Autonomy in Nursing: Exploring The Nurse Practitioner Pathway

a nurse practitioner presenting a diagnosis to her patient
a nurse practitioner presenting a diagnosis to her patient

Many nurses believe their profession is not just a job, but a calling. While many nurses feel that to Live with Purpose is to help their patients, professional goals for nurses vary, and some aspire to have greater influence on patient outcomes and overall well-being. The nurse practitioner pathway is a nursing career path that affords nurses greater autonomy in their practice, greater compensation, greater satisfaction and more professional opportunities.

This blog will help aspiring nurse practitioners (NPs) understand how the role expands upon the skills, knowledge and practice authority of a registered nurse and how to become an NP.


The Nurse Practitioner Profession

The NP role is an advanced practice role. NPs are prepared to do many of the same things physicians can do, including:

  • Conducting physical exams
  • Making medical diagnoses
  • Ordering labs and tests
  • Interpreting test results
  • Prescribing medication
  • Constructing treatment plans
  • Helping patients manage illness
  • Referring patients to specialists and managing transfers of care

Local practice authority laws determine whether NPs may conduct these activities and whether they can perform them autonomously or under the supervision of a physician.


Nurse Practitioner Care Settings

NPs can treat patients and work in a variety of care settings based on their population focus, including:

  • Hospitals
  • Inpatient/Outpatient facilities
  • Physicians’ offices
  • Critical care settings (emergency departments, urgent care facilities)
  • Surgical settings
  • Intensive care units


Nurse Practitioner Specializations

Depending on the specialization they choose, NPs can serve different patient populations in different care settings. The specialties NPs can choose from are:

  • Family nurse practitioner (FNP)
  • Adult-gerontology acute care nurse practitioner (AGACNP)
  • Adult-gerontology primary care nurse practitioner (AGPCNP)
  • Neonatal nurse practitioner (NNP)
  • Primary care pediatric nurse practitioner (PNP-PC)
  • Acute care pediatric nurse practitioner (PNP-AC)
  • Psychiatric mental health nurse practitioner (PMHNP)
  • Women’s health nurse practitioner (WHNP)


Nurse Practitioner Job Outlook

The job outlook for NPs is strong, making it a wise professional goal for nurses who wish to advance their career. Between 2020 and 2030, the Bureau of Labor Statistics (BLS) projects that the NP profession will grow by more than 50%, which the agency describes as “much faster than the average for all occupations.” Depending on their specialization, NPs may find that this growth varies, as primary care physicians, for example, are in extremely high demand, making family nurse practitioners (FNPs) particularly sought-after.


Nurse Practitioner Salary

The median annual wage of NPs as of 2020 was $111,680, according to the BLS. Wages in outpatient care centers and hospitals outpaced that of NPs in physicians’ offices and educational services.


What Is Autonomy In Nursing?

Autonomy in nursing refers to a nurse’s ability to make judgements and decisions about patient care and practice setting. Some common ways nurses display autonomy on the job include:

  • Determining when to administer pain medication
  • Adjusting patient positioning to offer greater comfort, better breathing capacity, etc.
  • Seeking out or requesting specialist input in response to clinical assessments and evaluations (e.g., poor mobility)

Nurses gain additional autonomy when they become NPs. They have graduate-level preparation to take on additional responsibilities, including diagnostic reasoning necessary to formulate medical diagnoses, and the advanced coursework necessary for determining treatment plans, including the prescription of medications.


Benefits of Autonomy in Nursing For NPs

Nurse job satisfaction has been correlated with nurse autonomy. Having the opportunity to be an independent thinker and caregiver is a key part of greater job satisfaction. 

The expanded autonomy NPs experience, in comparison to RNs, leads to career satisfaction. While this metric is not a direct indication of patient outcomes or financial savings/gains, it is still an important metric for the welfare of our health care system. Because health care professionals are in short supply across specialties and positions, maximizing job satisfaction is crucial to stemming any loss of ground in the race to close the talent gap. Satisfied NPs are much less likely to experience burnout or quit the nursing profession.

Furthermore, greater autonomy in the nurse practitioner role has benefits for the health care system. Increased NP autonomy makes the job more appealing to aspiring nurses, which builds the pipeline of advanced practice nurses. This is especially important in primary care settings, which are projected to see a shortfall of nearly 50,000 physicians compared to demand by 2034. FNPs are helping to grow the ranks of primary care providers at a faster rate than physicians—particularly in underserved health service areas, like rural settings.


Benefits of Autonomy in Nursing For Patients

Autonomy in nursing is also beneficial for patients. Patient satisfaction research has found that more than 80% of patients report that their nurse practitioner always listens carefully to them. Multiple studies have also found that patients of NPs experience shorter hospital stays.

When NPs have the autonomy to provide treatment to patients, they increase the opportunity to enhance patient satisfaction. In many care settings where NPs provide pre- and post-procedural care, they prevent any lapse or gap in attention to patient needs, which is simply not possible for physicians alone. This seamless transition of care leads to more satisfied patients, who are statistically more likely to have better health outcomes.

An NP student learning how to treat a patient at Marymount University


The Nurse Practitioner Pathway

Nurses who seek greater autonomy in a clinical nursing role may find the nurse practitioner pathway is a good fit for them. The path begins with a bachelor’s degree in nursing and registered nursing license. Next, NP candidates must earn an advanced practice degree through a graduate clinical nursing program.


Graduate Education: MSN vs DNP Routes

Registered nurses who aspire to become nurse practitioners have options as to which graduate degree they obtain on their nurse practitioner pathway.

A master’s of science in nursing degree (MSN) is an ideal degree for working nurses who want to continue working in a clinical setting and prefer the shortest timeline to completion. 

Some nurses may have already earned a master’s degree with a non-clinical focus, such as administration. These aspiring NPs may find that building upon their master’s degree with a post-graduate certificate is a better nurse practitioner pathway. Nurses who aspire to reach the highest level of education may also consider a DNP because it is a terminal degree and opens doorways to work in academia, policymaking, leadership, management and research.


Marymount University NP Programs

At Marymount University, aspiring NPs are invited to Learn with Purpose by attending a nationally ranked and awarded nurse practitioner program that will prepare them for the real-world challenges they will face on the job. Located in Washington, D.C., Marymount students have access to unparalleled population health, research, policy and academic experiences. Our Nursing students choose Marymount so that they can Live with Purpose after graduation and fulfill their goals, no matter their nursing career path. 

Marymount University offers three nurse practitioner pathways:


7 Reasons to Become an FNP Infographic


Our online graduate degree programs are perfect for working nurses and nurse professionals who don’t want to pause their careers to advance them. Aspiring NPs can earn a degree from anywhere with the flexibility to continue working and maintain personal commitments.

If you’re interested in becoming an FNP at Marymount, contact one of our student advisors to discuss which pathway is right for you.