What Degree Do You Need to Be a Nurse Practitioner?
Written By: Pattie Trumble, MPP, MPH
Do you want a job that pays well and is unlikely to become obsolete no matter how drastically the job market changes in the future? Consider becoming a nurse practitioner. The novel coronavirus crisis has accelerated a rising demand for primary care providers that was initially fueled by increasing medical needs of an aging Boomer population. Nurse practitioners and physician assistants are both qualified to provide this type of primary health care; where they differ is that physician assistants graduate with an education in general medicine whereas nurse practitioner education is geared to the health care needs of specific populations. According to the U.S. Bureau of Labor Statistics, employment for nurse practitioners should grow 26 percent by the year 2028. If you’ve been wondering what degree you need to be a nurse practitioner, this article explores the options that are available to you.
State Nurse Practice Acts
So, before we can talk about what degree do you need to be a nurse practitioner, let us first clearly understand the educational, certification, and licensure requirements you need to fulfill to become a nurse practitioner.
Nurse practitioners are one type of advanced practice nurse
. Other types of advanced practice nurses include clinical nurse specialists, nurse anesthetists, and nurse-midwives. Every state and territory of the U.S. has legislated some version of a nurse practice act in which, among other things, advanced nursing practice is defined. These nurse practice acts also establish the regulatory board that oversees nurse practitioner occupational requirements as well as the nurse practitioner’s scope of practice. There can be considerable variation from state to state in just what those occupational requirements consist of, but at a minimum, nurse practitioners must hold an unencumbered Registered Nurse (RN) license, earn a graduate degree and pass an examination that qualifies them for national certification within a specific population focus. Once you have completed these steps, you will be eligible to obtain Advanced Practice Registered Nurse (APRN) licensure within your state.
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The First Step: Obtaining a Registered Nurse License
Officially, the only requirement necessary to obtain an RN license is successful passage of the NCLEX-RN exam, which was developed by the National Council of State Boards of Nursing (NCSBN) to measure the fitness of U.S. nursing school graduates. You can sit for this test whether you have a Bachelor of Nursing Science degree (BSN), an Associate of Applied Science degree with a nursing emphasis (AAS) or a nursing diploma from a hospital-based nursing school.
A BSN has many advantages
over an AAS or a hospital diploma, however, and it is definitely the degree you need to be a nurse practitioner. Employers prefer RNs who hold BSN degrees, particularly if the job to be filled entails any sort of management responsibilities. This higher level of education means that you have had more training in whatever clinical field you subsequently enter. According to the American Association of Colleges of Nursing (AACN), facilities with higher numbers of BSN-prepared nurses demonstrate lower patient mortality as well as higher proficiency at diagnoses and implementing nursing interventions. BSN-prepared nurses tend to be more highly paid, too.
Additionally, many health care policy analysts believe it is only a matter of time states make BSN qualifications mandatory. In 2017, New York State passed the “BSN in 10” law
, which requires all registered nurses to obtain a BSN within a decade of obtaining their RN license for the first time. The New Jersey and Rhode Island state legislatures are currently reviewing similar bills.
A BSN is also a prerequisite for most Master’s of Nursing Science (MSN) degree programs, and nurse practitioners must, at a minimum, have an MSN.
The Second Step: Choose a Specialty
Before you figure out what degree you need to be a nurse practitioner, you’ll need to decide which specialty you want to specialize in. This will determine the advanced practice track you apply to whether that track is associated with an MSN or DNP
In a document entitled “Consensus Model for APRN Regulation
,” the NCSBN recognizes six distinct population foci as foundations for nurse practitioner specializations. These population foci are:
Family nurse practitioners deliver family-focused care, which can include the diagnosis and treatment of illnesses as well as disease prevention and wellness promotion. Family practitioners conduct patient exams, order tests, interpret test results, and prescribe medications.
Adult-gerontology nurse practitioners care for individual patients from adolescence through adulthood and into old age. There are two subspecialties within adult-gerontology: Primary care adult-gerontology nurse practitioners focus on adults within the general population while acute care adult-gerontology nurse practitioners focus on hospitalized patients.
Neonatal nurse practitioners care for high-risk and preterm newborns during the course of these infants’ initial hospitalizations. Often, neonatal nurse practitioners will follow these children for the first few years of these children’s lives.
Pediatric nurse practitioners specialize in the care of infants, toddlers, and adolescents. As with adult-gerontology nurse practitioners, this track contains two subspecialties: Primary pediatric nurse practitioners work with general populations, often in association with a pediatrician, while acute pediatric nurse practitioners focus on hospitalized children.
• Women’s health:
Women’s health nurse practitioners provide care to women from puberty through menopause.
• Psychiatric-mental health:
Psychiatric-mental health nurse practitioners assess, diagnose, and treat patients with mental health or substance abuse disorders.
The Third Step: Graduate Nursing Education
In order to become a nurse practitioner, you must attain either an MSN degree or a Doctor of Nursing Practice (DNP) degree. Selecting between these two options largely depends upon what you plan to do once you attain your APRN license. If you’re interested in interacting with patients as an autonomous or semi-autonomous practitioner within your chosen specialty field, an MSN will be sufficient. If, however, you’re interested in assuming a leadership position that goes beyond providing care, a DNP will be better suited to your goals.
