Learn How to Become a Family Nurse Practitioner

Family nurse practitioners care for patients across their whole lifespan, from infancy through old age.

Family Nurse Practitioner at a Glance

What you'll do: Care for patients over their lifespans, from infancy through adulthood.

Where you'll work: Hospitals, physicians' offices, outpatient care centers.

Degree you'll need: Master of Science in Nursing (MSN).

Median annual salary: $129,210 (BLS median for nurse practitioners).

Much like a primary care physician, family nurse practitioners (FNPs) care for patients throughout their lives. "It's a step up from a traditional registered nurse role," says Joel Shouse, FNP-C, who works at Allergy and Asthma Care of Indiana, a specialty clinic in central Indiana. "We can make diagnoses, order and interpret labs, and prescribe medications. In some states, family nurse practitioners can even open their own practices."

Some nursing schools let students go straight from undergraduate to graduate study, while others require one to two years of RN experience first. Shouse took the latter route, working 12 years as an RN across intensive care, cardiac ICU, and emergency settings before becoming a nurse practitioner. He recommends it. "Get into the nursing field first, so you get an inside look at what it means to be a provider."

What Does a Family Nurse Practitioner Do?

According to the American Association of Nurse Practitioners, FNPs focus on three clinical areas: primary care, urgent care, and internal medicine. As an FNP you provide direct and preventive care, including:

• Performing physical exams
• Prescribing medications
• Ordering diagnostic tests
• Developing treatment plans
• Treating chronic and acute illnesses
• Maintaining health records

Like a family physician, you partner with patients throughout their lives as a trusted provider. You can also subspecialize. Shouse, for example, focuses on asthma and immunology. Other subspecialties include medical-surgical, cardiac, endocrine and diabetes, renal and urology, postpartum, perinatal, long-term care, orthopedics, pulmonary, pediatrics, gerontology, ER and trauma, critical care, psychiatric, and rehabilitation.

"That's the beauty of the nursing model," Shouse says. "Once you're an FNP you can take your path where you like." Beyond clinics, FNPs work in hospices and palliative care centers, nurse-managed health centers, schools and universities, nursing homes, and their own private offices.

Nurse Practitioner vs Medical Doctor

A visit to the doctor's office does not always mean seeing a physician. To keep up with demand, nurse practitioners often handle your care instead. The quality is comparable, but the jobs differ. A physician completes four years of medical school after a four-year undergraduate degree, plus a multi-year internship and residency, roughly 12 years total. An NP typically starts with a BSN, adds an MSN or Doctor of Nursing Practice (DNP), and passes a certification exam, usually about six years total.

The approach differs too. A physician's training focuses on curing disease, while an NP's approach leans more holistic, centered on the whole body and mind, though there is plenty of overlap.

Degrees and Educational Requirements

An FNP is a nurse practitioner who specializes in family medicine. Both are advanced practice registered nurses (APRNs). You must be an RN first. Some programs let you move directly from undergraduate to graduate coursework; others require at least a year of work experience.

The field is shifting toward a doctorate as the entry standard. The National Organization of Nurse Practitioner Faculties has advocated for the DNP as the new educational minimum for nurse practitioners, and the Council on Accreditation of Nurse Anesthesia Educational Programs already requires doctoral preparation for new nurse anesthetists. No firm deadline applies to NPs yet, but keep the trend in mind when choosing between an MSN and a DNP.

If You're Seeking a Master's

Admission usually requires a BSN, though some programs accept an ADN or an undergraduate degree in another field. You will also need a state RN license in good standing, a strong undergraduate GPA (typically 3.0 or above), academic and professional references, and, for some programs, GRE scores. Most programs expect prerequisites like anatomy, statistics, and general chemistry. Many associate-degree RNs choose the RN-to-MSN bridge program, which earns a master's without four separate years for a BSN.

If You're Seeking a Doctorate

A DNP program requires a BSN from an accredited school with a strong GPA, an RN license in good standing, letters of recommendation, a resume, and a personal statement; some also want GRE scores. A DNP typically takes three to four years of full-time study. Whether you study on campus or online, you will need onsite clinical experience.

Most nursing programs, including FNP programs, offer online options, which work well for people balancing full-time work or family. Note that clinical hours still have to be completed in person at a hospital, clinic, or other approved setting.

How Important Is Accreditation?

Accreditation expands your access to jobs, grants, and financial aid, and it holds schools to consistent quality standards. The two nationally recognized accreditors are the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN). Accreditation is not permanent; it is awarded for a set period, usually five to 10 years, so check the status of your program.

What Licenses and Credentials Do I Need?

After earning your MSN or DNP with an NP focus, you take a national certification exam to be credentialed. Most FNP programs are built to meet national FNP certification standards. Check with your state board of nursing to learn which bodies it accepts: the American Nurses Credentialing Center (ANCC) and the American Association of Nurse Practitioners (AANP).

Getting Your National Certification

The ANCC's FNP-BC exam uses alternative item types and covers nursing theory; the AANP FNP-C exam is multiple choice and focuses on clinical practice. Both are timed and computerized. To sit for either, you need:

• An active RN license
• A master's, doctorate, or post-graduate degree from an accredited program
• At least 500 faculty-supervised clinical hours
• Coursework in advanced physical and health assessment, advanced pharmacology, and advanced pathophysiology

Getting Your State License

With your degree and certification, apply for APRN licensure through your state board. All FNPs can prescribe medications, though some states require you to apply for prescriptive authority. To prescribe controlled substances, you must register with the Drug Enforcement Administration's Diversion Control Division. Some states require a practice agreement with a physician, but 27 states and the District of Columbia grant nurse practitioners full practice authority, allowing them to practice without physician oversight.

Maintaining Your Certification and License

You renew your national certification and state APRN license by completing clinical practice hours and continuing education, generally every five years. Requirements vary by state.

How Much Can I Earn as a Family Nurse Practitioner?

The BLS does not list a median specifically for FNPs, but the median for nurse practitioners is $129,210. As the supply of primary care physicians shrinks and demand grows with an aging population and rising chronic illness, demand for FNPs will keep climbing, especially in rural and underserved communities.

How to Stay Informed

As an FNP, you direct your own continued learning, and the field offers plenty of support. The AANP runs 17 specialty practice groups, including acute care, health informatics and telehealth, and occupational and environmental health. There is also the International Council of Nurses' Nurse Practitioner network and organizations at the state level.

"Your journey doesn't stop with school; it just gets started," Shouse says. "It's up to you to become more proficient and always be learning. Every day you'll see something new come up."

Is Family Nurse Practitioner the Right Specialty for Me?

Beyond clinical skill, hiring managers look for flexibility, time management, organization, and strong communication. Shouse also says to make sure you "have the heart of a nurse" before stepping up. "It's a beautiful field, a holistic, patient-focused approach," he says. "But you have to make life-altering decisions for people in your care, so you have to be sure nursing is your calling."