While it is undoubtedly true that a new generation of health tech applications has helped reach previously underserved and disadvantaged populations, it remains an enduring truth that people suffering from illnesses and other health problems reach out for a reassuring human touch when they need expert help. At the frontline of medical and health delivery for the “patient” (a term meaning “the one who suffers”) in their hour of need is a growing army of expertly trained family nurse practitioners.
Let’s take a deeper dive into what goes into the making of a family nurse practitioner, how people can change careers by getting qualified, and what career opportunities stand in waiting for graduates once they’ve “made the grade.”
What is a family nurse practitioner?
A family nurse practitioner (FNP) is a medical professional who has undergone further training to gain credentials signifying a more advanced level of expertise than their original professional entry-level qualification. More specifically, these sought-after professionals have undergone a master’s degree that grants them Advance Practice Registered Nurse (APRN) status. They may, and many do, progress to a Doctoral degree.
Their advanced training equips them with deeper clinical knowledge to perform higher-level clinical duties as well as a raft of more senior managerial responsibilities than junior nurses are qualified to undertake. FNPs generally work under a physician but do so with a high degree of professional autonomy. They are, for example, qualified to order and/or undertake diagnostic tests, observe and assess symptoms, prescribe medications, perform physical examinations of patients, devise treatment plans, and treat injuries, serious conditions, and illnesses (both acute and chronic) that fall under the primary care umbrella. Treatment can include performing or assisting in procedures, in the surgical theater or at the bedside. Family Nurse Practitioners also maintain accurate patient records.
Yet it oversimplifies the role to describe it solely in terms of treating the unwell, as family nurse practitioners also work in the community to promote health and prevent disease with diverse communities – work that encompasses the entire lifespan and empowers patients to maintain their health whatever age they may be, from infants, children and adolescents to adults and seniors.
In other words, FNPs also practice health education with their patients, equipping them with the knowledge to prevent future illnesses and safeguard their health. The guiding principle of preventative care is that, wherever possible, preventing a health catastrophe is better than treating it after it has happened, and FNPs possess the expertise to educate people, who may be living unhealthy lifestyles, to make adjustments that could spare them considerable suffering.
How did the Family Nurse Practitioner role come into being?
Following the 1965 Medicare Act, healthcare pathways were suddenly opened for populations who had previously faced significant disadvantages to access the provisions – chiefly, these were elderly and, or low-income people. A knock-on effect of this surge in the numbers of people seeking healthcare was a shortage in the number of fully trained physicians available: not enough was in place to cope with the rise in hitherto underserved healthcare seekers. The result? Nurses stepped into the breach to fill the gap in provision, and the Nurse Practitioner role was born. The University of Colorado won the race to become the first higher education establishment to launch a nurse practitioner program. Focused on delivering primary care to children, it was initially a certificate program but evolved into a master’s degree a few years later in the 1970s. During this transition, the course content grew to encompass not only pediatrics but neonatology, family, adult, women’s health, gerontology, and other specialisms.
An indicator of the demand for these roles is evidenced by the fact that by 1973, a mere eight years after the Medicare Act, over 65 nurse practitioner programs were available in the United States. Just seven years later in 1980, that number had ballooned to 200 and two new professional organisations were created in response: the Nurse Practitioner Association for Continuing Education (NPACE) and the American Association of Nurse Practitioners (AANP).
The nurse practitioner profession has grown at an accelerating pace in line with unlimited demand ever since. Today, over half a century after the first roles were created, there are at least 355,000 nurse practitioners at work in the United States, with no sign of demand for their services declining. According to the AANP, this demand is likely to grow even stronger due to the expanding healthcare needs of an aging population as human lifespans increase.
Where do FNPs work?
FNPs provide advanced medical services in a broad variety of healthcare settings. In remote rural areas, where there are insufficient physicians to serve the whole community, they may be the primary care provider. The most common settings where FNPs are employed are:
- Clinics
- Private practice physicians’ offices
- Hospitals
- Outpatient services
- Community health centers
- Telemedicine
- Health insurance
How to become a Family Nurse Practitioner
People from a wide array of backgrounds can train to become an FPN, although the preliminary qualification before doing so is to graduate as a registered nurse (RN). However, the pathway to this qualification is remarkably diverse: as Business Insider reported, one RN came to nursing after first graduating as an attorney! Candidates must possess the academic and personal aptitudes to fulfill this demanding, but highly rewarding role, but before earning RN credentials, most have earned either a bachelor’s degree from an accredited higher education establishment or, until recently, a diploma from an approved vocational training program.
For those planning to become an RN, it is important to bear in mind that the vocational route is falling out of favor because most healthcare employers now require their clinician employees to possess a college degree. However, as the former attorney demonstrates, this degree doesn’t have to be in a clinical or medical science subject.
At this early stage, some people take combined courses which allow them to graduate simultaneously with a bachelor’s degree and RN credentials. Others make the progression in stages by first becoming a licensed practical nurse (LPN), while yet others who already have a bachelor’s degree in an unrelated subject take the option of an accelerated track to a nursing bachelors.
