What is a nurse practitioner? 

The United States is experiencing a physician shortage. American Medical Association President Jesse M. Ehrenfeld, MD, MPH, cites “critical strains” on physicians and considers “an urgent crisis … hitting every corner of this country.” The physician shortage can limit access to vital healthcare for millions of Americans.

How can healthcare professionals — including nurses — reduce the impact of the shortage?

Part of the answer may lie with nurses who want to grow their skills and continue their education and career by becoming nurse practitioners (NPs).

Nurse practitioners fulfill a vital role in the healthcare system. An NP is an advanced practice registered nurse (APRN) who has completed additional training beyond that required of registered nurses (RNs). Nurse practitioners can provide either primary or specialty care, depending on their focus, education and experience.

NPs work with patients of all ages and in various settings, including hospitals, clinics and private practices. NPs have extensive training that enables them to provide many of the same services as physicians, often at a lower cost. Depending on the state, they may also be able to practice independently without physician oversight, further increasing their ability to meet patients’ needs. In fact, an NP might be a patient’s primary healthcare provider.

Nurse practitioners undergo training to perform various duties, including:

• Conducting physical exams
• Ordering and interpreting diagnostic tests
• Diagnosing acute and chronic conditions
• Prescribing medications
• Providing health education
• Making necessary specialist referrals

Becoming a nurse practitioner involves substantial training and certification, including active licensure as an RN, a graduate degree in nursing and advanced clinical training. Read on to learn more about nurse practitioners, including their daily responsibilities, practices and differences from other healthcare professionals.

Even though nurse practitioners and physicians have overlapping responsibilities, key differences between the roles include education, training and scope of practice.

Medical doctors must complete a four-year undergraduate degree, four years of medical school and three to seven years of residency. NPs typically need a bachelor’s degree in nursing, a master’s or doctoral degree in nursing practice and to pass an NP board exam.

University of Phoenix requires all nurse practitioner students to attend a five-day, in-person residency. This is to ensure the efficacy of their training, says Raelene Brooks, PhD, RN.

Brooks is the dean of the College of Nursing, and she points to the importance of this program differentiator. During their residency training, students perform exams on live models as a way to put theory into practice and gain skills that will benefit them in healthcare settings.  

While NPs and medical doctors can diagnose conditions, prescribe treatments and act as primary care providers, the scope varies for NPs based on state laws. In some states, NPs can practice independently; in others, they must have a collaborative agreement with a physician.

Because of their shorter training period, NPs can often cost less to employ than medical doctors. This can help make healthcare more affordable and accessible in underserved areas.

Nurse practitioners and physician assistants (PAs) provide patient care services, but there are big differences in their education, training, practice model and areas of specialization.

Compared with the nursing background of NPs, which emphasizes a holistic approach to patient care, PAs usually focus on a disease-centered medical model.

To illustrate this difference, Brooks refers to a diabetes diagnosis. A physician or PA might focus on managing the illness through medication, she says, whereas a nurse practitioner will try to understand the patient’s community, diet and lifestyle as well. Does diabetes run in the family? Are there other ways, such as diet and exercise, to mitigate the effects of the disease? Understanding this will help them diagnose, educate and treat patients for their diseases.

Most PAs hold a master’s degree in physician assistant studies. Their education typically mirrors that of doctors, focusing on diagnosis and treatment, and the scope of care is greater. For example, nurse practitioners cannot provide surgical care, but physician assistants who work with surgeons may, for example, be able to close incisions and perform duties before, during and after surgery.

Areas of specialization and practice can overlap between NPs and PAs. NPs often serve specific populations like pediatrics, women’s health, mental health and older adults, while PAs also work in areas such as family medicine, emergency medicine and psychiatry. 

While NPs and RNs are types of nurses who play crucial roles in patient care, nurse practitioners have more education and responsibilities than RNs.

RNs usually hold a diploma, associate degree or bachelor’s degree in nursing. After completing the degree or program, they must pass the National Council Licensure Examination (NCLEX-RN) to become licensed RNs.

Although NPs all begin as RNs they must go on to complete a master’s or doctoral degree and additional clinical training. They must also pass a national certification exam in their specialty.

The responsibilities of NPs and RNs differ significantly. Consider the following job duties of RNs:

• Provide direct patient care
• Administer medications
• Monitor patient progress
• Educate patients and families

NPs have a broader scope of practice. They can diagnose and treat acute or chronic conditions, prescribe medication and perform certain procedures.

RNs and NPs can both work in different medical settings and gain experience in various fields. RNs might specialize in critical care or trauma, for example, and NPs can specialize in areas like family practice, pediatrics, adult gerontology, mental health and women’s health, among others.

What does a nurse practitioner do each day? Like any nursing-focused profession, the answer depends on where they practice and what they specialize in. Generally speaking, however, NPs often perform the following tasks:

• Take medical histories and conduct exams
• Diagnose acute and chronic illnesses
• Develop treatment plans and prescribe medication
• Educate their patients on health promotion

Remember, the scope of an NP’s practice can vary based on their location, autonomy and specialty.

While not exactly among the many related but alternative careers to nursing, working as an NP does offer a discrete professional experience. That’s especially true if you want to specialize in a particular branch of care. Some nurse practitioners focus on family medicine, while others might devote their practice to pediatrics. Other specialties include psychiatric and mental health care, acute care and neonatal care.

NPs specialize in particular areas of focus and their education is tailored to their chosen focus. Let’s walk through a couple of specialties for NPs below.