Going from RN to NP

The transition from a registered nurse (RN) to a nurse practitioner (NP) is a journey of professional growth that opens up new opportunities in the healthcare field. While both RNs and NPs play a crucial role in healthcare, NPs can prescribe medications, provide advanced care, and determine diagnoses, though their exact scope of practice varies by state (1). The transition from RN to NP allows nurses to expand their responsibilities, increase their income, and practice more independence, but the process of shifting between roles requires investment and determination.

The transition typically begins with the desire of an RN to continue their career development and expand their responsibilities (3). RNs function as the backbone of healthcare, from advocating for patients to providing patient care to documenting records, but their scope of practice is limited — unlike NPs, RNs cannot diagnose conditions, prescribe medications, or create treatment plans (2). In contrast, RNs are responsible for providing the majority of direct patient care, including administering medications, drawing blood, collecting urine samples, and recording patient information, while NPs typically perform less face-to-face patient care and more behind-the-scenes specialized care (4). From a financial standpoint, NPs report an average salary of $117,000, compared to the average RN salary of $90,000 (2, 5).

Although most RNs remain RNs for their entire career, some may develop an aspiration to extend their scope of practice and autonomy (6). Others may hope to leave the clinical side of healthcare and focus on research or administration instead (7). Whether searching for increased medical authority, more independence, or a career change, an increasing number of RNs are embarking on the route to becoming an NP (8).

The first step on the route from RN to NP is further education. In addition to their bachelor’s or master’s degree in nursing, a passing score on the NCLEX, and RN certification, NPs are required to hold at least a master’s of science in nursing (MSN), though those who hope to engage in research or hold advanced positions typically pursue a doctoral degree in nursing practice (DNP) (9). Both types of programs cover advanced clinical skills, pharmacology, diagnostic reasoning, and development of specialization (9). Pursuing either degree can take two to five years and cost anywhere from $20,000 to $70,000, depending on the type of program and level of previous education (9). Most NP programs also require a preceptorship, a clinical experience in which NP students shadow advanced nursing professionals to gain inside knowledge of their future field (10). Finally, NP students must pass a board examination before practicing as NPs (2).

The second step on the route from RN to NP is specialization. Many RNs work within a specialty, and becoming an NP allows them to play a more active role in treating or researching within that field. During advanced nursing education, NP students pick a specialty, with programs offering tracks in certain demographics (such as pediatrics) or clinical fields (such as psychiatry) (3). Primary care is the most common specialty, with around 80% of NPs becoming certified as family or adult primary care nurse practitioners (FNPs and AGPCNPs) (11). Certifications in other specialties, such as women’s health, neonatal care, and acute pediatric care, are significantly rarer, and there is a need within the field for such providers (11).

After completing two to five years of advanced education, selecting a specialty, and gaining board certification, RNs officially become NPs. This achievement opens many opportunities, as the projected demand for NPs will reach 38% by 2030, compared to a 6% demand for RNs (12, 13). NPs can also help fill in the healthcare gaps caused by the physician shortage, especially in states wherein they can practice independently (14). Furthermore, NPs report high levels of job satisfaction, specifically in the categories of autonomy and respect from colleagues (15). Although the route from RN to NP is labor intensive and expensive, the increased autonomy, scope of practice, and breadth of possible roles makes the majority of NPs happy they made the leap (15).

References

1: American Association of Nurse Practitioners. 2022. Scope of practice for nursing practitioners. American Association of Nurse Practitioners. URL: https://www.aanp.org/advocacy/advocacy-resource/position-statements/scope-of-practice-for-nurse-practitioners.

2: Zonneveld, K. 2022. RN vs. NP: comparing registered nurses to nurse practitioners. Nursa. URL: https://nursa.com/blog/rn-vs-np-comparing-registered-nurses-to-nurse-practitioners.

3: American Association of Nurse Practitioners. 2022. The path to becoming a nurse practitioner. American Association of Nurse Practitioners. URL: https://www.aanp.org/news-feed/explore-the-variety-of-career-paths-for-nurse-practitioners.

4: Behring, S. 2021. RN vs. NP: registered nurse vs. nurse practitioner, explained. All Nursing Schools. URL: https://www.allnursingschools.com/articles/registered-nurse-vs-nurse-practitioner/.

5: Guarniere, A. 2023. Registered nurses (RN) vs. nurse practitioners (NP). Indeed. URL: https://www.indeed.com/career-advice/finding-a-job/nurse-practitioner-vs-rn.

6: Clarke, E. 2022. 6 reasons to become a nurse practitioner. Nurse Journal. URL: https://nursejournal.org/nurse-practitioner/reasons-to-become-np/.

7: Lambert, L. and Housden, L. 2017. Nurse practitioner engagement in research. Canadian Oncology Nursing Journal, vol. 27. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6516367/.

8: Salsberg, E. 2018. Changes in the pipeline of new NPs and RNs: implications for health care delivery and educational capacity. Health Affairs. DOI: 10.1377/hblog20180524.993081.

9: Gaines, K. 2022. NP vs. DNP: what’s the difference? Nurse.org. URL: https://nurse.org/articles/family-nurse-practitioner-masters-degree-or-doctor/.

10: Zbrog, M. 2018. A guide to preceptorships for NPs. NP Schools. URL: https://www.npschools.com/blog/np-guide-to-preceptorships.

111: American Association of Nurse Practitioners. 2022. NP fact sheet. American Association of Nurse Practitioners. URL: https://www.aanp.org/about/all-about-nps/np-fact-sheet.

12: United States Bureau of Labor Statistics. 2023. Nurse anesthetists, nurse midwives, and nurse practitioners. Occupational Outlook Handbook. URL: https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm.

13: United States Bureau of Labor Statistics. 2023. Registered nurses. Occupational Outlook Handbook. URL: https://www.bls.gov/ooh/healthcare/registered-nurses.htm.

14: Jakucs, C. 2022. Nurse practitioners are primed to help bridge physician shortage. Nurse. URL: https://www.nurse.com/blog/nurse-practitioners-primed-to-help-bridge-physician-shortage/

15: United States Health Resources and Services Administration. 2022. National sample survey of nurse practitioners (NSSNP). HRSA NSSP 2014. URL: https://bhw.hrsa.gov/data-research/access-data-tools/national-sample-survey-registered-nurse-practitioners.