Candidates pursuing a Bachelor of Science in Nursing (BSN) should be aware that the course will require a large clinical component, including clinical placements to put learning into practice.
The next stage in how to become a Family Nurse Practitioner, is more specialized: the minimum qualification for this versatile and significant role is to gain a Master of Science in Nursing (MSN) degree – a course which often requires candidates to have obtained some years of prior nursing experience. Some accredited centers of learning like Marymount University offer family nurse practitioner-specialist MSN – an online MSN-FNP program that prepares its graduates for the national certification exam which all FPNs must pass. The program entails a combination of classroom teaching, laboratory experience and clinical placement, all of which are mandatory for FNP status.
During their master’s degree, all FNPs will typically study a range of core subjects, including:
- Pathophysiology
- Pharmacology
- Health care analysis
- Leadership and ethics
- Population health
- Primary health care
- Models of delivering care
- Physical health assessment and diagnostics
- Health care policy
The Maryland MSN-FPN degree covers each of the above in-depth.
While it is more efficient for some people to proceed to an FNP career in a “straight line,” as it were, via the nursing school route, many people discover after they have embarked on career paths chosen during adolescence or young adulthood that they crave something more fulfilling and socially valuable. Online options like the Maryland MSN-FNP program can offer all who find themselves in that predicament a new alternative, with flexible progression through the course available from the comfort of one’s own home (apart from clinical placement requirements, where help in sourcing suitable ones close to home is provided by the university).
What career opportunities exist for Family Nurse Practitioners?
This profession offers its graduates strong career security: FNP roles in the US have been expanding consistently at a conservatively estimated rate of 17,000 per year. And it doesn’t stop there: it’s also a particularly well-remunerated nursing role, with practitioners earning, on average, six figure salaries. In 2021, data from the U.S. Bureau of Labor Statistics highlighted that the median annual salary for family nurse practitioners was $120,680 – a figure that dwarfs the equivalent for registered nurses, which stood at $77,600.
Additionally, there are other rewards that are even more satisfying and fulfilling, for example, playing a key role as a family nurse practitioner to provide a critical service for patients in need of healthcare. This commitment and sense of fulfilment was reflected in 2021 statistics whereby only 12% of physicians opted for roles in primary healthcare but a staggering 89% of nurse practitioners did.
Even in economically testing times, demand for primary and family nurse practitioners is forecast to continue growing vigorously. For example, the Association of American Medical Colleges projects that over the next 12 years, the shortfall in trained physicians will reach 122,000. However, as the Bureau of Labor Statistics has acknowledged, there is a silver lining in this predicament: FNPs are qualified and competent to perform many of the duties of physicians and are set to play a crucial role in plugging this gap. In the coming decade, the Bureau predicts, demand for nurse practitioners is poised to surge by 52%, a figure which translates into approximately 16,900 new job openings for these professionals each year on average.
Recent research from the American Association of Nurse Practitioners found that the most popular practice settings for FNPs were hospital outpatient clinics, private physicians, and private group practices but this is far from an exhaustive list and there is plenty of room for a broad range of interests in this discipline.
Many FNPs, for example, opt to work in Community Health Centers that frequently serve low-income populations, helping people of all ages who may be unable to afford health insurance and may face additional barriers due to language differences.
Some practitioners opt to work in Urgent Care Clinics, delivering acutely needed treatment interventions to people suffering a range of different illnesses and conditions.
Others choose to focus on Home-Based Primary Care (HBPC), providing vulnerable patients with the medical care they need in their own homes.
Flying solo, otherwise knowns as “going into private practice,” is also an option for qualified family nurse practitioners, although this requires additional entrepreneurial skills to be successful. FNPs in private practice are responsible for the business side, maintaining a viable enterprise whilst simultaneously fostering long-term, professional-clinical relationships with a diverse range of patients. Those who pursue this option often spend some years gaining expertise and experience in salaried clinical settings first.
Practitioners who enjoy working with children and teens may be drawn to providing their services to school-based health centers. These centers are usually, collaborative operations that partner community health organizations with schools. They allow FNPs to deliver a complete range of age-appropriate healthcare services to youngsters where they are located. Universities also offer these services to older adolescents and young adults.
FNPs may also choose to provide their invaluable expertise to hospice settings, helping terminally ill patients to manage their conditions in their last days and providing indispensable emotional support for their final journey. This work also involves communicating closely with the patients’ loved ones, providing invaluable support and comfort as they prepare for their farewell.
In conclusion
Becoming a Family Nurse Practitioner is a deeply rewarding career path in respect of finance and spirituality. FNPs are compassionate, academic individuals who want a fulfilling career. It is an extraordinarily diverse career which offers a range of options and opportunities to those who quality, providing settings and specialisms to suit all interests.
It continues to be an especially in-demand healthcare profession. Yes, becoming an FNP requires a great deal of demanding work and commitment but the rewards it yields for the rest of one’s professional life are, for those with the aptitude and dedication to pursue it, without parallel.