Nurse Practitioner Certification (SNP-BC)

Certification includes continuing education requirements that nurses must satisfy on an ongoing basis to practice as an APRN.

Getting registered or licensed by the state you practice in

The final step to becoming a nurse practitioner is registration or licensure for the state in which you will practice. There is wide variance in the conditions for registration or licensure that states may impose on NP practice. Some, for example, may have requirements for completing a supervised or collaborative practice.

A related issue to state regulation of nursing is full practice authority. Nurse practitioners, depending on where they live, may have the autonomy to perform their job duties — like interpreting diagnostic tests or prescribing medication — without the supervision of a physician or physician's assistant. There has been a recent shift in expanding the practice scope of NPs and APRNs, with legislation being passed in increasing numbers that grants full practice authority through a state nursing board.

Full practice authority in many cases is being leveraged to bring high-quality care within reach of underserved or rural patient populations. Leaning on NPs to deliver this care, as well as meet the increasing demand for health care amid a nursing shortage, has spurred several states to reconsider their laws on full practice authority.

Currently, states that extend full practice authority include Alaska, Arizona, Colorado, Connecticut, Hawaii, Idaho, Illinois, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington and Wyoming. The District of Columbia, Guam and Northern Mariana Islands are also on the list.

As for the remainder:

• States (and territories) that allow reduced practice are Alabama, Arkansas, Delaware, Indiana, Kansas, Kentucky, Louisiana, Mississippi, New Jersey, New York, Ohio, Pennsylvania, Utah, West Virginia, Wisconsin, American Samoa, Puerto Rico and the Virgin Islands. Reduced practice is equivalent to state laws limiting the ability of NPs in at least one element of full practice, such as evaluating patients.
• States that allow restricted practice are California, Florida, Georgia, Massachusetts, Michigan, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas and Virginia. Restricted practice is equivalent to the limitations on NPs' practice authority like requiring instructions and approval from another health provider before NPs can deliver care.

Earn your degree from Bradley

The road to becoming a nurse practitioner may be a multiyear and multistep process, but it can also be rewarding. NPs are depended on to deliver high-quality care, provide leadership, educate patients and their families, and coordinate with other stakeholders as autonomous care professionals. Financially, NPs also stand to earn a higher salary as APRNs.

When assessing the steps you need to take to become an NP, depending on where you are in your career, consider Bradley for your graduate education. As mentioned, nurses with a BSN can enter the MSN-FNP or DNP-FNP program, while those with an MSN can enter the DNP leadership track, and those with an ADN, nursing diploma or non-nursing bachelor's can enter the RN-MSN-FNP program. Another way to prepare for becoming a nurse practitioner is an FNP certificate with an MSN entry, like the type Bradley offers.

Overall, there are many education decisions to make on the path to becoming an NP. Choosing the best degree programs for your needs is essential. Bradley's nursing programs are offered online and allow students to pick their own approved site supervisors. Want to learn more about the MSN-FNP program or another track? Contact an enrollment advisor today.

Recommended reading:

How the Bradley University online FNP prepares nurses for ANCC and AANP certification exams

Sources:

American Association of Nurse Practitioners

Bureau of Labor Statistics

BLS