• The MSN Degree
If you are able to attend school fulltime, you should be able to complete an MSN degree in two to three years. Most universities that offer MSN programs understand that many nurses will need to work; these schools permit part-time enrollment with the caveat that degree candidates will need to complete the course of study within a certain time cap. Some schools offer accelerated MSN programs that allow students to complete their coursework in less than a year.
Traditional BSN-to-MSN programs offer two types of classes:
didactic courses that use a hierarchical teaching method and rely upon structured materials, and experiential learning sessions called practicums or clinical rotations during which students shadow advanced practice nurses, interact with patients and gain hands-on experience. Didactic requirements vary according to the mandatory core nursing classes, specialty classes, and capstone projects, but typically, degree candidates must complete somewhere in the neighborhood of 30-semester credits.
Clinical rotations are scheduled for health care facilities that are near the university the degree candidate is attending, or close to his or her home or place of work. Clinical sites include public hospitals, university medical centers, ambulatory care centers, private practices, and similar facilities. Depending upon the school and the specialty a student is pursuing, he or she will be required to complete between 500 and 1,000 clinical hours.
Distance Learning Format:
An increasing number of MSN programs are being offered in a distance-learning format. So long as the program is accredited by a respected agency, you can be confident that the curriculum meets a high standard. While some MSN programs are offered entirely online, most utilize a hybrid format in which the majority of the coursework is offered over the internet, but students are expected to visit campus two or three times every semester to participate in skills-building intensives.
• The DNP Degree
Aspiring nurse practitioners can take advantage of two types of DNP tracks. Traditional DNP programs take up where an MSN program ends; so-called bridge programs accept BSN-prepared students and allow degree candidates to satisfy their master’s and doctoral requirements in the same academic stretch. More often than not, nurse practitioner specialty training is offered in conjunction with BSN-to-DNP tracks. BSN-to-DNP tracks typically involve three to four years of full-time study and as many as seven years of part-time study.
A typical BSN-to-DNP degree requires between 65 and 95 credits for completion. The course of study includes both didactic components and clinical preceptorships. Just as with MSN programs, DNP degrees are offered through distance learning as well as on university campuses.
The Fourth Step: Certification from a Specialty Nursing Board
Once you’ve finished training for the degree you need to be a nurse practitioner, you will need to pursue certification through a licensing board such as the American Nurses Credentialing Center
(ANCC) or the American Academy of Nurse Practitioners
(AANP.) This involves passing a certification examination.
The AANP offers certification exams for aspiring adult nurse practitioners, family nurse practitioners, and adult-gerontology primary care nurse practitioners. The ANCC offers certification exams for aspiring acute care nurse practitioners, adult nurse practitioners, family nurse practitioners, both primary and acute gerontology nurse practitioners, pediatric primary care nurse practitioners, and psychiatric-mental health nurse practitioners. Acute and primary pediatric nurse practitioners can also be certified by taking an examination administered by the Pediatric Certification Nursing Board
while the National Certification Corporation
administers the examinations of women’s health and neonatal nurse practitioners.
Once you have obtained national certification, you can seek to be licensed as an advanced practice registered nurse through your state’s board of nursing. The professional boundaries you will be responsible for working within after you receive your APRN license vary from state to state: Twenty-one states and the District of Columbia allow nurse practitioners to practice autonomously but the remaining states all require some degree of physician oversight.
The Bottom Line
Aspiring advanced practice nurses who’ve been wondering, “What degree do you need to be a nurse practitioner?” have two options. A Master’s in Nursing Science degree program will prepare you for a professional role as a hands-on caregiver and will take two to three years to complete if you have enrolled fulltime in your program. A Doctor of Nursing Practice, on the other hand, will prepare you both as a hands-on caregiver and as a clinical leader, and typically involves three to four years of full-time study. The two degrees support different career paths, so it’s important to assess your own professional ambitions before you decide which degree to pursue.
Frequently Asked Questions Answered
Is a BSN Always a Prerequisite for an MSN?
Well the answer is “no”
If you don’t have a BSN and are wondering, “What degree do you need to be a nurse practitioner?”, it’s definitely worth investigating the following two pathways:
For someone who has completed your AAS and is registered as a nurse, you can enter any one of the 129 RN to MSN programs
and complete your graduate nursing education. This way you can earn a dual degree of a BSN and an MSN.
Alternatively, if you are keen on completing an MSN program but have a bachelor’s in a non-nursing field
you can consider any of the Direct-entry MSN programs
. These programs are designed so that degree candidates complete BSN requirements in their first year of studies. As of 2019, there were 282 direct-entry MSN programs
in the U.S.
Pattie Trumble, MPP, MPH
Pattie Trumble is a nurse who worked in both California and New York for many years as an emergency room nurse. She holds a Bachelor’s Degree in Economics from the University of California, Berkeley, and an Associate Degree in Nursing from the Samuel Merritt Hospital School of Nursing. After 10 years of providing direct care, she went back to school and earned concurrent Master’s degrees in both public policy and public health from the University of California, Berkeley. Thereafter, she worked for various public health agencies in California at both the community and state levels providing economic and legislative analysis.