If you are a registered nurse or LPN/LVN looking to take the next step in your career, you should certainly consider an advanced practice degree and the steps to become a nurse practitioner.
According to April Kapu, President of the American Association of Nurse Practitioners, an advanced practice degree is all about “continuing to build upon the education you have to create more opportunities…It’s about creating opportunities and reaching people in different ways throughout your career.”
For Kapu, a holistic approach to patient care is basic to nursing practice at all levels, “taking into consideration…where [patients] live, where they work, their transportation, their access.” This same holistic lens shapes the NP role. “As a nurse practitioner, we diagnose, we prescribe pharmacologic and non-pharmacologic therapies, we coordinate care with everybody on the healthcare team.”
And patients are responding, she notes, by increasingly indicating a preference to be seen by NPs, even when MDs are in-clinic as well. This preference has also been observed by Karen Perion, an adult-gerontological and acute care NP. Patients “feel more at ease; they feel more collaboration [and] more advocacy” from NPs. For Perion, “advocacy, collaboration, and communication” are the three key things she learned as a bedside nurse, and these are also the goals she brings into her NP practice each day.
The Need for Nurse Practitioners
But it’s not just about having a fuller engagement with the care of individual patients. NPs also reach many millions of patients who would otherwise struggle to find care at all.
According to Kapu, 89% of new NPs are certified in primary care. This ratio has remained constant even as the number of practicing NPs has exploded in recent years, from 148,000 in 2010 to 222,000 in 2016, to 355,000 by Spring of 2022. These numbers make clear how NPs have stepped in to fill the substantial and growing shortage of primary care physicians in the U.S.
In fact, by last year there were more NPs licensed for primary care than there were primary care physicians, who now make up only about 30% of all MDs. But the current physician shortfall extends well beyond primary care. Rural areas of the U.S. are now deeply under-served by both general practitioners and specialist physicians. Another clear barrier to care is economic — many physicians are unable to accept Medicaid, while many Americans on Medicare struggle to find primary care physicians and specialists accepting new patients.
It is no surprise, then, that NPs are in particular demand in rural America and, over 80% of NPs accept Medicare and Medicaid patients.
Education To Become a Nurse Practitioner
Of course, the enhanced clinical responsibility of the NP role requires further education and certification. Many RNs are already increasing their career opportunities by going beyond the Associate Degree to a four-year BSN. The next step would be a Master of Science in Nursing, typically requiring another 18 to 24 months of study beyond the BSN level.
But practical nursing experience still plays a central role in advancing one’s formal nursing education. As Karen Perion emphasizes to her own nursing students at Harper College near Chicago, students who attain their associate’s degree in nursing should put in at least a year of practical bedside nursing before they consider a bachelor’s degree and probably even more before considering a master’s degree. “You’ve got to get your feet wet; you’ve got to figure out what’s your passion — what exactly do you want to do within nursing?”
After all, an advanced practice nursing degree opens up a host of specialties within the NP role. Aside from primary care, NPs can specialize in acute care and gerontology, pediatrics, psychiatric care, women’s health and other areas. Typically, these require choosing your specialty at the start of your graduate coursework, and both that choice and the coursework will make a good deal more sense if it’s grounded in practical, bedside nursing experience in that specialty.
Finally, for those nurses who want to make a difference in their field beyond individual patient care, the final step would be a doctorate in nursing practice. DNPs play advanced roles in nurse leadership as well as research and teaching. As Kapu says, “We want nurses to lead in every space: we want nurses to be on boards and in government. We want them to lead hospital and executive teams. And that’s where the doctorate really comes into play.”
Next Steps and Financial Aid
Of course, many working nurses considering an NP path will be concerned about tuition expense. But Kapu emphasizes that there are now very considerable financial-aid resources available to nurses, in the form of scholarships and fellowships, grants, and loan-forgiveness programs, offered not only by nursing schools but also by healthcare employers themselves as the need for advanced practice nursing becomes increasingly clear.