NPs are situated between registered nurses (RNs) and physicians when it comes to the type of education they have and the amount of responsibility for taking care of people that they assume.

In this article, you’ll learn about nurse practitioners’ education, specialization, and level of autonomy they have as compared to RNs and MDs.

Education and Training

To become an NP, you first need to go to college to earn your BSN, which a Bachelor of Science in Nursing degree. While there are two-year associate nursing degrees (ADNs), the four-year BSN track is required if you want to go on to be a nurse practitioner.

Depending on the program, by the time you get your BSN, you’ll have between 700 and 800 hours of experience working with patients.

Next, you need to pass the National Council Licensure Examination to become a licensed registered nurse (RN). This is required in all 50 states.

Whatever path you take to get your BSN, you must then go to graduate school to earn a Master of Science in Nursing (MSN) degree or a Doctor of Nursing Practice (DNP) degree, which is becoming increasingly more preferred. Several organizations have even called for DNPs to be the new standard for nurse practitioners.

The coursework includes at least 500 hours of supervised clinical work. It typically takes between two years and four years to complete this type of program.

Finally, you have to pass the National NP Certification Board exam to become a licensed NP.

Specialization

Nurse practitioners specialize in one type of medicine. When choosing a specialty, you may want to consider several factors, such as:

What type of conditions (cancer, mental health) or patients (children, seniors) are you most interested in treating?What’s the job pool like for that specialty? Is there an especially high demand?How does the specialty affect your pay?What environment and schedule would you like? For example, you may prefer a fast-paced, variable schedule in an emergency room vs. a slower-paced, consistent schedule in a doctor’s office.

The NP Master’s program curriculum is designed to focus on your specialty from the beginning. Common NP specialties include:

FamilyNeonatal (newborns)Pediatric (children)AdultGeriatric (seniors)Acute care (short-term illnesses)Oncology (cancer)Mental healthWomen’s health

If you want to add another specialty or subspecialty, you can do so later, such as after you’ve started your career. You’ll likely need to obtain certification in that area before you can add it to your practice.

Duties

Nurse practitioners can provide a broad range of care. Unlike RNs, NPs can:

Diagnose and treat illnessesWrite prescriptionsOrder medical testsInterpret test resultsCoordinate primary and emergency careBe primary care providers

The duties of an NP are very similar to those of a doctor. The primary thing NPs can’t do that doctors can is independently perform surgical procedures.

NPs may have a different approach than doctors, though. The American Association of Nurse Practitioners says NP’s training emphasizes the “health and well-being of the whole person” by focusing on:

Disease preventionPromoting good healthEducationCounseling

Autonomy

In the U.S., about half of the states allow NPs to practice without direct oversight from a doctor. That means they have complete autonomy and can even go into private practice.

This is the source of some controversy in the medical community. The American Medical Association has argued that NPs have too much autonomy and their training isn’t adequate for treating complex conditions.

But NPs say they’re trained to know when a patient needs to be referred to a doctor or a specialist.

Increasing the number of NPs in the U.S. has helped the medical system deal with the shortage of primary care providers.

Summary

Nurse practitioners have to earn a Bachelor’s of Science in Nursing and then a master’s or doctorate in nursing. They’re then required to pass licensing exams.

NPs choose a speciality when starting a Master’s program and their coursework focuses on that specialty throughout.

NPs can diagnose and treat illness and perform most of the functions that doctors can. Some states require NPs to be overseen by a doctor while others allow them to practice without oversight.