In the US, NPs are licensed by the state in which they practice, and have a national board certification (usually through the American Nurses Credentialing Center or American Academy of Nurse Practitioners). Nurse Practitioners can be trained and nationally certified in areas of pediatrics, geriatrics, women's health, psychiatry and acute care.
Nurse Practitioners treat both acute and chronic conditions through comprehensive history taking, physical exams, physical therapy, ordering tests and therapies for patients, within their scope of practice. An NP can serve as a patient's "point of entry" health care provider, and see patients of all ages depending on their designated scope of practice. The core philosophy of the field is individualized care. Nurse Practitioners focus on patients' conditions as well as the effects of illness on the lives of the patients and their families.
Because the profession is state regulated, care provided by NPs varies. A nurse practitioner's job may include the following:
NPs practice in all U.S. states. The institutions in which they work include the following:
NPs specialize in a particular field of health care practicing advanced nursing not medicine.
To be licensed as a nurse practitioner, the candidate must first complete the education and training necessary to be a registered nurse (RN).
Requirements for a registered nurse (RN) include either an associate degree in nursing (ASN), a Bachelor of Science degree in nursing (BSN), or completion of a diploma program, as well as direct patient care for acutely or chronically ill patients. Associate degree in nursing programs, which are offered by community and junior colleges, usually take 2 years. BSN programs are offered by colleges and universities and take 4 years.
In most states a master's degree is required. To become NPs, nurses with an ADN or diploma must first complete a bachelor's degree or enter in various programs offering an ADN to master's degree via a "bridge program," most of which award the bachelor's degree while completing the requirements for the master's.
Once registered nurse status is attained, the candidate must complete a state-approved advanced nursing education program that usually specializes in a field such as family practice, adult health, acute care or women's health. The degree can be granted by:
The variety of educational paths for NPs is a result of the history of the field. In 1965, the profession of nurse practitioner was instituted and required a master's degree. In the late 1960s into the 1970s, predictions of a physician shortage increased funding and attendance in nurse practitioner programs. During the 1970s, the NP requirements relaxed to include continuing education programs, which helped accommodate the demand for NPs. The certifying organizations, states, and employers require a minimum of a master's degree for new NPs (already established NPs with lesser education were grandfathered in).
After completing the education program, the candidate must be licensed by the state in which he or she plans to practice. The State Boards of Nursing regulate nurse practitioners and each state has its own licensing and certification criteria. In general, the criteria include completion of a master's degree in nursing and certification by an accrediting body (ANCC, AANP). The license period varies by state; some require biennial relicensing, others require triennial.
Before or after receiving state licensing, a nurse practitioner can apply for national certification from one of several professional nursing organizations such as the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners (AANP). The American Nurses Association (ANA) does not offer certification directly, but through its credentialing center, the ANCC. Some NPs pursue certification in a specialty. Several organizations oversee certification, including the following: